Currently, the United States health care system is struggling with an acute shortage of health practitioners especially nurses who are the major and significant primary health providers and close allies of the patients on their journey to full recovery and enhancement of their well-being. Thus, there is a need to boost and support the effort that will increase the number of health care practitioners in the country. On the other hand, just like the rest of the world, United States is also an aging society and the general population keeps increasing. Notably, during the 21st century, persons of the age of 65 years above have tripled and there is a shift from acute to chronic diseases (Moore et al., 2016). This has continued to put pressure for policies to be formulated that govern the publicly funded health programs which aim to improve the efficiency and effectiveness of the healthcare system to meet the needs of all citizens when it comes to addressing wellness of every individual in the United States. Therefore, the hospital Chief Nursing Office is in support of the grants to States for scholarship programs. This program aims at enhancing the quality of health care service provision by ensuring there is the adequate and steady supply of dentists, physicians, pharmacists, behavioral and mental health professionals, certified nurse practitioners, certified nurse midwives and physician assistants (Reed, 2015). Additionally, this policy requires the beneficiaries to serve in underserved and shortage areas for one year after completing their education program. It is worth to note, in this policy, it is mandatory for an individual receiving this grant to maintain a certain level of academic achievement during his/her period in college while receiving the scholarship. As such, this policy will ensure the beneficiaries are health practitioner of high caliber, distinguished leaders, disciplined, qualified and experts in their area of the health profession.
The Hospital Chief Nursing Office of Mount Sinai Hospital supports this bill. This is one of the largest and oldest teaching hospitals in the United States in New York. However, the hospital does not have enough health practitioners to address all the needs of our clients. The hospital requires more practitioners to boost the workforce to improve the service delivery. Thus, grants to States for scholarship programs offers an opportunity for all health care organization across the country to have a constant availability of efficient and qualified health workforce. Although the graduates injected into the workforce is not enough, there is hope that with time the country will achieve the recommended nurse to patient or physician to patient ratio. It is policies like this which will make sure the practitioners and patients ratios are achieved. Notably, not every individual can afford college fee, hence it is through this policy that bright and poor students can access college to advance their education. Therefore, it is important to allocate enough funds to this policy to ensure more students access higher learning after high school.
The background of the policy
The Public Health Service Act came into law in the year 1944, under the health professional education section; there is a provision for providing loan and to medical students including nurses to enable them to continue with their training and education (Cornell University School of Law, 2016). The grant to States for scholarship programs is under the bill entitled “Building a Health Care Workforce for the Future Act” which is an amendment to the Public Health Service Act (Reed, 2015). When this bill becomes law it will force Department of Health and Human Services (HHS) to offer grants which will match what States are offering to students in the form of scholarship programs to health professions to make sure the supply of health practitioners is adequate and meets the needs of patients. The bill was introduced to the senate by Senator Jack Reed and Senator Roy Blunt, read twice and forwarded to the Committee on Health, Education, Labor, and Pensions for more deliberation and amendments before it becomes a law (Reed, 2015). In addition, this policy will provide grants to medical school to boost the mentorship programs in the primary care projects and nurture a sense of responsible leadership among students. In an effort to promote health competencies and innovations the Department of Health and Human Services will provide grants to medical universities and colleges to promote health competency programs selected by the Advisory Committee on Training in Primary Care Medicine and Dentistry (Library of Congress, 2016). Furthermore, the Institute of medicine (IOM) together with the Department of Health and Human Services will document and evaluate the program under the provision provided by Medicare and Medicaid. After proper assessment program, the IOM will give recommendations on how best to improve the program to meet its goals and address challenges faced by the health sector.
Provide any evidence-based guidelines published on the issue
This policy will guarantee the beneficiaries have mentors who will guide the students during their period in school. Providing mentorship to students is a significant element which ensures continuity of the nursing profession and imparts skills necessary in nursing (Mccrory & Rutter, 2015). As such, this policy is essential and relevant since it provides a mentorship program where young practitioner in colleges and Universities can be nurtured to become excellent professionals in future. Connecting students with role models at early stages of their career will equip them with experience and knowledge of handling health care challenges and stress associated with medical profession (Mccrory & Rutter, 2015). It also gives students and mentors a chance to share wisdom and dispel any myths associated with healthcare profession. When students get the opportunity to interact with their mentors, they get a chance to learn patient care skills (Mccrory & Rutter, 2015). Giving students an opportunity to work in underserved and shortage areas give them valuable lessons on how the available resources and treatment plans have impacts on patient’s well-being coupled with the financial and social dilemma.
Entry-level jobs offer a good opportunity for career growth and development (Advanstar Communications Inc, 2011). This policy offer students a chance to serve for a minimal of one year after leaving college and University hence gives them a platform to test their skills and learn real life issues in healthcare. Additionally, these new entries will strengthen healthcare system which is grappling with the demands of s baby boomers who requires more medical services than the rest of population (Advanstar Communications Inc, 2011).
