Float Nursing on the Rise

Float Nursing on the Rise

Every hospital has stories of nurses who thrive by floating. More than likely, they have chosen to be part of the hospital’s float pool. Yet, for floor nurses who must take float assignments when their unit’s census is low or to fill staffing shortages across the hospital due to absences, vacancies, or high-acuity levels, floating can be a major source of job dissatisfaction. In the past decade, hospitals across the country have revamped their float policies to give nurses greater autonomy and agency in deciding whether or not to float. 

Risi Bello, RN, has been a float nurse at MedStar Washington Hospital Center in Washington, DC, for 12 years, and for the most part, loves it. The flexible schedule, the variety of clinical experiences, and the constant exposure to new patients and coworkers are what attracted Bello, 49, to floating in the first place. She’s only required to work a total of 48 hours over a six-week period, which she can work in either 8- or 12-hour shifts. Although two of her shifts have to fall on major holidays each year, the schedule has given Bello, a married mom of six, a work-life balance she might not have achieved had she been a floor nurse.

And watching Bello work on two different floors during separate shifts in late December, it was clear that she was comfortable wherever she went in the 926-bed hospital. She confidently cared for four patients she had met only hours before, knew where to access the floor’s medication and supplies, and updated patient records on a hand-held mobile device.

“You get to meet the best people in the hospital,” says Bello, a native of Nigeria. “It’s socially engaging and you learn a lot because you’re not stuck with a particular set of diagnoses.”

Tools for Success

In an essay published last year in MedSurg Nursing, Katie J. Bates, MSN, RN, reflects on recent research gauging nurses’ attitudes towards floating as well as her own experiences with it early in her career. Recent graduates and experienced nurses alike can feel “alone, anxious, and even incompetent when floated to other units,” if they haven’t received proper orientation, she wrote in her piece, “Floating as a Reality: Helping Nursing Staff Keep Their Heads Above Water.”

Nurses who float to unfamiliar units can get stuck either with less challenging patients or with the most difficult cases to give staff nurses a break. They may feel less productive as their time is spent searching for supplies or seeking help from nurses on the unit. These scenarios make the floating nurse feel “undervalued and expendable,” and patient care may suffer as a result, explains Bates, a critical care staff nurse at Good Samaritan Hospital in Puyallup, Washington.

Bates recommends creating tip sheets, informational packets, or pocket guides for float nurses that contain specific information about subspecialties. For example, “an orthopedic tip sheet may describe hip precautions for postoperative patients,” she wrote. Bates also suggests having a dedicated resource nurse in each unit who doesn’t take her own patients, but is there to assist nurses who float to the unit. Finally, Bates says the unit’s charge nurse should check in with the float nurse periodically to ensure she is comfortable with her patient load and responsibilities.

Bates acknowledges that budgetary constraints may preclude efforts to implement these changes. Yet additional resources and staff support are critical to turning floating into a positive experience, she argues.

Float Pools or Resource Nurse Teams 

In response to dissatisfaction floor nurses have expressed about mandatory floating, several hospitals have developed dedicated teams of full-time float nurses. At MedStar Washington Hospital Center, the float pool is composed of 91 nurses who are mostly full-time floaters, says Rosemarie Paradis, RN, MS, NEA-BC, CENP, FACHE, the hospital’s vice president of nursing excellence. Additionally, the pool is also staffed by nurses from other hospitals who want to pick up shifts on their off days.

Over time, the float pool has attracted new employees, with 20 nurses being added to the float pool in the past two years, according to Dennis Hoban, the hospital’s senior director of recruitment services. Float pool nurses, Paradis says, are expected to improve their skills and maintain their competencies just as floor nurses are.

While the hospital relies on the float pool first to cover deficiencies in staffing, occasionally staff nurses are called upon to float outside their home units. “As has been our normal practice, nurses float to areas that are similar to their own…and where they have the competency to work,” says Paradis.

In 2006, University of Utah Health Care’s University Hospital in Salt Lake City transformed its resource nursing unit—what the hospital calls its float pool—from an underutilized tool into a highly valued asset. Until that point, the nurses in the unit had been perceived as fill-ins and denied opportunities to take on challenging assignments and complex patients. Now, the 45 nurses in the unit are sought after by other units because the 654-bed hospital decided to invest in training them, explains Karen Nye, BSN, RN, the resource nurse manager.

