In This Issue

NJ’s Action Coalition: A Year of Progress
Leader’s Column – Celebrating NJ’s Leaders
Leading Nurse Researcher Works to Quantify the Looming Nurse Shortage
A Fond Farewell: Mary Ann Christopher
Scholars, Leaders & IOM Recommendations Shine at NJNI’s Annual Meeting
Did You Know?

NJ’s Action Coalition: A Year of Progress

Following Nightingale LanternNurses in boardrooms, at the state legislature informing lawmakers, nurse residencies…
Thanks to a dedicated network of volunteers powering New Jersey’s Action Coalition, the Garden State is moving at a rapid pace to advance those and other recommendations from the Institute of Medicine’s landmark Future of Nursing: Leading Change, Advancing Health report.

In its first year, the Future of Nursing: Campaign for Action in New Jersey has made tremendous progress. On December 2, Action Coalition members joined other nursing, health, public policy, education and business leaders at the New Jersey Hospital Association (NJHA) to discuss first year accomplishments and future goals. The discussion was guided by the Action Coalition’s three co-leads: Edna Cadmus, PhD, RN, NEA-BC, clinical professor and director, DNP Program-Leadership Track of Rutgers University College of Nursing; Mary Ann Christopher, MSN, RN, FAAN, president of the Visiting Nurse Health Group and chair of the New Jersey Nursing Initiative’s (NJNI’s) National Advisory Committee (NAC); and David Knowlton, president of New Jersey Health Care Quality Institute. The meeting also provided the opportunity to honor seven non-nurse leaders for their support and guidance throughout the year.

During the meeting, Christopher provided an overview of what other state Action Coalitions are accomplishing and said that New Jersey is “well-positioned to lead.” The New Jersey Action Coalition is working to advance four pillars of the report: practice, education, leadership and data. It has set up a work group to address each pillar.

“I sit here a little bit shocked to hear what you have accomplished in such a short amount of time. You are doing things that are resonating with people,” Knowlton said.

Transforming Practice
Co-chairs of the practice work group, Patricia Barnett, JD, RN, of the New Jersey State Nurses Association and Betty Sheridan, MA, RN, of South Jersey Healthcare, discussed the advances made in the first year. They include securing support from Senator Joe Vitale and Assemblywoman Nancy Muñoz to advance legislation and regulations that support nurses working at all levels and help ensure that they can practice to the full extent of their training and education.

“One of our goals is to have staff nurses recognize their value and have that recognized throughout the state,” Sheridan said. “We want to reach out to all staff, not just APNs (Advance Practice Nurses). Using nurses to the full extent of their education will save health care dollars.”

Transforming Education
Discussing the work of the Action Coalition, Deanna Sperling, MAS, RN, CNA, BC, president of the Organization of Nurse Executives of New Jersey and co-chair of the education work group, said “this has been a great opportunity for academe and practice to come together and has been a long time coming in our state.” Sperling and fellow co-chairSusan Salmond, EdD, RN, CNE, CTN, of the University of Medicine and Dentistry of New Jersey discussed the education work group’s work to address the 80/20 academic progression goal as well as the effort to establish a pilot nurse residency program in the state. In its first year, the education work group has defined core competencies and a model for a 12-month residency program. Its immediate next steps include adapting the competencies into a formal curriculum and seeking funding sources to move the program forward.

Transforming Leadership
“We recognize that nurses don’t necessarily know what the roles and responsibilities of board members are, so we are developing an initiative to address that,” said Aline Holmes, MSN, RN, APNC, of NJHA and co-chair of theleadership work group. Holmes was describing one of the next steps in the work group’s efforts:  providing the tools nurses need to take seats on boards. Together with co-chair Mary Wachter, MS, of the Visiting Nurse Association Health Group, Holmes described first-year successes; they include securing appointments of a number of nurses to boards.  They also talked about goals for 2012.

The leadership work group has created a database of nurses in the state who have expressed an interest in taking on leadership roles and serving on boards. The database is maintained by NJHA. The group has also created a companion leadership opportunity list of organizations and agencies that will need board members; in coming months, they will identify nurse leaders who can step into these roles as vacancies arise.

