Newsletter Issue 7: May 2011

In This Issue

Simulations and Celebrations: NJNI Scholars Gather for Learning, Graduation
Leader’s Column – Nursing, Business and Two Years of Transformative Change
Veteran Nurse Professor Has New Vision for Nurse Education
NJ’s Action Coalition Moving Ahead
Did You Know?

Simulations and Celebrations: NJNI Scholars Gather for Learning, Graduation

“My chest still hurts,” groaned the man lying on the hospital bed. “What are you doing? I need help!” Adding to the stressful atmosphere were the beeps of medical equipment, the raised voices of medical professionals, and the frustrated pleas of the man’s daughter who had accompanied him to the hospital.
The man, actually a human patient simulator mannequin, was part of a simulated—yet realistic—emergency room scenario involving the Robert Wood Johnson Foundation (RWJF) New Jersey Nursing Scholars. The agitated daughter was played by a nursing student.
Simulations, as the scenarios are called, were among the main topics at the April 15 in-person meeting of the New Jersey Nursing Initiative’s (NJNI’s)Collaborative Learning Community (CLC). The event, which took place at The College of New Jersey, convened all Scholars and included a ceremony for those who will be graduating from their master’s programs this summer.
“A Wonderful Day”
The 18 New Jersey Nursing Scholars who will receive their master’s degrees this year belong to the first cohort of Scholars. Their graduation marks the realization of one of NJNI’s top goals which is to strengthen the state’s ability to educate more nurses through the preparation of nurse faculty.
Calling it a “wonderful day” for the program, NJNI program director Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., who is the Carol Kuser Loser Dean and professor of nursing, School of Nursing, Health, and Exercise Science at The College of New Jersey, welcomed the graduates into the ranks of RWJF alumni and a new generation of nurse leaders.
“We expect a lot from you in terms of your nurse faculty careers. We want your help in transforming nursing education, in transforming health care and in becoming nurse leaders in education, research practice and policy,” she said to graduates at the ceremony.
Maryjoan Ladden, Ph.D., R.N., F.A.A.N., senior program officer for RWJF, echoed the sentiment. “We look forward to welcoming you as nurse faculty – you are the future leaders of the profession,” she said.
The graduating Scholars are:
  • Elizabeth Arnold, Kean University
  • Christine Bray, Richard Stockton College of New Jersey
  • Erin Cleary, Fairleigh Dickinson University
  • Caitlin Faupel, Richard Stockton College of New Jersey
  • Andrew Fruhschien, Fairleigh Dickinson University
  • Hye Jin Gehring, The College of New Jersey
  • Primrose Germain, The University of Medicine & Dentistry of New Jersey
  • Maryann Magliore-Wilson, The University of Medicine & Dentistry of New Jersey
  • Kristine Martinho, The College of New Jersey
  • Tara Lynne Parker, William Paterson University
  • Latoya Rawlins, Monmouth University
  • Mary “Rusti” Restaino, William Paterson University
  • Patricia Saveriano, The University of Medicine & Dentistry of New Jersey
  • Michelle Skiber, Monmouth University
  • Jenee Skinner-Hamler, The University of Medicine & Dentistry of New Jersey
  • Andrea Taylor, Kean University
  • Lia Valentin, The University of Medicine & Dentistry of New Jersey
  • Dorothy Withers, The University of Medicine & Dentistry of New Jersey
Learning in Real Life
The CLC is a signature program of NJNI’s Faculty Preparation Program. It provides special learning opportunities to help the Scholars offer their future students the best possible instruction.  The meeting’s focus on simulations was a response to Scholar requests for more experience with this teaching tool.
Simulations are highly sophisticated exercises intended to provide a safe place to respond to a likely clinical scenario that is as realistic as possible. In simulations, nursing students learn the importance of effective communication, teamwork and handling stressful circumstances. Simulation can be used to create high or low stakes scenarios that students may one day face as nurses, without practicing on actual patients. After a simulation, students have the opportunity to re-group and discuss successes and challenges they faced during the exercise, so that they will be better prepared to respond to similar situations in real life.
Instructors use simulations to assess student skills and identify areas for improvement. They can be complicated affairs involving multiple actors or mannequins recreating a complex medical procedure or emergency, or they can be designed to test something as simple – but crucial – as remembering to wash one’s hands. Some schools and hospitals include simulations using mannequins programmed to speak foreign languages to recreate communication challenges that sometimes arise. In recent years, instructors often have a hard time finding available clinical sites for students to practice in, making simulations an attractive option for insuring competency development.
In addition to the simulation, Scholars at the CLC participated in a series of workshops, some led by their colleagues in the Ph.D. program who are specializing in simulations.
A Collective Experience
In the afternoon, Scholars participated in a session on team-based learning led by Michelle Clark, Ph.D., R.N., associate professor at the University of Nevada, Las Vegas, who is widely known for her work in this field. Team-based learning maximizes the effectiveness of learning in small groups, and can be used in place of lectures. The method requires active learning and makes students accountable to the instructor and their small groups. The Scholars, their mentors and invited guests formed small groups in the session and worked on solving problems and answering complex questions to experience and learn more about this engaging and effective teaching method.
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Leader’s Column – Nursing, Business and Two Years of Transformative Change

By Tom Bracken, president of the New Jersey Chamber of Commerce
Two years ago this month, the Robert Wood Johnson Foundation New Jersey Nursing Initiative (NJNI) launched with a hearing before the New Jersey Senate’s Health, Human Services and Senior Citizens Committee. Our launch came at a pivotal moment, when businesses were seeing health costs skyrocket, the state was facing looming nurse and nurse faculty shortages, and communication among stakeholders was infrequent and unproductive.
The New Jersey Chamber of Commerce Foundation viewed this partnership with the Robert Wood Johnson Foundation as an important opportunity to transform the health and health care of our residents and improve the economic health of the state. Each year, in this country, inadequate or poor quality health care costs businesses as many as 45 million avoidable sick days, which translates to more than $7 billion a year in lost productivity. Business in New Jersey cannot afford that kind of cost.
We know there is a clear link between the nurse faculty shortage and economic competitiveness. A strong nursing workforce—well-prepared by effective nurse faculty—can help improve employees’ health and wellness, and provide the health care and services that our workers and their families need. As the newly appointed president of the Chamber, I have seen how NJNI is helping to create partnerships, establish programs and lead efforts that will improve health and health care in the state, ultimately leading to a healthier and more productive workforce.
In just two years, we have accomplished much. We have held two Health Care Business Summits. We have partnered with the State Employment and Training Commission to develop a strategic plan for the health care workforce in New Jersey, which includes addressing faculty shortages at schools that educate health professionals. This plan is being further developed and implemented by the newly-established Health Care Workforce Council.
We have been selected as the host organization for New Jersey’s Action Coalition charged with implementing the recommendations of the Institute of Medicine’s landmark report Future of Nursing: Leading Change, Advancing Health. New Jersey’s coalition is one of 15 state coalitions nationwide that are part of the Robert Wood Johnson Foundation’s Future of Nursing: Campaign for Action, an unprecedented and ambitious initiative to use all the skills, talents, knowledge and experience of nurses to meet the increased demand for health care.
This summer, 18 New Jersey Nursing Scholars who were master’s candidates will graduate and begin looking for positions as nurse faculty. They are a keystone of NJNI’s efforts to address the nurse faculty shortage and are among our future nurse leaders. We wish them well as they begin their work and look forward to collaborating with them on future endeavors.
In the past two years we have sought out and cultivated partnerships with diverse stakeholders including leaders in business, health, academia, philanthropy and public policy. The opening of new channels of communication has strengthened our work and laid the framework for sustainability. We are proud to have played a central role in establishing these new and exciting collaborations.
Ensuring 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 is a goal we all share. In the years to come, we hope to build upon our successes and make New Jersey a model for the nation. Thank you for your support.
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Veteran Nurse Professor Has New Vision for Nurse Education

May 31, 2011
Nancy Lenaghan teaches students to prevent and catch medical errors with heightened pedagogic focus on quality and safety in nursing.
Eight years ago, Nancy Lenaghan lost a family member to a medical error, and ever since she’s been working to keep others from experiencing the same kind of tragedy.
For Lenaghan, M.S.N., A.P.R.N., C.N.E., a nurse and nurse educator for more than four decades, that means transforming nurse education so that nursing school graduates are able to catch medical errors before they happen and save lives before they are lost.
A guiding light on Lenaghan’s journey is Quality and Safety Education for Nurses (QSEN), a project funded by the Robert Wood Johnson Foundation (RWJF) that aims to prepare aspiring nurses to improve the quality and safety of the health care systems in which they work.
QSEN is the Foundation’s response to recent reports documenting the high number of patient injuries and deaths that come from medical errors in hospitals. Nurses have a key role to play in reducing medical errors, the Foundation believes. They are largest group of health care professionals in the country and spend more time with patients than most other providers.
“Nurses are with patients 24 hours a day, seven days a week,” Lenaghan says. “They play a very pivotal role in terms of creating a culture of safety.”
Yet ensuring safe patient care today is a huge challenge. People are living longer and as a result are dealing with more chronic and more acute conditions. At the same time, because of the soaring cost of health care, patients are being discharged from hospitals sooner than in years past.  Ultimately, nurses are responsible for more patients with more acute and chronic conditions.
Meanwhile, demands on nurses are growing. Nurses are responsible for everything from providing care to advocating on behalf of their patients and checking lab results  to collaborating with physicians and other health care team members. “They’re managing so many issues at once,” Lenaghan says, “and there are lots of distractions.”
To improve care, Lenaghan is advocating for a transformation of nurse education. Toward that end, she developed a simulation project designed to teach nursing students to stay focused and manage competing responsibilities in the kind of chaotic, high pressure environments that are health care organizations today. “We can’t teach the same way we used to,” she says. “We need to develop new strategies so students can internalize what safety is all about.”
Lenaghan Embeds QSEN Competencies into Existing Curriculum
A nurse educator for more than three decades, Lenaghan knows as well as anyone how to do that. After earning her master’s degree in nursing in 1977, she became an instructor at Washington Hospital Center School of Nursing. A decade later she joined Brookdale Community College, where she now is a professor. “I became a nurse because I wanted to touch human lives,” she says. “I consider it a privilege to work with humans at their most vulnerable time in their life. I wanted to share that passion I have with students.”
In 2008, Lenaghan was serving as chair of the department of nursing at Brookdale and began to look seriously into developing a teaching activity that incorporates QSEN competencies such as evidence-based practice, patient centered care, safety, teamwork and collaboration, and quality improvement. Informatics is also a QSEN competency.
An expert in kidney disorders and sepsis, Lenaghan integrated the QSEN competencies into an existing case study about a simulated patient—an 85-year-old Italian woman—who arrives at the hospital with a urinary tract infection and goes into septic shock.
During the simulation, students encounter and respond to a range of safety problems such as incorrect IV solution, a missing ID band, and water on the floor; provide patient-centered care by communicating with a confused and reluctant foreign-born patient and advocating on behalf of the patient’s main caregiver, her daughter; and collaborate with other members of the health care team from radiology and respiratory therapy.
Before the simulation project, students research and discuss literature on evidence-based practice relating to cascading health crises such as occurs with multiple organ dysfunction syndrome. Afterward, students create a simulated quality improvement plan to reduce the incidence of hospital acquired urinary tract infections.
Before incorporating the activity into the school’s curriculum, Lenaghan instructed her colleagues on how to teach it and monitored its implementation. The simulation first ran in 2008 and is now a fixture in the curriculum.
The students responded extremely well, Lenaghan says. They enjoyed the detailed simulation and upon completion had a better grasp of the QSEN competencies. “The simulation was extremely helpful in learning how to communicate and report to other members of the health care team,” one student wrote in a follow-up report. “It also helped with learning about delegation.”
Lenaghan presented the activity at a national QSEN conference last year; in October, she presented it at the annual conference of the New Jersey Nursing Initiative (NJNI), a five-year, $22 million project of the Robert Wood Johnson Foundation and the New Jersey Chamber of Commerce Foundation that is working to transform nursing education in the state.
Since she attended the conferences, she has received emails from faculty in several states inquiring about the project. Meanwhile, Brookdale’s nursing program was recognized by the National League for Nursing as a Center of Excellence.
In the coming years, Lenaghan and her colleagues at Brookdale plan to embed the QSEN competencies more deeply into the school’s curriculum. “It’s a work in progress,” she says.
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NJ’s Action Coalition Moving Ahead