“We have a timeline of expectations,” says Nye. “We make sure they have training opportunities within a certain date of their hire, and we make sure they adhere to that timeline.”

Now, resource nurses can earn advanced certificates in the ER, ICU, burn, and neurology units. The hospital’s AirMed medical transport team relies heavily on resource nurses since its work requires flexibility and versatility, says Nye. Most recently, a new cardiovascular ICU opened with the assistance of Nye’s resource nurses.

Since there is greater trust and utilization of resource nurses across the hospital, Nye preschedules them in units at risk of paying out too much overtime to staff nurses. The result has been a significant cost savings for the hospital. In five ICUs that accepted pre-scheduled resource nurses in 2010, there was a 62% reduction in overtime hours over a ten-month period, according to a 2011 nursing report published by the health system.

More Options for Staff Nurses who Float

Other hospitals have done away with mandatory floating by floor nurses altogether to boost employee morale and reduce turnover. In 2005, Aultman Hospital in Canton, Ohio, eliminated mandatory floating in response to frustration nurses expressed at being floated from their home units on days when patient volume or acuity was low.

The 808-bed hospital replaced its old float policy with a “Willing to Walk” program, which gives floor nurses the right to decline an offer to float without negative consequences, according to Eileen Good, MSN, MBA, RN, Aultman’s senior vice president for clinical advocacy and business development. Good oversaw the development of the program when she was the hospital’s chief nursing officer.

A floor nurse who declines to float to other units can either take time off without pay or use benefit time. Giving nurses choices and greater autonomy helped Aultman earn Magnet recognition from the American Nurses Credentialing Center in 2006.

Before Good proposed the “Willing to Walk” program, Aultman had developed specialty float pools of nurses trained to work in similar units across the hospital. Good noticed that only a few floor nurses were being floated each day because units were taking advantage of the specialty float pools, composed of 40 to 50 nurses. The rates of floor nurses required to float had decreased significantly. “If we could improve this process with float teams, then why couldn’t we just eliminate [mandatory floating]?” she asks.

As a result of these changes, Aultman reduced its turnover rate from 8.3% in 2007 to 4.3% in 2010. The hospital is in the process of reapplying for Magnet designation, says Good.

While Mercy Hospital, a 175-bed facility in Portland, Maine, hasn’t eliminated floating, it created a tiered system of compensation directly tied to the floating nurse’s competency level in 2007. The new policy was aimed at easing ill will on both sides of the float divide: nurses who floated felt unwelcomed and out of their depth when working in unfamiliar territory, while floor nurses resented the fact that float nurses were getting paid a higher daily rate regardless of their skill level.

Aside from compensation issues, there were also no clear expectations of float nurses or the units that received them, explains Scott Edgecomb, RN, RRT, CCRN, clinical nurse lead in the hospital’s critical care unit. “The expectation was that they would function at a pretty high level when they arrived,” says Edgecomb, a member of a retention and recruitment council that developed the policy. Yet, no structure had been put in place to ensure float nurses received adequate training.

The new policy created four distinct levels of competency for nurses who float, with Level One functioning as little more than “helping hands” on the receiving unit all the way to Level Four, demonstrating the highest level of competency and an ability to take complex cases on specialty floors. Now each level is compensated differently, replacing the across-the-board pay differential float nurses received before.

Edgecomb says the new float policy creates greater incentives for nurses to develop their skills, and that nurses who float now are most likely functioning at a Level Three or Four. Floating is no longer looked upon with dread, but as an opportunity to earn more and develop competencies in specialized units. And the recruitment and retention council has sought to mentor nurses who are proactively seeking floating assignments that expand their skill set.

“People were stepping forward and saying they were interested in assuming those higher level roles,” he says.

Floating as New Nurse Orientation 

Advocate Christ Medical Center in Oak Lawn, Illinois, has developed a new program that aims to introduce new nursing graduates to their professions through floating. The program aims to solve two problems: the high number of seasoned float pool nurses who were leaving the pool to take positions as floor nurses and the inability of new nursing graduates in the area—south of Chicago— to find jobs, explains Kristen Brown, MSN, BA, RN, CPN, the hospital’s professional nurse educator and nurse residency coordinator.