The work group is also generating awareness of the Nurse Leaders in the Boardroom resource, produced by the Robert Wood Johnson Foundation and the Center to Champion Nursing in America.

“They’re not just generating lists, they’re getting people appointed to boards. This is incredibly important, because you actually have people on the inside who can make change,” Knowlton said.

Workforce Data
In 2011, the workforce data work group, headed by Kevin O’Brien of Partners in Care and Deborah Zastocki, DNP, RN, of Chilton Hospital, spearheaded a national scan to look at how other states handle health care workforce data collection and storage, looking at 35 state data center models.

Work group members hope to coordinate with New Jersey’s data collection repositories to develop a model that objectively presents how the health care workforce is organized and the costs associated with its current structure. The goal is to aggregate data in meaningful ways so it is possible to look at the business case for the delivery of care today, as that data can inform efforts to re-structure the nursing workforce.  “We need to change the funding paradigm,” said O’Brien. “We need to know what [service] is being delivered and what is not of value. A lot of this is tied to how we’ve organized the workforce.”
Champions Following Nightingale’s Lead
At the meeting, seven individuals and organizations were honored for contributing to the New Jersey Action Coalition and presented with replicas of the legendary lantern that Florence Nightingale used in her transformative work in Turkey a century ago during the Crimean War.

The lanterns featured a quote from Nightingale, signifying the importance of their contribution:
“May we hope that leaders will arise who have been personally experienced in the hard, practical work, the difficulties and joys of organizing nursing reforms, and who will lead far beyond anything we have done.”

The 2011 New Jersey Action Coalition champions are:
• U.S. Representative Rush Holt for Transforming Practice
• Arnold Speert, former President of William Paterson University and NJNI NAC Member for Transforming Education
• The Governor’s Appointments Office for Transforming Leadership
• Kevin O’Brien, president of Partners in Care, for Workforce Data
• New Jersey Hospital Association, represented by Betsy Ryan, president
• Assemblywoman Nancy Muñoz, nurse legislator
• Horizon Health Innovations, represented by Carl Rathjen and Mary Aikins, RN

To learn more about the work of the New Jersey Action Coalition, or to find out how to join a work group, visit
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Leader’s Column – Celebrating NJ’s Leaders

Susan Bakewell-SachsBy Susan Bakewell-Sachs, PhD, RN, PNP-BC, New Jersey Nursing Initiative Program Director and Interim Provost, The College of New Jersey

2011 has been a remarkable year for the Robert Wood Johnson Foundation (RWJF) New Jersey Nursing Initiative (NJNI). Through our vast network of partnerships we have achieved many successes, and are working hard to address and end the nurse faculty shortage.

In 2011, we have greatly expanded the scope and reach of the New Jersey Academic Resource Center, servicing hundreds of students and faculty. We have graduated our first cohort of RWJF New Jersey Nursing Scholars, many of whom are now nurse faculty in the state. We have expanded our presence online through our blog, state resource map, and Facebook page to reach new audiences and continue providing timely news and information. And through our work with the New Jersey Action Coalition, we have started to bring the Institute of Medicine (IOM) Future of Nursing report recommendations to life.

None of this would be possible without the knowledge, guidance and dedication of leaders in business, health, public policy and academe who have become an integral part of the NJNI team. Through their insight, passion and commitment, we have made tremendous progress toward making New Jersey a model for the nation in building a well-prepared, adequate nursing workforce to meet future needs.

We are successful in part because we have always drawn from the very best the state has to offer, going beyond the realm of nursing to make the nurse faculty shortage relevant and important  to the broader public. From the statewide Health Care Workforce Council to the New Jersey Action Coalition, our work is stronger because of the diversity of those leading the way.

That is why we would like to take this time to give special recognition to someone who has been an essential part of NJNI leadership since the Initiative launched in May 2009: Mary Ann Christopher.

As chair of our National Advisory Committee (NAC), she has provided a vision and the framework for NJNI’s work. Christopher also took a principal role in advancing the IOM report’s goals in the state by serving as co-lead of the New Jersey Action Coalition. Her work included supporting the efforts of the leadership work group. Christopher has also presented often to groups on behalf of the Action Coalition as well as on the IOM report in general.

