Office of Nursing Workforce
Barriers to Nursing Education Task Force
Final Report
June 2004
Background
In 2002, the Mississippi Development Authority (MDA) and the Mississippi Office of Nursing Workforce (ONW) entered into a partnership for the enhancement of the nursing workforce and the career opportunities within the state of
In response to the increasing nursing shortage in
Phase I of Barriers to Nursing Education began in the Fall of 2002 and included a survey of all nursing students and nursing faculty in the state of
All twenty-two nursing programs in the state of
Of the student respondents, 88% were female and 12% were male. Student age ranged from 18-62 years of age, with the largest proportion (56%) being in the 20-29 age group. Student respondents indicated their top 3 barriers to successful completion of nursing school to be: 1) lack of financial support, 2) family issues, and 3) the inability to balance family, children and school.
Of the faculty respondents, 98% were female and 2% were male. Fifty-two percent (52%) of the faculty respondents have taught for more than 11 years, with 32% of the faculty having taught for more than 15 years.
Conclusions drawn from this study included both faculty and student concerns. These concerns were divided into three broad areas:
1) Student Work/Family Issues
< Number of students with children
< Large percentage of students have at least one job
< Childcare issues
< Household bills
< Health issues
2) Counseling Needs
< Financial
< Psychosocial
3) Preparedness Factor
< Differences in student and faculty perceptions
< Pre-nursing assessment needs
< Pre-nursing education issues
< Faculty development
Based on the findings of this study, the Office of Nursing Workforce identified several key areas that called for future exploration. Phase II of the Barriers project was developed in an attempt to provide additional information that may lead to a student’s successful completion of nursing school.
Phase II of the Barriers to Nursing Education began in the Fall of 2003. A task force was established to develop strategies to ameliorate the barriers identified in Phase I. Task force members were solicitated from various stakeholders such as Deans and Directors, hospital CEO’s, and leaders from the MS Department of Education, the Rural Health Association, MS Hospital Association, MS Board of Nursing, and MS Nurses’ Association.
The Barriers Task Force created four sub-groups to facilitate the work of the group. Each subcommittee met over the 2003-2004 fiscal year and made recommendations on ways to reduce the barriers identified in the Phase I survey. The four groups formed were entitled:
· Financial
· Life Demands
· Student Preparation
· Retention/Attrition
The Financial Sub-Group focused on problems such as lack of Workforce Investment Act (WIA) funding for all schools of nursing, lack of funding for indirect educational expenses, difficulty navigating the financial aid process and lack of availability/funding for dependent day care. The Life Demands group dealt with the problem of student’s difficulty in managing time and money and lack of health care and insurance coverage.
Student Preparation’s work focused on problem related to pre-nursing student’s lack of preparation in math and sciences, unrealistic expectations of nursing school, lack of awareness of factors that influence success in nursing school and the feasibility of requiring a certified nursing assistants course prior to admission. Retention/Attrition sub-group worked on developing a standard definition of attrition among MS schools of nursing and the lack of awareness of resources available to insure student success.
Various strategies were used to address the issues identified by each sub group. A complete listing is attached.
Outcomes and Recommendations of Task Force
Financial –
· Recommend that all schools of nursing (SON) become WIA approved, which would make students eligible for funding. All SON’s were contacted and assisted with WIA approval. Include WIA as source of funding in all publications, websites etc that deal with nursing education in MS.
· Recommend that ONW staff facilitate the development of guidelines for various funding agencies to provide monies to cover indirect expenses that would not interfere with federal financial aid or other income related aid.
· Post information gathered regarding financial aid process on ONW website.
· Recommend that ONW staff seek information regarding models for day care/sick childcare assistance.
· Contact Colleagues in Caring members to determine if models exist that outline successful attempts to provided day care for student’s dependents.
· Seek grant funding for childcare project.
Life Demands –
· Developed a web-based resource network which provides students, faculty, and healthcare providers with information that may help reduce barriers for nursing students and nursing faculty. This resource will be continually updated as additional information becomes available.
· Recommend that the directory be expanded to include services outside
· Recommend the creation of a pilot partnership between 3 community colleges and 3 senior institutions where learning support and other support service would be made available to students.
· Hind’s Community College, using the findings discovered in the Phase I Barriers study, implemented a “navigator” position in their nursing program. The “Navigator” is a faculty member who provides support to nursing and allied health students in need of a variety of services such as psychosocial, emotional, financial support, study skills, and time management skills. Analysis of the Navigator Project included surveying students to determine interaction with the navigator, reasons for the contact, if needed help was provided, and if they would recommend the navigator to other students. Findings supported the need for the student “navigator” and found the leading reasons for student navigator contact was for 1) study skills, 2) test taking skills and 3) emotional/psychosocial issues.
· Recommend development of continuing education model for incoming nursing students and nursing faculty that will educate them on support agencies available to help students during nursing school. Provide information and links on ONW website and establish pilot project to tract impact of the education of faculty and students.
· Recommend that MS Nurses’ Association investigate the various possibilities for providing insurance coverage for nursing students and their family.
· All SON’s make available applications for Medicaid and Chips at student’s orientation.
