When Dennis Sherrod,
Ed.D., RN, began planning a campaign to entice young people into nursing
three years ago, he wanted something exciting and powerful, something
that would project nurses as smart, independent thinkers, capable
of a myriad of exciting feats, from breathing life into a newborn
to relieving an aging person's pain. It would have posters. It would
have a Web site. And, naturally, it would have a video.
Although his
creative energies were fired up, Sherrod, associate director for recruitment
and retention at the North Carolina Center for Nursing, was not starting
out cold. He was plugged in to a network called Colleagues in Caring,
a nursing workforce development project that allows different regions
to share ideas and information about attracting, educating, retaining
and keeping track of nurses.
Colleagues in
Caring was started in 1996 with funds from the Robert Wood Johnson
Foundation. Its original purpose was to coordinate nursing education
programs, making it easier for students to move from an LVN or AD
program into an RN or BSN program.
But with guidelines
from the foundation, a broader mission quickly evolved, said Rebecca
Rice, Ed.D., MPH, RN, deputy director for Colleagues in Caring's national
office in Washington, D.C.
Through its regional
sites, Colleagues in Caring would gather data to document the state
of the nursing workforce and would work to develop an adequate supply
of nurses by improving education, recruitment and work environment.
The new mission soon proved timely.
"Lo and
behold, it wasn't too long into the project that the nursing shortage
started," Rice said.
Colleagues in
Caring includes 40 regional sites in 40 states. Half are independently
funded. Most regional programs include some aspect of workforce data
collection, educational mobility, scholarship, recruitment and workplace
improvement. Each has its own way of running its program, with successful
and not-so-successful experiences, which it readily shares with others.
The collaboration
between Sherrod in Raleigh, N.C., and Barbara Mitchell, MSN, RN, in
Indianapolis offers a good example of how the exchange works.
Ten years ago
Mitchell, executive director of central Indiana's Nursing 2000, a
nonprofit educational program to promote nursing careers, created
"A Day in the Life of A Nurse."
The program allows
high school students to spend time with a nurse at work. Surveys of
participants showed that nearly 60 percent of respondents went into
nursing programs. To complement the program, Mitchell created a Web
site and a video.
Sherrod learned
of Mitchell's work when Nursing 2000 joined Colleagues in Caring as
a nonfunded member. Using her experiences and examples, as well as
information from his own student focus groups, Sherrod created a Web
site aimed at high school, middle school and elementary school students.
He recently produced a video to show how nurses make a difference
in people's lives.
Just as Sherrod
borrowed from Indiana, Colleagues in Caring sites in Mississippi,
Missouri, Arizona and other areas are incorporating aspects of North
Carolina's recruitment campaign into their programs.
Sherrod, Mitchell
and other site directors eagerly list other sources of inspiration:
Mississippi's competency model, which matches nursing degrees with
expected levels of performance; California's expertise in data collection;
Kansas City's design for continuation of funding; and Pennsylvania's
brochure for high school students.
Collaboration
between regional sites, often by e-mail, is sometimes so fast and
furious, regional directors don't always know who originated what.
Ann McNamara, Ph.D., RN, project director for Arizona Colleagues in
Caring, said she's traded a lot of information with the Kansas City
site in setting up a separate institute to provide continuing support
for her program. "I'm not sure if we gave the idea to them or
they gave it to us," she said.
Under rules laid
out by the Robert Wood Johnson Foundation, each project must have
input from every aspect of nursing. South Dakota's 40-member consortium,
for example, includes representatives from community colleges and
universities, hospitals and nursing homes, nursing organizations,
home health agencies, government agencies, and mental health and consumer
groups.
Recently, members
attended a retreat in Sioux Falls, S.D., where they discussed the
role of nurses in four future health care scenarios, ranging from
high-tech health care delivered at a grocery store to a barter economy,
where patients exchanged vegetables for care.
Before Colleagues
in Caring, members of the different groups rarely spoke to each other,
let alone discussed the future, said Marge Hegge, Ed.D., RN, project
director of the South Dakota consortium.
"We have
few resources here in South Dakota," she said. "This has
given us the luxury of getting together face to face and talking about
our issues. The payoff has been a trust level that we haven't had
in this state for a long time. It's lifted us all beyond our own levels
and our own areas."
Such cooperation
may not be possible on a national level, Rice said, which is why she
believes Colleagues in Caring works best as a collection of regional
sites with her office providing a framework. National organizations
usually have a specific mission, she said. Local and regional organizations
have closer ties to the community and are more willing to put aside
differences.
Resources and
regulations also vary from state to state. Some, such as Arizona,
have legislation mandating articulation between two- and four-year
higher education programs. Others, such as North Carolina, have state-established
nursing centers. Some, such as California, have extensive data collection
systems.
California's
experience shows why data collection is such an important part of
Colleagues in Caring's mission.
With information
collected through the California Strategic Planning Committee for
Nursing/Colleagues in Caring project, the state now knows that many
nurses with inactive licenses cannot return to work, that California's
nurses and nurse educators are older than those in the rest of the
country, and that while enrollment in nursing programs reflects the
state's population, the graduates do not, said project director Ellen
Lewis, MSN, RN.
But regional
data can't always be used on the national level, Rice said. Different
sites collect information in different ways, partly because of local
laws and available funding. One of Rice's goals is to establish a
uniform set of information that all sites would provide to a national
database.
Policy-makers
already use information from individual sites. Recently, the General
Accounting Office asked regional Colleagues in Caring programs for
data on the supply and demand of nurses in their areas. Lewis said
she has provided California's data to national lawmakers and to policy
groups in other states. Many sites regularly supply information to
their state legislatures.
Translating information
into action can be a slow process, Lewis said. Her organization worked
hard to get the state to allocate $15 million to expand nursing education
programs, only to see the funds evaporate this year because of California's
energy crisis.
"I'm amazed
that the need has been detailed, but there just doesn't seem to be
a response from the state Legislature," she said.
The slow pace
of politics can make it difficult to measure the effects of Colleagues
in Caring's work so far.
Rice emphasizes
the importance of the process, of communication, networking and building
on each other's information-like Sherrod's video, which took on a
life of its own after he told the producer he wanted it to show the
emotion pervasive in nursing.
"Then you
need a song," the producer said. "OK," Sherrod responded.
"Write me one."
The result, "Imagine
the Difference," plays at the end of the 20-minute video. It
has brought tears to the eyes of some listeners. Sherrod plans to
have radio stations across North Carolina play the song as a public
service announcement.
Mitchell in Indiana,
for one, can't wait to see the new video. "It will be more current
than ours, more updated," she said. "And that's great."