Bring back Operation
Nightingale to cope with
Hawaii’s nurse shortage
I agree with the Star-Bulletin's Feb. 19 editorial, "Nursing shortage demands strategy center," which called for establishing a center for nursing at the University of Hawaii that would conduct research on how the state should address the nurses shortage. However, that proposal offers only a long-term solution.
A more immediate solution -- which would complement the proposed center for nursing -- would be for the Legislature to re-implement Operation Nightingale, a pilot program administered by the state Department of Health that has proved successful in immediately increasing the number of licensed nurses in Hawaii.
The hundreds of nurses who went on strike a few months ago complained of staffing issues -- mandatory overtime, vacation and sick leave -- and low morale caused by understaffed units and working conditions that required long hours and more patients than nurses could safely care for. These same conditions were rampant during the state's acute nursing shortage in the late 1980s and early 1990s.
In 1987, I introduced and helped pass legislation that established Operation Nightingale, a review and training course that prepared foreign- and U.S.-trained nurse graduates for written exams required by the National Council Licensure Exam For Registered Nurses (NCLEX-RN) and the state Board of Nursing. These graduates -- typically nurse aides, ward clerks, licensed practical nurses, physician's secretaries or those in other nursing-related jobs -- represented an untapped resource of personnel and expertise.
Operation Nightingale established a public-private partnership between the state of Hawaii and participating hospitals. Under this agreement, the DOH provided classroom facilities, books, review materials and instructors. In return, hospitals maintained the employment status, benefits and salaries of qualified employees who participated in the program.
Operation Nightingale was effective in boosting nurses' morale because staff could be promoted internally. The program also averted the costly alternative of bringing in nurses from the mainland.
The program's first graduating class had a passing rate of 73 percent, which was astounding when compared to the 3 percent pass rate of foreign-educated nurses. At its height, Operation Nightingale produced approximately 30 registered nurses every six months. The program was discontinued when the demand for qualified nurses was met.
With lessons learned from the nurses strike, and taking into account Hawaii's aging population and a continued decrease in nursing applicants, it's time that the Legislature seriously consider re-implementing Operation Nightingale. Act 212, which established the program, remains a part of the Hawaii Revised Statues. The Legislature must simply provide the necessary funding and interaction with hospitals.
Operating Nightingale cannot single-handedly solve the state's nurses shortage, but it has been proven to quickly produce registered nurses at a fraction of conventional nursing school costs. The program complements efforts by our public and private universities to produce qualified health professionals to meet the growing demand for licensed nurses.
Romy M. Cachola represents District 7 (Kalihi, Foster Village) on the Honolulu City Council.
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