The New Jersey Action Coalition is one of 15 state coalitions working to implement the recommendations of the Institute of Medicine’s landmark report Future of Nursing: Leading Change, Advancing Health as part of the Robert Wood Johnson Foundation’s Future of Nursing:Campaign for Action. The action coalitions are responsible for developing and implementing plans that use all the skills, talents, knowledge and experience of nurses to meet the increased and growing demand for health care.
New Jersey’s coalition is seeking and investigating successful models in which nurses are exerting influence in health care design and delivery by: increasing the number of nurses in key decision-making roles in hospital and health care administration; exploring opportunities for nurses to play a greater role in ensuring the proper and efficient coordination of patients’ care across the continuum, working with the insurance industry and as Medicaid is restructured; increasing nurses’ influence in shaping patient care practice models and processes in all health settings; participating in the design of accountable care organizations; and exploring other models of care—for example, the Visiting Nurse Association of Central Jersey’s work with at-risk populations, such as the homeless and mentally ill who have been released from institutions.
Since its launch in December, the New Jersey Action Coalition and its members have been reaching out and talking with stakeholders, creating partnerships, and working toward solutions. The coalition held its first public forum in February, bringing together state leaders in health, business and education to learn more about how they could join this effort. In all, more than 200 participated in the Campaign for Action Forum, hosted by The College of New Jersey in honor of the 40th anniversary of its nursing program.
“I have never seen anything quite like this,” said Robert Wood Johnson Foundation senior adviser for nursing Susan Hassmiller, Ph.D., R.N., F.A.A.N. about the response to the recommendations to improve health and health care through nursing in the recent Institute of Medicine report. Hassmiller, who was part of the illustrious committee that produced the recommendations, encouraged participants to take part in the “call to action.”
“The report is a rallying point,” she said. “There are a lot of decisions being made on Capitol Hill and at the statehouse without a nurse at the table. We need nurses’ perspectives and voices at every level.” Hassmiller encouraged participants to follow the Campaign for Action on Facebook and Twitter.
Campaign Already Underway in NJ
New Jersey’s Action Coalition has already identified several successful and replicable models in which nurses play leadership roles in improving health care. From nurse-led mobile outreach units that have been proven to prevent unnecessary visits to emergency rooms to education programs that are making it easier for nurses to attain advanced degrees, the coalition is using real-life stories to present successful strategies that can be brought to scale in New Jersey.
The New Jersey coalition is led by Edna Cadmus, Ph.D., R.N., N.E.A.-B.C., clinical professor and director, DNP Program-Leadership Track of Rutgers University College of Nursing; Mary Ann Christopher, M.S.N., R.N., F.A.A.N., president of the Visiting Nurse Association of Central Jersey and chair of the New Jersey Nursing Initiative’s National Advisory Committee; and David Knowlton, president of the New Jersey Health Care Quality Institute. Their excitement and enthusiasm were contagious at the February Forum. “It’s about time for something like this!,” said Patricia Murphy, Ph.D., A.P.N., chair of the New Jersey Board of Nursing. “We’re very ready to work in a collaborative way to make things happen and allow all of these initiatives to advance. We want to be a partner.”
Participants left the Forum armed with “sticky notes” with the message “Because you can’t do it without Nurses!” They were invited to get inspired, jot down their ideas and “stick” them on oversized columns representing each of the “pillars,” or main issue areas, included in the report. They include inter-professional collaboration, improving workforce data collection and analysis, improving nursing education and more. To learn more about the efforts underway in New Jersey, click here.
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Did You Know?

The New Jersey Nursing Initiative now has a blog! We’re celebrating our second anniversary by launching a brand new blog, “News & Notes on Nursing in NJ.” It will allow us to keep you informed about all of the latest developments related to nursing. In addition to keeping you up-to-date on our work, “News & Notes on Nursing in NJ” will provide updates on health, health care and education issues locally and nationally, and will serve as a forum for leaders across the state— including our very own New Jersey Nursing Scholars—to chime in with their own views.

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Newsletter Issue 6: March 2011

In This Issue:

New Jersey Playing a Leading Role in National Nursing Campaign
Leader’s Column – Nurses Are Ground Zero for Quality and Safety
New Jersey Hospital Teams Up with Local Nursing Schools to Solve Nurse Faculty Shortage

New Jersey Playing a Leading Role in National Nursing Campaign

Inaugural meeting of New Jersey Regional Action Coalition provides roadmap for state efforts
Nursing in America is in the midst of a major transformation, and New Jersey has a leadership role.
The New Jersey Nursing Initiative (NJNI) kicked off 2011 by co-hosting a meeting of diverse health care stakeholders from across the state. These leaders will help implement an unprecedented and ambitious initiative to use all the skills, talents, knowledge and experience of nurses to meet the increased demand for health care. The meeting is part of the NJNI’s work as a leader of the New Jersey Regional Action Coalition (RAC) for the Robert Wood Johnson Foundation’s (RWJF) Future of Nursing: Campaign for Action.
In November, RWJF announced that the Campaign would work closely with five states to initiate implementation measures that can be successfully emulated in other parts of the country. New Jersey is one of those five states, and NJNI and the New Jersey Chamber of Commerce Foundation are working together to lead a long-term coalition that will be part of the national effort to advance key nursing-related issues .
In January 2011, the members of the New Jersey RAC met in Princeton to begin the important work of identifying measures to implement. The meeting was led by David Knowlton, president and CEO of the New Jersey Health Care Quality Institute and former deputy commissioner of the New Jersey Department of Health, NJNI National Advisory Committee Chair Mary Ann Christopher, M.S.N., R.N., F.A.A.N, and Edna Cadmus, Ph.D., R.N., N.E.A.-B.C., clinical professor and director of the DNP Program of the Leadership Track at Rutgers University.
Attendees included diverse stakeholders from across the state, including representatives from
AARP New Jersey, Hotel and Restaurant International Union Welfare Fund, New Jersey Assembly Health and Senior Services Committee, New Jersey Association of Health Plans, New Jersey Collaborating Center for Nursing, New Jersey State Council of Carpenters, New Jersey State Nursing Association, Robert Wood Johnson Medical School, St. Francis Medical Center, Rutgers, State Employment and Training Commission, the Visiting Nurse Association of Central Jersey and many others.
Knowlton outlined the key messages from The Future of Nursing: Leading Change, Advancing Health, a report from the Institute of Medicine that is driving the Campaign:
  • Nurses should practice to the full extent of their education and training;
  • Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression;
  • Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the U.S.; and
  • Effective workforce planning and policy-making require better data collection and an improved information infrastructure.
He asked the group to develop two measures for each message that could be implemented in New Jersey within the next nine months.
NJNI Director Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., Chamber of Commerce Foundation President Dana Egreczky and Mary Ann Christopher provided guidance, suggesting that the group consider the health care workforce and education environment in the state as they proceeded.
Edna Cadmus outlined some underlying goals of this work. “On our side, we’ll be working to be sure we meet the needs of the citizens of New Jersey,” she said. “We need to work collaboratively and the effort must be interdisciplinary. We should look at the models that exist and see if there are ways to bring them into New Jersey.”
Knowlton led the group in a brainstorming discussion which yielded the following ideas for measures to implement:
  • Collect information on what advanced practice nurses in a variety of specialties are legally allowed to do in the state, as well as the applicable regulations and laws governing their work. Identify the impact of those limitations on the state’s ability to provide access to health care and share that information with health care facilities.
  • Identify demonstrations of collaborative models, including Accountable Care Organizations, patient-centered medical homes, and clinics.
  • Work with New Jersey hospitals and nursing schools to develop a system similar to the American Association of Colleges of Nursing’s model for nursing residency programs that include academic credits. 
  • Identify best practice models of degree articulations (such as ASN to BSN shared curriculum and simultaneous enrollment, e.g. Oregon Model).
  • Join the RWJF Nurse Leaders in the Boardroom program to support current and emerging nursing leaders in New Jersey.
  • Encourage the Governor to name nurses to two cabinet or subcabinet positions.
  • Establish a functional database of information about the health care workforce in New Jersey.
  • Develop a program to conduct outreach to New Jersey high schools to educate students about careers in health care and the education they need to pursue them.
As the meeting drew to a close, participants were asked to complete forms indicating which areas they would like to work on over the next nine months.


Leader’s Column – Nurses Are Ground Zero for Quality and Safety

Mar 15, 2011
By David Knowlton, President & CEO, New Jersey Health Care Quality Institute; former Deputy Commissioner, New Jersey Department of Health, Co-Chair of New Jersey Regional Action Committee
The great thing about my job as President and CEO of the New Jersey Health Care Quality Institute is that everyone in the world of healthcare agrees that quality and patient safety are the top goals for our health care system. And having worked alongside nurses since the earliest days of my career, I can say without reservation that they are our most important allies in this work as they are at “ground zero” when it comes to quality and safety.
Our mission at the New Jersey Health Care Quality Institute has always been to take on projects that will ensure that quality, accountability and cost containment are all closely linked to the delivery of health care services. We understand that one of the best ways to strengthen the quality and safety of our health care system is to make sure that nurses are an integral part of the system, from the delivery of care to decision-making and everything in between.
Squandering Manpower
In today’s challenging climate, we do not have the luxury of squandering limited resources. In no arena is that more true than in making sure that the right person is doing the right job. As the Institute of Medicine’s landmark report, The Future of Nursing: Leading Change, Advancing Health, notes, in order to transform our health care system, we must ensure that nurses can work to the full extent of their training and education.
The time has come for the value of nurses to shine beyond hospital walls and physician offices. We want nurses to use the full extent of their skills and training, to get to the highest level of education and training available, and to work as real partners with physicians and hospitals. Our vision is to see more nurses in the boardroom, in state government and even legislating in the halls of Congress.
Fully Integrating Nurses
In many respects, nurses are the “missing link” to health care reform. Without their crucial knowledge on quality and safety, any reform effort will fail to achieve our goals of greater access, improved quality and reduced costs. The only way we can hope to see a difference is to make sure that nurses have a seat at the table. We can do this with your help.
New Jersey today finds itself in the exciting position of being a hub of activity for health care reform. I feel passionately about quality and safety in health care and have long been an enthusiastic advocate for nurses. I was delighted to recently be named a co-chair of New Jersey’s newly-formed Regional Action Committee (RAC), which provides me the opportunity to give back and a platform for something I strongly believe in. [For more on the RAC read: New Jersey Playing a Leading Role in National Nursing Campaign].
Fully integrating nurses in the health care system is something from which everyone would benefit, but experience tells us we cannot do this alone. With the RAC, we hope to start a conversation among new, diverse and influential groups including the Chambers of Commerce, municipal planning commissions, policy-makers and others. Our work is only just beginning.
The future of nursing starts now, and New Jersey is proud to be leading the way.


New Jersey Hospital Teams Up with Local Nursing Schools to Solve Nurse Faculty Shortage

Atlanticare sends its clinical nurses to fill vacancies at local nursing schools and benefits from a larger pool of better-prepared nursing graduates.
 
