NEW YORK NURSE: January-February 2011
by Mark Genovese
Christine T. Kovner has shown that research can make a tangible difference in the everyday lives of registered nurses.
A professor at the New York University College of Nursing and a leading researcher on nursing issues nationally, Kovner works to provide important data for New York nurses, creating a foundation for protecting nursing practice and improving workplace environments. Her work has been referenced extensively by NYSNA for many of its legislative and contract campaigns. In 1994, she was named Distinguished Nurse Researcher of the Year by the Foundation of New York State Nurses.
Kovner started out as an economics major in college. “In my third year, I realized there was no work that I wanted to do that people with such a degree could do,” she said. “I saw that one could become a nurse by going to college – it was the late 1960s and I’d previously thought the only option was a hospital’s diploma program – so I decided to pursue it. It seemed like a career in which I could help make the world a better place for people who were at a disadvantage.”
After encountering a rigid supervisor in her first job, “I realized that the only way I could do something about such supervisors was to get their jobs – therefore I had to go to graduate school,” Kovner said. “I liked graduate school and began to realize that I wanted to find out the answers to various questions. Also, if I wanted to change policy, having data would be helpful.”
In fact, not only helpful, but valuable. In 1994, she conducted an evaluation of the health personnel rate adjustment program for the New York State Department of Health. The next year, she published an analysis of vacancy rates, turnover, and wages among nursing occupations in New York state hospitals, nursing homes and diagnostic and treatment facilities in the Journal of the New York State Nurses Association.
A study she conducted in 1998 with the U.S. Agency for Health Care Policy and Research found that hospitals that provided only one more hour than average of nursing care per patient per day, had 10 percent fewer patients with complications.
Then, in 2000, Kovner collaborated with Carol S. Brewer, associate professor of nursing at the University at Buffalo, on a study contracted by NYSNA to track trends in supply and demand for RNs in New York state. It provided evidence that difficult working conditions for nurses contributed to the attrition of working RNs and declines in nursing school enrollments.
Kovner and Brewer are continuing a national study they started in 2006, funded by a grant from the Robert Wood Johnson Foundation, to track the early careers of registered nurses in an effort to discover the reasons behind the nursing shortage. It is seeking to determine if new nurses are leaving particular settings or leaving the profession altogether.
Kovner’s newest contribution, in collaboration with Darlene Curley, executive director of the Jonas Center for Nursing Excellence, is the first effort to shed light on the considerable “ripple effect” that faculty has on nursing and patient care. “Darlene and I were trying to put some numbers on the positive impact faculty have,” Kovner said.
Released this past December, it estimated that a nurse faculty affects the care of 3.6 million patients. Kovner and Curley started with the figure of 900 current faculty vacancies in nursing schools offering baccalaureate programs, provided by the American Association of Colleges of Nursing. The report estimated that over a 25-year career, an educator will prepare 7,500 nurses, and that over a 30-year career, each nurse will care for 14,400 patients. Therefore, the loss of one faculty position can affect the health of millions.
They consider these figures to be a cautious estimate. Kovner said the major challenge for developing such an estimate is determining the underlying assumptions. “For example how many years do faculty typically work, how many students do they teach?” It’s also difficult to take into account the wide range of nursing practice areas and varying state workforce regulations.
In 2009 alone, a shortage of nurse educators meant nearly 55,000 qualified applicants were turned away from nursing programs. This situation will only intensify as the nation’s population ages and nursing faculty vacancies increase.
Kovner hopes that estimates such as these can be used to increase funding for physician education, and therefore, RN education. “Those who provide funding for education – whether the source is public or private – want to know how an individual earning a PhD results in better patient care,” she said.
They’ll ask: ‘Why should we care if schools produce more PhD nurses?’ I think the answer is that if we want to educate more nursing students – more than we currently educate or even the same number that we currently educate – we need the faculty.”