Scott Gelzer Sue Schuler Paula Lucey

4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Scott
Gelzer
 Sue Schuler
 Paula Lucey
Greater Milwaukee Foundation
Aurora Foundation
Rogers Memorial Hospital Foundation
United Way of Greater Milwaukee
Faye McBeath Foundation
 Local,
regional or statewide private, family,
independent or grantmaking community
foundations and public charities were eligible
 10 awards of up to $250,000 were made
annually (2006-2010) for projects lasting
two-three years
 Local foundations/other funding partners
matched awards with at least $1 for every $1
awarded
 Priority areas included faculty development,
diversity, geriatrics, public health,
collaboration, leadership
PIN is a partnership
of the Robert Wood
Johnson Foundation
and the Northwest
Health Foundation
to encourage local foundations to act as
catalysts and develop strategies needed to
create and sustain a stable and adequate
nursing workforce.
 Philanthropy
was grantee; each partnered
with relevant local nursing organization(s) – 1
or more
 National and local commitments to technical
assistance, collective problem-solving, and
leveraging resources
 All participants engaged in local and national
evaluation and follow-up for sustainability of
partnerships
1
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 50 partnerships in 37 states and the
Western Pacific Island territories
 More than 230 funders including private
foundations, hospitals/systems,
workforce development agencies,
economic development programs,
private industry
 Nearly $10,000,000 matched locally
 More than 550 individual partnerships
established in local communities;
an average of 10 partners per project
 Foundation
established in 1964;
sunset in 2014
 Major areas of interest: children; aging
and elders; health; health education; civic
and governmental affairs
 Private, independent foundation that has
engaged in numerous funding and
partnership projects
 PIN
took us to a higher level of
functioning, combining the roles of
grantee and grant maker
 Funds
are general in nature and support
the project as a whole, allowing maximum
flexibility in allocating resources to
students, faculty, employers and others to
make things happen
 Project
sunsets in September 2014
2008
2006
2007
2010
2008
0
2007
2009
2008
2010
10
2009
2009
2007
2010
2009
2008
2006
2010
2008
2008
2007
2009
2007
2008
2010
2007
2009
06
06
2009
2006
2007
2008
2007
2006
2010
2007
2007
‘ 06
‘06
‘09
2007
2006
‘09
2008
0
6
All Partners (50 Partner Sites)
Pacific Islands PIN (2008) not shown
 Partnership
led by the Faye McBeath
Foundation, local health systems, schools
of nursing and community service
providers
 Third
party evaluator is an academic
partner, Medical College of WI
 Project
provides nurses with a “voice” in
various policy & resource settings
 25%
of families are impacted by mental
health issues
 Workforce has decreased as Colleges have
decreased exposure to mental health care
situations and media has often re-enforced
stigma
 Evolution to community mental health
means nursing role has to evolve as well
 Changes occurring in Milwaukee area and
across the state
2
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Nursing
has lost it’s voice in mental health
 Too often seen as only having a technical,
skill role…
◦ Medications
◦ Physical Assessment
◦ Physical needs
 We seem to have lost our role as leaders in
Mental Health
The research agenda includes the following
steps:



To assess the demand for mental health nurses
in Greater Milwaukee currently and in the near
future
To upgrade the skills and knowledge base of
practicing mental health nurses
To encourage more student nurses to choose
mental health as a focal point in their career
 The
state RN survey in 2010 found only
494 WI nurses identified as MH nurses
(Source: WI Center for Nursing)
 90% are Caucasian, 6% are African
American
 93% are female
 41% are over 50 years of age
 41% work in acute care settings
 Fewer than 4% have a Masters Degree
 Designed
to help transform mental health
services through enhancing the role of nurses
in providing and managing care for mental
health consumers
 Created several active discussion forums –
educators & employers, mental health nursing
instructors and an active advisory committee
 Conducted original research on mental health
nursing
Research has been carried out through a
partnership involving the Public Policy Forum
and two Jonas Scholars (Jonas Center for
Nursing Excellence) who are PhD students at
Marquette & UW-M.
 Assistance has also been provided by WCN
 Long Range Goal: Data-informed strategies and
actions for a redesigned mental health system
 Through this approach, Nursing’s Voice and its
partners can improve the quality of service for
and quality of life of consumers
 120
mental health nurses
and 34 employers
responded to a 2012 Public
Policy Forum survey,
developed with WCN
 Questions addressed
nursing skills &
competencies of existing
workforce and recent
nursing graduates, as well
as employer demand and
employee satisfaction
3
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Findings
showed both agreement and debate on
current skills, training needs and job satisfaction

 Employer

 Priority

respondents projected a demand for
additional nurses in mental health
Nursing skills include: understanding
dual diagnosis and/or co-occurring disorders,
including appropriate treatment options or
protocols
 Most
important is to understand the person’s
bio-psychosocial and spiritual needs
 Mental
health nurse satisfaction comes from
working with patients
 Employers
and nurses disagree about the most
important skills and competencies for a patient’s
recovery
 However,
there is agreement about specific skills
 For
instance, co-occurring treatment is a priority
for both sets of respondents, training for nurses
is imperative
 Create
a mechanism for continuing education
 Support
updates & revisions in Bachelor’s level
mental health nursing education
 Support
to APN

for academic progression, i.e., Bachelors
Support selected pilot projects
 Clarify
the role of the nurse in outpatient setting,
as part of a team approach to recovery
 Create
additional opportunities for students
interested in MH nursing