One way to improve the health care system of the future is to look to the past.
That, at least, is the view of Robyn Begley, D.N.P, R.N., N.E.A.-B.C., a nurse executive who works with the New Jersey Nursing Initiative (NJNI) to help 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.
One key way to do that, according to Begley, chief nursing officer at Atlanticare, a magnet-designated hospital in southeastern New Jersey that won the Malcolm Baldrige National Quality Award in 2009, is to strengthen the link between nurse education programs and area hospitals.
In the past, most nurse training programs were run by hospitals, but these so-called diploma programs receded in recent decades as academic institutions took over the responsibility of educating aspiring nurses. But, Begley says, nurses and the patients they serve would benefit from stronger ties between the institutions where nursing is taught and where it is practiced.
“We learn from history,” Begley says. “There are some really good components of nurse education programs of the past that we want to use in the future.”
One key way to do that is through the kind of joint appointment faculty system put in place by Begley and partners at nearby nursing programs. Under the joint appointment system, clinical nurses with master’s degrees at Atlanticare spend part of their workweeks teaching nursing students at the Richard Stockton College of New Jersey and at the Atlantic Cape Community College (ACCC).
Although joint appointment faculty systems are not new, the partnership between Atlanticare, Stockton and ACCC is unique because, unlike other partnerships between universities and their affiliate hospitals, this system is bringing separate entities together, according to Brenda Stevenson Marshall, Ph.D., M.P.H, M.A.E, the dean of health sciences at Stockton.
“We’ve created a new model that can be replicated by other organizations,” she said. “We’re taking two separate entities and joining them together. It’s extremely useful for anyone else trying to do this.”
The system is a major plus for all involved, Begley, Stevenson Marshall, and others say.
To start, more instructors enable nurse education programs to fill vacancies caused by a severe shortage of nurse faculty and then to accept more nursing students. That helps ensure that the nursing workforce of the future will be prepared to meet the growing demand for health care in New Jersey and across the country.
For their part, nursing students benefit from instruction from practicing nurses who are able to share clinical knowledge and real-world patient experiences with students in health care systems they know well. They may also be more likely to consider teaching in the future, Stevenson Marshall said. “If they see academics going to the clinical setting, and vice versa, they will be much more amenable to that sort of model in future,” she said. “That will help alleviate the severe shortage of qualified academics in the future.”
At the same time, the system allows clinical nurses to step back from clinical jobs and explore opportunities in nursing research and education. “The joint appointment opens up a world to clinical nurses that they didn’t realize was there,” said CheryleEisele, Ed.D., R.N., A.P.N., B.C., program coordinator of the B.S.N. program at Stockton. “It sparks an interest that they carry on.”
Indeed, several clinical nurses who have participated in the joint appointment system at Stockton have gone back to school in preparation to teach full-time, Eisele said.
Last, but certainly not least, hospitals and health care organizations benefit from a larger supply of better-trained nurses and from stronger ties with academic institutions that help ensure that nursing practice is continuously informed by cutting-edge scientific research. And that, in turn, helps hospitals get and keep magnet status, according to Michelle Sabatini, R.N., Ph.D., A.P.Nc., graduate director of M.S.N. programs and assistant professor of nursing at Stockton. “It’s extremely beneficial.”
Barriers to Joint Faculty Appointment Programs Not Insurmountable
Setting up such a program is not without its challenges.
To establish the appointment system, Atlanticare officials, for example, provided clinical nurses with refresher courses to ensure they understood current teaching methodologies; subsidized clinical nurse salaries to make up for lower pay rates for instructors; and made room in nursing schedules to allow nurses to leave the bedside and go to the classroom.
“There are barriers,” Stevenson Marshall said. “But we didn’t find any that were insurmountable.”
Supportive administrators at health care organizations and educational institutions are also critical, Begley and Stevenson Marshall said.
The seeds of this particular joint faculty appointment program were planted a decade ago when Begley, a veteran nurse executive and past president of the Organization of Nurse Executives of New Jersey, was working with the local associate degree nursing program to increase the number of nursing students in anticipation of an impending regional nursing shortage.
Begley began to explore joint faculty appointment system models as a way to stem the nurse faculty shortage in order to produce more graduate nurses. Soon after, Begley approached nursing schools in the area and offered to “share” Atlanticare nurses with schools on an interim basis. Now, Begley and her partners are working to formalize and expand the program.
“The thought of expansion is exciting,” Stevenson Marshall said. “It’s a win-win all the way around.”

Newsletter Issue 5: December 2010

In This Issue

In National Spotlight
NJNI Welcomes New Scholars
Leader’s Column – Building a Stronger System in 2011
New Jersey Nurse-Led Program Recognized for Nursing Excellence and for Being a Model of Community Support
Investing in Talent, Strengthening NJ’s Health Care Workforce
Did You Know?

In National Spotlight

Edna Cadmus, Ph.D., R.N., N.E.A.-B.C., clinical professor and director, DNP Program-Leadership Track of Rutgers University College of Nursing, and co-chair of New Jersey’s Regional Action Coalition.
Edna Cadmus
NJNI Leads a Regional Action Coalition
New Jersey was recently selected as one of only five pilot states in the United States to participate in the first phase of the prestigious The Future of Nursing: Campaign for Action. NJNI will have a significant role in the campaign, which will build on the infrastructure NJNI has built and its work to date.
The Campaign for Action isan unprecedented initiative to address the increased demands for care by utilizing all the skills, talents, knowledge and experience of nurses. Its purpose is to guide implementation of the recommendations of the Institute of Medicine’s (IOM’s) landmark report Future of Nursing: Leading Change, Advancing Health. The goal is to transform the nation’s health care system so that all Americans have access to high-quality, patient-centered care where they live, work, learn and play and across the lifespan.
With leadership from the Robert Wood Johnson Foundation and partnerships from diverse sectors in the health care sector—including doctors, nurses, insurers, consumers, business, government, foundation, academia and health systems—this nonpartisan coalition will work to transform the health care workforce through implementation of the IOM report recommendations.
NJNI has Key Role with the NJ “RAC”
The Campaign has identified five pilot states, including New Jersey, to take leadership roles in moving the recommendations forward at the grassroots level. The Future of Nursing Regional Action Coalitions (RACs) involved in these pilot programs will help move key nursing-related issues forward. NJNI will serve as the headquarters for the New Jersey RAC.
Building on the work of NJNI and the New Jersey Chamber of Commerce Foundation, New Jersey’s RAC is directed by three distinguished co-chairs who are known throughout the state for their keen insight and leadership. Representing the fields of nursing practice, education and public policy/advocacy, the co-chairs are: Edna Cadmus, Ph.D., R.N., N.E.A.-B.C., clinical professor and director, DNP Program-Leadership Track of Rutgers University College of Nursing; Mary Ann Christopher, M.S.N., R.N., F.A.A.N., president of the Visiting Nurse Association of Central Jersey and chair of NJNI’s National Advisory Committee; and David Knowlton, president of New Jersey Health Care Quality Institute.
The other states chosen to host RACs and some of their affiliated groups are:
  • California – Betty Moore School of Nursing at the University of California, Davis; California Institute of Nursing and Health Care;
  • New York – Institute for Nursing; New York State Workforce Center; New York AARP Executive Council;
  • Michigan – Michigan Health Council; and
  • Mississippi – Mississippi Department of Budgeting and Administration; Nursing Workforce Center.
NJNI’s selection as a RAC was announced at the National Summit on Advancing Health through Nursing on November 30 in Washington, D.C. The nation’s top health leaders from government, business, public health, academia and other sectors gathered to discuss how to move forward with report recommendations pertaining to nursing education, interprofessional collaboration, scope of practice and leadership.
For more information, visit https://www.thefutureofnursing.org/. To become involved with the RAC, contact NJNI Deputy Director Lynn Mertz at Lynn.Mertz@njchamber.com.
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NJNI Welcomes New Scholars

A small and very promising cadre of America’s future leaders in academic nursing have a few things in common: they are enrolled in rigorous nursing programs that teach them about cutting edge information in the field, they have supportive mentors who are dedicated to guiding them as they pursue advanced degrees, and they go to school in New Jersey.

At the end of October, the New Jersey Nursing Initiative (NJNI), a program of the Robert Wood Johnson Foundation (RWJF) and the New Jersey Chamber of Commerce Foundation, welcomed the next generation of nurse faculty at its second annual meeting, “Nursing Leadership: Education, Practice and Policy,” in Princeton.
“You are our future leaders,” NJNI Program Director Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., told the Scholars. “We are going to be counting on you to be using your voices, to be leading change.”
NJNI is working to ensure that New Jersey has the well prepared, diverse nurse faculty needed to educate nurses to meet the demand for health and health care in the 21st century. The program is providing $13.5 million over the next five years to New Jersey’s master’s and doctoral level nursing programs and collaboratives, and will produce at least 46 new nurse faculty.
“You don’t know how exciting it is for me to see all of you here,” former New Jersey Governor and Chairman of the RWJF Board of Trustees Thomas Kean told the scholars at the meeting. “You are the future. What you do with your degrees will be wonderful for nursing.”
The New Scholars
NJNI’s second and final cohort includes 20 scholars who are pursuing master’s degrees from New Jersey nursing programs and collaboratives. They join the first class of 29 scholars in masters’ and doctoral programs as they prepare to become nurse faculty.
“I feel as though now I’m becoming part of the bigger picture and I have an opportunity to give back to the profession,” said Marlin Gross, B.S.N., R.N., a member of the second cohort who is pursuing a master’s degree in nursing at Richard Stockton College. “Being a part of this is phenomenal.”
The meeting gave the new scholars the chance to meet their peers, network with mentors and faculty, and hear from renowned experts in nursing and health care.
Second cohort scholar Grace Qarmout, B.S.N., R.N., who is pursuing a master’s degree in nursing at Fairleigh Dickinson University, appreciated the opportunity to get to know her fellow scholars and faculty at other nursing schools over the course of the three-day meeting. “It made the program more exciting to see the collaborative that we have here and to know the other people that I’m working with,” she said.
Each scholar has received a scholarship covering tuition and fees, and a $50,000 per year stipend to cover living expenses for the two to four years spent as full-time students. Scholars also receive mentoring from nursing leaders from across the country who help them complete their graduate or doctoral studies. Upon graduation, scholars have the opportunity to receive financial incentives if they become faculty members at schools of nursing in the state.
Being a part of the program “is an honor and a huge stepping stone… in getting to the faculty role,” said Ruta Brazaitis, B.S.N., R.N., a member of the second cohort who is pursuing a master’s degree in nursing at William Paterson University. “Now I have the assistance I need to do that.”
Building a Nursing Career
A career is an evolution, Angela Barron McBride, Ph.D., R.N., F.A.A.N., told the group in her keynote address. McBride is the chair of the National Advisory Committee of the RWJF Nurse Faculty Scholars program and distinguished professor and university dean emerita at Indiana University School of Nursing. She recently published a book on nursing careers, leadership and optimism, The Growth and Development of Nurse Leaders.
“A career means you are not doing, in every decade, the same thing. You keep evolving,” she said. McBride provided an overview of an academic career – from initial preparation to the final stage of “gadfly or wise person” – and the key transitions between the stages.
Mentoring, she said, comes at every stage of a career in academic nursing. “You incur the obligation to nurture subsequent generations and to shape the future. You have the obligation to nurture and mentor even if you’re a curmudgeon.”
She encouraged the scholars to honestly analyze their strengths and weaknesses, and to make friends with people who have skills different from their own.
“Other people cannot keep you optimistic; you have to manage yourself,” McBride said. Failure is expected, but you should admit your mistakes and move on. “I can’t tell the difference between failure and life experience anymore.”
“I wish each one of you a happy career,” she said in closing.
Advice from Mentors, Experts
The meeting featured several breakout sessions designed to give scholars a more intimate look at their future as nurse faculty and at emerging trends in the field. Topics included aligning practice with education, quality and safety, negotiating a clinical role, and establishing a dedicated education unit.
Scholars in NJNI’s first cohort, who are each in their second year pursuing a master’s or doctoral program, had lively discussions with mentors about their futures. They received candid advice on tenure tracks, research and publication, and transitioning from students to faculty.
“I think some of the best moments have been the mentorship and the ability to work closely with faculty,” said Andrew Fruhschien, B.S.N., R.N., N.J.E.M.T.B., a scholar from the first cohort who is pursuing a master’s degree in nursing at Fairleigh Dickinson University. “I think that’s been really important in learning to become an educator when I come out of this program.”
Robert Scoloveno, M.S., R.N., a first cohort Scholar pursuing a doctoral degree in nursing at Rutgers, said the meeting left him feeling “reinvigorated.” To hear from experts in the field and learn how to become a better educator “makes me feel like there’s great potential not only as a nurse but as a nurse educator,” he said.
Encouraging Nursing Leadership
The meeting came just weeks after the Institute of Medicine, in collaboration with RWJF, released its groundbreaking report, The Future of Nursing: Leading Change, Advancing Health. The report is the result of a two-year initiative to assess the nursing profession and make recommendations to transform it. The report recommends that nurses play an increased leadership role in our health care system.
Susan B. Hassmiller, Ph.D., R.N., F.A.A.N., RWJF’s senior advisor for nursing, briefed the scholars on the recommendations. “This report was written for you. It really is an opportunity for nurses to lead the transformation of our system,” she said. “You are part of the Robert Wood Johnson Foundation ambassador team. Reach out and educate policy-makers and others on the report’s findings.”
Hassmiller encouraged the scholars and their mentors to host “watch parties” for the report’s launch summit, which was broadcast online from Washington D.C. Nov. 30 and Dec. 1.
Laurie Cancialosi, legislative director for New Jersey Senator Joseph Vitale, agreed that nurses should be full partners with other health care professionals. “I think putting nurses into leadership positions is important,” she said after the briefing. “Every component [of the health care system] needs to have an equal seat at the table for appropriate medical care and patient care. Nurses need to be at the table for every decision.”
Ellen-Marie Whelan, Ph.D., R.N., a senior policy analyst at the Center for American Progress Action Fund, briefed the scholars on the health reform law and its implications for nursing. Whelan is an alumna of the RWJF Health Policy Fellows program (2003-2004), where she spent a year working in the office of then-Senator Tom Daschle (D-S.D.).
The scholars also heard from panels that challenged them to take an active role in public policy. They were encouraged to get involved in their communities and to talk to diverse audiences about nursing issues and improving patient care.
“This has given me so much to think about,” said Maryann Magloire-Wilson, B.A., R.N., a member of the first cohort is pursuing a master’s degree in nursing at The University of Medicine and Dentistry of New Jersey. “I never really thought of myself in that regard, in policy, in government… I feel like I can do more than I probably thought that I could… because if they think that we can, then we can.”
“Each of us is a leader. We’re not to wait for someone else to lead,” Bakewell-Sachs said at the close of the meeting. “I’m newly inspired to step up again… This is a rare opportunity in time. This is a momentous opportunity in time, and aren’t we lucky to be here.”
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Leader’s Column – Building a Stronger System in 2011

By Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., NJNI Program Director
2010 has been a banner year for the New Jersey Nursing Initiative (NJNI), culminating with the selection of 20 new Robert Wood Johnson Foundation New Jersey Nursing Scholars, and the honor of having been selected as a Future of Nursing Regional Action Coalition. So it is with great excitement and momentum that we look to next year and the promise it brings—most notably the graduation of our first cohort of scholars.
In 2011, 18 Scholars will graduate from their master’s degree programs. They will bring the skills, knowledge and enthusiasm that New Jersey needs for its future nurse faculty. We look to them to guide the new generation of nurses as they navigate a rapidly changing environment for health and health care.
That is why we are calling on practice and academe to work together to create a strong and well-balanced nurse faculty base from the outset, by exploring the many benefits of joint appointments.
Created intentionally and with the goal of supporting the most capable and best prepared professionals in the field, joint appointments stem from the understanding that the research and science of nursing informs practice, and vice versa. Rather than a piecemeal arrangement of two jobs at differing institutions, the joint appointment signifies a thoughtful collaboration between education and practice. It is precisely the kind of partnership we need to develop a dynamic nursing workforce, able to respond to our state’s growing health care needs.
As our scholars begin to prepare for their roles as nurse faculty, we ask institutions of clinical practice and education to set the wheels in motion. Joint appointments will make our system stronger and, once established, will benefit countless students and ultimately patients. Let’s make this one of our goals for 2011, as we continue to work to make New Jersey a model for other states.
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New Jersey Nurse-Led Program Recognized for Nursing Excellence and for Being a Model of Community Support

When Maria Brennan, M.S.N., R.N., C.P.H.Q., was a little girl, her grandmother broke her hip. A doctor reset the bone, but it was a nurse who helped her recover. Brennan was inspired. Ever since then, she has strived to help people recover from illness and injury.
“Nurses provide a great service to humankind,” she says. “I am as excited about nursing today as I was the day I decided to be a nurse.”
She has good reason to be excited.
The Women’s Heart Center at St. Joseph’s Regional Medical Center, a member of St. Joseph’s Healthcare System in Paterson, N.J., where Brennan is chief nursing officer and vice president for patient care services, recently won a prestigious award that recognizes innovative nursing programs.
In October, the American Nurses Credentialing Center and Cerner Corporation, a provider of healthcare informatics, awarded the Women’s Heart Center with the 2010 Magnet Prize, which recognizes innovative programs at Magnet-certified organizations and carries a prize of $25,000.
“For me, this award means nursing excellence,” Brennan says. “I believe it’s a representation of the many programs at St. Joseph’s and the type of quality nursing care that we provide to our community.”
The center was cited in particular for its high degree of community outreach by advanced practice nurses.
At the Women’s Heart Center, the advanced practice nurses closely interact with the community in locations such as local businesses, churches, mosques, even hair salons.    They teach women about risk factors for heart disease and stroke, offer prevention strategies and explain available diagnostic and treatment options. Spanish-speaking nurses are available to teach courses at bodegas and other local organizations.
The center was developed by Carolyn Strimke, M.S.N, R.N., C.C.R.N., and Margie Latrella, M.S.N., R.N., A.P.N.-C., both advanced practice nurses. It is directed by a physician and managed by nurses.
Under the program, nurses charge a modest fee to screen clients for heart disease, review client medications and diet, and provide counseling and education. If necessary, nurses refer clients to a primary care physician or a cardiologist for further diagnostic testing and treatment.
The center opened in 2005 and counseled more than 1,700 women its first year, 450 of whom were screened. Over the next four years, the number of women screened rose to 2,700 per year. The award money will be used to grow the program even further, and Brennan hopes it will become a model for similar nurse outreach efforts around the country and the world.
Brennan Touts Advanced Practice Registered Nurses’ Wide Range of Skills
Brennan credits advanced nurse practitioners for much of the center’s success.
“Nurses really have a unique way of communicating with patients,” she says. “Physicians do a good job of explaining things. But the minute the doctor leaves the room, the patient says to the nurse, ‘Now, tell me what he just said.’ The nurse goes over it in layman’s terms and in detail. We’re great patient educators.”
Brennan has long advocated for nurses.
When the Women’s Heart Center was in the planning stages, Brennan persuaded its director to staff it with advanced practice nurses instead of physician’s assistants. She then helped the director, a cardiologist, hire two advanced practice registered nurses for the cardiology department. He was so impressed with their skills that he hired seven more to work in the department.
Brennan also volunteers with the New Jersey Nursing Initiative (NJNI), a five-year, $22 million project of the Robert Wood Johnson Foundation and the New Jersey Chamber of Commerce Foundation that is working to transform nursing education in New Jersey. As a volunteer, she explores innovative roles for nurses and ways to increase faculty capacity in the state. She is also a representative of the Organization of Nurse Executives of New Jersey.
Brennan earned her associate’s degree in nursing at Staten Island Community College in New York and went on to get a bachelor’s degree in nursing at Pace University and a master’s degree at Hunter College—both of which are also in New York.
Her first job was as a staff nurse at a Downstate Medical Center in Brooklyn. From there, she began a long climb up the nursing ladder that has taken her to administrative heights at several hospitals in New York and New Jersey.
She joined St. Joseph’s Healthcare System seven years ago and has no plans to leave, particularly because she strongly supports the organization’s mission to deliver high quality care with a special concern for the poor.
“I am truly committed to working with culturally diverse populations,” she says. “I believe it’s my calling.”
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Investing in Talent, Strengthening NJ’s Health Care Workforce

A hallmark of the New Jersey Nursing Initiative’s (NJNI’s) work is bringing together partners from vastly different organizations and industries to work together to analyze challenges and brainstorm solutions. On November 19, NJNI convened a meeting of New Jersey-based philanthropic organizations to discuss innovative ways to address the states nurse and nurse faculty workforce shortages. The meeting, co-sponsored by the Council of New Jersey Grantmakers, the New Jersey Chamber of Commerce Foundation and the Robert Wood Johnson Foundation, brought new voices to the table, and was a first step in building collaborations in other areas.
New Jersey’s “Void” in Educating Nurses
According to Poonam Alaigh, M.D., M.S.H.C.P.M., F.A.C.P., commissioner of the New Jersey Department of Health and Senior Services who briefed participants at the meeting, the state’s health care workforce shortage is real and poses dangers to our residents. She said more should be done to avert a crisis. “I hadn’t realized how much of a void we have when it comes to educating more nurses. This is critical,” Alaigh said.
Robert Wise, Susan Bakewell-Sachs, and Pamela Dickson at NJNI’s November 19 convening.
Wise, Bakewell-Sachs, Dickson
The nursing community needs to be part of the solution, Commissioner Alaigh said. She said her Department is looking at ways to invest in talent and build a stronger, more diverse health care workforce, and that recruiting and retaining nurses and nurse faculty is a key part of that effort.
Increasing training in health information technology, simplifying graduate medical education funding and enhancing loan redemption programs are some of the ways the state is working to address the looming health care workforce shortage. Alaigh encouraged funders to look at ways to work collaboratively to enhance the work taking place at the state level. She also noted the creation of a state initiative to seek out innovative solutions and replicate them elsewhere.
Building the Health Care Workforce
The new statewide Health Care Workforce Council is expected to play a significant role in meeting the state’s future health care needs. It is chaired by Robert Wise, president and chief executive officer of Hunterdon Healthcare, and member of NJNI’s Leadership Council. The Health Care Workforce Council was created under the direction of Governor Chris Christie, and is part of the New Jersey State Employment Training Commission.
“Before we pull the trigger on solutions, we really need to organize,” Wise said. “The Health Care Workforce Council intends to bring disparate groups together so all ideas can be discussed. Getting questions on the table is the first step, looking at solutions is the next step. We are looking for the ideas that are worth funding and replicating.”
The Council will work to identify priorities and solutions for the state. It is unique because the coalition that won the grant for the Council was comprised of non-traditional partners, including unions, higher education representatives, health care organizations and more. Wise invited those at the meeting to join the new initiative.
Maximizing Impact through Collaboration
In keeping with the theme of collaboration, Joan Hollendonner of the Horizon Foundation for New Jersey shared her experience applying for and being granted a highly competitive Partners Investing in Nursing’s Future (PIN) grant this fall. PIN is a collaboration between the Robert Wood Johnson Foundation and Northwest Health Foundation. The $245,000 grant awarded to the Horizon Foundation is being matched by local philanthropic organizations, and it will help improve the skills of graduate nurses seeking their master’s degrees in New Jersey.
According to Hollendonner, the grant is especially noteworthy because it brought together a diverse group of foundations. She shared the process used to secure participation from diverse groups, noting that in the end “the funders all love the collaboration and the people involved in the project.”
Participants discussed other dynamic ways that collaborations are making a difference across the state and the country. Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., program director for NJNI, spoke of the urgent need to “Jersify” creative initiatives that are taking place elsewhere in the country.
Bakewell-Sachs challenged participants to reflect on ways to include non-traditional partners in future work to support the state’s health care workforce. “How can we bring all of these ideas to bear in a state that is just now learning to collaborate?,” she asked, pledging to ensure that continuing to build and strengthen collaborations will remain one of the highest priorities for NJNI.
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Did You Know?