· Inform Deans/Directors of the willingness of NP programs to provide health services to nursing students. Encourage agreements.
· Share best practices with Deans/Directors and Nurse Executive considering mentor programs between nursing staff and nursing students such as “PALS in Nursing” program at
Student Preparation –
· Established an Externship for
· ? Investigate the disparity between instruction in SON and skills required for practice.
· Permission was obtained from OAADN to post the support modules on ONW website and make them available to all nursing student. List of modules attached. Modules can be used as self-study or in the classroom setting.
· Conduct literature review related to success in nursing school for faculty and students. Post on website for ease of access. Use full text where possible.
Retention/Attrition –
· Develop and disseminate a standard definition of attrition beginning Fall 2004.
· Collect attrition data for the purpose of tracking trends; assess reason for leaving nursing program. Report aggregate data using the Public Health Districts.
· Conduct exit interviews with all students leaving programs when possible to collect and report aggregate data to ONW/IHL.
· Contacted all Deans and Directors of schools of nursing for the purpose of identifying best practices and share findings with other schools.
· Share information via website about current support available to assist students such as; MOAADN modules, PharmAid, mentoring strategies, critical thinking instruction and seminars groups.
· Solicit stories of success from current nursing students that can be used to encourage beginning students. Publish on website. Create contest to encourage participation.
· Establish a referral network to WIN Centers for students leaving nursing programs without degrees. Create a “Care Package” for students failing out of nursing that would have information about WIN, support and counseling options and information about other health careers.
Recommendations –
Recommendations from the Task Force include continuation of the project with Phase III including the following:
· Request funds to analyze attrition data collected by Deans and Directors.
· Present findings of Barrier Project and Strategies developed in Phase II to Deans and Directors/faculty and others – Seek feedback from major stakeholders and modify planned strategies if needed.
· Conduct CE workshop for nursing faculty on intergenerational issues/values clarification.
· Develop and maintain website to include support services for students.
· Conduct research to measure the impact of Barrier strategies on student attrition rates in BSN and AD programs.
· Identify best practices within schools of nursing who have low attrition rates and high pass rates on NCLEX – Develop Model to be replicated.
Student Preparation –
| | Issues | Strategies | Findings |
| Financial | Lack of participation by all nursing programs in WIA funding eligibility Lack of funding for indirect educational expenses. Difficulty for student’s in navigating the financial aid process. Lack of availability/funding for dependent day care. | Assess WIA status of schools and assist non-WIA approved schools become approved. Develop standard list of costs that can be submitted to WIA. Work with MHA, MHHCA and MNA to set up foundation for indirect costs Develop plan to assist students navigate financial aid process Survey Deans and Directors regarding child care | All SON’s were contacted and assisted with WIA approval process. Recommend that ONW facilitate the development of guidelines for funding agencies to provide monies to cover indirect expenses without effecting student’s federal financial aid or other aid. Post information gathered regarding financial aid process on ONW website. ONW to seek information regarding models for day care/sick childcare assistance. Seek grant funding for project. |
| Life Demands | Student’s difficulty managing time and money. Lack of healthcare and insurance coverage | Explore partnering between sr. and comm. colleges to share resources Create repository of counseling services – web based Replicate the Navigator Program Consider Insurance included in IHL loans Survey insurance situation in all schools Seek funding for insurance coverage - Legislative proposal, foundation, Medicaid, Chips Explore feasibility of NP students providing health care for nursing students | Directory of available services posted on web site. Expand to include services outside Create pilot project of 3 comm. College and 3 4 yr. Institutions where learning support in cc be made available to students in 4 yr institutions. Modules regarding support post on ONW website. Expand the Navigator Program in other SON’s. MNA will seek solutions to providing insurance coverage options for students and family. Make available applications for Medicaid and Chips at student’s orientation. Make Deans/Directors aware of willingness of NP programs to provide health services to nursing students. Encourage agreements. |
| Student Preparation | Pre-nursing student’ lack of preparation in math and sciences. Lack of counseling/orientation regarding the expectation of nursing school. Lack of awareness of factors that influence success in nursing school. Possibility of nursing students completing certified nursing assistants course prior to admission. | Create externship program for Star Science Teacher Investigate feasibility of making the Learning Support Modules from Mississippi Organization for Advancement of Associate Degree Nursing available on line for all students and faculty Develop online modules related to tutoring of nursing students. Conduct literature search related to success in nursing programs and place findings on web Ask schools of nursing to use exit interviews with nursing students dropping out of nursing programs to gather data on reasons for attrition Develop attrition chart for use in collecting data and analysis Investigate the feasibility of C. N. A. requirements | MOAADN granted permission to ONW to post support/learning module on website for all nursing students to use. |
| Retention/Attrition | Lack of uniformity in way attrition is determined in schools of nursing. Lack of awareness of faculty and students of resources available to insure student success | Develop standard definition for attrition Collect data, demographics needed for determining attrition Identify best practices in nursing programs Identify nursing student success stories Develop faculty CE to help deal with cultural and generational issues/values clarification Obtain funding for faculty CE program
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