Growing out of Brown’s practicum requirements for her master’s degree, the program is starting small but could change the way the 695-bed hospital recruits its nursing staff. In 2013, the program’s pilot year, six nursing graduates were hired from over 100 applicants, and Brown plans to hire at least two more rounds this year.

Nurses in the new graduate float program receive a 12-week orientation and participate in a 12-month nursing residency program, where they receive training with content specialists and have a chance to interact with their peers. Once they start to float, they are sent to specific zones within the hospital—medical-surgical units, orthopedics, surgical trauma, and women’s surgery—where clinical coaches work with them one-on-one over a three-month period.

Brown says the program will enable the hospital to rebuild its float pool with clinically competent nurses. By moving away from hiring to a specific vacancy and capturing strong candidates early in their careers, the hospital can fill vacancies as they occur. It also gave new graduates a chance to learn about the health system and specialties they may want to explore in the future.

“This could be the way new nurses are hired here, potentially,” Brown says. “If you have high quality candidates, you don’t have to worry about finding a spot for them. You’ve got a continuous pipeline of individuals coming in.”

Archana Pyati lives in Silver Spring, Maryland, and writes frequently on health and science topics.


How to Land a New Grad Position in a Tough Market

How to Land a New Grad Position in a Tough Market

As graduation season quickly approaches, it’s time to start focusing on that first job.  It’s becoming increasingly difficult for new graduate nurses to find a job in some areas of the country.  New nurses can increase their chances of gainful employment after graduation by employing a few key tips.

Start the Job Search Early

If you’re a nursing student reading this blog and haven’t started your job hunt yet, do so NOW! It’s too tight of a market for new graduates to wait until they graduate to find a job. Start applying to jobs and externships a few months before graduation before slots fill up.


If you have already applied to a few jobs and haven’t heard anything back from HR don’t be afraid to call to check on the status of your application. Some may worry about upsetting the recruiter, but I’ve done this on numerous occasions to my benefit. The worse that could happen is they tell you they are pursuing other applicants. This is actually a good thing. You don’t want to be left wondering if HR doesn’t call back to let you know you weren’t a good candidate for the job. 

Network, Network, Network

Tell anybody and everybody you come in contact with that you are a nursing student on the verge of graduating…even if they don’t directly work in health care. You never know who is married to whom, or who has a brother/sister/mother who is in the field. If you know someone personally who works at a facility that can forward your resume to a key person, even better! Use networking to your advantage.

Don’t Be Too Picky

Many nursing students have a goal of landing their “dream job” immediately after graduation. Typically these areas are the ICU, ER, NICU and Pedi positions. I just want to be honest…these positions are hard to get as a new graduate because they are flooded with applications from hundreds of other new grads.

Keep your options open and make a short list of at least 3 areas you could see yourself working. I wanted to work Mother/Baby when I was in school until I did my clinical rotation and found it wasn’t for me. From there I thought ER would be best for me. When I graduated there were no ER positions open so I took a job in Neuro ICU. Looking back on my 9-year tenure in ICU, I can’t say I ever wanted to work ER after becoming a seasoned ICU nurse.

Be Open to Relocation or Commuting

I know this may be a difficult pill to swallow for some, but it’s not practical to think you’ll get a job at the sole hospital in town. Relocation or a longer commute may be necessary. With experience your chances of getting into the hospital of your choice may be easier.

In addition to working as a RN, Nachole Johnson is a freelance copywriter and an author with her first book, You’re a Nurse and Want to Start Your Own Business? The Complete Guide, available on Amazon. Visit her ReNursing blog at www.renursing.com for more ideas to reinvent your career.

Resume Mistakes You Don’t Want to Make

Resume Mistakes You Don’t Want to Make

Last week we reviewed key aspects recruiters look for in a resume.  This week we will focus on what recruiters don’t want to see on a resume and how to avoid getting your resume tossed in the trash.

I’ve had a few resume revamps over the years to reflect my evolving career as a nurse pursuing higher education or seeking out a new position. Over the years I’ve added sections, deleted sections and moved things around, but it was all built upon my original resume written years ago.

Each time I completed a resume revamp, I researched the latest in resume etiquette and found that a few aspects popular when I first started my resume are now considered a no-no, but I still see some people making the same outdated mistakes that may get their resume tossed in the trash before even getting to the hiring manager’s desk.

