A Conceptual Model that Promotes
Recruitment and Retention of
American Indians into Nursing
Loretta Heuer, PhD, RN, FAAN, North Dakota State University
Lane Azure, PhD, Cankdeska Cikana Community College
Mary M Wright, PhD, RN,CNE, North Dakota State University
Melinda Anderson, DNP-C, RN, North Dakota State University
Literature
• Nursing pipeline
•
Illustrates the need to have a plan and resources
to meet the nursing workforce needs.
• Minority nurses ‘pipeline’
•
Closes health care disparities (Mcalister, Gold & Sullivan-Bentz,
2011).
North Dakota Nursing Statistics
Purpose
• To have academic and community partners identify
themes with related strategies that would lead to the
successful recruitment, education and employment of
American Indian Nursing Students.
•
A pipeline for American Indian Students.
Methodology
• Event
•
Future of American Indian Nursing in North Dakota Conference
• Site
•
Standing Rock Reservation – Prairie Nights Casino & Sitting
Bull College
• Design
•
A community based participatory action data collection
methodology
• Sample
•
Tribal elders, nursing faulty, nursing staff, nursing
administrators, and directors
Sample (N=35)
•
•
•
•
Education:
•
•
•
•
Some college (n=1, 2.9%)
Two year degree, LPN (n=1, 2.9%)
Four year degree, 11% (N=4)
Master’s degree (n = 19) or a doctorate (n = 8), 54%
Employment:
•
•
University 49% (n = 16)
Four- (n = 5) or two-year (n = 5) universities/colleges (n = 10), 28%
Income:
•
•
•
•
$70,000 or above (n = 22, 63%)
$55,001To $70,000 (n=4, 11%)
$40,001 to $55,000 (n = 4, 11%)
$25,001 to $40,000 (n = 2, 5.7%).
Ethnicity:
•
•
White 66% (n = 23)
American Indian or Alaska Native population 29% (n = 10)
Nominal Group Technique
•
•
•
Designed by Delbeq & Van de Ven
•
•
In the early 1970’s
Maximized group participation in making decisions and
reaching consensus.
Process
•
A number of steps that can be adapted in small ways, while
retaining the goal of the method.
Three groups
•
•
•
Group 1 – 13 Participants
Group 2 – 10 Participants
Group 3 – 12 Participants
Items Generated
• The steps included:
•
•
•
Group 1 – 85 items generated
•
•
During clarification step, some items combined
Data reduction to 9 items
Group 2 – 43 items generated
•
•
During clarification step, some items combined
Data reduction to 8 items
Group 3 – 56 items generated
•
•
During clarification step, some items combined
Data reduction to 15 items
Group 1 Ranking
•
Mentoring services
107
•
Develop support systems in the institution
105
•
A designated area in college /facility where students feel safe-home away from home
93
•
In-house daycare for jobs/school
92
•
Tribal support
91
•
K-12 stem curriculum
91
•
Nurse camps at grade schools at reservations run by nursing college students
91
•
"NO EXCUSES" Orientation
87
•
Employment for spouse
86
Group 2 Ranking
•
Peer to peer mentor support system
78
•
Adequate orientation 3-6 months after graduation
77
•
Development of Self-Confidence/Leadership programs for American Indians
•
Access to education resources to attend trainings
74
•
Cultural sensitivity for instructors (nursing)
73
•
Increase visibility of American Indian nurses (e.g. Publicity(Recognition) for nurses who are
role models . Show a variety of nurses who are role models to American Indians in primary
and secondary schools).
67
•
Plan of action (global) with all invested parties (IHS, Tribal, Nation, Schools, etc.)