Beginning in January 2012, Christopher will be moving on from her work with the Visiting Nurse Health Group to become the next leader of the Visiting Nurse Service of New York as its president and chief executive officer. This is a bittersweet moment for NJNI, and we offer profound thanks to one of our most outstanding leaders.  We recognize how much we have benefited from her wise and thoughtful counsel, and wish her the best.  We count ourselves lucky that she will not be a stranger to New Jersey and are grateful that she will continue serving as chair of the NJNI NAC.

We also recognize those who are giving their time and talent to help make New Jersey a state where every patient can know that “a nurse will be there for you.” And we welcome the next generation of leaders, our New Jersey Nursing Scholars alumni and those just now completing their studies. Working together, pooling the resources of talent statewide, we will be able to achieve our goal.
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Leading Nurse Researcher Works to Quantify the Looming Nurse Shortage

Jeannie CimiottiJeannie CimiottiJeannie CimiottiSecond-career nurse is helping to build a national data set to predict the future supply of and demand for nurses as the population ages.

You might say that Jeannie Cimiotti—a nationally renowned nurse scholar and the new head of a New Jersey nursing workforce data center—fell into her profession by accident.

One morning a couple of decades ago, she happened to see a little girl run into a busy street and get hit by a car. A teacher of visual and performing arts at the time, Cimiotti felt helpless as she waited alongside the girl, who was a student of hers, for the ambulance to arrive. When it did, she stood in awe of the emergency medical technicians who came to the rescue.

The next day she applied to become a paramedic, taking the first step in a long and arduous—but extremely rewarding—process of switching careers to nursing.

At first, Cimiotti, DNSc, MS, MFA, kept her day job as an art teacher in Jersey City, N.J., and worked nights and weekends as a student paramedic. One day, while working in a coronary care unit, she was asked to monitor an electro-cardiogram machine. When she noticed some irregularities, she calmly reported the situation to the supervising nurse, who responded with some unexpected advice. “You should consider nursing,” she told Cimiotti. “Other students come in here and see something odd and go all crazy. But you can take it in and not overreact.”

And that is what Cimiotti did. She went back to undergraduate school and earned her second bachelor’s degree in 1997, when she was in her mid-30s. Nursing may not have been her first professional love, but it has since become her most deep and lasting one.

In the years since, she has risen quickly through the ranks of the profession. She has worked as a pediatric nurse and nurse educator, has earned her master’s and doctoral degrees in nursing, and has won international acclaim for research she helped conduct on the effects of nursing workforce environments on health outcomes in the U.S. and abroad.

Cimiotti now brings her rich background in nursing to the New Jersey Collaborating Center for Nursing, an organization funded by the state of New Jersey and the Robert Wood Johnson Foundation (RWJF) that gathers and analyzes data about the state’s nursing workforce to guide policy decisions and spark innovation in nursing education, practice and research. Cimiotti succeeded Geri Dickson, PhD, RN, who retired from the position earlier this year.

The center complements the work of the New Jersey Nursing Initiative (NJNI), a multi-year, multi- million dollar project of RWJF and the New Jersey Chamber of Commerce Foundation that is working to ensure that New Jersey has the well prepared, diverse nurse faculty it needs to educate nurses to meet the demand for health and health care in the 21st century.

“Working together I’m quite certain we can make sure that New Jersey has nurses of the highest quality and that we’ll have enough of them to meet patient needs,” Cimiotti said.

The state is in many ways making progress toward the shared goal of ensuring that there are enough nurses in New Jersey to meet future demands. It is home to more hospitals that have achieved Magnet-level status—meaning they have been recognized for healthy working environments for nurses, which have been shown to improve patient outcomes—than any other state. And it is one of only 18 states that have enacted legislation requiring hospitals to publicly report nurse staffing ratios.

Looming Nurse Shortage
But like the rest of the nation, New Jersey has a long way to go to curb a looming nursing shortage that threatens to undermine the quality of patient care. The population is living longer, but sicker, and more nurses will be needed to meet increasing, and increasingly complex, patient needs. The nursing workforce, meanwhile, is graying along with the rest of the population, and nurses are expected to retire en masse in the not-too-distant future.