Here are a few resume don’ts to keep in mind for your revamp:

1. GPA. No one has ever asked me my GPA when interviewing me for a job.  Honestly employers really only care that you have a degree and experience for the job you’re applying.

2. Nursing License number. Placing your license number on your resume is unnecessary and an easy steal for identity thieves. Employers can look up your professional license number on your state’s BON.

3. References available on request. This is a statement that goes without saying and wastes valuable space on your resume. Leave it out and provide references when asked.

4. Photo. Unless you’re applying for a modeling or acting position, a photo is a no-no for your resume.

5. Unprofessional email address. Don’t apply for a job with an email address like [email protected] or [email protected]. This is unprofessional and an employer is likely to trash your otherwise stellar resume because of something like this. Set-up a new email account for job-hunting if you just so happen to have one of these cutesy email addresses.

6. Not tailoring to a specific job. Each resume you send out should be tailored to the specific job you apply for. This means adding specific keywords (see last post) for each job and changing your objectives section.

7. High school. High school education should be left out if you are not a new grad who completed nursing school right after graduating high school. Employers don’t really care about high school education if you’ve completed a college degree.

8. Hobbies. I have to admit, at one point in time I did include my hobbies and interests on my resume. This information is a bit too personal to include on a resume. What if you love the NFL team your interviewer hates? Or your political preferences don’t align with the interviewer? This is a no-win situation. Leave this section out of your resume.

9. Typos. Proofreading your resume for mistakes before submitting to an employer is critical. First impressions are important and nothing turns off hiring managers more than spotting typos in a resume. Typos make even the most qualified candidate for the job look unprofessional

10. Lie. This is a biggie. Lies on your resume is a no-no. This includes embellishing your title, education or work experience. Don’t leave out dates of employment; this is a red flag for employers who may think you are hiding something.

What other resume no-no’s have you seen? Leave a comment so we can talk about it! 

In addition to working as a RN, Nachole Johnson is a freelance copywriter and an author with her first book, You’re a Nurse and Want to Start Your Own Business? The Complete Guide, available on Amazon. Visit her ReNursing blog at http://renursing.wordpress.com.


Revamp Your Resume for Maximal Results

Revamp Your Resume for Maximal Results

As the year comes to an end many people start to evaluate their goals for the upcoming New Year. Typical resolutions like losing weight, saving money, and trying a new hobby prevail, but what if your resolution is to find a new career?

When one applies to a new job they usually submit a resume. As an applicant, you want to put your best foot forward. What may have worked for you 5 years ago may not work for the competitive job market now. A resume revamp is in order if you plan on changing specialties, the content is outdated, or you are a recent graduate.

My recent graduation from a Family Nurse Practitioner program prompted the need for a resume revamp. As a nurse with over 12 years of experience my resume was nearly 4 pages long and it didn’t embody all the qualities recruiters look for in an applicant.

What qualities do recruiters look for in a resume?

Four key aspects:

  • Concise: Keep it to 1-page; 2 if you have extensive experience. Obviously my old resume wasn’t concise. I’m surprised I’ve gotten so much attention in the past with a resume that long. We’ll see how much of a response I get from a 1-page resume.
  • Clear: Make sure your resume format isn’t cluttered and hard for a recruiter to read. If it is, it will surely be tossed in the trash no matter how qualified you are for the job. Also be on the look out for poor grammar and typos. This is another reason good applicants get overlooked for a job.
  • Consistent: Keep abbreviations contained within your resume consistent and make sure they are universally understood. Keep all fonts within the resume the same and no smaller than 11 point for easy readability.
  • Keywords: Many resumes submitted online go through a scanner, weeding those out that don’t have specific keywords for the position. This means your resume gets lost in cyber world before any human could lay eyes on it. Keyword examples for a nursing resume include: Registered Nurse (RN); health care; intensive care; admit; medication administration.

Use these tips to revamp your resume for maximal results…your new career in the New Year! Stay tuned for next week’s installment reviewing the most common resume mistakes people make.

In addition to working as a RN, Nachole Johnson is a freelance copywriter and an author with her first book, You’re a Nurse and Want to Start Your Own Business? The Complete Guide, available on Amazon. Visit her ReNursing blog at http://renursing.wordpress.com.