Funding nursing education programs and research has been a major concerning for decades. Lack of funds has seen nursing profession lagging behind when it comes evidence-based learning, innovations and designing up clinical practices that address the needs of the patients together with their families (Duffy, Frenn & Patterson, 2011). It is for this reason that National League for Nursing (NLN) Board of Governors set up a program to award grants to support research in nursing education to enable students and scholars to carry research in nursing practice to improve the quality, safety and service delivery. According to Duffy et al. (2011), more funding is needed to fund nursing education if we are we expecting to train and prepare professionals to handle the complex and highly risky health care system and delivered quality health care which customized to patient’s needs. NLN from the early 1980s has been a staunch supporter for provisions of scholarships for nurses to enable them to learn and advance their knowledge in teaching, nursing education, leadership and evidence-base learning which is in line with the goals of the grants to States for scholarship programs policy. As such, the grants to States for scholarship programs policy will be an improvement to NLN.
Key Policy Events [regulatory and legislative]
Prior to the introduction of the grants to states for scholarship programs, a number of grants and scholarships programs existed which include, NLN program, Nurse Training Act and Hospital Employee Education and Training (HEET) grant to name a few. Essentially, the new NLN program which was initiated in 2000 has managed to award grants every year. It started with a total of US $10,000 in 2000 but in 2010 the total worth of funds given to researcher was US $70,000. However, Duffy et al. (2011), note that although NLN program has been funding students and scholar to carry out research, the funds are not enough, more needs to be done to meet adequate materials to boost evidence-base level that is required in nursing practice to ensure there is improvement in quality, spur innovation in nursing practice and support more Ph.D. students to successfully complete their doctoral dissertations (Duffy et al., 2011). In the year, 1964, the Nurse Training Act was enacted; this gave birth to Nursing Workforce Development Program which sort nursing education investment and funding from the federal government (Sadighi, 2014). The mandate of this policy was to ensure there was sustainability education for nurses to meet country’s health requirements by increasing the number of nurses. Nursing Workforce Development Program has been the main source of funds for nursing education but currently, the funds provided by the government does not meet the existing demand. The affordable care act has increased the number persons who can access healthcare, hence, there is the need to recruit and educate more nurses to improve the ratios of patients to practitioners. Hospital Employee Education and Training (HEET) grant offers funding to colleges to offer Nursing Assistant Certified program and give a chance to employees who wants to advance their career path in nursing.
Financial Data
The current health care profession is aging and many care providers are on the verge of retiring. It is estimated that on average, it costs a health care organization US $85,000 when a nurse retires or leave the profession (The American Hospital Association, 2013).This cost is as a result of settling retirement benefits and recruiting for a new nurse to fill the vacancy. Therefore, there is need to train more young nurses and offer an avenue for old nurses to become mentors instead of retiring so as to cut the cost associated with retirements. The mentorship program promised by the new policy will ensure the number of nurses who retire is small and sustainable.
Key/Major Stakeholders
According to McKinlay, Clendon & O’Reilly (2012), most nurses and students who wish join nursing profession; individual education achievements and progression are seen as the only way whereby a person can have a clear career path. However, the cost associated with higher learning is barring many nurses and students from continuing their education. Therefore, there is need to develop a strategy that will guarantee nurses an avenue to continue their education, develop their nursing competencies and achieve their dreams. The current policies have not addressed the issues of funding effectively since many are geared towards funding a specific area, for instance, nursing research or leadership mentoring. The American Association of Colleges of Nursing acknowledges that 66.8% of nurses are able to access college education because of grants such as Nursing Workforce Development Program (Title VIII) (Sadighi, 2014).
Social, Economic, Ethical, Legal, and Political Factors
McKinlay, Clendon & O’Reilly (2012), observes that a number of policies have been enacted to enhance desirable clinical outcomes, access to healthcare by the patient, reduce inequalities, improve the working environment and expand the role executed by the primary care providers. As such, expansion of opportunities to access postgraduate opportunities to nurses by awarding them is a significant step in addressing the challenges in health care system and meeting the education needs of the primary providers. This is ethical and social obligations to stakeholders such as government where they are ought to ensure availability of quality health care to citizens.
The organizations such as hospitals and nurse organizations have a legal mandate to ensure their staffs are well trained and qualified. McKinlay et al. (2012), assert that within a health care organization there ought to be a room for professional development, access to research materials and space for practitioners to develop their skills and clinical knowledge. According to McKinlay et al. (2012), inadequate funds, lack of study time and study leaves are some of the major barriers that prevent care providers from continuing their education. Thus, there is the need for all stakeholders to review the current education system, workforce atmosphere and career path to offer opportunities to nurses and students to proceed with their education both in the undergraduate and postgraduates programs. Lack of localized study opportunities, tuition fee for graduate courses and travels expenses are some of the challenges that prevent nurses from pursuing high education. As such, these financial challenges are some of the reasons which push students to apply for educations loans, grants and scholarship to as to be able to finish college or university (McKinlay et al., 2012).
