All new graduates nursing is the short-term goal of nurse educators, with a long-term goal of boosting graduate numbers through simulation.
Kathy Holloway, chair of nurse educator group NETS, was responding to the Nursing Council’s recently released Future Nursing Workforce Supply report that projects nursing graduate numbers would need to double to about 3000 a year by 2035 to meet the higher health needs of the ageing population. The report also projects that the ageing nursing workforce and increasing demand will see a nursing shortage start to hit from 2020 onwards.
“I think 100 per cent employment (of new graduate nurses) should be our goal,” says Holloway.
“We spend a lot of money training and supporting new graduates to become registered nurse and then as a system we need to maximise that investment by having the opportunity for them to feed them into the workforce.
“What processes and systems we put in place to work towards that goal … well, I don’t think they will happen overnight.”
“But you also can’t produce them (graduate nurses) and keep them in the fridge until we’re ready for them.”
Meanwhile, she said NETS was already working on overcoming barriers to increasing student numbers to meet projected shortfalls in the future.
“If we’re wanting to have increased graduate numbers in 2020 (as indicated in the BERL report) we need to start training them in 2017.”
Holloway said a NETS national meeting was being held this week (Nov 4–8), where working groups were reporting back on strategies to overcome two barriers that NETS members highlighted at a forum in April.
The first was the number of clinical learning placements available.
“If we continue to use clinical placements in the same way we use them now we can’t easily increase capacity – we need to do something different,” said Holloway.
She said NETS was looking at new clinical learning model strategies including the use of clinical simulation, dedicated education units (DEUs) and Auckland’s student nurse integrated team model
At present, the Nursing Council standards do not allow clinical simulation hours to be included in the 1100 clinical experience hours a student is required to do during their nursing degree.
Holloway said her personal mission was to change the terminology so people didn’t talk about clinical placements but about clinical learning experiences instead, as the focus should be on the outcomes of the clinical learning – building competence and confidence – not the place.
Simulation would be discussed at this week’s meeting including how to introduce standardised approaches to integrating simulation into the undergraduate curriculum and a “national benchmark” for simulation. She said a good foundation for this work was the recently released joint nursing school report Clinical Simulation In Nursing: A literature review and guidelines for practice (report available at: www.akoaotearoa.ac.nz)
Holloway said the Council was being kept aware of NETS work in this area and NETS wanted to have further discussions with Council about the inclusion of some simulation hours.
Council chief executive Carolyn Reed has said the council is awaiting with interest a major US research study looking at the use of clinical simulation in nursing training. The randomised control study, being conducted by the National Council of State Boards of Nursing, involved students from ten nursing schools being allocated either to standard clinical placements, 25 per cent simulation, or 50 per cent simulation. The cohort graduated in May 2013 and the nurses are being followed in their first year of practice, with final results of the research due to be released in April 2014.
The second barrier to increasing graduate numbers being looked at by NETS is the need for more nurse educators and where they were to come from. Holloway said the average age of nurse educators was higher than the average for nurses but there was little good data about what nursing faculty actually looked like and whether it reflected the populations that nurses serve.
Proposals for addressing this issue and clinical learning experiences were to be discussed at the meeting with the aim of coming away with an idea of what research activity and barriers were needed to overcome these barriers and increase student numbers to meet projected shortfalls.
Holloway also pointed that the BERL report scenario that requires 3000 graduates a year by 2035 was built on the existing model of care continuing and that scenario could change with the introduction of different care models and skill mixes.
