When her daughter's school needed volunteers for Read Across America, certified emergency nurse Cathy McFarlane, RN, seized the chance to teach second- and third-graders about nursing. She wore her nurse uniform and read So You Want To Be An Emergency Nurse to the class.

"It's planting a little seed that nursing might be a fun thing to do," said McFarlane, a nurse educator at Torrance (Calif.) Memorial Medical Center. "I hope the students remember that the person who came to their class was a fun person to be with."

But McFarlane also has a more personal reason for reaching out to students. "What motivates me to do it is I look at the nursing shortage and I wonder who is going to be around to take care of you and me in our old age," she said.

McFarlane is one of many nurses throughout the country who act as ambassadors of the profession as they forge ways to draw students to nursing. Some organizations have launched advertising campaigns to promote a positive image of nurses, while others pioneer career days and job shadowing programs to bring students into hospital settings.

A survey conducted by Nurses for a Healthier Tomorrow, a national coalition of 32 nursing and health care organizations, suggests that the nursing shortage will become more acute unless more students are drawn into nursing programs. The organization hired a company to interview 1,800 second- through sixth-grade students throughout the country. The report indicated that the majority of students "had no compelling reason to become a nurse."

"In almost all groups, we would find at least one child who had an extraordinary experience within the health care delivery system … but the nurses generally did not stand out in their experience or their ensuing desires. School nurses stood alone in collective experiences but they were virtually undistinguished from administrators, cafeteria workers or other non-teaching positions," the report said.

The survey also found that most students had been taught why it was worthwhile to become a doctor, but they hadn't learned the value of nursing. The ninth- and 10th-graders didn't know how nurses advanced in their careers and thought nurses stayed in the same job for 40 years.

But organizations such as the Coalition for Nursing Careers in California are determined to change these stereotypes. The group was formed by two Kaiser Permanente nurses, Toni Casal and Katie Bray, who asked four nonprofit health plans to pitch in $5,000 a year.

In October, CNCC launched a Web site aimed at teaching youth about the opportunities in nursing. Visitors to the site (www.choosenursing.com) can select and read stories of different nurses who share their paths into the profession. One nurse was afraid she couldn't be a nurse because she struggled with math, while another didn't realize that speaking a second language could help with her nursing career.

Nurses who visit the site will also find something they can use to help spread the word about nursing. The site offers presentation materials that can be downloaded from the Internet. The information can be used by nurse ambassadors in any part of the country. CNCC's goal is to recruit 2,000 nurses in California to go out to schools and do presentations by May of 2002.

The CNCC site is modeled after a similar one produced by California Center for Teaching Careers (CalTeach), a group working to recruit teachers for California schools. The CNCC team also plans to follow CalTeach's strategy of using two other forms of communication-television and the telephone. The coalition aims to fund television service announcements about nursing and a toll-free number people can call to reach a nurse and ask questions about the field.

"We wanted to develop a multimedia campaign that hits young people," said Casal, MHS, NP, RN, co-chair of the CNCC. "We saw that other groups were looking at nursing issues such as job satisfaction problems and nursing school space problems, but we saw that even if you solve those problems now, you still have to sell the nursing profession to young people."

Casal believes nursing is an easy profession to sell. The coalition's ads will highlight perks such as schedule flexibility, good pay, travel options and job security.

Nurses for a Healthier Tomorrow is launching a similar campaign. The group has sent a 30-second public service announcement to 200 television stations nationwide. Hospitals interested in promoting nursing in their local areas can buy a media kit that includes the public service announcement for $100.

Facilities such as the Mayo Clinic in Rochester, Minn., are advertising the benefits of nursing in a different way. Last year, the hospital launched Nursing Career Day and invited 100 students from Minnesota, Wisconsin and Illinois to the Mayo Clinic for the event. More than 50 nurses volunteered to escort student groups throughout the day and answer questions.
One of the most popular events of the day was a hands-on skills fair in which students experimented with intubating or putting an IV into a mannequin and dressed up in surgical clothing. The students also listened to a panel presentation from a variety of nurses, such as a flight nurse, nurse practitioner, nurse anesthetist and hospital staff nurse.