There is a definite need for nurses with an interest in
mental health now and in the future
Few area nurses are nationally certified or advanced
practice nurses (APN’s)
Schools of Nursing are providing a basic foundation
in mental health nursing, however deeper knowledge
and clinical experience is lacking in many programs
RN role in MH settings is often unclear
Redesign needs to consider the optimal role for RN’s
and APN’s, both working solo and in teams with
allied professions, including certified peer specialists
 Aging
MH nurse workforce
related to the end of the
recession
 Reduction of MH curriculum in some area
Schools of Nursing; fewer course hours
and less clinical experience
 Students often encouraged to go in to
acute care nursing prior to selecting a
specialty
 Retirements
Supported
2 curriculum initiatives, one
new APRN program at Alverno and a
curriculum re-design at Cardinal Stritch
Created a pilot internship program for
nursing students
Supported a Scholars in Residence
program for faculty at Behavioral Health
Acute Care Hospital
4
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Mission
of supporting PhD students to
earn their degree, develop leadership
skills, and become faculty
 Nursing’s Voice funded a student from
UW-M and Marquette University, both in
their nursing PhD programs
 The students chose to survey
undergraduate students about their
attitudes and interest in Psych/mental
health nursing
 Results
confirm the need to expose
students to a mental health experience
early in their nursing education
 More
exposure though education and work
experience results in increased
preparedness and less anxiety and
stereotypes about working with this
population
 Stigma
issues remain but seem to decrease
as knowledge and exposure increases
 Leadership
◦ Every nurse is a leader and we need mental health
nurses to lead the revolution to quality community
care
 Dementia
◦ Plan to update educational staff on care of
individuals with dementia and different diagnosis working with Alzheimer’s Association
◦ Resources for staff and families
 251students
from 8 nursing schools in
Milwaukee Co. responded to a 2013 survey
 The
focus of the survey was to measure the
nursing student’s attitudes toward and interest in
mental health nursing
 This
is the first known survey of students of this
magnitude in the U. S.
 Survey
results show that stigma is a challenge for
many nursing students; there are available
educational strategies which appear to reduce
this stigma
 Goal
was not to offer clinical updates but
to discuss issues of importance to current
mental health nurses
 Hosted
two well attended dinner events
 Stigma
◦ Connected with WISE
◦ How can Nurses help reduce stigma
 Compassion
Fatigue
◦ Issue for mental health nurses
 Many
community based mental health
nurses work in smaller organizations
 Benefit
from opportunity to meet other
nurses and share stories
 Students
nurses
attend and network with working
5
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Based
on work done through a parallel
grant, we have created a handbook with
several modules that can be used for
orientation of nurses new to mental health
 Recognize
that many work for smaller
organizations with limited nursing
education
 Have
 Called
together educators to talk about
curriculum
 Shared
resources between faculty
 Defining
needs for clinical sites
 Networking,
many had not met each other
ability to add modules
 The
curriculum review revealed significant
differences in theory and clinical hours
allocated to MH in Milwaukee area
Baccalaureate Nursing programs
 Some
programs integrate MH concepts into
other nursing courses and other have a
dedicated course in Psychiatric Nursing
 There
are a limited number of clinical sites
available and finding and developing new
sites take extensive faculty time
 Created
an employment based internship
program for nursing students
 Students
are hired by employers with
financial and educational support from
Nursing’s Voice
 Opportunity
nursing
to learn about mental health
 Called
both groups together in order to
discuss needs
 Fruitful discussion but employers were
under-represented
 Needs of employers and product coming
from schools is not matching
 Area that needs some additional
development, we are going to call together
again
 One
focus is to get organizations without
nurses to hire interns to see the potential
value of a nurse
 To
manage this, developed a roving
mentor with expertise in mental health.
This allows the intern to have a mentor
6
4th Annual WCN Conference
Breakout B: Building a Sufficient and Competent Nursing Workforce to Serve Persons with Mental Illness: A Collaborative Model
 Another
area of interest to Nursing Voice is
the promote inter-professional education
 Completed
 Working
 Key
with Medical College of Wisconsin to
look at comparable needs for education potential related to suicide education for
residents and NPs
 Also
working with MCW to develop a series of
Webinars on Community Mental Health as a
possible prototype for a certificate program
 Published
an OP Ed in the Milwaukee
Journal to share the importance of
developing the nursing workforce for
mental health and the role that nursing
provides
 Alverno – APRN
 Cardinal Stritch – New BSN
 Milwaukee Homeless Vets
 Scholars in Residence
 Jonas Scholars (2)
 Level
of success is often determined in the
planning stage
 Value of community expertise is equal to that of
research and academe
 Parity of community in-kind resources & cash
 Must be at least one academic and one
community champion
 Sustainability discussions should begin in the
first year
 The larger the funding required, the earlier the
conversation should happen
project with national expert to
plan for future
components to sustain are the internship,
employer/education communication and
on-going education and networking
opportunities for current mental health
nurses
 Raising
Nursing’s Voice in Mental Health Care
 Fundraising
 Form
is not partnership
teams to apply together
 Community
Foundations, supporting
Organizations & United Ways are possible
candidates
 Embody
the PIN strategy
Paula Lucey
Nursing’s Voice, Director
[email protected]
Sue Schuler, MSN, RN
Project Mental Health Nurse Consultant
[email protected]
Scott Gelzer
The Faye McBeath Foundation
[email protected]
 http://publicpolicyforum.org/sites/default/files/
NursingsVoiceSurveyBrief.pdf
 http://www.partnersinnursing.org/
7