The recession has mitigated the effects of the shortage for the time being. Nurses are putting off retirement or adding hours to compensate for income lost during the recession. But as the economy recovers, more nurses will retire or cut their hours, and there aren’t enough new nurses to follow in their footsteps.

“When this economy improves we’re going to be in a bad situation,” Cimiotti said. “Right now hospitals aren’t hiring a lot of nurses because those who should have retired aren’t, or they are coming back to the workforce. But when the economy improves and nurses bail out, we’ll be in a really serious situation nationwide.”

To address the shortage before it occurs, Cimiotti and colleagues from other states are working to develop a minimum data set to more accurately predict the supply of and demand for nurses in New Jersey and across the nation. She is also working to boost the number of Magnet-accredited hospitals in New Jersey; study working conditions for nurses in New Jersey hospitals; and investigate the number of hospitals in New Jersey that require nurses to have a bachelor’s degree.

In addition, she will oversee an annual educational capacity survey to assess student enrollment in New Jersey nursing schools, which will help NJNI in its mission to ensure that there are enough nursing school faculty to prepare the next generation of New Jersey nurses.

“I would love to see New Jersey noted for its nurses and its quality of care,” she said “I want other states to look at us and say, ‘Wow! Look at what New Jersey has done.’”

Nearly two decades after she left the public school classroom in Jersey City, Cimiotti is now in a place where she can help make that dream a reality. “I have never felt so well positioned in my life to really make a difference in patient care,” she said. “I think being the executive director of this center allows me to work side by side with administrators from health care facilities and stakeholders across the state. It’s almost like a researcher’s dream come true.”
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A Fond Farewell: Mary Ann Christopher

State Senator Joe Vitale presents Mary Ann Christopher a proclamation

Accolades, tributes and official proclamations poured in from leaders all across the state in recognition of the tremendous contribution Mary Ann Christopher has made to nursing in New Jersey throughout her career.

Christopher was feted at the New Jersey Action Coalition’s December 2 meeting. She will be stepping down from her position as Action Coalition co-lead in December, as she prepares for her new role as president and chief executive officer of the Visiting Nurse Service of New York (VNSNY), effective January 2012.

In a proclamation, Governor Chris Christie noted that Christopher’s “energetic leadership and dedication to patient advocacy” have furthered the nursing profession. “Your efforts have had a profound and positive impact on the state of New Jersey. Thank you for a job well done,” he said.

Unable to attend the event himself, U.S. Congressman Rush Holt sent a representative from his district office, Alex Koerte, with a special message for Christopher. He offered his “deepest appreciation” for all her work and expressed a desire to continue working together to advance the role of nursing.

A longtime champion of Christopher’s nursing and patient advocacy work, State Senator Joe Vitale presented a proclamation in recognition of her legacy and contributions to residents of the garden state. Quoting Henry Adams who said “a teacher affects eternity:  he can never tell where his influence stops,” Vitale said “and so it is with nurses, and so it is with Mary Ann Christopher.”

Christopher said her decision to accept the VNSNY position was a difficult one, in large part because of her tremendous affection for New Jersey. “I love what I do every day in New Jersey. It has been a joy for me. It’s been a joy for me because of you. It has been a privilege.”

VNSNY is the nation’s largest not-for-profit home health care organization providing a wide range of services to New Yorkers of all ages and helping meet health care needs throughout the five boroughs of New York, and in Westchester and Nassau counties. Prior to her appointment with VNSNY, Christopher was president and CEO of the Visiting Nurse Association Of Central Jersey, serving more than 127,000 people annually throughout New Jersey.

Mary Wachter, co-chair for the Action Coalition’s leadership group, will become the new Action Coalition co-lead, along with Dave Knowlton and Edna Cadmus. Christopher will remain in her role as chair of the National Advisory Committee for NJNI.
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Scholars, Leaders & IOM Recommendations Shine at NJNI’s Annual Meeting

NJNI 3rd Annual Meeting Scholars“There’s a lot on New Jersey’s shoulders,” Susan Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation (RWJF) senior adviser for nursing, said at the New Jersey Nursing Initiative’s (NJNI’s) third annual meeting. “But I can feel it here in this room: we can do it… When the history books come out I want this generation to be known for solutions, and for New Jersey to have taken the lead.”