67
•
Heath career tracking in high school
61
77
Group 3 Ranking
•
Mentoring program
85
•
Assess academic risk
82
•
Need for American Indian nurses
78
•
Multiple methods of teaching and learning in nursing
74
•
Increase family support and involvement
72
•
Develop a sense of belonging
71
•
American Indian faculty
70
•
Counseling life skills non academic student support services
68
•
Academic support at the elementary and secondary level
67
•
Strengthen relationships with other nursing students
67
•
Develop onsite residential nursing programs
64
•
Goal setting , time-line within the discipline
59
•
Prescreen for barriers
53
•
Change admission criteria
53
•
Educational opportunities for K-16
51
Themes
Educational Preparation K-12
Non-Academic Supportive Programs
Nursing Program Support
Transitional Support for a Nursing Career
Recruitment and Retention of American Indian Nurses within
the Workforce
Global Plan of Action
Educational Preparation K-12
•
Academic support at the elementary and secondary level
•
•
K-12 STEM Curriculum
•
Sciences, math, technology
Cultural Knowledge and Application
•
Clear need for American Indian nurses Educational opportunities from K-12
•
Nurse camps
• Grade School
• High School
•
•
Tribal Support
Mentoring & Experiential Opportunities
•
Health care tracking in high school
Non-Academic Support
•
•
Tribal Support
Family Support
•
•
•
Increased family support and involvement
Counselling of life skills
•
•
•
Employment for spouse
Financial workshop
Financial Support
Daycare
•
College
Nursing Program Support
•
•
•
•
•
Preparing for Admission
•
•
Prescreen barriers for enrollment into nursing school
“No Excuses” Orientation
Adapting Program Policy
•
Admission criteria
Designated space
•
•
•
Home away from home
A sense of belonging
Centralized access for mentoring
Support services
•
Tutoring, advising,
Assessment
•
Assess for Academic Risk
•
Early detection and intervention in students that need additional help.
Nursing Program Support
•
Cultural Knowledge and Application
•
Cultural sensitivity for nursing instructors
•
•
Resources Access to educational resources for faculty
Mentoring Program
•
Peer-to-peer mentor support system
•
Encourage students to seek mentor
Nursing Program Support
•
Curricula Delivery
•
•
•
•
•
Goal setting time-line within the discipline
•
Giving student deadlines
Cultural sensitivity nursing instruction
Explore innovative approaches to curriculum delivery
• Develop circular teaching methods vs linear (Group 3 , 12)
• Multiple Methods of teaching and learning
Faculty
•
Native faculty
•
Increase number of diverse faculty
Student Relationships
•
Relationships with other nursing students
Transitional Support to Nursing Career
•
Leadership Program
•
•
Self-confidence/Leadership programs for American Indians
Cultural
•
Develop Onsite Residential Nursing Programs and foster integration of cultural
aspects.
•
•
Environment of care setting and patients
Mentoring Program
•
•
Support systems within the institution
Adequate orientation 3-6 month after graduation
Recruitment and Retention of AI nurses within
the Workforce
•
•
Need for child care resource and referral related childcare
Increase need for American Indian nurses
•
•
•
Recognition for nurses who are role models for NA in the schools
Opportunity to serve as role models
Increase visibility of American Indian Nurses
•
Media
Global Plan of Action
•
Convene Community Stakeholders
•
Involve invested stakeholders
•
•
•
•
•
•
•
•
•
•
•
•
•
Potential Students
Current Students
Parents
Elders
Nurses
Tribal Council
Elementary and Secondary School Councilors
Tribal Colleges
Nursing Program Directors
IHS representatives
Legislators
Foundation Representatives
Disseminate the findings
•
•
Presentations
Publications
Results of Nominal Group Technique
North Dakota American Indian Community & University Partnership
Recruitment
& Retention
Elementary
Secondary
Educational
Preparation
K-12
Wisdom
& Guidance
of Elders
PreSchool,
Kindergarten
Transition
Support
Friends
Peers
Tribal
Community
American Indian
CORE VALUES
Spirituality
Culture
Language
Career/Vocation
Nursing Program
Support
Extended
Family
Post –
Secondary
Non-Academic
Support
Conclusions
• Nominal Group Technique
•
•
•
Provided an opportunity to receive input
from variety of constituents.
Identified themes provide components for
further exploration and work.
Implemented some components.
•
•
Nurse camp (Edventures in Health Careers)
American Indian Nurses Visibility
•
•
•
Recruitment and Retention Video
American Indian Nursing Documentary
Policy Paper
• Future Work
•
Explore and validate the themes along with
specific strategies that can be implemented
and evaluated.
Questions?
CONTACT INFORMATON
Loretta Heuer, PhD, RN, FAAN
Professor
North Dakota State University
Phone: 701-231-8205
E-mail: Loretta.heuer@ndsu.edu
A special thank you to Mary Leff, MS,
Evaluation/Research Coordinator and Juessica Grund,
BS, Academic Grants Coordinator for their work in
this project.
Funded by The University Partnership Research Grant
for Health Professional Opportunity Grant, # 90PH0019,
Office of Planning, Research, and Evaluation,
Administration for Children and Families.