Many staff nurses move into management positions. Often these nurses are promoted because they are expert practitioners and have not had the opportunity to gain leadership skills. They need assistance in making the transition from staff nurse to nurse manager.
This article describes the development of a continuing education video program for registered nurses entitled "Moving Into Nursing Management" (Figure 1). The program was developed to assist the beginning nurse manager in leadership skills. The project evolved following a local survey which was done in the South Suburban Chicago area to determine the continuing education needs of staff nurses.
Professional continuing education has been an interest of mine for several years. I have been both a participant and a leader in such programs. I think that the university should be a center for professional continuing educational programs whether the participants are seeking formal course credit or are fulfilling requirements for professional certification. The quality of professional continuing education programs should be of the highest level possible, that the university and its resources can provide.
NEED FOR CONTINUING EDUCATIONAL MATERIALS
Continuing education is necessary for maintaining competence in the practice of nursing. Initial licensure does not guarantee long-lasting competence in the professions. Periodic updating is necessary to stay current in practice. Continuing education has been defined as a "planned learning experience beyond a basic nursing educational program . . . designed to promote the development of knowledge, skills, and attitudes for the enhancement of nursing practice, thus improving health care to the public."1
Thirteen states now have mandatory continuing education (CE) requirements in order to renew an annual RN license.2 Even though most states have not formally mandated it as a relicensure requirement, many nurses have adopted it in concept. Most practicing nurses, while currently registered in the state, realize a need to keep updated in the practice of their profession. For a variety of reasons they cannot pursue formal work toward a degree but they would benefit from a continuing education program that assists them in professional growth and possibly assists them in career advancement.
They have experienced the satisfaction of attending programs which, at best, add to their knowledge and instill a thirst for more learning, or, at least, make them feel they are keeping abreast of their colleagues' knowledge. Today, the number of nurses who never seek educational opportunities beyond their everyday employment is decreasing.3 Continuing education in nursing is here to stay.
Peter Drucker, a noted management theorist, stated that the "nations fastest growing industry may well be the continuing professional education of highly schooled midcareer adults. Most of this education takes place outside of the education establishment through companies, hospitals, and government bureaus. Private concerns are organizing seminars and producing audiovisual materials to take advantage of growth opportunities that universities shy away from" ( Wall Street Journal, March 3, 1981). He further stated that continuing professional education will become a third tier in addition to undergraduate and professional or graduate degrees.
In addition to the individual state regulations, other professional groups are requiring that RNs stay current in the field.
The Joint Commission on Accreditation of Hospitals requires, in Standard #5, that institutions, with their approval, provide opportunities for continuing education programs for nursing staff.4
The American Nurses' Association Standards for Nursing Service stipulate that "nursing service must assist personnel in maintaining and improving competency in practice."5 This can be accomplished through continuing education programs as well as through formal education courses. The need for continuing education programs for registered nurses has clearly been established.
In order to determine the particular continuing education needs of nurses in our local area, a market research survey was done in 1981. Two questionnaires were prepared. One was sent to staff development directors in over 200 health care agencies in the South Suburban Chicago area including hospitals and nursing homes. The other one was distributed to 100 randomly sampled working staff nurses. The area boundaries were the southern part of the city of Chicago south to Kankakee, east to the Indiana state line, and west to Joliet.
Information was requested on topics of interest, number of programs offered, attendance requirements, employee recognition, budget, employee input to programs, etc. Nearly all of the questionnaires from staff development directors were returned within 15 days. A total of 93 agencies responded. Four of the agencies requested a report of the results of the survey. Eighty-one staff nurse questionnaires were returned within 14 days.
Summary results of the survey showed that 95% of the agencies who responded had continuing education programs for nurses in their institution. Eighty percent of the agencies offered programs at least once a month. Fifty percent of those programs used outside resource materials. Seventy-one percent required employees to attend inservice programs and considered attendance at such programs in employee evaluation and promotion. The topic of interest most frequently checked indicated that improved skills in "nursing management" was a need of both staff development programs and working nurses.
The rapid return of the questionnaires indicated a high degree of interest on the part of the agencies responding. Over half of the agencies used outside resources as well as internal resources for their inservice programs. Most agencies had a budget for staff development, although it was limited in some cases.
Figure 1. Elements of the CE video program, "Moving Into Nursing Management."
The next phase was to complete a search of audiovisual materials that were currently available. The search revealed that most of the management visual media available was related to business and not specifically to nursing. One company had recently developed two series of five cassettes each, on nursing management. The material to be developed by Governors State University (GSU) would need to be on different management topics and would be slanted toward individual participant activities to be used in the program along with the videotapes.