Hurricane Katrina: Two Years Later

Hurricane Katrina: Two Years Later

Cheryl Nicks, RN, CNNP, CGT, CLNC, CPLC, had heard the evacuation warnings before. As a New Orleans native and longtime resident of the city, she remembered the times she had piled her belongings into a car and then sat in gridlock, only to turn around and come home hours later.

So when the evacuation orders for Hurricane Katrina came that August weekend in 2005, the Nicks family, like so many others, planned to stay put and ride out the storm. But as the warnings became more urgent, they changed their minds. On Sunday morning, August 28, they headed to a hotel in northern Mississippi.

The normal four-hour trip took the Nicks family 12 hours and ended with everyone sleeping in their cars in the hotel parking lot—their rooms wouldn’t be ready until the next day. On Monday morning, August 29, they turned on the radio to learn that the levees in New Orleans had given way and the city was under 20 feet of water.

“We all broke down and cried, because we realized we no longer had homes to go back to,” says Nicks, a former president of the New Orleans chapter of the National Black Nurses Association (NBNA).

Two years later, virtually nothing is back to normal for anyone who lived through Hurricane Katrina, one of the strongest storms to impact the United States in the last 100 years, according to the National Oceanic and Atmospheric Administration. With winds reaching 127 mph, Katrina caused widespread devastation along the central Gulf Coast states. Coastal cities in Louisiana, Alabama and Mississippi—including New Orleans, Mobile and Gulfport—bore the brunt of Katrina’s force. More than 250,000 people were displaced and approximately 1,800 people lost their lives. Total damages were estimated to be more than $125 billion.

Many nurses displaced by the storm eventually came back to either little or nothing. Some chose to completely abandon the area and try to rebuild their lives in other parts of the country. Others lost their jobs because of the extensive damage to medical facilities. And nursing students had to make decisions about whether to return to their schools or pursue their degrees elsewhere.

A Future in God’s Hands

The Friday before Katrina struck, Carolyn Mosley, PhD, RN, CS, FAAN, left the Louisiana State University Health Sciences Center School of Nursing in New Orleans, where she was a faculty member, for a scheduled business trip to Knoxville, Tennessee. Thinking the hurricane was headed toward Florida, she took little more than the clothes on her back.

When the forecast changed Friday night, giving the hurricane a 95% chance of hitting New Orleans, Mosley urged family members to leave, then tried to get home to pack up her belongings. She got as far as the Dallas/Fort Worth International Airport, unable to find a flight into New Orleans or a rental car to take her there. She wound up staying with friends in Fort Worth. The next morning, she attended her friend’s church and was struck by the minister’s sermon.

“He talked about not putting all of our hopes and trust in material things, but to place it in the Lord,” Mosley recalls. “That was a very poignant moment. I felt as if he were talking directly to me. I realized I was not going to get off so easily.”

Watching the devastation unfold from Fort Worth, she waited to hear if her family had made it out safely. She soon learned that her mother, sister and a nephew were in a New Orleans hotel room.

“[My nephew] was telling me about how they lost power, how hot it was in the hotel, how there was no running water, how much water was outside, how high [the flood water] was, and that there were bodies floating all around,” she says. She later found out that her own home and a rental property she owned were a total loss.

Mosley spent the next several days gathering displaced family members from Houston, New Orleans and Arkansas at her friend’s three-bedroom Fort Worth home. After setting them up with temporary housing, she headed back to New Orleans and the LSU Health Sciences Center. The campus was severely damaged and is still rebuilding today. The university provides an ongoing “Katrina Facilities Update” on its Web site.

In the wake of the hurricane, the school arranged for a cruise ship to dock in New Orleans to provide temporary housing for faculty members who had lost their homes. Mosley stayed there for several months.

“I used to like cruises,” she says. But she soon found that being “stuck in that ship” was a far from pleasurable experience. “Just the tininess of the cabin, not being able to go anywhere, no TV, no radio, no telephone. To me it was very primitive.”

Facing eviction from the cruise ship in May and having nowhere to live since her family had all relocated, Mosley turned in her resignation and put her professional fate “in the hands of God.” Her prayers, she says, were answered by the College of Health Sciences at the University of Arkansas, Fort Smith, where she accepted a position as associate dean and director of BSN programs. She was recently promoted to dean and plans to retire in the job, but still hopes to rebuild her home in New Orleans.

