Nursing school curricula and hospital-based training programs

AORN Journal, Dec, 2002 by Rick P. Ward, Collen Saylor

Current research shows that there is a shortage of licensed practicing nurses in the United States, and nursing is likely to experience even greater workforce shortages in the future. (1) Many believe that the current nursing shortage is the result of irregularities in supply and demand among the nursing workforce. In California, however, the shortage is more acute, and the demand for nurses is greater than ever because of the economic expansion and rapid population growth in California in the late 1990s. Increasing technology and the increasing prevalence of ambulatory care facilities have led to an increase in the number of patients who need nursing care accessing the health system. (2)

The current nursing shortage in the perioperative setting is the result of several social and technical trends. The social factors include an aging nursing workforce; an aging and chronically ill population that requires health care later in life; and technological innovations that create a changing, demanding, and fast-paced professional environment. (3) In addition, the lack of perioperative curricula in most schools of nursing and decreasing enrollments in many associate and baccalaureate degree programs result in fewer nurses who may be interested in perioperative nursing as a career.

In the large metropolitan area surrounding the city of San Jose, Calif, which is known as Silicon Valley, some hospitals have perioperative training programs in place for currently practicing nurses who are interested in moving into the OR; however, few, if any, of these facilities have preceptorship training programs in place for new graduate nurses interested in perioperative practice. The lack of perioperative curricula in local schools of nursing exacerbates the current and future perioperative nursing shortage because nurses are not being exposed to perioperative nursing during nursing school.

RESEARCH PROBLEM

In light of the current nursing shortage, this study was undertaken to determine whether there are training programs available and what, if any, perioperative curricula are offered at schools of nursing in Silicon Valley. Current perioperative staffing issues, the existence of perioperative training programs, and perioperative nursing school curricula in Silicon Valley became the focus of this study. The project evaluated whether training and socializing new graduate nurses into the perioperative setting would help alleviate staffing shortages. For this study, the perioperative setting is defined as the practice area--including preoperative, intraoperative, and postoperative clinical areas--in which a nurse ultimately is prepared to practice exclusively as a perioperative nurse. The variables of interest are

* local perioperative staffing issues,

* current facility-specific perioperative training programs available, and

* perioperative nursing curricula offered at local schools of nursing.

LITERATURE REVIEW

One main reason for the shortage of nurses is the aging of the RN workforce. Nurses have the most rapidly aging population of any occupation in the nation. For 17 years, from 1980 through 1996, the average age of the nursing workforce increased by more than four years--from 37 years of age up to 41 years of age--compared to a less than two-year increase in age for all other workers. During the same period, the proportion of the nursing workforce younger than 30 years of age decreased from 30% to 12%, and the actual number of working nurses younger than 30 years of age decreased by more than 40%. (4)

More than one-third of the nurses in California are 50 years of age or older, and nearly 15% are age 60 or older. (5) This trend indicates that fewer individuals chose nursing as a career during the past 20 years, and it shows that as the nursing workforce has aged, young nurses have not entered the profession in sufficient numbers to replace them. In addition, the current nursing shortage is not like the shortages of the past. It is driven by unique demographic issues and requires complex and far-reaching solutions that only now are being addressed by professional and government entities. (6)

Admissions to four-year and two-year nursing programs declined in the late 1990s and into the year 2000 as the expanding economy at that time provided many professional opportunities outside of nursing. Enrollments in basic baccalaureate nursing programs decreased by almost 5% in the fall of 1999, which was the fifth consecutive decline in as many years. (7) Another factor in the current nursing shortage is the age of associate degree program graduates versus the age of baccalaureate degree program graduates. In 1996, graduates of associate degree programs on average were 33 years of age versus an average of 28 years of age for graduates of four-year programs. (8)

On the demand side of the nursing shortage, there are some compelling social trends that are leading to the need for more nurses in the health care setting. These include an increasingly aging population, the rapid expansion of long-term care, and increased advances in and use of health care technology. In addition, improved approaches to primary preventive care, use of fiscal restraint in the health care setting, and increasing numbers of individuals with health care insurance are significant indicators of an increasing demand for nursing services in the future. (9)