The New Jersey Nursing Initiative’s website has county-specific information related to nursing and health. See the resource section.
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Newsletter Issue 4: October 2010

In This Issue:

NJNI Announces New Cohort of Scholars
Four Scholars Work Together, Create Model for Portfolio Development
Leader’s Column – NJNI’s National Advisory Committee
Leaders in Nursing Education Add Mentoring to Job Responsibilities
Horizon Foundation to Help Graduate Nursing Students
Did You Know…?

NJNI Announces New Cohort of Scholars

The Robert Wood Johnson Foundation (RWJF) New Jersey Nursing Initiative (NJNI) is proud to announce the members of the second and final cohort of RWJF New Jersey Nursing Scholars. Each of these nurses will participate in the NJNI Faculty Preparation Program and receive a scholarship covering tuition, a stipend to cover living expenses for the two to four years spent as a full-time student, and a laptop computer.
The 20 new Scholars are:
·         Jamie Boman, Fairleigh Dickinson University
·         Ruta Brazaitis, William Paterson University
·         Christine Brewer, Fairleigh Dickinson University
·         Catherine Carlton, Fairleigh Dickinson University
·         Tammy Cooper, University of Medicine and Dentistry of New Jersey
·         Diane Cukrow, Fairleigh Dickinson University
·         Marjory Deslume, Fairleigh Dickinson University
·         Caitlin Fett, The College of New Jersey
·         Nancy Flood, Monmouth University
·         Marlin Gross, Richard Stockton State College
·         Stephanie Henson, Richard Stockton State College
·         Karen Hoary, Monmouth University
·         Renee Kurz, University of Medicine and Dentistry of New Jersey
·         Tony Malek, Fairleigh Dickinson University
·         Alexander Manning, The College of New Jersey
·         Janice McConnon, Fairleigh Dickinson University
·         Nancy Mills, University of Medicine and Dentistry of New Jersey
·         Shelby Pitts, University of Medicine and Dentistry of New Jersey
·         Grace Qarmout, Fairleigh Dickinson University
·         Laura Zakresky, Kean University

Four Scholars Work Together, Create Model for Portfolio Development

In the fall of 2009, four newly-mintedRobert Wood Johnson Foundation New Jersey Nursing Scholars faced a challenging but exciting task: each had to begin creating a teaching portfolio—a document that provides key information on their competencies, service and scholarly work, a curriculum vitae and more. The portfolio serves as a record of each Scholar’s career in academia and is a key component of the New Jersey Nursing Initiative’s Faculty Preparation Program. The four were embarking on a difficult task that would be required of all Scholars in the program later.
“Part of our goal with the Collaborative Learning Community (CLC) is to push the boundaries of traditional nursing education beyond where they’ve been before. We want our Scholars, who are the future of nursing education, to look at challenges in a new light and to work collaboratively as much as possible,” said Diane Billings, Ed.D., R.N., F.A.A.N., the chancellor’s professor emerita at Indiana University’s School of Nursing in Indianapolis and director of the Faculty Preparation Program’s CLC. “Their portfolio development is a testament to that collaboration and it will serve as an invaluable resource for many others,” she added.
 
“Harder than Hard”
Patricia R. Reineke, Ph.D., R.N., assistant professor at the Henry P. Becton School of Nursing and Allied Health at Fairleigh Dickinson University (FDU), coordinates the Scholars work on portfolios. She runs a weekly seminar for the Scholars that alternates between FDU and Monmouth University. Reineke says that, initially the Scholars had difficulty with the portfolio project because they began with a blank template and only a vague notion of the educator competencies that they will master during their studies.
“It was harder than hard,” agrees Michelle Skiber, R.N., B.S.N., of Monmouth University. She and her three colleagues—Latoya Rawlins, R.N., B.S.N., also of Monmouth, and Andrew Fruhschien, R.N., B.S.N. and Erin Cleary, R.N., B.S.N. of FDU—are all part of the schools’ masters collaborative and all struggled with the portfolio development task early on. In the fall semester, as the Scholars were just beginning their studies, they told Reineke that they did not have much information to include in their portfolios.
So Reineke edited the template portfolio document to allow for a more comprehensive view of each of the education competencies required by the New Jersey Nursing Initiative and the National League for Nursing. She brainstormed with the Scholars on how their varied experiences in the Faculty Preparation Program were helping them meet their education competencies.
The “Aha Moment”
A critical part of the Scholar experience is the mentoring provided by experienced nurse faculty. Reineke asked each Scholar to begin a mentoring and reflection log that would include the date, the activity and a reflection of their thoughts on what they did and what they would do going forward. She instructed Scholars to keep track of all of their activities: mentoring experiences, classes, faculty meetings, and more.
“[The log] became the evidence of what they were doing. It enabled them to see if the experience they put in is one they’d like to take to another level,” said Reineke.
Reineke quickly saw that the reflective logs became the “aha moment” in the portfolio development process. “It showed them that they had the educational competencies there, and we listed them out to clearly demonstrate what they’d accomplished. It nicely illustrated for them everything they’d done in their first year. They were very proud,” she said.
Working Together
The Scholars regularly discussed their portfolios with one another and brainstormed ways to build their experiences. “We all worked together and used each other’s ideas; the portfolio template was a collaborative effort,” FDU’s Cleary said.
“There were plenty of things that we hadn’t thought were that important to include, but we quickly saw that they were, because they demonstrated our experiences,” added Fruhschien. Scholars might not have logged meetings with professors on curriculum development, even though they contributed to the process, he explained. By including that in the log, they were able to demonstrate their experience in that area.
Rawlins added that it was important to start early on the portfolio development, because waiting until later in the year could make the process more overwhelming than it already was. She said she and her colleagues are looking forward to helping the next cohort of Scholars with their portfolios.
“The greatest thing about the Faculty Preparation Program has been the outstanding amount of support we’ve received,” added Rawlins. “To have so many people supporting your transition from bedside nurse to educator is really wonderful. It makes it so much easier and I am very grateful to the program. This portfolio is something we will use when we go out to look for work as nurse faculty.”

Leader’s Column – NJNI’s National Advisory Committee

By MaryAnn Christopher, R.N., M.S.N., F.A.A.N., NJNI National Advisory Committee Chair
Guiding the work of New Jersey Nursing Initiative (NJNI) is the National Advisory Council (NAC) made up of leaders from as far north as North Dakota, to the west (Texas), south to Mississippi, as well as local opinion leaders from New York and New Jersey.  They represent former elected officials, lobbyists, state government decision makers, educators, and of course nurses.  Together, since our formation, the NJNI NAC has been thoroughly engaged and excited by the work of the program, whether it was interacting with the Faculty Prep Scholars or strategizing with the staff of the program office as to how we can impact policy in the long run.
This group of volunteer leaders has gone beyond the roles of typical board members, seeking to get directly involved in the mentoring and development of the scholars—our future nurse faculty.   They have broken up into subgroups to identify opportunities to ensure that the scholars are exposed to the policy process, understand board structures all with the goal of helping the scholars begin to develop their social networks and recognize the role and responsibility they have beyond the classroom.  In some cases this means connecting them with leadership programs that exist within nurse education, such as the great work of Sigma Theta Tau. In other cases, it means making them aware of the state policy making process here in New Jersey.
As colleagues, NAC members have helped us understand the impact of the economy on NJ’s budget, as well as, assisted in tracking the progress of health reform and its impact on nursing.
We are living in a time when resources are stretched and the role of nursing and nurse education is in flux.  Having a board that can guide the program office through these turbulent times will be critical to ensuring NJNI succeeds.

Leaders in Nursing Education Add Mentoring to Job Responsibilities

Two senior nurse faculty in New Jersey are helping young nurses make the often challenging transition from clinical practice to the classroom.
Throughout their careers, David Anthony (Tony) Forrester, Ph.D., R.N., A.N.E.F., a professor at the University of Medicine and Dentistry of New Jersey School of Nursing in Newark, and Gloria Essoka, Ph.D., R.N., C.P.N.P. a visiting professor of nursing at Seton Hall University in South Orange, have made personal commitments to mentor new nurse faculty members.
In doing so, both are helping schools of nursing retain faculty—a key goal of the New Jersey Nursing Initiative (NJNI), which aims to ensure that New Jersey has the well prepared, diverse nurse faculty it needs to meet the demand for health and health care. NJNI is supported by the Robert Wood Johnson Foundation (RWJF) and the New Jersey Chamber of Commerce.
Mentoring the Next Generation
For Forrester, mentoring new nurse educators is a high-priority endeavor. In addition to his primary role as a nursing professor, he also serves as professor in residence/ interdisciplinary health research consultant at Morristown Memorial Hospital. In this capacity, he helps nurses complete original scientific research and evidence-based practice projects and launch successful scholarly careers.
“It’s very gratifying,” he says, noting that several of his nursing protégées have papers that have been published or accepted for publication in academic nursing journals. “A great part of my job is to help them succeed and then stand aside and cheer them on by saying, ‘Ta Da!’”

Essoka has taken a more informal approach to mentoring. Over the course of her career, she has taken it upon herself to help 15 to 20 young nurse faculty members navigate the often turbulent waters of academic nursing.
During the year, she identifies a novice educator who is struggling with the transition to academia and initiates a series of informal conversations about everything from teaching to research to personal life. She advises her mentees about research projects, edits papers before publication, and helps them manage the classroom.
“I feel that if one is able to help others along the way, then he or she should just do it,” she says. “I like to see people who have potential be able to make some progress.”
Essoka has mentored many neophyte faculty, but one woman—a single mother whom she describes as “rough around the edges”—stands out. Essoka shepherded this struggling mom through her early career and into her current role as a tenured professor in New York.
 
Success as Educators, Researchers and Community Leaders
Forrester and Essoka have had long, successful careers as professors, researchers and leaders in their communities.
A nurse educator for more than three decades, Forrester earned widespread acclaim in the 1980s and 90s when he published the first true clinical HIV/AIDS research in nursing literature. He has since published extensively in areas including critical care family needs, minority men’s and women’s health, and physical restraints management. He also serves as a peer reviewer for a number of professional and scholarly nursing journals.
He is currently conducting funded research into the effects of gum-chewing on patients who have undergone abdominal surgery. The results are not yet in, but he hypothesizes that chewing gum on a prescribed schedule will help prevent surgery-related complications.
Forrester has also taught a range of courses to nursing students at all points on the education spectrum. He is currently devoting most of his teaching time to students earning their doctoral degrees in urban health systems (Ph.D.) and nursing practice (D.N.P.). He teaches courses in health care policy and law, leadership development for new faculty, and a graduate-level cognate course in nursing education.
Whatever the course, he says he always keeps his role as a mentor in mind. “When I teach students, I teach them as a faculty mentor,” he says. “I am always trying to role-model expert faculty leadership behaviors.”
For her part, Essoka adds mentoring to her long list of responsibilities as a department chair. She also provides leadership in the two departments that she chairs, develops schedules, recommends faculty for appointments, actively participates on various committees, and advises students.
Essoka says she has always considered helping others part of her job, even though it hasn’t always been part of the job description. At one point in her long career, she worked at a day care center and conducted physical examinations for children, advised parents about pediatric health and held classes on issues such as immunizations, injuries and health maintenance.
She did similar work at a residential camp for inner-city children, whom she says she could relate to after growing up poor herself. “Because I grew up in that same kind of environment, I have a more realistic perception of what it is that people can do, what they can afford, and what’s realistic,” she says. “And I am able to speak in lay language.”
Essoka spent two years working as a nurse educator in Malawi, an experience she considers to have been the greatest cultural adventure of her life. Her major contribution was helping faculty transform the curriculum into a baccalaureate program.
She is a member of the Advisory Board of the Minority Nurse Leadership Institute, housed at Rutgers, the State University of New Jersey, where she has served as a mentor.
One high point of her scholarly career came when she and a colleague studied the effects of children’s perceptions of their own health. They found that children who were disabled perceived themselves as healthy as long as they were able to take care of themselves. That perception helped motivate these children to engage in more independent self-care and boosted their self-esteem.
Essoka plans to continue her mentoring and volunteer work. After she retires in a few years, she plans to volunteer at a homeless shelter for women and children and at a literacy center for the blind, where she can use her skills as a nurse practitioner and educator.
She also plans to travel to her husband’s native Cameroon to teach nursing courses to university students and advise nursing faculty on curriculum development. “I cannot imagine having had a richer, more stimulating and satisfying career than I did as a nurse educator,” she says. Through my work, I have cared for the sick, educated countless students, and mentored faculty for the future.”

