Participants introduce themselves at HealthImpact’s nursing forum at WesternU Dec. 8, 2016. (Alexander Atjet, WesternU)

Nursing leaders discussed how to improve the health of Californians by improving nursing education at a special meeting held at Western University of Health Sciences in Pomona, California Dec. 8, 2016.

HealthImpact, formerly the California Institute for Nursing & Health Care, stopped at WesternU as part of its “listening tour” to review and discuss its “Nursing Education Plan White Paper and Recommendations for California.” The document provides recommendations and strategies to prepare nurses for an ever-shifting health care environment, and serves as a call to action for nursing education and practice. The recommendations include creating multiple entry points into nursing education, influencing nurses to continue their education, and promoting lifelong learning.

Nursing educators from WesternU, Cal State San Bernardino, North-West College, Azusa Pacific University, Loma Linda University and other institutions joined clinicians and other stakeholders at the meeting, where questions and open dialogue were encouraged.

HealthImpact is updating an influential 2008 white paper that has served as a guiding document for the profession.

“With the pace of education, we knew it was important to reconsider what needs to change going forward,” said Carolyn Orlowski, MSN, RN, HealthImpact’s Southern California Regional Director. “We’re really talking about enhancing the health of Californians through nursing.”

Fourteen percent of U.S. nurses live in California, so “people look to California for nursing education and practice change,” Orlowski said.

“Through it all we tried to challenge each other to be bold, to think big, and not just arrive at standard answers that are easy to come up with,” said Dr. Cindy Greenberg, acting associate dean for Cal State Fullerton’s College of Health and Human Development.

The white paper has five recommendations – five interrelated concepts that prepare nurses for the future. The first recommendation is to build strong academic-practice partnerships along the continuum of care. The second is to promote academic progression for all registered nurses to obtain a BSN or higher degree by 2030. This is a challenge because it has been a polarizing conversation in past years. But institutions offering associate degrees should collaborate rather than compete with those offering bachelor’s, master’s and doctoral degrees.

“How can we best meet needs in a way that we’re not competing, but rather streamlining and advancing all levels?” Greenberg said. “How can we eliminate barriers?”

Some associate degree programs have agreements with other institutions so nursing students are taking courses that best position them to advance without hidden prerequisites.

“There is a consensus that nurses should have at minimum a bachelor’s degree, but we need to rely on prelicensure programs to do an excellent job. Most of the diversity in nursing comes from community colleges,” Greenberg said. “Community college is phase one of your career.”

“This is the beginning, not the end,” Orlowski said. “Once you get your bachelor’s degree, it’s not the end.”

The third recommendation is to create career pathways, develop programs and provide resources to assure a well-prepared and diverse nursing faculty. The fourth recommendation is to establish transition-to-practice residency programs for all new graduates and nurses transitioning to new specialties and roles.

“Anyone transitioning into a new role in practice should have a transition or mentoring plan in place,” Orlowski said. “This must happen for all nurses, whether you’re transitioning as a nurse practitioner (or) whether you’re a newly licensed nurse. There must be programs in place. It’s a resource issue.”

The fifth recommendation is to provide transformative learning opportunities that prepare nurses for evolving roles in rapidly changing interprofessional practice environments.

“We know there will be dramatic changes to health care in the future,” Greenberg said. “We must be thinking about how to address that, how are we preparing practitioners who are prepared to step into those roles. It’s all about improving health care outcomes.”

College of Graduate Nursing Interim Dean Mary Lopez, PhD, RN, said HealthImpact is pulling together multiple constituencies in California to improve nursing education and health outcomes throughout the state.

“WesternU is a leader in nursing education and health outcomes. We need to be at the table and part of this, which is why it’s important to be part of this meeting,” she said. “We’re pleased with the turnout and with the mixture of the types of partners in the room. I think this is going to move the conversation forward.”