The statistics from the Bureau of Labor Statistics shows that in order to meet the country’s health requirements, the number nurses has to be 3.437 million by 2022 (Sadighi, 2014). As such, all stakeholders have a duty to make sure this target is achieved if the sanity in the health care is to be maintained. The federal government as one of the employers of the nurses has the legal, political and moral obligation to support nurses to cultivate their confidence and consolidate their expertise in their field of practice to strengthen their professionalism and attitude towards health care delivery (McCusker, 2013). One way of showing support to health practitioners is by giving them financial support to advance their education.
Policy intervention Options
According to the American Nurse Association, the United States has to produce 1.1 million new RNs by 2022 (ANA, 2014). The American Nurse Association observes the demand for health care is increasing due to increasing in old age population and many nurses have attained their retirement age. Thus, there is a call to train new nurses. The current funding programs such as Nurse Training Act (Title VIII of the Public Health Service Act) are not sufficient since they have not managed to sufficiently fund nurse students (ANA, 2014). Thus, there is the necessity to enact another policy to offer comprehensive and multipronged plan such as the grants to States for scholarship programs which will guarantee more nurses in future. Moreover, there is the need for a policy which will make sure the new graduates are competent to deliver quality care and able to engage in disease prevention initiatives (ANA, 2014).
Proposed Recommendation
Although the grants to States for scholarship programs offer tuition fee and mentorship, it is not enough. The program needs to include coaching and networking. The beneficiaries should have coaches who will offer intellectual, moral, legal and religious support to these students whenever they meet challenges. Additionally, the beneficiaries should have the opportunity to network with health professions in different specialties to have the opportunity to learn as they interact with these experts as they discharge their duties.
The secretary and the stakeholders managing this policy ought to take a yearly review to assess whether the grants are in line with the market value of the dollar. Notably, the value of the dollar at times is affected by inflation and global markets (Clendon, 2013). Thus, the fluctuations of the value of the dollar affect prices. Therefore, there is the need to ensure the grants are adjusted yearly depending on the value of the dollar and market price to ensure, the amount awarded to students can sustain them while in school.
The current nursing education system is faced with a lot of challenges and it is not preparing nurses to fully execute their mandate. These challenges are in terms of lack of enough mentors, faculty shortage and not enough training sites. It is worth to note, the advanced practice registered nurses (APRNs) play a significant duty in care provision and it is high time they are allowed to practice to their full extent in regards to their training and education (AACN, 2015). According to American Association of Colleges of Nursing (AACN), the number and quality of preceptors are wanting, hence measures have to be taken to address this issue since it limits the number of students accepted at colleges and universities (AACN, 2015). Therefore, there is the need to increase the number of educators and mentors to make sure universities and colleges can accommodate students will benefit from this policy.
Nursing Implications
Sadighi, (2014), asserts that not increasing grants for nurse education will result in few educators and nurse graduates. This will shrink the workforce. The small workforce will not be able to address the current health challenges and access to care. As such, the poor and underserved areas will not access quality care.
On the other hand, giving health practitioners support financially, mentoring and improving workplace environment helps in enhancing job satisfaction since care providers feel they are valued, appreciated and respected (McCusker, 2013). In addition, the financial support will give nurses an opportunity to improve their competency in nursing. As a result of job satisfaction and professionalism enhancement, health practitioners will be inspired to offer quality and safe services to their clients.
Additionally, it is evident that rural settings attract fewer nurses and other health professions (Advanstar Communications Inc, 2011). Thus, these areas have fewer experts in different areas of medical care such as a pharmacist, physician, and nurses. Therefore, this policy will give rural areas a chance to have qualified graduates serve in these communities and in the process increase access to care and availability of qualified health professions in small rural communities (Advanstar Communications Inc, 2011).
Conclusion
As mention above, the health care system is facing a great shortage in terms primary care providers. Furthermore, the aging population is putting pressure on the current workforce. Thus, there is an urgent necessity to educate and train new, young and energetic practitioners. This will help immensely to address the shortage of health professions the country is grappling with. Therefore, there is need to implement the grants to States for scholarship programs so as to increase the number of health practitioners by increasing access to education and mentorship programs. Additionally, the underserved areas such as rural communities will also benefit from this program since health practitioners upon their graduation will be required to serve these areas. For this reasons, this policy is worth implementing. Furthermore, the grants to States for scholarship programs will give fund to colleges and universities to expand their mentorship program to address the mentors and educators challenges.
Reference
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