Horizon Foundation to Help Graduate Nursing Students

The Robert Wood Johnson Foundation (RWJF) and the Northwest Health Foundation (NWHF) recently named the Horizon Foundation for New Jersey as one of nine recipients of new grants, as part of Partners Investing in Nursing’s Future (PIN). This unique national initiative is helping to find innovative ways to create an adequate nursing workforce appropriate in size and equipped with the specific skills necessary to meet the changing demands of the 21st century patient population.
The New Jersey Nursing Initiative will work with the Horizon Foundation to launch an online program, Nursing Academic Resource Center of New Jersey. NJNI and nine New Jersey nursing programs[1] will launch the on-line Academic Resource center to assist nurses in their first year of graduate study to succeed in their pursuit of a master’s degree. Nurses who attain a master’s degree become eligible to continue their careers and become nurse educators.
The on-line Center includes a virtual platform for assessments and advanced skills work including ESL students, and faculty training and evaluation of students’ progress. The program will be piloted with 1,000 first-year master’s students for two years in nine nursing programs in the state.
The PIN program provides support to local and regional philanthropies to act as catalysts in their own communities and to develop strategies for creating and sustaining a viable nursing workforce. Additional local funders who partnered with the Horizon Foundation for New Jersey include the Healthcare Foundation of New Jersey, Johnson & Johnson, The Edward W. and Stella C. Van Houten Memorial Fund and the Verizon Foundation.

Did You Know…?

There is a 7 percent vacancy rate for nurse faculty in New Jersey.  With the economic crisis and state budget shortfalls continuing, institutions may choose to eliminate vacant positions, which would exacerbate the faculty shortage. Cuts in nurse faculty positions would result in fewer students being accepted into nursing schools, including graduate programs that position them to educate the next generation of nurse faculty.
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Newsletter Issue 3: May 2010

In This Issue:

Joel, Johnson Are Models for Future Nurse Education Leaders in New Jersey
Leader’s Column
– The Salary Question
Mother-Son Duo Forge Parallel Paths in Nurse Education
Did You Know…?
NJNI on National Stage on Behalf of Nurses
Call for NJ Nurse Leaders

Joel, Johnson Are Models for Future Nurse Education Leaders in New Jersey

New Jersey boasts some of the brightest stars in nursing education, but there is an urgent need for more luminaries—and more nurse faculty—in the state.
To ensure that New Jersey has the well prepared, diverse nurse faculty it needs to meet the demand for health and health care, the Robert Wood Johnson Foundation (RWJF) and the New Jersey Chamber of Commerce launched the New Jersey Nursing Initiative (NJNI) last year. The goal of the program is to develop nurse faculty leaders like: Lucille Joel, Ed.D., R.N., F.A.A.N., a professor of nursing at Rutgers, the State University of New Jersey, and interim director of the school’s Ph.D. Program; and Barbara Ann Johnston, Ph.D., R.N., C.N.E., the Hess Endowed Chair for Nursing Education and professor of nursing at Monmouth University in West Long Branch.
After more than three decades in nursing education, Joel and Johnston have become influential leaders in nursing education in New Jersey—each in her own way.
A Scholar and Leader
Joel has become renowned for combining her academic responsibilities with advocacy work in local, national and international nursing communities. For her, no two days are the same. She may spend one day teaching a class on health care trends or interviewing techniques, another day coaching doctoral students about how to publish their research findings, and another day at an international association discussing immigrant nurses.
“I believe nurse faculty have a responsibility to be visible and active in their professional community,” she says. “So, many of my days are spent at meetings in other states or with foundations, hospital associations, or state nurses associations.”
Joel is currently project director of the NJNI Faculty Preparation program at Rutgers, which aims to shape the next generation of national leaders in academic nursing through career development awards. She has been the first vice-president of the International Council of Nurses, and served as president of both the New Jersey State Nurses Association and the American Nurses Association. She is the immediate past president of CGFNS International (formerly the Commission on Graduates of Foreign Nursing Schools), which screens foreign health care workers who are seeking occupational visas to immigrate to the United States.
An Active Life Onand OffCampus
Similarly, Johnston says variety is the spice of her professional life as a nurse educator. When she’s not preparing for or teaching courses in advanced pathophysiology, education, and wellness and aging, Johnston spends her time serving on university committees, writing grant proposals and conducting research.
Off campus, she has also served as a nursing representative on the United States Pharmacopeia, a non–governmental entity that sets standards for drugs and other health care products sold in the United States. She has served as a board member on a state Geriatric Society; was an alternate delegate to the White House Conference on Aging; and is currently a faculty mentor to RWJF New Jersey Nursing Scholars.
“Each day has variety,” she says. While the bulk of her time is spent with students, research on medication management for the elderly is also a high priority.
When elderly patients go to see a doctor, Johnston says, they often come out with another prescription to add to their list of medications. But these patients often end up in the hospital with unintended medication problems. Being cared for by several doctors and using several pharmacies sometimes lead to duplication of medications and uncoordinated medication schedules, she says.
“Things are improving in many long term care institutions,” she says. “But problems still do occur, particularly for those elders living at home.”
Research to Improve Health and Health Care
Johnston is currently studying tools that will assist nurse practitioners and nurses evaluate patients taking multiple medication regimens to provide for patient safety and reduce polypharmacy. The tools will come in handy especially in areas like Monmouth County and nearby Ocean County, both of which have high populations of senior citizens.
She has also recently completed research that showed that the presence of an on-site pharmacist at nursing homes helps ensure that medications are properly administered via feeding tubes, and reduces over-medication in elderly patients. The study was conducted on a national scale.
The first phase of the study—called “A Survey of Texas Long-Term Care Facilities to Determine the Characteristics of Medication Administration through Enteral Feeding Tubes”—was funded by grants from Texas Tech University.
The second phase of the survey—called “A Nationwide Survey of Long-Term Care Institutions to Determine Characteristics of Medication Administration through Enteral Feeding Tubes”—was funded by the Gustavus and Louise Pfeiffer Research Foundation.
Survey results were published in the journal Nutrition in Clinical Practice.
Joel’s most recent area of scholarship involves immigrant nurses. While president of CGFNS International, she became concerned with the situations encountered by recent nurse-immigrants that hampered their adjustment to the U.S. workforce. She found that foreign nurses’ adjustment to practice in this country was linked to their comfort with idiomatic English, their understanding of the U.S. health care system, and their ability to become assertive advocates for their patients.
Joel has also written and edited numerous books and journal articles on the nursing profession, psychiatric nursing, and advanced practice nursing, among other topics. But policy remains her chief area of interest. “[I’m committed to] working with nursing groups to secure legislation that would profit the profession and subsequently also profit the public,” she says
Both women work with students to complete their scholarly projects.

Leader’s Column – The Salary Question

By Catherine Alicia Georges, EdD, RN, FAAN, NJNI National Advisory Committee member

Without the teachers, there would be no students. Here in New Jersey and nationwide, we are finding ourselves in the increasingly challenging situation where there are fewer nurse faculty than are able to meet the demand from students. In fact, more than half of all nursing schools in New Jersey are turning students away because of a lack of faculty, even though the demand for nurses will be greater than ever as the baby boom generation ages and chronic disease spreads.
Nurse faculty play a vital role in our health care system, with nurse faculty careers providing some of the most rewarding and challenging opportunities. But for far too long, the nurse faculty career has failed to draw compensation that is comparable to those of other nursing fields. A recent Advance for Nurses 2010 salary survey of nurses working in the Greater New York/New Jersey Metro Area finds that nurse faculty earn nearly 20% or $17,000 less than advance practice nurses, on average.
Admittedly in lean economic times it is difficult to advocate for pay increases. But if we are to adequately address our state’s growing health care needs, we must act now to ensure that nurse faculty are compensated fairly. Low salaries can and do discourage highly qualified nurses with advanced degrees from choosing a career as nurse faculty, though more are desperately needed. In New Jersey, the average age of nurse faculty members is 55, and many are nearing retirement age.
We must devise creative solutions, encourage innovative partnerships and find new and sustainable sources of funding to provide the economic support our academic leaders urgently need.
The New Jersey Nursing Initiative is doing its part to help alleviate the nurse faculty shortage. We are currently in the process of selecting the second and final cohort of Robert Wood Johnson Foundation New Jersey Nursing Scholars. These include some of our state’s best and brightest young nurses who have decided to pursue a nurse faculty career. In so doing, they will have the opportunity to influence countless nurses and make their mark on the future of nurse education. But even so, the salary question remains, and will continue to discourage otherwise promising candidates from pursuing a nurse faculty career.
The time is now upon us, and we must strongly encourage our state’s leaders to prioritize the issue of nurse faculty salaries. To learn more about the issue, visit www.NJNI.org.


Mother-Son Duo Forge Parallel Paths in Nurse Education

Robert Scoloveno and his mom are both leaders in nursing education. She is the interim dean of the graduate school of nursing at Rutgers, and he’s earning his nursing doctorate.
Robert Scoloveno, M.S., R.N., left home decades ago, but he still sees his mother, Mary Ann Scoloveno, Ed.D., R.N., all the time. That’s because they both spend their days on the campus of Rutgers, the State University of New Jersey. Mary Ann Scoloveno is a nursing professor and the interim associate dean for the university’s graduate school of nursing, and Robert is earning his doctoral degree in nursing at the university and working part-time as a simulation coordinator.
“It’s strange,” Scoloveno says. “I see a lot of the same people now who I remember seeing as a child. I see nurses who she taught at work and I see the instructors who she’s mentored or worked with.”
Scoloveno grew up in New Jersey, where his mother worked as a pediatric nurse practitioner at a local doctor’s office. Mary Ann Scoloveno was a beloved figure in the community, Scoloveno says, often offering medical advice and treatment to friends, family members and neighbors who came knocking on the door of his childhood home or who called her with late-night questions about their children’s health.
“She was looked on quite favorably, especially by her patients,” Scoloveno says.
Scoloveno Inspired to Consider Nursing as a Second Career
But it wasn’t just his mother who left a positive impression of nurses on Scoloveno. Nurses, he says, helped his wife recover from a stroke she suffered as a young adult and helped his son survive after a premature birth. Together, the nurses in his life inspired Scoloveno to consider a second career in nursing after he lost his first job as an optician in a retail store in Somerville, New Jersey. That nurses continue to be in high demand also influenced his decision to leave the optical field, he says.
So instead of pursuing what he feared would be another dead-end job as a retail optician, Scoloveno decided to follow his mother into nursing and nurse education.
In 1999, Scoloveno earned his associate degree in nursing at Raritan Valley Community College in Branchburg, N.J.; he then went on to earn a bachelor’s and master’s degrees in nursing from Rutgers. In 2006, he took an opportunity to become a clinical instructor in nursing at Rutgers, and quickly realized that he shared his mother’s passion for teaching. “I saw it as an opportunity to affect the whole process,” he says. “I wasn’t just caring for one or two patients in the Intensive Care Unit. I was teaching 30 students every semester.”
Pursuing an Advanced Degree as Nurse Faculty
Last year, Scoloveno decided to dive deeper into nurse education. He applied for a scholarship from the New Jersey Nursing Initiative, a project supported by the Robert Wood Johnson Foundation and the New Jersey Chamber of Commerce Foundation. He was one of 29 outstanding nurses accepted to the program in 2009 and is now working toward his Ph.D. in Nursing. He studies resilience in adults diagnosed with chronic illness.
The New Jersey Nursing Initiative aims to increase the number of nurse faculty in the state so that there will be enough nurse educators to meet projected patient demands. More nurse educators will enable nursing programs to accept more applicants, which will help ensure that all state residents have access to adequate nursing care.
Each New Jersey Nursing Scholar receives a scholarship covering tuition and fees at their host institution for two to four years, an annual stipend of $50,000, and a laptop computer. Scoloveno gets the added bonus of seeing his mother and her colleagues on a regular basis. Witnessing the positive legacy his mother has created as a nurse makes it “a lot easier” during challenging times to know he made the right decision for himself, he says.

