Cross-Sectional Study to Determine Factors Term Paper

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[. . .] South Africa is being chosen because the scarcity of physicians in some parts of the country means that nurses receive extensive medical training because there may be times when they are the only medically trained person within hundreds of miles. Hasina Subedar, head of the South African Nursing Council, states, "The pitch is 'pack your bag', we'll do the rest. As long as the nurse agrees to work in an American hospital for two years, everything else from green cards for the entire family to airline tickets to apartments are taken care of" (CBS News, January 17, 2003).

One option which has been overlooked by many during this period of "healthcare hysteria" is the cadre of skilled, intelligent and available licensed practical nurses. These nurses have one year of educational training and, usually, a great deal of "hands-on" experience. At first glance, it would appear that they are an untapped resource in North Carolina. With closer examination, it becomes evident that not many of them go back to school either through an R.N. program or a B.S.N. program. There are several incentives, both monetary and esteem-building, which are meant as encouragement for them, but the numbers taking advantage of these incentives is still very low. This reluctance is puzzling since there is such a need for them in healthcare facilities. For these reasons, this study will examine practical nurses in North Carolina participation or non-participation in higher educational programs. Of course, the desired outcome will be an increased rate of practical nurses returning to school, however, whether that will happen or not is unforeseeable at this time.

What This Research Will Answer

The nursing crisis in the United States as a whole, and in North Carolina, particularly, is severe and only expected to get worse in the near future. Various plans and educational programs have been suggested which will affect the situation in several years, but the need for trained, educated health service practitioners is urgent. One of the main reasons for this shortage in North Carolina and the rest of the United States is demographics. The general population of the country is aging and, as it ages it requires an increasing degree of health care. The nursing population is getting older, also, with more nurses retiring each year. The number of nursing educators is dwindling, because of the number of retiring faculty members as well as the lack of students to teach. The general population of nurses has declined throughout the last decade resulting in a disproportionate number of lower level degrees. The nation and North Carolina in particular, need more upper level nursing practitioners.

Practical nurses are no longer employed in the majority of acute care settings in North Carolina. Many of the institutions that do hire PN's have begun to make the intention of pursuing of a higher level degree a condition of employment.

Theory and Hypotheses

The theory: Barriers exist in the educational system in North Carolina that are preventing PNs from pursuing the RN degree. It is expected that PNs will be motivated to pursue higher education if the barriers to achievement are removed and if they feel they will gain significant benefits from it.

Hypothesis # 1: The barriers preventing PNs in the state of North Caroling from pursuing RN education are identifiable and are expected to fall into the following categories: 1) subject's time for further education, 2) economic ability and perceived benefit of further education, 3) perceived value of further education, 4) perceived convenience of further education, 5) perceived institutional barriers to further education, and 6) motivation to pursue further education.

Hypothesis # 2: Identification and removal of the barriers preventing PNs in the state of North Carolina from pursuing RN education will motivate these PNs to strive for a higher level of education.

Hypothesis # 3: A distance learning approach will eliminate many of the barriers to PN to RN education in the state of North Carolina and provide a greater motivation and opportunity for this group of individuals to pursue RN education.

Summary of Chapter One state of upheaval and unrest exists in the healthcare profession today, most especially in the areas of nursing and supportive services. Nurses have become disenfranchised due to negative public opinion, extreme job stress, added job responsibilities and heavier caseloads with no additional help. As the population as a whole ages, the number of young people choosing to become a nurse is declining. Nurses and nurse educators are retiring with no one stepping up to fill their places. This is a very frightening statement when it is presented as fact. In an article entitled, "A Call to Action: Addressing Vermont's Nursing shortage," the author stated, "The stability of a healthcare system pivots on a sufficient supply of an appropriately education and skilled nurse workforce today." (Healthcare Review, 2001).

An untapped resource is a significant number of Licensed Practical Nurses who would have to get more educational training before they saw significant gain in salary and other job options. This study will investigate the seeming reluctance of PNs to return to school in order to become a Registered Nurse instead of a Practical Nurse. The following chapter will investigate the reason(s) PNs are not taking advantage of monetary incentive and sign-on bonuses to become Registered Nurses.

The History of Nursing in the United States - A Proud Legacy Until Now?

Chronology

1800's

The need for skilled nurses during wartime sparks the profession's birth.

Florence Nightingale improves conditions in Crimean War field hospital hospitals, reducing mortality rates.

Thousands of women on both sides of the American Civil War leave their homes to tend to the wounded.

The nation's first school for nurses opens in Boston.

1900-1960's

The nursing profession flourishes after nurses' training programs are established. Periodic shortages occur due largely to wars.

Army Nurses Corps is established.

North Carolina enacts the first nursing-licensure law.

The University of Minnesota establishes the first university-based

Nursing education program.

World War I triggers a nursing shortage; nurses' groups try to get

Nursing education programs moved from hospitals to colleges.

All states have adopted nursing licensure laws. Only nurses who meet the educational standard prescribed by the laws can call themselves, "Registered Nurses," or RNs.

The nation's entry into World War II sparks another nurse shortage.

Congress passes Nurses Training Act, which provides scholarships to students who agree to work in essential nursing services during the war.

A government panel predicts more shortages and recommends the government provide more financial aid to nursing education.

Congress passes Nurses' Training Act of 1964 providing $240 million over five years for nursing scholarships and education programs.

1970's - 1980's

Interest in nursing wanes as the women's rights movement creates new job opportunities for career-minded women. Questions arise about whether a true nursing shortage exists.

President Gerald Ford vetoes the Nurses' Training Act, claiming that the nursing shortage is over, skeptical Congress overrides his veto.

President Jimmy Carter tries unsuccessfully to slash funding for the Nurses' Training Act, claiming the U.S. has enough nurses. But nurses groups predict "the biggest nursing shortage ever."

1990's - 2000's

The managed-care revolution prompts cost cutting hospitals to lay off thousands of nurses, creating extra work for those who stay. Job dissatisfaction and retirement spark widespread nursing shortages.

California passes law setting minimum nurse to patient ratios for hospitals; law is expected to go into effect in 2003.

Chicago Tribune investigation finds that thousands of hospital patients have accidentally died or been injured due staff shortages caused by hospitals' cost cutting.

Following the September 11th terrorist attacks, Congress questions whether the nursing shortage might imperil the nation's ability to respond to additional assaults.

A government report estimates the nation lacks 110,000 RNs.

The American Hospital Association estimates that 13-22% of all hospital RN jobs are vacant.

The New England Journal of Medicine reports the nursing shortage is endangering patient care.

President Bush signs the Nurses' Reinvestment Act, establishing the National Nurse Service Corps and providing federal aid for nursing students and grants to improve nursing education, practice and retention. It also establishes a program to help nursing schools train people in geriatric.

CQ Researcher, 2002).

Cross-Sectional Study to Determine Factors in the Educational Advancement of the Licensed Practical Nurse to the Registered Nurse in the State of North Carolina

Chapter Two

Review of the Relevant Literature

As has been discussed, a serious nursing shortage exists in this nation as well in nations throughout the world. The purpose of this descriptive research study is to examine the related scholarly literature especially, the studies and articles which address the educational opportunities which exist for the licensed practical nurse to gain further education.

The following questions framed this descriptive research study: A) Is there a nurse shortage in the United States and more particularly, does a shortage exist among the health care agencies in North Carolina? B) What is the… [END OF PREVIEW]

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