Research Summary by Peter Buerhaus, RN, PhD, FAAN and Karen Donelan, ScD
Awareness and Impact of the Johnson & Johnson Campaign for Nursing's Future
May 10, 2006 -- Since 2002, our research team has been awarded grants by Johnson & Johnson to conduct broad reaching studies related to the nursing shortage, perceptions of the nursing profession, and the effectiveness of the Johnson & Johnson Campaign for Nursing's Future. Our team includes nurses, nurse educators, a physician, survey researchers, health services researchers, public health students and health policy academics. We have conducted surveys of the general public, of parents and teenagers, of nursing students, of registered nurses (RNs), physicians and hospital executives. Topics have included the nursing shortage, nursing recruitment, nurse workforce issues, diversity in nursing, images of nursing, work experience, satisfaction with current job and with nursing as a career, workplace discrimination, working relationships with nurses, staff, physicians and management, the impact of the shortage on the quality of health care, and many other issues. In 2004 and 2005 we have presented in public forums and published our data widely in several peer-reviewed nursing journals, including Nursing Economic$ (a six part series), the Journal of Nursing Administration, the Journal of Professional Nursing, and Health Affairs (a chronological list of recent publications may be found at the end of this summary). Several more manuscripts have been submitted to medical, nursing, health policy and health care quality journals.
The questions we have asked about the Johnson & Johnson Campaign for Nursing's Future have focused on several core Campaign activities. Campaign initiatives include: A national television, print, and interactive advertising campaign (presented in English and Spanish), developing and maintaining a web site, producing and distributing recruitment and retention materials, awarding student scholarships, raising funds to support nursing education programs, and sponsoring research projects. The web site developed by Johnson & Johnson, www.discovernursing.com, thus far has logged more than 10 million unique visitors. Johnson & Johnson has produced and distributed a variety of recruitment materials, including 10 million brochures, pins, posters, and videos in English and Spanish. These and other materials were distributed free of charge to all junior and senior high schools, hospitals, nursing schools, and nursing organizations across the nation. Recently, these recruitment materials were augmented by new videos offering patient perspectives of nursing care, training modules, and the production and national broadcast in Spring 2005 of the movie "14 Hours." Johnson & Johnson also has hosted regional fundraising celebrations of nursing called "The Promise of Nursing." These events are designed to engage local health care organizations, which employ nurses to spend an evening recognizing the nursing profession and raising funds for faculty and student scholarships. Events have been held in California, Arizona, Michigan, Massachusetts, Tennessee, Georgia, New Jersey, New York, Illinois, Pennsylvania, Florida, Washington and Texas, with several more planned for 2007. Collectively, the events raised more than $9 million, with $2 million expected to be added in 2007. Thus far, more than 530 student scholarships, 102 renewable faculty fellowships, and 91 grants to nursing schools have been awarded (Johnson & Johnson, 2006). Johnson & Johnson has funded several independent research projects on the nursing shortage and studies to evaluate the Campaign, including our team's work.
Given the level of activity, we anticipated, and measured, considerable awareness of the Campaign's initiatives.
Campaign Awareness and Impact
Findings of our work (much of it conducted in late 2003 and throughout 2004) reflect the responses of RNs (national sample, n=1,697), nursing students (national sample, n=496 nursing students) and hospital chief nursing officers (CNOs) executives (national sample n=222) to the Campaign. Awareness of four key elements of the Campaign have been tested: 1) Brochures and videos encouraging people to "Be A Nurse", 2) National television commercials about nurses 3) the website www.discovernursing.com; and 4) "Promise of Nursing" fundraising events.
Overall, 59% of RNs, 79% of nursing students and 98% of hospital CNOs were aware of one or more of the above Campaign activities. Among RNs, 40% were aware of recruitment brochures and videos (compared with 64% of students and 98% of CNOs), 47% had seen or heard of national advertisements (compared with 58% of students and 90% of CNOs), 10% had seen the website (compared with 16% of students and 51% of CNOs) and 4% were aware of the regional Promise of Nursing events (compared with 1% of students and 40% of CNOs). Among those who were aware of these brochures, ads, and website, 30% of RNs, 24% of students and 66% of CNOs could identify Johnson & Johnson as the sponsor in an open-ended item test of recall. Among nursing students who had not yet decided to become a nurse and saw Johnson & Johnson advertisements while they were still making the decision to enroll in an educational program, it is highly likely the Campaign had a positive impact on their decision as over 90 percent said the advertisements made them feel good about becoming a nurse With respect to RNs, 62% felt the campaign had positively influenced the image of nurses in the general public, 32% said the activities had no impact in this dimension, and 7% thought the impact was negative. On all other items, RNs were divided between whether campaign activities had a positive impact or no impact at all. The vast majority of CNOs surveyed reported positive impact in all areas we queried about (Donelan, Buerhaus, Ulrich, et al 2005).
