HJAR Sep/Oct 2023

NURSING CRISIS 16 SEP / OCT 2023 I  HEALTHCARE JOURNAL OF ARKANSAS enough flexibility to invest in the plans of study and required clinical shifts necessary for successful graduation. 34 Solution Act 672 creates partnerships among nurs- ing education programs and healthcare organizations to create positions that allow student nurses to earn clinical credit hours while working as a non-licensed employee. Partners must outline provisions for over- sight and evaluation in their agreements. Healthcare agencies must identify at least one nurse supervisor or clinical nurse edu- cator to oversee earn-to-learn partnerships. Nursing students at these facilities will be assigned to a minimum of one or maxi- mum of two RNs to provide safe patient care under their guidance while earning a limited portion of their direct patient care clinical credits. Students in these positions may not be scheduled to work more than 20 hours per week to promote academic success and must follow rules set by the Arkansas State Board of Nursing. Act 672 was modeled after legislative initiatives in several states including Oklahoma, Tennes- see, Missouri, and Florida. Act 672 can be found here: https://www. arkleg.state.ar.us/Bills/Detail?id=SB299 Act 673: Data Repository — Passed Problem Current data collection methods show an adequate, and in certain areas a sur- plus, number of nurses in Arkansas. Yet, surveys of nurse employers suggest that there is a discrepancy between the number of licensed nurses living inArkansas and the number of licensed nurses actively working inArkansas. Nationally, the total number of RNs decreased by over 100,000, the steepest decline in four decades, andArkansas is no exception. 2,8 Many nursing experts are pro- viding anecdotal explanations for the hem- orrhaging nursing workforce, but the reality is that there has been a lack of resources to explore the evidence and identify root causes. For Arkansas leaders and lawmak- ers, detailed data is needed to understand the factors that may be contributing to the poor retention and high turnover rates among nurses. Additionally, Arkansas does not have a method to track nursing work- force attrition. Understanding the data in greater detail is essential for effective policy development at the federal, state, and orga- nizational level (Figure 5). Solution Act 673 allows for the development of a state-sponsored repository to collect, ana- lyze, report, and trend nursing education and other pertinent workforce informa- tion. Major targets of data collection include analysis of statewide educational capacities and root cause analysis for nurse retention and turnover rates. The data obtained will inform leadership in the creation of a living action plan for Arkansas nursing workforce priorities. Act 673 can be found here: https://www. arkleg.state.ar.us/Bills/Detail?id=SB300 CONCLUSION Nursing leaders, healthcare organiza- tions, and legislators (at the national and state level) agree that the current nursing workforce crisis must be addressed. If the status quo continues, Arkansans will face undesirable outcomes ranging from delays in care to potential increases in morbidity and mortality. We must safeguard our future by stabilizing the current nursing workforce and restoring structure to our healthcare system. Our state is at an inflection point, and we must act if Arkansas hopes to retain the current nursing workforce and effec- tively educate the next generation. Leaders from the ACN, nursing educators, and law- makers like Sen. KimHammer are putting in the challenging work to offer genuine solu- tions to our crisis. The recent legislative ses- sion provides hope after passing innovative legislation that is measurable, appropriate, and practical. n REFERENCES 1 Berlin, G.; Burns, F.; Essick, C.; et al. “Nursing in 2023: How hospitals are confronting shortag- es.” McKinsey & Company. May 5, 2023. https:// www.mckinsey.com/industries/healthcare/our- insights/nursing-in-2023 2 American Association of Colleges of Nursing. “Nursing shortage fact sheet.” Updated October 2022. https://www.aacnnursing.org/news-data/ fact-sheets/nursing-shortage 3 American Hospital Association. “Strengthening the Health Care Workforce: Strategies for Now, Near, and Far.” June 2002. https://www.aha.org/ system/files/media/file/2022/06/strengthen- ing-the-health-care-workforce-Supporting-the- Team.pdf 4 Raso, R; Fitzpatrick, J.J.; Mascik, K. “Nurses’ In- tent to Leave Their Position and the Profession During the COVID-19 Pandemic. Journal of Nurs- ing Administration 51, no.10 (Oct. 1, 2021): 488- 494. doi: 10.1097/NNA.0000000000001052. 5 Nursing Solutions Incorporated. “2023 NSI National Health Care Retention & RN Staffing Report.” March 2023. https://www.nsinursing - solutions.com/Documents/Library/NSI_Nation- al_Health_Care_Retention_Report.pdf 6 Koehler, T.; Olds, D. (2022). “Generational Dif- ferences in Nurses’ Intention to Leave.” Western Journal of Nursing Research 44, no.5 (May 2022): 446–455. doi:10.1177/0193945921999608 7 Auerbach, D.I.; Buerhaus, P.I.; Donelan, K.; Staiger, D.O. “A Worrisome Drop in the Number of Young Nurses.” Health Affairs Forefront (April 13, 2022). https://www.healthaffairs.org/content/forefront/ worrisome-drop-number-young-nurses 8 Arkansas Hospital Association. “Arkansas Health Workforce Projections: 2021-2035.” Prepared by GlobalData Plc. (January 2023). https://www.ark- hospitals.org/images/webdocs/ArkansasWork- forceReport-January2023.pdf 9 Buerhaus, P.I.; Auerbach, D.I.; Skinner, L.E.; Staiger, D.O. “State of the Registered Nurse Work- force as a New Era of Health Reform Emerges.” Nursing Economics 35, no.5 (September-Oc- tober 2017): 229-237. http://aaacn.inurse.com/ sites/default/files/documents/StateoftheRegis- teredNurseWorkforce.pdf 10 International Council of Nurses. “International “We must safeguard our future by stabilizing the current nursing workforce and restoring structure to our healthcare system.”