DEVELOPMENT OF THE PROJECT
The target authence was to be employed registered nurses. The program also had to be suitable to meet the needs of nurses returning to work after several years or more who needed additional leadership skills. The next six months (March to September 1981) was spent working with the Instructional Communications Center of the university to develop three videotapes and an instructional packet. They were to be used together and the package could be sent out of the university to be used by various health care agencies for professional continuing education purposes. The video materials included information on the various areas of nursing management in the form of narratives and actual hospital scenes.
The packet gave step-by-step instructions of how the video was to be used and included additional materials. The main thrust of the project was to give content information on nursing management and then immediately have the participants perform activities that encourage transfer into the work setting. This was a form of interactive video instruction. Each tape was divided into sections. After each section the video was turned off while the participants complete specific activities.
Specific management content areas on the video included: 1) the nurse manager role, 2) leadership styles, 3) nursing process and the management process, 4) management by objectives, 5) motivation and management theory, 6) employee evaluation, 7) quality assurance, and 8) the nursing audit.
Figure 2. Interactive video instruction with Linda Ziemann, MSN.
Principles of adult education state the learners learn best when they participate in the learning and when the information is relevant to the learners' needs.6 Therefore, the format adopted was one of individual participation and immediate transfer to the work setting.
The next step was to obtain a filming site. This was established with a local hospital located near the university. The project required two days of filming in the hospital to complete individual scenarios. The director of nursing and the assistant director of nursing were most cooperative in helping us to film this series. Many of the head nurses and staff nurses volunteered to participate in the scenarios which was greatly appreciated as this was an individual faculty research project and no monies had been appropriated to complete it (Figure 2).
Three evaluation procedures were used to test the program. First, the faculty author personally used the program series at two local hospitals in November and December of 1981. The program was delivered to ten newly appointed or current head nurses and assistant head nurses. The program was presented for a two-hour session, once a week for three weeks, using all of the developed materials. In the process of this testing, one of the hospitals purchased the program.
The second evaluation was done by two staff development directors in two Illinois hospitals in January 1982. These persons used the materials according to the outlined suggestions.
The third evaluation consisted of personal interviews between Staff Development Directors and the faculty member and the Instructional Developer from GSU. Portions of the video were viewed and the packet of materials reviewed.
Evaluation forms were completed by the four hospitals that used the program and a total of 35 registered nurses who participated in the testing. Changes were made in the instructional materials based upon the input from these testing procedures. All four hospitals said the program was suitable for their continuing education needs. One hospital purchased the materials during the testing time. One staff development director's interview revealed that the program was excellent and the other stated that it was not suitable for their program.
DISTRIBUTION AND NATIONAL MARKETING
Based upon the positive results obtained from the testing, a nationwide marketing plan was developed and implemented in March 1982. An advertising brochure was designed by the Instructional Communications Center. Mailing lists were obtained of the American Hospital Association approved agencies and baccalaureate nursing programs in the US. A preview tape was created from the video materials and was available to those agencies who made inquiries to the brochure. In March 1982 the brochures were mailed. Evaluation forms were completed by each agency that responded for a preview tape and/or purchased the program.
At this point, a contract was established between the faculty member and the university on media developed materials, as fees for the series would be involved. At the writing of this article, there were 69 preview requests and 11 sales of the program.
An evaluation form was completed by those who participated in the program. It consisted of 16 questions on a fivepoint scale ranging from strongly agree to strongly disagree. The majority of the items fell on the four-point agree and five-point strongly agree sections. The results indicate that baccalaureate nursing students and working registered nurses found the program helpful in developing better management skills and would like more programs of this nature. The content was found to be current, accurate and interesting.
Another evaluation form was completed by those who previewed the program but did not purchase it. Four basic questions were asked concerning appropriateness of the content, clear instructions, worksheets, and technical quality, again using a five-point scale. The results indicated that the information was appropriate and the format was a desirable method of continuing education instruction for working nurses. Continued efforts of evaluation are still in progress.
IMPLICATIONS FOR NURSING
Continuing education programs are needed to keep nurses updated in their profession. The topic, issues in firstline nursing management, was well received. There is little available on videotapes to instruct people on nursing management. More such programs are needed. The format of this program, with an emphasis on individual participation, appears to be helpful and holds people's interest.
The need for continuing education programs for working nurses is vital today more than ever before due to the rapid changes in our health care delivery system and because of the lack of uniformity in nursing educational curriculums. This article presented an example of how university faculty research time can be devoted to the development of programs that meet the continuing education needs of employed staff nurses. It also is an example of the cooperative efforts that are possible between nursing education and nursing service to enhance nursing as a profession.
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- Boissoneau R: Continuing Education in the Health Professions. Rockville, MD, Aspen Systems, 1980.
- Styles MM: Continuing education in nursing. One hope for professional coherence. Nurse Educator 1976; l(2):6-9.