Boise State University, Nursing Department

2. St. Luke’s Wood RiverMedical Center St. Luke’s Boise & MeridianMedical Centers Gooding County Memorial Hospital Idaho Elks Rehabilitation Hospital St. Luke’s Magic Valley Regional Medical Center McCall Memorial Hospital Syringa General Hospital Boise State University, Nursing Department Weiser Memorial Hospital Elmore Medical Center

3. VISION MISSION VALUES We exist to… Our decision-making guide… By 2010, Rural Connection will be nationally recognized nurse leaders who create innovative processes that improve patient care. Attainable Collaborative Sustainable Value to Membership Respect for Diversity and Uniqueness Provide a collegial environment for creative solutions to patient care for rural, urban, and academic partners. Mission* Vision* Values Rural * Urban * Academic

4. Rural Connection began in 1990 through a "Strengthening Hospital Nursing" grant funded by the Robert Wood Johnson Foundation / Pew Charitable Trust.  The grant ended in 1995 and Rural Connection continues to evolve and participate in projects that improve health care practices. Rural Connection is a consortium of nursing leaders who are innovators for patient care.  Through collaboration and a shared vision, Rural Connection provides a collegial environment for rural, urban, and academic partners. Education, performance improvement, research, sharing of resources, and ongoing communication and networking are a part of a Rural Connection tradition that has been nurtured since 1990.  Rural Connection membership is rural, urban, and academic.  Its membership includes hospitals throughout Idaho and also includes Boise State University, Department of Nursing.

5. “We do our best work within a trusting, respectful, and non-competitive environment.” (Ed Dahlberg, President & CEOSt. Luke’s Health System)

6. A 501(c)3 non-profit organizationcomposed of rural, urban, and academic nursing leaders A voice for nursing leaders and the urban, rural, and academic nursing experience. A networking forum for nursing leaders in Idaho. A collection of resources and services for the rural, urban, and academic nurse. A driver of initiatives that directly impact health care practices and nursing. Rural Connection now…

7. Board of Directors Amy Bearden CNO, St. Luke’s Magic Valley Regional Medical Center Steve Frei CNO, Syringa General Hospital Lisa Looney Director of Nursing, Weiser Memorial Hospital Lorraine Reinhardt CNO, Gooding County Memorial Hospital Deborah Mills CNO, Elmore Medical Center Jeanette Ullery, Standing Guest Director of Education, St. Luke's Regional Medical Center Beth Gray VP of Patient Care, McCall Memorial Hospital Joanne Clavelle VP Patient Care Services and CNO, St. Luke's Boise and Meridian Regional Medical Centers Sharon Kensinger, President CNO, St. Luke's Wood River Medical Center Judy Taylor, Secretary Treasurer Director of Nursing, Idaho Elks Rehabilitation Hospital Pam Springer , President Nursing Department Chair, College of Health Sciences, Department of Nursing Boise State Noreen Davis, President Elect Senior VP Nursing and Patient Care Services, St. Luke's Health System Buffie Main, Executive Director Rural Connection

8. ROI for Rural Hospitals: 4 nurses Wages/benefits to attend 12 days of off-site training = $10,560 Program participation fees = $4,000 Travel expense (120 miles per trip) = $700 Total Organization Costs = $15,260/4 nurses Replacement Cost/Nurse = $57,200 ($44,000 + 30% fringe) 75% retention  375% ROI

9. VISION MISSION VALUES We exist to… Our decision-making guide… By 2010, Rural Connection will be nationally recognized nurse leaders who create innovative processes that improve patient care. Attainable Collaborative Sustainable Value to Membership Respect for Diversity and Uniqueness Provide a collegial environment for creative solutions to patient care for rural, urban, and academic partners. Mission* Vision* Values Rural * Urban * Academic

10. Why “Rural” Connection….. • Of the 44 counties in Idaho, 35 are considered to be rural. Of the 44 counties… • 2 counties have between 0-2 RNs for every 1,000 people • 14 counties have 3-5 RNs for every 1,000 people • 22 counties have 6-9 RNs for every 1,000 people • 6 counties have at least 10 RNs for every 1,000 people Sixty-seven percent of Idaho residents are from rural or frontier counties. SOURCE: (Idaho Rural Counties) Idaho State Office of Rural Health (RNs Employed in Idaho Counties) Idaho Nursing Workforce Center

11. Characteristics of Rural & Urban Nursing SOURCE: Bushy, Angeline (2000). Orientation to Nursing in the Rural Community. Thousand Oaks, CA: Sage Publications.

12. Telling the story: the dance of collaboration and our commitment to finding solutions where rural, urban, and academic partners meet…….

