Recently, a national survey reported that Hawaii is the second-worst state for nurses due to professional demands coupled with low annual salaries adjusted for cost of living, job openings and health care facilities per capita, competition and rising aging population.
However, this report failed to provide an adequate portrait of a state with one of the most progressive nursing practice environments in the country.
Ten years ago, Hawaii had a nursing shortage. With the Legislature’s support, the Hawaii State Center for Nursing (HSCN) was created and funded by nurses contributing a portion of their licensing fees. The center serves as the convener to improve health by ensuring that Hawaii nurses practice in a supportive environment while meeting state needs.
To address the shortage, nursing schools statewide responded. Enrollment across the associate, bachelor’s and graduate levels increased, and new pathways were developed, including the graduate entry programs in nursing.
Nursing employers also responded. The statewide Nurse Residency Program was launched by the HSCN and all nursing schools to support nurses entering their first nursing job. This program has successfully served more than 260 nurses, increased the job- retention for new nurses to 94 percent and continues to be a success locally and recognized nationally.
Employers, nursing facilities and nursing schools statewide again joined forces with the HSCN to support associate-prepared nurses to earn bachelor of science in nursing degrees, an effort that aligns with the Institute of Medicine’s Future of Nursing Report Recommendation.
To date, our state has established public and private programs to support these efforts, with more than 100 nurses enrolled in these programs in the first year alone. Nurses who have completed these programs describe them as increasing their leadership and empowerment in their careers to advocate for patients.
A shortage of primary care providers is projected. Again, nursing education responded by opening an advanced practice nurse-practitioner program leading to the doctor of nursing practice (DNP) at the University of Hawaii-Hilo. The UH-Manoa program expanded, and both campuses offer nationally accredited programs leading to the DNP. With the support of our Legislature in 2010, Hawaii became one of the first eight states in the nation to enable Advanced Practice Registered Nurses to practice to the fullest extent of their education and training, improving access to health care in both rural and urban areas statewide. Employers are hiring APRNs to provide direct services in all settings where health care is delivered.
New opportunities, like the opening of Queen’s Medical Center-West Oahu and the Maui Memorial Medical Center public-private partnership, are ways our health care community ensures nurses can continue to serve their communities. Hawaii nurses have the second-highest annual mean wage for metropolitan and rural areas across the nation. Few job openings indicate nurses are staying with their employers, a sign of satisfaction in their work environment.
What the national report does not convey is the considerable ways our state responds to the changing needs of Hawaii and our nursing workforce, and the incredible passion and aloha nurses put into their work. Hawaii nurses are consistently rated the highest in quality and ethics in the nation. Hawaii has the second-best compensation for nurses across the nation, we adapt with professional and educational opportunities to ensure the success of nurses and to ensure adequate access to care in the state, and we continue to look for ways to improve, engage and respond to both our nurses’ and community’s needs.
This needs to be celebrated.