Did You Know…?

By 2020, New Jersey is expected to have a projected shortfall of at least 40,000 nurses.

NJNI on National Stage on Behalf of Nurses

The New Jersey Nursing Initiative (NJNI) was delighted to have one of its representatives take part in the recent release of a groundbreaking Robert Wood Johnson Foundation survey conducted by the Gallup Organization on the role of nurses in health care reform.
Richard Hader, R.N., Ph.D., F.A.A.N., senior vice president and chief nursing officer at Meridian Health, serves as co-chair of NJNI’s “Create Innovative Approaches to Increase Faculty Capacity” working group. Hader spoke at the official survey release in Washington, DC, in January, as part of a panel of national nurse experts.
“Actions speak louder than words and we should begin with educating ourselves by identifying the key components regarding health care reform. Seeking the answers to pertinent questions such as: ‘As a nurse leader, how will health care reform change my strategic focus for my area of responsibility?’ is necessary,” said Hader. “Nurses need to become politically astute to insure that our opinions are heard and acted upon.”
For the survey, Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions, Gallup interviewed key opinion leaders including insurance, corporate, health services, government and industry thought leaders as well as university faculty, and found that these opinion leaders see significant barriers that prevent nurses from fully participating as leaders in health and health care. Yet an overwhelming number said they thought nurses should have more influence. The survey was the first of its kind to be conducted on the perceptions of the role of nurses in health care reform.
Hader’s work with NJNI focuses on increasing the efficiency and flexibility of nursing program delivery, and addresses faculty retention issues. His work at Meridian Health has helped establish the innovative Georgian Court – Meridian Health School of Nursing, a four-year, baccalaureate program that is helping improve recruitment and retention.

Call for NJ Nurse Leaders

This month, two New Jersey-based nurse leaders graduated from the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program, highlighting the accomplishments of the state’s nurse leaders and underscoring the need for more nurses in the state to step forward.
The New Jersey Nursing Initiative’s (NJNI) Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., Carol Kuser Loser Dean and Professor of Nursing, School of Nursing, Health, and Exercise Science at The College of New Jersey, andGloria McNeal, Ph.D., A.C.N.S.-B.C., F.A.A.N, are New Jersey’s newest Executive Nurse Fellows, 2007 cohort, becoming part of a national network of experienced executive nurses trained to lead and shape the U.S. health care system of the future.
As NJNI’s program director, Bakewell-Sachs is giving voice to the urgent need to solve New Jersey’s dire shortage of nurse faculty, and reaching out to educators, health executives, businesses, policy-makers and others to design collaborative, sustainable solutions to the nurse faculty shortage. Until recently, McNeal chaired NJNI’s working group on “Create Innovative Approaches to Increase Faculty Capacity”, and in January she was named founding dean of the Mervyn M. Dymally School of Nursing at Charles Drew University of Medicine and Science in Los Angeles. NJNI’s National Advisory Committee member Nelson Tuazon is also an RWJF Executive Nurse Fellow, 2008 cohort.
“The Executive Nurse Fellow program provides an exceptional opportunity for nurses to take their leadership to another level and receive invaluable mentoring and policy experience,” said Bakewell-Sachs. “With the wheels set in motion for health care reform, New Jersey needs more of our talented senior nurses to apply for this program and learn how to best project the nurse voice in our state’s policy decisions.”
The three-year fellowship is open to nurses in senior executive roles in health services, (including patient care service, integrated delivery systems, health plans, and other health organizations engaged in organizing and delivering health care); public/community health; and nursing education. The next call for applications will be issued in the fall of 2010.

Newsletter Issue 2: January 2010

In This Issue:

Victory: New Law Aims to Alleviate New Jersey’s Nurse Faculty Shortage
NJ Nursing Scholars Convene at Annual Meeting
Leader’s Column – Identifying Critical Resources
Building a Collaborative Learning Community: Q & A with Diane Billings
RWJF New Jersey Nursing Scholars Go Way Back
Did You Know…?
Toward Creating a Business Alliance
Nation’s Top Experts Re-Envision Clinical Education

Victory: New Law Aims to Alleviate New Jersey’s Nurse Faculty Shortage

New Jersey became the 17th state to provide loan forgiveness for nursing faculty on January 16 when Acting Governor Stephen M. Sweeney signed the Nursing Faculty Loan Redemption Program Act into law. The state senate passed the bill unanimously on January 11, declaring a nursing workforce shortage of “crisis proportions” caused, in part, by a shortage of faculty members at the state’s schools of nursing. The state assembly passed it earlier, on January 7.
The new law calls for the Robert Wood Johnson Foundation New Jersey Nursing Initiative (NJNI) to work with the Higher Education Student Assistance Authority to create incentives for persons to enter graduate nursing education programs by providing loan redemption in exchange for full-time employment in the state as a nurse faculty member.
“In New Jersey, as elsewhere, we are facing a debilitating shortage of nurse faculty, and as a result many of our schools of nursing are being forced to turn away qualified students who want to become nurses,” said Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., program director for NJNI and dean of the School of Nursing, Health, and Exercise Science at The College of New Jersey. “With so many nurses at or near retirement, the population aging and chronic diseases affecting more people, our state’s health care system will be strained to the breaking point. We commend lawmakers for passing the Nursing Faculty Loan Redemption Program to address this problem now, before it worsens. This law will have lasting benefits for our state’s health care system and its residents.”
The program will address the nurse faculty shortage by providing incentives for individuals to pursue masters and doctoral degrees in nursing. The minimum educational requirement for nurse faculty in New Jersey is a master’s degree in nursing (MSN), as set by the New Jersey Board of Nursing regulations. Upon graduation, the program will provide loan redemption in exchange for full-time faculty employment for five years at a school of nursing in the state.
The New Jersey Collaborating Center for Nursing at Rutgers reports that there are 567 full-time nurse faculty working in the state. Their average age is 55, and 74 of them are expected to retire within five years. More than half the state’s nursing schools already limit student enrollment due, in part, to limited faculty lines. For doctorally prepared faculty in particular, it can be challenging for schools to find qualified faculty applicants.

NJ Nursing Scholars Convene at Annual Meeting

Classes had started at their respective schools, but the first-ever group of Robert Wood Johnson Foundation (RWJF) New Jersey Nursing Scholars had never met face-to-face until now—the first New Jersey Nursing Initiative (NJNI) Annual Meeting in October. The two-day meeting was an introduction to RWJF and the NJNI, and an opportunity to learn more about what would be expected of them as Scholars and nurse educators.
“Your job is so critically important… You’re going to touch the entire health care system—New Jersey and beyond,” RWJF senior advisor for nursing Susan Hassmiller, Ph.D., R.N., F.A.A.N., told them the first morning. “You are answering the call to ensure that New Jersey has the well prepared and diverse nurse faculty it needs… We want New Jersey to be the go-to place for nursing and nursing education.”
NJNI is a five-year, multi-million dollar project of RWJF and the New Jersey Chamber of Commerce Foundation, which is transforming nursing education in the state and ensuring that it has the well prepared, diverse nursing faculty needed in the future. A major goal is to increase the number of nurse faculty in the state, so there will be enough nurses to meet the needs of state residents.
One component is the Faculty Preparation Program, which is providing full scholarships and $50,000 per year stipends to full-time masters’ and doctoral students who plan to become nurse faculty in New Jersey. In addition to scholarships and stipends, a financial incentive program will encourage the scholars to take faculty positions at New Jersey nursing programs. The 29 Scholars who attended the Annual Meeting are the first cohort. The Faculty Preparation Program has awarded $13.5M in grants to New Jersey based nursing programs and education collaboratives, each run by a project director.
Becoming a New Jersey Nursing Scholar
The meeting provided opportunities for the Scholars to network with one another, project directors, RWJF program officers and others. Scholars took the opportunity to discuss their shared excitement and anxiety, and acquire valuable advice from mentors and experienced teachers.
During a breakout session, Bob Atkins, Ph.D., R.N., an assistant professor in the College of Nursing at Rutgers and an RWJF Nurse Faculty Scholar, gave the Scholars advice on how to maximize their experience. Gwen Sherwood, Ph.D., R.N., F.A.A.N., professor and associate dean for academic affairs at the University of North Carolina at Chapel Hill School of Nursing, also shared her wisdom, discussing team dynamics and challenging the Scholars to evaluate how their beliefs, knowledge and experiences affect the way they view their upcoming journeys.
Building the Collaborative Learning Community
The Scholars will participate in a series of webinars, online discussions and face-to-face meetings as part of a Collaborative Learning Community (CLC) that will provide important lessons and information that will help them pursue their careers as nurse educators. [See NJNI Newsletter story: “Building a Collaborative Learning Community: Q & A with Diane Billings” in this issue for more information.]
Diane M. Billings, Ed.D., R.N., F.A.A.N., chancellor’s professor emeritus of nursing at Indiana University School of Nursing, Indianapolis, and facilitator of the CLC, led the scholars in a discussion about the role of the nurse educator. A panel of educators provided insights into what to expect in the classroom and in the academy as faculty members. They explained that nurse faculty are more than just teachers; they are researchers and mentors, and they give back to the community when they continue to practice as nurses.
Advice from Nurse Leaders
Patricia Benner, Ph.D., R.N., F.A.A.N., visiting professor at the University of Pennsylvania and professor emerita from University of California, San Francisco, gave the second day keynote speech, “Celebrating our Successes – Facing Our Challenges.” She drew on the results of the Carnegie Preparation for Professions Program study, the first national nursing education study in 30 years, to share best practices for compelling and effective teaching. Benner served as senior scholar on the Carnegie study research team.
The “Innovations in Nursing Education” session featured a panel of veteran nursing faculty, who discussed innovations and expanded on their respective topics in breakout sessions afterwards. Pamela Jeffries, D.N.S., R.N., F.A.A.N., A.N.E.F., associate dean of academic affairs at Johns Hopkins School of Nursing, talked about the use of simulations as practice, a teaching method and an assessment tool. University of Medicine and Dentistry of New Jersey at Newark School of Nursing professor David Anthony (Tony) Forrester, Ph.D., R.N., A.N.E.F., discussed ways the Scholars can enhance their students’ classroom experiences, as well as their own as educators. Diane Skiba, Ph.D., F.A.A.N., F.A.C.M.I., demonstrated how technology is being used in nursing education, from basic online courses to innovative, elaborate virtual reality classrooms.
“We are in an extraordinary place and time of aligning forces for transformative change,” said NJNI Director Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., who is the Carol Kuser Loser dean and professor of nursing at The College of New Jersey in Ewing. “We have the support of the Robert Wood Johnson Foundation. We have the engagement of the business community. We have faculty preparation scholars and program faculty committed to the future of nursing education, and a context of national expectation for improved health and health care.”
To learn more about the New Jersey Nursing Scholars, visit www.www.njni.org/nurse-scholars.