Her experience as a Hurricane Katrina survivor taught her to stop taking things for granted, Mosley adds. “I enjoy life. I don’t plan to save anything,” she declares. “I want to spend [my life] from day to day because there is no guarantee that my body will be here to use the next day, and no guarantee that Mother Nature will allow me to [hold on to anything.]”

“It Will Never Be the Same”

As the current president of the New Orleans Black Nurses Association, Rebecca Harris-Smith, MSN, RN, has heard more than her share of stories about displaced nurses. She herself was one of them, as were many of her chapter members.

Harris-Smith, a nurse coordinator for a philanthropic organization that trains RNs to start health ministries in their churches, fled to Houston when Katrina hit. The national NBNA, based in the Washington, D.C. area, tracked her through her cell phone, and she was able to get on her computer and track down her chapter members. The national organization—with the assistance of NBNA members in 34 states—helped ensure that Katrina evacuees from all of the affected areas were provided with clothing, medications, medical care, financial assistance and other urgently needed goods and services.

After her home was destroyed, Dr. Carolyn Mosley lived on a cruise ship, then relocated to Arkansas.After her home was destroyed, Dr. Carolyn Mosley lived on a cruise ship, then relocated to Arkansas.

Harris-Smith stayed in Houston until October 2005, although she wasn’t called back to her full-time job until January. She was one of the lucky ones—her home in the West Bank area was not heavily damaged and she and her husband were able to move back.

Still, she says New Orleans is not the same city for her. “There are so many displaced loved ones and friends who will never be back,” she explains. “The city is struggling. The home I grew up in, near the Industrial Canal in the Ninth Ward, was completely washed away. I have friends who lost loved ones and family. How can you ever get that back? For me it will never be the same again.”

Harris-Smith continues to work with active chapter members who are still living in FEMA trailers and trying to rebuild their homes. Members were displaced to Houston, Atlanta and Mississippi, but many have returned to New Orleans.

“Just like anything else, it’s that family connection,” she says. “This is home. These are my people, so it’s like I just need to be a part of that.”

A Slow Restoration Process

Dillard University, a private, historically black university in downtown New Orleans, was devastated by Hurricane Katrina. The storm and flooding left the university’s classrooms and campus buildings under more than 10 feet of water.

For Dillard’s nursing school, it would be a year before students and faculty were able to resume classes on campus. Unlike other academic divisions at the university, the nursing school gathered its senior class—many of whom had fled to areas around New Orleans—and resumed instruction in temporary off-campus locations in September 2005, just weeks after Katrina hit, says Dean of Nursing Betty Dennis, DrPH, RN. The school worked with Southern University School of Nursing in Baton Rouge, another HBCU, to share classroom space and a skills laboratory, as well as to secure student housing.

Dillard’s sophomore and junior nursing students were more scattered throughout the country after the storm, so the nursing division worked with colleges and universities all over the map to help its displaced students enroll at those schools to continue their studies. “Many of the universities really were very cooperative in understanding what our students were going through and helping them to get through this without [having to interrupt their education],” Dennis reports.

By spring 2006, the entire university had relocated to the Hilton New Orleans Riverside Hotel on the Mississippi River. The university worked with the hotel to set up classroom space, with additional classrooms set up across the street at the World Trade Center of New Orleans.

With the consent of the Louisiana Department of Education, the university created two 13-week semesters, allowing students to stay on course with their studies. The Class of 2006 graduated in July rather than May, but the exterior of the campus was cleaned up enough to allow for a traditional graduation on the lawn of the Avenue of the Oaks on campus. Seven nursing students graduated with that class.

“Just about all of our students came back after the storm, which is a great testimony to the university,” says Karen Celestan, senior director of university communications and marketing. Two years after Katrina, the Dillard University campus is operating at about 75% capacity and will welcome its largest freshman class—250 students—this fall.

Even though the campus restoration is progressing, Dillard’s nursing school—along with every other nursing school in the Gulf Coast—continues to be tremendously impacted by Katrina. Many health care facilities still have not reopened, leading to a shortage of hospital beds. Before the storm there were more than 2,000 hospital beds in New Orleans. Two years later the city is still inching back, with less than 1,000 beds available.