Only months after the first class of New Jersey Nursing Scholarsgraduated from the program, ten new PhD students were officially welcomed into the NJNI family. The new cohort got an introduction to the program at the NJNI third annual meeting, held October 20-21 in Princeton, New Jersey.

They joined current scholars, representatives from NJNI’s first graduating class, mentors and nurse faculty for two days of networking and information sessions to acclimate them to the program and their futures as nurse faculty.

“The opportunities that have come with [being a New Jersey Nursing Scholar], the networking opportunities – especially this conference every year – the people that you meet, has been extraordinary,” said Scholar Kristi Stinson, MSN, RN, APN-C, who is attending Seton Hall University.

The Future of Nursing Education
The meeting focused on education progression, which has garnered increasing attention since the release of the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. The report calls for more nurses to earn bachelor’s degrees and more advanced degrees, with a goal to double the number of nurses with doctorates by 2020. NJNI is helping to advance that work.

There are emerging models in nursing education that show great promise in meeting these recommendations, said keynote speaker Vickie Niederhauser, PhD, RN, dean of the University of Tennessee at Knoxville School of Nursing and an alumna of the RWJF Executive Nurse Fellows program. But one plan doesn’t work for everybody, she cautioned, and each state should tailor a plan to its needs. “There’s more than one way to get where we’re going.”

When she was the associate dean of the University of Hawaii’s School of Nursing and Dental Hygiene, Niederhauser helped to change Hawaii’s education system to make it easier for nurses to pursue higher degrees. At the time, the only way for some nurses to get a baccalaureate degree was the move to another island, which wasn’t feasible for many families. Niederhauser and her colleagues adapted a consortium model used in Oregon to create a partnership among Hawaii schools of nursing to offer a state-wide unified baccalaureate curriculum and distance learning opportunities.

“Changes in the health care system are both uprooting and uplifting,” she said. “The key to success is being inspired.”

New Jersey’s Role
“We have called the Future of Nursing report a blueprint, a game changer, a call to action,” said NJNI Program Director Susan Bakewell-Sachs, PhD, RN, PNP-BC. “It’s all of those things. It gives us the weight to carry forward.”

Forty-seven percent of New Jersey nurses are at least baccalaureate prepared, but only 9 percent have master’s degrees and less than one percent have doctorate degrees. In a state with 111,000 registered nurses, we’re “not achieving adequate education progression,” Bakewell-Sachs said. New Jersey schools of nursing struggle with the same capacity issues as institutions in other states, turning away qualified applicants because there is a shortage of doctoral-prepared faculty. As record numbers of nurses and nurse faculty near retirement, the impending nursing shortage threatens to leave the state unprepared to meet the health care needs of its citizens.

But the NJNI Faculty Preparation Program has already made progress in changing the state’s prognosis. Last spring, the first cohort of 18 New Jersey Nursing Scholars graduated with master’s degrees, and many began careers as nurse faculty in the state this fall. The Faculty Preparation Program will produce at least 61 new nurse faculty committed to working in the state.

“We have to seize the moment,” Bakewell-Sachs said. “In my career I’ve never seen a greater moment in time, a greater spotlight on us.”

The Scholars’ Role
“People try to sell us change when we’re hungry for transformation,” Heather Andersen, RN, MN, EdD, told the Scholars. Andersen is the founder of Human Source, a management consulting company that works with leaders in business, government and higher education to facilitate transformation within their organizations. “One of the best parts of the [Future of Nursing] report is that it makes business sense.”

Andersen’s motivational remarks included suggestions for ways the Scholars can help advance the recommendations in the IOM report. She also helped facilitate small group discussions in which the Scholars discussed how New Jersey could meet its nursing education needs and how they could help.

“I’m going to leave you with one message,” Hassmiller told the Scholars in closing. “Hang around with people who are solution-makers… Put New Jersey on the map. Take the lead.”
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Did You Know?

The Robert Wood Johnson Foundation New Jersey Nursing Initiative (NJNI) is continuing to expand its social media presence, and is proud to unveil its new Facebook page, launched in December. As with the NJNI website and blog, the Facebook page will provide an additional platform for news, events, information and online connections.
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