1. Nelson, Roxanne BSN, RN


Foundations are stepping up to fund nursing initiatives.


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Nurses make up the largest part of the health care workforce and are essential to patients' health and safety. Yet as important as nurses are, nursing has largely been ignored as a recipient of philanthropic largesse, until recently. The number of philanthropic organizations recognizing the importance of nursing is growing, perhaps because of publicity about the nursing shortage, as exemplified by Johnson and Johnson's Campaign for Nursing's Future.


Partners Investing in Nursing's Future. The Robert Wood Johnson Foundation (RWJF) is the largest philanthropy in the United States devoted exclusively to improving health and health care, as well as the largest philanthropy devoted to putting dollars into nursing. Although addressing the nursing shortage has been central to RWJF's goal of improving the quality of health care, funding has thus far been concentrated in only one area: medical-surgical nursing.


"Our work at the foundation was strictly focused on retaining nurses who were working on medical-surgical units," explains Susan Hassmiller, PhD, RN, FAAN, a senior program officer at the RWJF. "We wanted to have an impact on retention, and improving the work environment is key to that."


The foundation eventually decided to expand its focus, but wanted to do so in an innovative manner. "We are just one foundation," says Hassmiller, "and we wondered whether we could get other foundations to step up to the plate." The result was the creation of Partners Investing in Nursing's Future, a collaboration between the RWJF and the Northwest Health Foundation. Their intent is to create partnerships with local foundations to encourage investment in nursing workforce solutions.


"Our goal is to motivate other foundations to underwrite nursing programs," Hassmiller says. Category A foundations are those that have not made any grants to enhance nursing programs or projects within the last five years. Category B foundations have funded some nursing projects, but do not consider it a strategic intent. Category C foundations are similar to the RWJF, where strengthening nursing is a primary goal.


"We knew that we could get a lot of Category Cs to apply, but our aim was to get as many As as possible," says Hassmiller. "We wanted to bring in as many foundations as we could who have never funded nursing projects before."


Currently, four Category A foundations are receiving funding from the initiative. Funding is available for up to two years for as many as 10 projects that address nursing issues at the local or regional level, with a maximum award of $250,000. When the RWJF comes up with $250,000, Hassmiller says, then the local foundations, with other partners, must match these awards.


Just recently begun, the initiative has no data to report yet. But the program has been very successful, according to Hassmiller. "We've opened up our second call for proposals, and 97 foundations are registered so far. We had 107 apply for the first round."


The Betty Irene Moore Nursing Initiative. In 2003 the board of the Gordon and Betty Moore Foundation approved the 10-year, $110-million Betty Irene Moore Nursing Initiative, a program focused on improving the quality of nursing care in five counties of the San Francisco Bay Area-Alameda, Marin, San Francisco, San Mateo, and Santa Clara.


"The nursing initiative came about as a result of Betty Moore's experience as a hospitalized patient," says Helen Kim, chief program officer. Hospitalized several times, Moore experienced more than one medication error. After her last hospitalization in 2000, she became concerned about patient safety in acute care. "She noticed that nurses seemed very frazzled and overworked, and patient care was not well coordinated," says Kim.

Figure. At the Who W... - Click to enlarge in new windowFigure. At the Who Will Care for Me? conference November 3 in New York City, cosponsored by the Jonas Center for Nursing Excellence and the New York Academy of Medicine, members of the Nursing Crisis Is Here panel considered options for filling the critical need for nurses. From left to right are Bill Baker, Channel Thirteen, moderator; Christine Kovner, New York University College of Nursing; Thomas Smith, Cambridge Health Alliance; Lori Melichar, Robert Wood Johnson Foundation; and James R. Tallon, Jr., United Hospital Fund. The conference was supported by grants from the John A. Hartford Foundation, the Robert Wood Johnson Foundation, the New York Community Trust, and the Beatrice Renfield Foundation.

While health care wasn't part of the foundation's initial focus (it was set up for environmental and scientific programs), Moore decided to ask the foundation whether anything could be done to improve patient safety. "We did have a third program called the San Francisco Bay Area Program, and we began to explore what we could do under this program to improve patient care in the Bay Area," Kim says.


The focus is on acute care hospitals, and the success of the program will be measured by improved patient outcomes. To date, the nursing initiative is working with 39 acute care facilities, and the foundation will fund projects designed to increase the number of-and retain-experienced, qualified RNs in the region, as well as expanding the number of available training programs.


"Given the forecast of a nursing shortage," says Kim, "we decided to invest in expanding the nursing education programs in the Bay Area to increase the pool of quality RNs. We are also funding programs that will lead to additional faculty." An example is the accelerated doctoral program at the University of California, San Francisco, where students receive a scholarship in return for making a commitment to teach for three years. The first class will be graduating next spring, adding 42 new nursing instructors to the field.


The Jonas Center for Nursing Excellence, launched in New York City just before Nurses Week in 2006, is dedicated to solving problems facing the nursing profession, as well as to helping it transform itself.


The Barbara and Donald Jonas Family Fund has long had an interest in nursing, says Marilyn DeLuca, PhD, RN, CNA, executive director of the program. "The fund was started [in 2005], and nursing was designated as one of the primary areas of giving. The nursing shortage is a large public health crisis and is not getting the attention it should. We want to try to strengthen practice settings and practice models. We also want to encourage better and more frequent communication between practice settings and academia," says DeLuca.


In May of last year the center announced its first grants, which ranged from $150,000 to $400,000 for periods of up to three years. One grant went to Lehman College School of Nursing at the City University of New York and Bronx Lebanon Hospital System for a program called Expanding Diversity Among the Nurse Workforce: A Collaborative. Another went to the School of Nursing at Columbia University for its Evidence-Based Practice Nursing Program.


"The majority of grants are for three years, and a few are shorter," DeLuca says. "For most programs, it is difficult to accomplish very much in a short time. But even after the grant expires, we would like to continue to see data. We want to build a program that has sustainability, long after the grant funding comes to an end."


The Jonas initiative focuses on New York City for now, but DeLuca says that they consider it a demonstration site. "We would like to build partnerships and bring in more philanthropists to fund nursing projects, and get the attention of the media and corporations."


Roxanne Nelson, BSN, RN