Leader’s Column – Identifying Critical Resources

By Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C., NJNI Program Director
The overall goal of the Robert Wood Johnson Foundation New Jersey Nursing Initiative (NJNI) is to ensure that New Jersey has the well prepared, diverse nurse faculty needed to educate nurses to meet the demand for health and health care in the 21st century. A key part of developing solutions to the projected nursing workforce shortage is identifying the resources we have available and where the need is greatest. This past summer, NJNI laid the groundwork with a statewide asset mapping project that is helping to detect the strengths and challenges facing the state’s nursing workforce.
Asset mapping is designed to identify people, places and other items in the state that can serve as resources as we work to eliminate the nursing shortage. To help us identify these resources, we hosted a series of regional meetings in July, with more than 100 experts from the nursing, education, business, health care and government fields providing key insights. The meetings took place at Cumberland Community College, co-hosted by the South Jersey Medical Center, at Fairleigh Dickinson University—Florham Park, and at the New Jersey Hospital Association.
The information we’ve been able to gather from our colleagues is impressive, and will soon be available on our website, www.NJNI.org. We have learned not only what resources we have, and how to best leverage them, but also what resources we lack and where. This information will be vital as we move forward.
Additionally, through social network mapping, we have been able to identify the nature of existing relationships, for example how well the nursing education community is connected to the business community and others. This will help us strengthen existing relationships and foster new ones where they are lacking—all with the goal of promoting nurse faculty capacity among traditional allies and new interested partners.
The asset mapping project has also brought to our attention innovative partnerships within the state that are already working together to address the nursing workforce and can help us replicate these successful models.
In all, we are off to a wonderful start to 2010, and are looking forward to working with you as we continue advancing our work! We are excited to share the asset mapping results, and to invite you to get involved and share your expertise as we make New Jersey a model for nursing and nursing education.

Building a Collaborative Learning Community: Q & A with Diane Billings

The Collaborative Learning Community (CLC) is a new and innovative approach to nurse education that enables participants to learn about timely topics and interact with each other and with leaders in the field. The program, a component of the New Jersey Nursing Initiative, blends face-to-face meetings and workshops with a series of Web-based seminars, or webinars, and online discussions. The 10-seminar program takes place over a period of two years and is open to Robert Wood Johnson New Jersey Nursing Scholars, faculty, mentors and others interested in improving nurse education.
The program is led by Diane M. Billings, Ed.D., R.N., F.A.A.N., the chancellor’s professor emerita at Indiana University’s School of Nursing in Indianapolis. Excerpts from a recent interview with her follow:
Q: What are the goals of the Collaborative Learning Community?
A: We’re hoping that Scholars get to know and learn from each other and that they share resources with one another. We also hope to use the program to develop a sustainable model for schools across the state to cultivate, recruit and retain nurse faculty.
Q: How have you integrated technology into the program, and what have these innovations enabled you and the Scholars to do?
A: We are conducting a series of webinars for Scholars, faculty, mentors and other partner institutions that contribute to the Scholars’ development. We also host online discussion forums and post information about the program and other nurse education resources in the online component of the Collaborative Learning Community.
Q: How are the Scholars responding?
They are doing great. They are active participants; they are networking; they’re learning about their classmates’ views; they’re thinking and reflecting on their own practice as nurse educators; and they’re being thoughtful and sharing resources.
Q: You launched the CLC with a discussion you led about the role of nurse educators. What was your main message?
A: That there are many aspects to the role of nurse educator, from organizing clinical experiences, to classroom teaching, to learning about various teaching and evaluation strategies.
Q: What have other webinars focused on so far?
A: So far, we have focused on understanding the needs of students. In one session we discussed the diversity of student learning styles and skill levels, and in another webinar we had a panel of nurse educators who shared their expertise about the impact of race and gender in student learning. We also covered strategies to promote a multicultural learning environment for students.
Q: Can you give us a preview of what’s next?
A: We will have webinars about innovations in clinical teaching; technology and nursing education; and how to manage classroom challenges such as academic honesty and disruptive behavior.
Q: How has the program affected the participants?
A: The Scholars and the faculty are getting to know each other by participating in the webinars and in online follow-up discussions. We’re hoping to build these kinds of relationships so that students have a broad network of contacts throughout their careers. I’m especially pleased that the faculty who are working with the Scholars are also participating. It really enriches the community when the faculty and the student mentors and project directors are engaged.
Q: Why is this kind of community important?
A: We want New Jersey to be known as a place where teaching matters, where we have excellent, well-prepared faculty who are using the ‘best practices’ in nursing education.
Q: What do Scholars get out of the program?
A: The program enhances Scholars’ education and provides great networking opportunities that will help them now and down the road. Being a Scholar is a real entrée into professional practice.
 
Q: How will you evaluate the program?
A: We will continually evaluate the program. By the end of the two years, Scholars will have a portfolio of work they have completed that addresses the various competencies expected of a nurse educator. The Scholars, faculty and the RWJF evaluators and project team will use these portfolios to document the Scholar’s learning throughout the grant period.

RWJF New Jersey Nursing Scholars Go Way Back

Neighbors Tara Lynne Parker and Maryann Magloire-Wilson recently discovered they are members of the same small group of future leaders in nurse education.
Tara Lynne Parker, R.N., B.S.N., and Maryann Magloire-Wilson, R.N., B.A., see each other all the time: They live in the same small community in northwest New Jersey and send their children to the same elementary school.
But they never expected to bump into each other at the Robert Wood Johnson Foundation (RWJF) in Princeton, N.J.—some 50 miles away from their home in Allamuchy, N.J.
So when Parker saw Magloire-Wilson at the first collaborative meeting of the New Jersey Nursing Initiative last fall, she did a double-take.
“I thought to myself, ‘What a coincidence! That woman looks just like Maryann!’” Parker recalls. “I frantically searched through our directory and sure enough, there it was—Maryann Magloire-Wilson’s name.”
The two women—nurses, neighbors and friends—laughed when they realized they had one more thing in common: They are both RWJF New Jersey Nursing Scholars.
As such, they receive full tuition and fees to attend a graduate-level nursing education program, an annual stipend of $50,000, and a laptop computer. Magloire-Wilson is enrolled at the University of Medicine and Dentistry of New Jersey and Parker attends William Paterson University. The goal of the program is to build the supply of nurse educators in the state—a key way to ensure that New Jersey has an adequate, well-prepared nursing workforce in the future.
The two women also marveled at the fact that two people from a community of fewer than 4,000 residents were accepted by institutions participating in the Scholars program. “It truly is a wonder,” Magloire-Wilson says.
Their shared experience has given them one more thing to talk about when they bump into each other at neighborhood events or at the local school information night. “Having Tara to talk to has been an absolute blessing!” Magloire-Wilson says. “Who better would understand the demands of being a scholar, student, nurse, mother, and wife? It has been great to have a confidante that lives so close by!”

Did You Know…?

More than half of New Jersey nursing schools limit student capacity because of a lack of faculty lines and a lack of qualified faculty applicants.

Toward Creating a Business Alliance

Business leaders and health care experts gathered on December 8 to discuss the implications of health reform, resolving to create a Business Alliance that will develop collaborative solutions to the nursing shortage. The innovative Business Summit on Healthcare: A Framework for Reform was sponsored by the New Jersey Chamber of Commerce Foundation, Johnson & Johnson, the Horizon Foundation and the Robert Wood Johnson Foundation New Jersey Nursing Initiative.
The Need for Reform
“Costs have more than doubled in the last decade for employers. Health care spending is growing and we cannot afford to keep spending this much per year,” warned Katie Strong Hays, executive director of congressional and public affairs for the U.S. Chamber of Commerce.
Using Camden as a microcosm for the state, Jeffrey Brenner, M.D., department of family medicine at the Robert Wood Johnson Medical School, presented the findings of his detailed study on the costs and quality of local care. He found that a poorly managed health care system is costing New Jersey taxpayers millions of dollars annually, while providing less effective care to residents in need. “The bottom line is that businesses in New Jersey are paying a lot of money for poor quality care… Most of the fix to all of this is primary care and nursing,” said Brenner.
To better address the challenging heath care needs of his community, Brenner has created a pilot program that establishes neighborhood health exchanges that maximize physician and nurse effectiveness and reduce the need for costly emergency room visits. Through the Camden Coalition of Heath Care Providers, Brenner and his colleagues who are social workers, nurses, physicians, and hospital administrators are creating powerful solutions to the health care crisis that are inexpensive compared to hospitalization and emergency care and can be replicated elsewhere in the state.
Expert Panel Discussion
A number of speakers said that creating solutions to the looming nurse faculty shortage will be key to the success of health care reform. Susan Bakewell-Sachs, Ph.D., R.N., P.N.P.-B.C. dean of the School of Nursing, Health and Exercise Science at The College of New Jersey, Robert Wise, president of the Hunterdon Medical Center and Sonia Delgado, M.G.A, senior associate with the Princeton Public Affairs Group provided expert analysis of the current situation. Bakewell-Sachs warned attendees to expect “significant nurse retirements in the next five years.”
New Jersey should “consider creating a stimulus program for nursing” in the state, Wise said. He recommended that businesses view nursing as a “value and not a cost.” Wise encouraged greater nurse collaboration and said that solutions to the current crisis will be found locally. He urged participants to become involved in addressing issues related to the nurse faculty shortage and to pool local resources to best address the nursing crises in their communities.

Nation’s Top Experts Re-Envision Clinical Education

Leaders in innovation

Leaders in innovation, Yedidia, Weems, Teel, Murray, MacIntyre, and Joanne Fucello (L to R) exchange ideas during the Re-Envisioning Clinical Education conference.

Nearly 130 of the state’s leading nurse educators came together at The College of New Jersey on November 13 for the Robert Wood Johnson Foundation New Jersey Nursing Initiative’s (NJNI’s) groundbreaking conference, “Re-Envisioning Clinical Education.”The day-long event brought together leaders in both clinical and classroom education for frank discussion on ways nurse faculty can focus on quality and safety, incorporate innovative teaching and learning methods, and promote greater collaboration between academia and practice in order to better prepare the next generation of New Jersey’s nurses.

We need to “encourage inquiry. Inquiry will drive practice,” said Gwen Sherwood, Ph.D., R.N., F.A.A.N., professor and associate dean for academic affairs at the University of North Carolina at Chapel Hill, School of Nursing. Sherwood encouraged participants to “begin to view the role of the nurse as the driver of quality” in health and health care and, as such, guide their curriculum and students toward quality and safety.

Cautioning against a “we have always done it that way” mentality, Teri A. Murray, Ph.D., R.N., dean of the Saint Louis University School of Nursing, said “it really is time in nursing education for us to give up our sacred cows… Our model of nursing education is born out of tradition; it has not been tested.”

Murray discussed the need to abandon the “mother duckling” model of clinical education where success or failure depends solely on the strengths of the individual clinical nurse faculty member working with a group of students. Instead, she offered examples of innovative academic-practice partnerships that strengthen the educational experience, including: Dedicated Education Units in hospitals devoted to collaborative teaching with schools, and clinical collaboratives that place students with preceptors in a single health care organization and foster relationships between the schools and clinical partners. These groundbreaking new methods are taking hold in schools and clinical settings across the country, she said.

Other presenters included Michael Yedidia, director of Evaluating Innovations in Nursing Education; LaNelle Weems, M.S.N., R.N., project director of the Mississippi Office of Nursing Workforce; Cynthia Teel, Ph.D., R.N., associate dean of graduate programs, University of Kansas School of Nursing; and Richard MacIntyre, Ph.D., R.N., F.A.A.N., professor at Samuel Merritt University School of Nursing.

Conference participants discussed innovative clinical education strategies currently being used in New Jersey, and provided suggestions for improving communication between academia and practice. Their recommendations included regional meetings between schools of nursing and clinical partner leadership; engaging staff nurses more in education and planning; and creating an online discussion board or forum to share ideas.