"The most important thing is to keep the day moving," said Theresa Elwood, organizer of the event. "High schoolers want a variety and a lot of different modes of media to learn from."

The organizers of UNITE-LA, a federally funded school-to-career program, also are discovering ways to attract students to hospitals. The program allows students from the Los Angeles area to participate in hospital tours, and the tour guides are instructed to give details about their jobs.

"The students don't just need a tour," said June Levine, MSN, RN, project director for the health careers program of UNITE-LA. "They need good information about what they are seeing. A lab host, for example, needs to explain the different jobs there are in a lab and what education is required for the jobs."

Levine also uses her connections in the health care community to enlist guest speakers for the schools. "A lot of times the schools don't know who to call, and I know how to get through and find someone," Levine said.

Nurse ambassadors also are making appearances in classrooms at Farnsworth Elementary School in West St. Paul, Minn. Nursing students from the nearby Century College teach health-related classes to the elementary students, such as sex education.

"It was really successful," said Lora Kincade, MS, RN, nursing instructor at Century College. "Many of the nursing students were approached by students after class saying they wanted to be nurses."

At the Mayo Clinic, nurses use modern technology to connect with students. The clinic has launched a pilot program in which 60 RNs will become e-mentors for 60 sixth-graders at Stewartville Middle School.

At the end of October, the nurses and students started weekly e-mail exchanges. The nurses share their experiences in nursing and also help students with certain homework assignments. The sixth-graders will visit the Mayo Clinic to meet their RN e-mentors, and at the end of the school year, the RNs will visit the students in school.

For older students, one hospital in North Dakota has created nurse intern positions to give teens a taste of the daily job. Local high school students can take a course in which they learn how to be nursing assistants. As part of the program, the students work as interns at Altru Health System in Grand Forks, N.D. The interns help with feeding, bathing and adjusting patients as well as checking vital signs.

The program started eight years ago. Between 70 percent and 80 percent of the students who participate typically go on to nursing school, said Margaret Reed, MBA, RN, chief nurse executive at Altru Health System. Altru often helps these former interns find financial assistance to pay for nursing school.

"The thing we've found is that students need to connect with health workers," Reed said. "They need to continually have support because there are so many opportunities today and they can easily lose direction. If they know the hospital wants them to succeed, they are more likely to stay in that field."

Randy Peterson, a nurse in Phoenix, agrees that it is important to work closely with students who are interested in nursing.

As a school nurse at Maryvale High School, he noticed that students consistently dropped out of the nursing track vocational program that his school district offered. His school is in a city populated largely by lower-income families, and Peterson was confident that the students would fare better if they could get help with classes earlier in their high school careers.

He decided to pioneer a new program called the Maryvale High School Student Nurse Academy. Peterson draws freshmen and sophomores into the program by showing a film called "Choose Nursing."

To prevent students from falling behind, he reserves time for them to study in his classes every week. Students in the program spend time with nurses at hospitals, and they can attend a nursing camp where they watch surgeries being performed and become CPR certified. By the time they graduate, the students have LVN licenses. This year, 17 students are enrolled in the program.

"The hardest thing is getting them interested in nursing," Peterson said. "A lot of freshmen don't know what they want to do when they grow up. I explain to them that working as an LVN is better than flipping burgers."

Anna Sanchez, 15, is one of the students in Peterson's program. When she first heard about the student nurse academy, Sanchez was hesitant to pursue nursing.

"At first I wasn't very sure about what I wanted to do, but after we went to the hospital I realized that nursing is a very good career and that I could learn a lot from it," she said. "I got more interested, and it helps a lot to realize that I am good at things I didn't even know about."

Although nurses such as Peterson run programs for students, nursing ambassadors such as McFarlane find simple ways in their daily lives to promote the profession. During the summer, she works as a camp nurse at Kennolyn Camp in Santa Cruz, Calif. Every year during the closing speech, she asks the kids how many of them would like to come to camp forever and ever.

"Then I tell them I've found a way: Go to nursing school," she tells them. "Then you can be the camp nurse every summer for the rest of your life."