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Source: https://centerforactivedesign.org/ariaapartments

 

Over the past several years, I’ve been covering efforts to promote healthy communities in ways that will foster health among individuals and communities in ways that can reduce the need for acute care services and, concurrently, health care spending.

There is growing recognition that stable housing is key to health and coordinated health care. Someone who doesn’t have stable housing can be lost to health care providers, impeding the ability to work over time to help people better manage their chronic illnesses. And being homeless is associated with myriad health problems, both physical and mental. This has become so important that states such as New York are exploring ways to improve health outcomes and reduce health care spending by providing stable housing for people.

But the link between housing and health goes beyond just having a stable home. Evidence is mounting that demonstrates that how the housing is designed is key to health. The New York State Health Foundation is funding work to design low income housing in the Bronx and Brooklyn that promotes the active engagement of residents and enhances their possibilities for health.

Leading this work is the Center for Active Design, a non-profit organization that uses design to foster healthy and engaged communities. Today on HealthCetera, producer and  moderator Diana Mason, PhD, RN, interviews Joanna Frank, Executive Director of the Center for Active Design.

So tune in on Thursday, April 6, 2017, to HealthCetera Radio on WBAI, 99.5 FM in New York City or streaming online at www.wbai.org. Or you can listen anytime or download the interview by clicking here:

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This article was originally published by Kentucky Health News. Reprinted with permission as part of the CHMP Nursing and Healthcare Workforce Media Fellowship.

 

Some hospitals in Kentucky can’t find enough nurses; they and nursing colleges work toward short-term and long-term solutions.

Highlands Regional Medical Center interns (photo provided)

 

While studies show Kentucky will have a surplus of registered nurses in the next decade, right now many of the state’s hospitals are struggling to hire enough nurses to care for patients.

 

“I am hoping this is cyclical,”Susan Ellis, the vice president of Patient Care Services at Highlands Regional Medical Center in Prestonsburg, Kentucky, said. “But my fear is that this one is much deeper than any of the past nursing shortages that I have seen, and by deeper I mean it is spread much wider.”

 

 

Most of the state’s critical-access hospitals, which usually have fewer than 20 patients at a time, haven’t been hit by the shortage. But at any given time larger Kentucky hospitals may have between a 10 percent and 40 percent vacancy rate, Ellis said.

 

 

 

Highlands is a 184-bed facility that needs about 120 registered nurses in its clinical area and is about 24 short, or 20 percent.

 

“We are feeling it in our facilities,” Ellis said. “And surrounding facilities that I have spoken to, some of their chief nursing officers, they are feeling it too. . . . You really can’t run your facility without your registered nurses; they are at the patient’s bedsides.”

Chandler Medical Center, University of Kentucky (UKHealthCare)

 

The University of Kentucky, which operates a 569-bed hospital that largely serves Central and Eastern Kentucky, has also struggled with the shortage of nurses.

 

“I think most of the folks in Lexington who are trying to hire registered nurses would share a similar perspective,” Colleen Swartz, the chief nurse executive at UK HealthCare said. “For example, as recently as three years ago, which would put us in that 2013-14 time-frame, we would post a registered nurse position and get 20 applications for it, but right now we have positions that we have posted and re-posted and had no applicants.”

 

 

Kentucky has about 45,500 full-time employed RNs, whose average annual salary is about $60,000, according to the federal Bureau of Labor Statistics. The Kentucky Board of Nursing website reports 69,337 active RN licenses in the state.

 

The latest Kentucky Occupational Outlook to 2024 report said the state would need an additional 16,047 full-time registered nurses between 2014 and 2024, or a 36 percent increase from the estimated 45,086 in the 2014 workforce to the projected need of 61,133. “Health-care-related occupations are expected to grow at such a high rate primarily because of Kentucky’s aging population,” the report said.

 

By 2030, one in five Americans will be 65 or older, the U.S. Census Bureau predicts. The National Council on Aging says 80 percent of older adults have at least one chronic health condition, and 68 percent have at least two.

 

Peter Buerhaus, a health-care workforce expert at Montana State University, agreed that the aging population will increase the need for new nurses, but added that states should also pay attention to their retiring RN workforce because more than one-third of RNs are likely to retire over the next 10 years.

 

“One million nurses who are over the age of 50 are going to be retiring, and with that retirement goes an awful lot of knowledge and skill and experience,” Buerhaus said. “It is a major, major quantitative and qualitative change in nursing.” He added that health reform and the primary-care provider shortage, which is expected to worsen over the next 10 years, will also drive the need for more nurses.

 

Retirement does not appear to be as big a problem in Kentucky as in most states. The average age of a Kentucky nurse is 40; the national average is 50.