13. Telling the story: the dance of collaboration and our commitment to finding solutions where rural, urban, and academic partners meet……. Boise State University, Nursing Department While hospitals work to create comprehensive and meaningful orientation programs, Rural Connection is working to ‘bridge the gap’ between preparation and practice by creating relationships and forums for dialogue between academics and industry. “New graduate nurses now comprise more then ten percent of a typical hospital’s or health system’s nursing staff and this number is certain to grow moving forward” (Advisory Board). The emergent need to prepare for the nursing shortage makes it imperative that Rural Connection and other nursing organizations help the universities and service providers to be prepared for an influx of students and interns.

15. Idaho’s population 55 and older will increase 50 percent by 2016. Idaho nurse-to-citizen ratio is 20+ percent below the national average. Idaho’s nurses are aging One in five is younger than 35 Two in five are over age 50 Idaho has fewer nurses per capita than any surrounding state except Nevada. A Looming Crisis

16. Demand through 2016 Idaho employers are projected to hire an additional 7,500

17. Gap Analysis Registered Nurses

18. Gap Analysis Graduate-Level Nurses

19. A Closer Look at Faculty

20. Living & working inside the Rural Connection Framework

21. Rural Connection Theoretical Framework Person:The person refers to those who are served by our actions. This may include other Rural Connection Board Members, faculty, and/or staff directly and patients and/or students indirectly and may represent individuals, groups, communities, or organizations. Environment: The environment is the intersection of urban, rural, and academia in Southern Idaho and the surrounding region. We understand and respect that the cultures of these areas differ; and we utilize those differences to support change. We target interventions and processes that positively impact all three areas. Health: Health refers to the climate of the organization of Rural Connection as well as the work climate in the facilities we represent. The projects we undertake positively impact the health of our organization(s), patients, students, and communities we represent. Nursing Leadership: Nursing leaders design processes and systems that allow organizations to prosper by providing a collegial environment for creative solutions to patient care. Leaders demonstrate accountability and integrity in actions.

22. Nurse Residency Program  Mentorship  • Preceptor Program • Rural Competency

23. Preceptor Program Providing a foundation and network for supporting the development of nurse preceptors by improving their skills in teaching, leadership, mentorship and communication, Rural Connection is administering a comprehensive, sustainable preceptor program for rural and tertiary care centers alike. The program has a unique appreciation and respect that the cultures of rural, urban, and academic differ when it comes to supporting the first-year nurse or the nurse returning to practice. The curriculum is rooted on the idea that precepting in those environments is a unique experience and teaching methods and orientation programs cannot be one-size fits all.

24. Topics:Teaching & Learning Styles ~ Competency ~ Critical Thinking & Clinical Judgment ~ Communication & Conflict Management ~ Delegation ~ Team Building 23 Workshops Statewide Over 300 Preceptors Program Demand Continues

25. Framework in action: Nurse Residency Program • 2007 Pilot Program 148 Participants from 5 Hospitals NOVEMBER 2009 Rural Connection Residency The Graduate Nurse Residency Program is designed to ease the transitional challenges of moving from nursing student to clinical nurse professional. This project is currently in the research and development phase as Rural Connection studies the most innovative programs in the nation.

26. Framework in action: Nurse Residency Program • 2007 Pilot Program 148 Participants from 5 Hospitals NOVEMBER 2009 Rural Connection Residency The Graduate Nurse Residency Program is designed to ease the transitional challenges of moving from nursing student to clinical nurse professional. This project is currently in the research and development phase as Rural Connection studies the most innovative programs in the nation.

27. Rural Connection Residency 2010 what’s different this time? • Rural & Urban Cohorts • Real Time Learning • Residency is where you are… What’s the ROI?

28. ROI for Rural Hospitals: 4 nurses Wages/benefits to attend 12 days of off-site training = $10,560 Program participation fees = $4,000 Travel expense (120 miles per trip) = $700 Total Organization Costs = $15,260/4 nurses Replacement Cost/Nurse = $57,200 ($44,000 + 30% fringe) 75% retention  375% ROI

29. Mentoring Leaders Promoting the professional development of nursing personnel and the practice of nursing, Rural Connection strives to develop a model for mentoring new nursing leaders. In 2007, Rural Connection hosted a nursing leadership conference with Tim Porter-O’Grady with over 200 nurses in attendance. Rural Connection is currently identifying the leadership domains most needed by new leaders in each Rural Connection setting so that we can support competent nurse leaders of the future. “Leadership is essentially a work in progress— a never-ending journey with facets and elements that add up to a broad and complex mosaic” -Tim Porter O’Grady

30. From Preceptor to Mentor… Mentoring in the Moment: a Rural Connection Leadership Program Mentorship Domains: Leadership Story Telling Communication Facilitation Conflict Management Listening Spirit of the Expert

31. Nursing Advocacy Acting as a voice for nurse leaders and the urban, rural, and academic nurse experience, Rural Connection remains abreast of current affairs and legislation that will affect nursing in Idaho in an effort to educate and provide recommendations to policy makers and the citizens of Idaho.

32. Where can you find out more? www.ruralconnection.org