Image of Nursing
Health care is changing, and there is no question that methods to recruit and educate professional nurses also must change. This has always been true. In the United States, unlike many other countries, nursing remains one of the most trusted, admired, and respected professions. As efforts to recruit a diverse workforce increase, so must efforts at recruitment change in creative ways. While the Johnson & Johnson Campaign clearly is recognizable to many, and is seen as a positive factor by many, no one initiative can be all things to all nurses or prospective nurses. Indeed, it is especially positive that the Campaign is seen to have fostered state and local initiatives in regions where many nurses work and practice. Our research will continue to address issues of the image of nursing, perceptions of causes and solutions related to the nursing shortage, improving work environments, work relationships and innovations in nurse recruitment across the nation. Further, this year we plan to conduct a national survey on the public's image of nurses and perceptions of the value of nursing to complement our prior efforts to survey health professionals about the profession. And, during the next two months, we are conducting another national random sample survey of RN to update and monitor findings from the survey of RNs conducted in 2004, with data to be reported later this year and in 2007.
Addressing the issues and problems confronting the nursing profession are enormously important and challenging given current estimates of a decline in the future supply of RNs, an aging workforce, an expected sharp increase in demand for health care as the nation's 80 million baby boomers consume ever more health care, growing pressures to increase quality and safety of patient care in all settings, immigration of RNs educated in other countries, a global shortage of nurses, and inadequate capacity in this nation's nursing education system to educate all the nurses who will be needed in the future These challenges are truly societal and increasingly global; they are greater than what the nursing profession, by itself, can successfully handle, are larger than the health care industry can adequately address, and are beyond even the resources of the public sector, both federal, state, and local governments. The private sector has to become involved, as have Johnson & Johnson and other companies, if we are to be prepared for what lies ahead and assure access to safe and high quality health care services and to have a thriving nursing profession. Thus, we strongly encourage other researchers and nursing organizations to bring data to the discussion of the future of nursing, the image of nursing and innovations in fostering positive work environments and working relationships among health professionals that will benefit patients.
Peter I. Buerhaus, PhD, RN, FAAN
Valere Potter Distinguished Professor of Nursing
Senior Associate Dean for Research
Vanderbilt University School of Nursing
Karen Donelan, ScD
Senior Scientist in Health Policy
Massachusetts General Hospital
Buerhaus PI, Donelan K, Ulrich BT, Norman L, Dittus R. State of the registered nurse workforce in the United States. Nurs Econ. 2006 Jan-Feb;24(1):6-12, 3.
Norman LD, Donelan K, Buerhaus PI, Willis G, Williams M, Ulrich B, Dittus R. The older nurse in the workplace: does age matter? Nurs Econ. 2005 Nov-Dec;23(6):282-9, 279.
Buerhaus PI, Donelan K, Ulrich BT, Norman L, Williams M, Dittus R. Hospital RNs' and CNOs' perceptions of the impact of the nursing shortage on the quality of care. Nurs Econ. 2005 Sep-Oct;23(5):214-21, 211.
Ulrich BT, Buerhaus PI, Donelan K, Norman L, Dittus R. How RNs view the work environment: results of a national survey of registered
nurses. J Nurs Adm. 2005 Sep;35(9):389-96.
Donelan K, Buerhaus PI, Ulrich BT, Norman L, Dittus R. Awareness and perceptions of the Johnson & Johnson Campaign for Nursing's Future: views from nursing students, RNs, and CNOs. Nurs Econ. 2005 Jul-Aug;23(4):150-6, 180, 147.
Buerhaus PI, Donelan K, Ulrich BT, Kirby L, Norman L, Dittus R. Registered nurses' perceptions of nursing. Nurs Econ. 2005 May-Jun;23(3):110-8, 143, 107.
Norman L, Buerhaus PI, Donelan K, McCloskey B, Dittus R. Nursing students assess nursing education. J Prof Nurs. 2005 May-Jun;21(3):150-8.
Buerhaus PI, Donelan K, Ulrich BT, Norman L, Dittus R. Is the shortage of hospital registered nurses getting better or worse? Findings from two recent national surveys of RNs. Nurs Econ. 2005 Mar-Apr;23(2):61-71, 96, 55.
Buerhaus PI. Six-part series on the state of the RN workforce in the United States. Nurs Econ. 2005 Mar-Apr;23(2):58-60, 55. Review.
Buerhaus PI, Donelan K, Norman L, Dittus R. Nursing students' perceptions of a career in nursing and impact of a national campaign designed to attract people into the nursing profession. J Prof Nurs. 2005 Mar-Apr;21(2):75-83.
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