UK College of Nursing students practice (photo provided)

 

 

Swartz said UK HealthCare didn’t have any immediate concerns about losing nurses to retirement, but said the hospital has worked with its older nurses to figure out how to best manage the large geographic footprint of the facility as it has grown.

 

“There are nurses who have been here, say 20 years,” Swartz said. “You just can’t replace the judgment and the knowledge and the critical thinking that they have through those years of experience. It’s priceless to us.”

 

Buerhaus said there isn’t a nursing shortage from “a big macro national perspective,” but that some areas of the country, especially rural areas, are experiencing a shortage. “It is an uneven picture across the country.”

 

Buerhaus noted that his research, published in the journal Nursing Outlook, forecast that Kentucky, as part of the East South Central region of the U.S., is expected to have “substantial growth” in its number of full-time registered nurses between 2015 to 2030.

 

“What this suggest to me is that in the East South Central part of this country we are going to have fewer older nurses who are going to retire and a stronger growth of young people coming in,” he said about his research findings.

 

A 2014 U.S. Department of Health and Human Services report says that nationwide there will be a surplus of 340,000 full-time equivalent registered nurses in 2025, and a surplus of 16,500 in Kentucky.

 

However, another report by Georgetown University, which it says uses a study methodology based on nursing demand and “active supply,” says that by 2020, the nation will have a shortage of about 193,000 nursing professionals by 2020.

 

Whatever forecast is correct, that doesn’t affect today’s shortage of nurses in Kentucky, which is forcing hospitals and nursing schools to find creative ways to fill those vacancies.

 

In Part II: innovative approaches help Kentucky hospitals meet their nurse staffing challenges.

 

This article was produced as part of the Health Care Workforce Media Fellowship, run by the Center for Health, Media & Policy, New York, N.Y. The fellowship is supported by a grant from the Johnson & Johnson Foundation. Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

This article was originally published by Kentucky

The Academy Health National Health Policy Conference in Washington DC brought together experts in science, health, media, and policy to navigate the current political climate and to discuss the future of American health care. Evidence was presented, knowledge was disseminated, and yet uncertainty prevails. As the Trump Administration continues to foster this VUCA policy environment, the promise to #MakeAmericaGreat has eroded to #MakeAmericaAnxious.

 

Turbulent minds lead to turbulent times. Article 25(1) of the Constitution of the World Health Organization states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition.” The moral compass is spinning, especially surrounding health care. Variant proportions of values, law, and evidence will shape the future of health care reform and Americans are anxiously awaiting the impending declarations that will greatly impact the health, education, equity, and diversity of our country. Gutting the ACA and block granting medicaid remain high on the conservative agenda.  The ramifications of these reforms are likely to result in adverse health outcomes for vulnerable populations including children, the elderly, the disabled, and women.

 

In a recent interview with Diana Mason on Healthcetera Radio, we discuss how anxiety and fear have manifested in the lives of the children and families that I care for in my practice as a pediatric nurse practitioner in San Diego. Additionally, we explored strategies to #RiseAbove this over-looming cloud of ambiguity. I was delighted to hear from Healthcetera listener and activist, Barbara Backer, who inspired further investigation to seek local solutions and promote positive interventions.

 

At a recent workshop for the San Diego Chapter of the National Association of Pediatric Nurse Practitioners, Olympian and Certified Life Coach Mary Andrews suggests that thinking like an Olympian can help lead individuals through fear and ambiguity. Andrews is no stranger to complex, volatile, and high stress environments. She represented the United States in the javelin throw for the 1980 Olympic Games. Her unique lived experiences as an elite athlete, a life coach, and her passion for empowering others has forged the path for her to inspire greatness. Andrews offers important insight about how Olympians address fear and uncertainty: “Fear is informative and it’s sometimes necessary to come to grips with it. Olympians always play big and they plan for the worst-case scenario. They give time to the fear, then plan and prepare for it. Let it inform, don’t deny it, and always remain in constant action for what you want.” Andrews’ advice rings true for all who may be struggling with the current political climate or life in general.

 

For more insight, tune into Andrews’ upcoming interview on Healthcetera radio. Senior Fellow Kristi Westphaln and Mary Andrews discuss how to think like an Olympian, play big in the game of life, and how to shift your thoughts from fear and doubt into strategies for self-care and repair. Andrews urges leadership, strategy for success, and she knows her game!

 

Tune in to HealthCetera on Thursday, March 30 at 1:00 PM at 99.5 FM streamed live at www.wbai.org or listen to the interview here on our iTunes channel

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The Academy Health National Health Policy Conference