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September 2017 
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Things We're Working On...

Summer is slowly ending and it seems like the all-too-familiar routines of the year are settling into place. It has been busy summer at OCN; many people have workforce questions right now! Rather than give you run down of all the rabbit trails we’ve been working on, I wanted to share with you a few big issues that we are heatedly discussing.
 
 
Four Challenges Facing the Nursing Workforce in the United States
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The most recent issue of the Journal of Nursing Regulation has a fascinating article titled “Four Challenges Facing the Nursing Workforce in the United States.” According to the authors, these challenges include:
  • The aging of the baby boom generation
  • The shortage and uneven distribution of physicians
  • The accelerating rate of registered nurse retirements, and
  • The uncertainty of health care reform
These are familiar themes in Oregon. This past June, OCN convened several nurse leaders from health systems in the Portland area. I’ve also had the opportunity to travel to several rural areas in Oregon this year to talk about obstacles Oregon nurses face in doing workforce planning. I think they would agree with all the above challenges, and might add a few more.

While national projections on the nursing shortage can highlight emerging issues, it’s extremely important that we use state-level data to look at Oregon’s unique workforce planning needs and challenges. In the next year, OCN will do research around the aging of Oregon’s nurse workforce, and how retiring nurses will affect the overall nurse workforce. 
 
 
Increased Number of Nurses Licensed by Endorsement in Oregon
A close look at nursing workforce data shows a big uptick in the number of nurses obtaining their license by endorsement.  In fact, this category of nursing license type has increased by 49 percent since 2013. [Note: Licenses obtained by examination only grew by 12 percent during this same period.]

It begs the question: who are these nurses and where are they working?  OCN is working with the Oregon State Board of Nursing to try to answer those questions.  As soon as we have some information to share, we’ll post it on our website.
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The IOM goal of 80% BSN by 2020: Will we make it?
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In 2010, the Institute of Medicine (now the National Academy of Medicine) landmark report “The Future of Nursing” recommended 80 percent of all nurses should be baccalaureate prepared by 2020. Even then, this was described as an audacious goal, and many states across the country looked to education models such as the Oregon Consortium for Nursing Education to increase BSN graduates. As 2020 is only two years away, will Oregon achieve this goal?

In a nutshell, no. However, we aren’t alone; most states will not. According to nursing workforce data, more than 54 percent of Oregon’s nurses have a BSN or higher, an 11 percent increase since 2012. However, while our neighbors of Washington and California have increased their BSN-educated workforce percentage to above 60 percent in recent years, Oregon appears to have stalled. Why?

Digging into the data, we can see many younger nurses have BSNs while the older workforce has ADN as their highest level of education. This tells us that the emphasis on BSN education has resonated with nurses entering nursing school, and OHSU’s statewide curriculum has made an impact at shifting nursing education culture toward the BSN. However, transitioning from an ADN education to a BSN can be tricky and rely on specific conditions.  

On Wednesday, September 27, OCN’s Research Director Rick Allgeyer will host a free webinar to go over our latest report, “Characteristics of the Nursing Workforce in Oregon – 2016,” and discuss in-depth some of the challenges Oregon’s nursing workforce is facing, including academic progression. The webinar is a great opportunity to ask questions you might be having about Oregon’s workforce.
 
 
Health Policy Impacts the Nurse Workforce

It seems like every day health policy is changing. The “will-they-won’t-they” drama of repealing the Affordable Care Act seemed to end when the US Senate entered recess. As Congress reconvenes, echoes of new attempts to repeal the ACA are bubbling up. Dr. Betty A. Rambur, PhD, RN, FAAN, who spoke at OCN’s 2016 annual conference, published a paper in July to make sense of it all for nurses. It’s a good primer for how reimbursement impacts nursing, and how payment reform could shift the nursing workforce. 

As of today, the ACA is the law of the land, but given the contentious attempt to repeal the law, there are concerns about what leaving the ACA in place means. Stay tuned for how that law is going to change in the future. We’ll be watching to see what impact those changes will have on Oregon’s nursing workforce.
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