For Oklahoma’s Nursing Leaders, Necessity is the Mother of Collaboration

Lea Brown MSN, RN, NPD-BC

Lea Brown MSN, RN, NPD-BC is the Education Coordinator for Stillwater Medical in Stillwater, OK. She is a member of the Oklahoma Academic-Practice Partnership and has spearheaded partnerships with local nursing schools for her organization.

Long before the pandemic, Oklahoma was struggling with a shortage of registered nurses (RNs). In the early 2000s, the Oklahoma Nurses Association (ONA) and Oklahoma Hospital Association were building task forces with the sole purpose of addressing the gap between RN supply and demand, an issue they never fully resolved. Then cometh COVID-19. Exhausted nurses chose to leave the workforce in favor of retirement, a different career path, or just plain old unemployment so they could care for their families. Others were enticed to leave the state by higher wages in other places or entered travel nursing contracts outside of Oklahoma; the state’s hospitals now find their nursing vacancies at a critical level. This dire situation is spurring nursing leaders to come together and create solutions, knowing full-well that a failure to act would negatively affect patient outcomes.

Oklahoma nursing leaders learned partnerships were key to finding solutions to shortages. The ONA, Oklahoma Organization of Nurse Executives, and Schools of Nursing Education Deans and Directors collectively formed the Oklahoma Academic-Practice Partnership in response to the nursing shortage well before COVID-19 reared its head. When the pandemic exacerbated the shortage, the group pivoted to laser-focus the use of Academic-Practice Partnerships (APPs) towards staffing hospitals as a direct result of COVID-19. APPs consist of a nursing school and a health care organization partnering to provide prelicensure nursing students employment in healthcare while simultaneously earning school credit for clinical experience. The American Association of Colleges of Nursing has long favored APPs to help develop nursing students’ critical thinking and NCLEX pass rates. Oklahoma nursing leaders envisioned the program as a way to extend nurses' arms at the bedside and ensure that these students received the required clinical experience, and a new emphasis on promoting APPs in Oklahoma was born.

The Oklahoma Academic-Practice Partnership quickly got to work in the midst of the pandemic. Since in-person meetings were no longer a possibility, the group met virtually to brainstorm solutions beyond APPs that could immediately impact the nursing shortage. This group became a brain-trust and spawned even more ideas to get hospitals the help they desperately needed. They suggested that the State of Oklahoma could use Cares Funds to contract with a company like MatchWell to crowdsource nurses and other healthcare workers. They thought a governor-directed executive order could remove obstacles for inactive nurses to get their licenses reinstated and entice them back to the workforce. They revamped the state’s Nurse Refresher program to a competency model thus reducing the amount of time and cost for the program for those wishing to get back into nursing. They envisioned the creation of a nurse extender position in hospitals made up of staff who have been away from the bedside for years. Finally, and most importantly, they saw the success of a pioneer APP between OU Medicine and The University of Oklahoma College of Nursing and wished to use it as a model across the state. In November 2020, the group amassed all their strategies in a letter to Oklahoma Governor Kevin Stitt, with APPs serving as the centerpiece of all the strategies, in hopes of garnering his support. They followed the letter up with meetings with the governor’s office and state health officials then held joint press conferences to plead their case to the public. Of all the Partnership’s ideas, the APPs got the most traction.

As more industry leaders learned about APPs, more members joined the Partnership to find out how their entities could benefit. The Partnership became a place where leaders could share ideas about how to form successful APPs in their communities. Members took the OU APP model and replicated it with their local partners. Hospitals such as Norman Regional Hospital shared their Memorandum of Understanding templates for their partnerships. As data from its APP pilot program came in, Oklahoma Christian University shared the results with the group so others could learn from its successes. The group found the Partnership’s collaboration to be extremely impactful at local levels.

The work of the Partnership goes on; it continues to look at new ways to address the nurse supply and demand gap. The members brainstorm ways to promote nurse wellness and curb the long-term effects of compassion fatigue on the healthcare workforce. They discuss ways to address nurse dissemination of COVID-19 misinformation. They share ideas to innovative ways to use healthcare staff; one example is how Mercy Hospital in Oklahoma City shared its success with using LPNs in its Labor and Delivery department. 

The group also discusses new ways nursing schools can partner with each other. Oklahoma City Community College recently shared its 1+1 program with the Partnership; this program allows qualified nursing students who were not accepted into its associates degree in nursing (ADN) program to continue their journey with partner practical nursing (PN) programs at our Career and Technical Schools. These students then have a guaranteed spot in the second year of with the OCCC’s ADN program after they complete their PN program. Efforts are currently underway to replicate this program in other Oklahoma communities.

The Partnership will have long-lasting efforts on Oklahoma nursing, not only at the state level but especially the local levels. Collaboration among Partnership members has led to more collaboration between local healthcare facilities and schools. More students are pouring into the workforce to aid exhausted bedside nurses and are gaining invaluable experience leading to a more practice-ready graduate. These students will have a huge jumpstart into their profession over their traditional counterparts. The impact this will have on Oklahoma nursing and the patients they serve is too early to tell, but the future is looking bright. 

January 2022