“We need clinical facilities in order to implement the [nursing] program. When there are problems with the number of facilities and health care providers, there are problems with us finding the clinical experiences our students need,” Dennis says. “We are being very creative. We’re doing a lot of outreach, working together with other nursing programs. We’re doing all we can do to provide those experiences.”

Celestan says the university is probably three to five years away from being completely restored. The campus is still cleaning up, repairing damage and rebuilding what was lost to the storm. “Everyone is trying to get their programs back together,” adds Dennis.

Setting an Example

Dillard University nursing student Randi Horne attended classes in a Hilton Hotel. Dillard University nursing student Randi Horne attended classes in a Hilton Hotel.

Randi Horne was a sophomore nursing student at Dillard University when Katrina struck. She, too, didn’t take the hurricane warnings seriously at first, deciding to head back to her hometown of Houston only after a girlfriend called to offer her a ride. The normal five-hour trip took 10 hours.

Horne watched the news reports from Houston, waiting to hear something about her school. Instead of enrolling at another university, she decided to stick it out at Dillard. She’d already paid her tuition and she felt a sense of loyalty to her professors. So when the call came in spring 2006 to resume classes at the Hilton, she headed back to New Orleans.

The experience of going to school in a luxury hotel was “not as nice as it sounds,” Horne remembers. With no library facilities or the usual amenities available on a college campus, she had a hard time finding a place to study.

“Nursing students don’t just study in the daytime,” she explains. “We study at night and whenever we can find time.”

When big conventions came to town, the school had to give up its classroom space in the hotel’s ballroom. And when the students did have class, the divider walls did little to muffle the sounds of the class next to them.

“It was hard to focus, but we wanted to finish school, so that’s what we had to do,” Horne says. “We had to set so many examples for everyone because we wanted to show we could still come back and succeed [in spite of] the hurricane.”

Horne graduated this year and is in the process of weighing her nursing career options. The hurricane, she says, taught her to be flexible. “I learned to endure,” she emphasizes. “I’ve learned to be patient, to work with as few resources as possible.”

Welcome Relief

Joe Ann Clark, EdD, RN, is the executive director of the Louisiana State Nurses Association (LSNA), based in Baton Rouge. Shortly after the hurricane hit, the 1,079-member association established a relief fund to assist nurses displaced by Katrina.

To date, 228 nurses have received an average of $500 apiece from the fund, which is still collecting money and providing grants. Clark says donations have come in from all over the world from businesses, nursing organizations and individuals.

Although the applications for assistance have slowed in the past few months, Clark still receives pleas from displaced nurses trying to get back on their feet. “Many of the nurses had lost everything they had. Some of them were [displaced to other cities] but were still having to pay mortgages from New Orleans,” she says. “The stories on those applications are really horrific. Some of [these nurses] were very ill and had no income.”

An LSNA member is putting together a book about the relief fund recipients. The association plans to donate sales from the book, which should be finished by this fall, back to the fund.

The Mississippi Nurses Association (MNA), based in Madison, Miss., also established a relief fund for hurricane-affected nurses. Initially, about $80,000 from the fund was used to pay the licensure renewal fees for every nurse on the Mississippi Gulf Coast who needed assistance, says Ricki Garrett, MNA executive director.

The 1,800-member association has about $56,000 left in its fund and is working on how best to utilize the money to help the most nurses on the Gulf Coast. The fund received a $200,000 boost in April of this year, when Johnson & Johnson held a fundraising event. Garrett says those funds will be used for nursing scholarships, assistance to schools of nursing whose facilities were damaged by Katrina, and mental health continuing education.

“We are seeing a large number of nurses with chronic fatigue syndrome and mental health issues related to the storm,” she explains. “There are many nurses on the Gulf Coast who are still living in FEMA trailers two years after the hurricane. Those individuals are not only trying to work and take care of their patients, they also have to deal with insurance adjustors and FEMA and other government entities. In a lot of cases, more than one family is living in that FEMA trailer, so you can imagine the stress levels of these people.”
Garrett predicts it will be at least 10 years before the Gulf Coast is completely back to normal. “People thought if they survived Hurricane Camille in 1969, nothing could be worse than that,” she says. “Katrina was so many hundreds of times worse than Camille.”
In Mississippi, the requests for help from nurses, nursing schools and students have not slowed, even two years later. MNA members have made several trips to the coast to bring relief supplies to hospitals, clinics and schools. Scrubs, stethoscopes, watches with second hands, toiletries, clothes and books are all items in demand.

Garrett says it’s easy for people who live in other parts of the state to forget what’s happening on the coast. “The nurses in the Mississippi Gulf Coast are still struggling daily,” she maintains. “We hope people will remember that.”

No Place Like Home

After the storm, Cheryl Nicks and various members of her family scattered to Arkansas, Atlanta and Baton Rouge, marking the first time in 40 years the tight-knit family was not all living in the same city.

When Nicks finally saw her New Orleans home in October 2005, she was relieved to find it had taken in only two feet of water. Although mold was growing three feet up the wall, she realized it wasn’t a total loss after all. She moved back into her house, sleeping on a futon and cooking on an electric hot plate during the six-month renovation. She also returned to her job at New Orleans’ Touro Infirmary, a not-for-profit faith-based hospital.

“I needed to go home and be back in my house,” Nicks says, even though it was lonely and scary in her neighborhood for a while because so many residents had still not moved back. Today her house is 95% completed, but she doubts that many of her friends and neighbors will ever recover from the storm.

“We’ve lost families, communities, friends, neighbors, people who will never ever return,” she says, adding that the bodies of two childhood friends were found in the attic of their house during the recovery process.

Asked why she felt the need to return to New Orleans, Nicks’ reply is simple: “Where [else] do you go? There’s always going to be something—tornadoes, earthquakes, hurricanes. Where do you run to? I don’t believe you can run from disaster. This is where my roots are. My grandparents are buried here. This is home for me.”

Nursing School Enrollments Continue to Decline—But at a Slower Rate

A recent four-part study on the changes in the RN work force by Douglas O. Staiger, PhD, David I. Auerbach, PhD(c) and Peter I. Buerhaus, PhD, RN, FAAN, points to troubling implications for the already-dwindling RN profession.

The study found no evidence of any re-emergence of interest in nursing by first-year college students, based on a survey of freshmen over the last five years. Researchers believe this stems from a permanent shift in the labor market.

According to the third article in the series, “Expanding Career Opportunities for Women and the Declining Interest in Nursing as a Career,” published in Nursing Economic$, fewer women are currently entering the field of nursing because of expanded work opportunities for women over the last three decades in what were once male-dominated professions, such as medicine, law and business.

The authors state that while interest may regenerate in nursing, there will probably never be the same amount of women entering the field as there were in the 1970s, when women’s job opportunities were less varied.

The most recent study of nursing school enrollments by the American Association of Colleges of Nursing (AACN) also reflects this trend. According to the AACN, the year 2000 marks the sixth annual drop in baccalaureate nursing program enrollments and the third consecutive decline in master’s enrollments in as many years.

This downward spiral comes at a particularly bad time, as the demand for baccalaureate- and graduate-prepared nurses of all races and ethnicities continues to grow across the country. Hospitals, primary care facilities, home care agencies, outpatient surgical centers and other health facilities in many regions report an increasing shortage of registered nurses, threatening the nation’s ability to meet the health care demands of the future. The need for minority RNs is particularly imperative: As the United States’ racial and ethnic minority population continues to grow, so does the need for minority RNs who are able to provide culturally and linguistically competent care.

According to the AACN survey, nursing student enrollment in entry-level bachelor’s degree programs declined by 2.1% between fall 1999 and fall 2000, and master’s degree enrollments declined by 0.9%.

One year prior, however, enrollments fell even more drastically: Entry-level bachelor’s degree nursing programs had a 4.6% decrease in enrollments in 1999 and master’s degree enrollments fell by 1.9%.

AACN President Carolyn A. Williams, PhD, RN, FAAN, says of the slowing decline, “Hopefully we are witnessing the early effects of the last two years of widespread media coverage on the emerging nursing shortage.”

One statistic that would seem to support Williams’ view is the doctoral program enrollment statistic. This enrollment figure had remained stable for the last five years, but in 2000, it rose by 2.5%.

Just Published!

The Minority Nurse Spring 2018 issue is now available.

Improving Patient Care Through Unique Clinical Solutions

How Nurses Can Make Better Financial Decisions

 How to Protect Yourself from Stressful Work Experiences


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