Journal of Nursing & Patient CareISSN: 2573-4571

Research Article, J Nurs Patient Care Vol: 2 Issue: 1

Achieving Outstanding Outcomes in Recruitment of High Schoolers to a High School Summer Camp: Structure and Process Considerations

Connelly L*, Kathol L, Miller J and Stover A

UNMC College of Nursing, USA

*Corresponding Author : Liane Connelly PhD, RN, NEA-BC
Assistant Dean, Northern Division, UNMC College of Nursing, 801. E. Benjamin, Norfolk, NE. 68701, USA
Tel: 402-844-7895
E-mail: [email protected]

Received: March 17, 2017 Accepted: April 14, 2017 Published: April 14, 2017

Citation: Connelly L, Kathol L, Miller J, Stover A (2017) Achieving Outstanding Outcomes in Recruitment of High Schoolers to a High School Summer Camp: Structure and Process Considerations. J Nurs Patient Care 2:1.doi: 10.4172/2573-4571.1000111

Abstract

Once again, the US nursing workforce is facing a severe shortage of professionals. Retiring nurses, the implementation of the Affordable Care Act, technology, and the expanding role of the RN have increased the need for nurses. In Nebraska, nearly 4,000 RNs will are needed by 2020 to address this shortage. Because the opportunities for employment for high schoolers who are considering career choices are so broad, reaching out to diverse high school students to attract them to nursing is essential. Furthermore, recent studies have indicated that many high schoolers, as well as high school counselors, are not aware of the role that RNs play in the US health care system. To address the need to reach out to high school students from diverse backgrounds, the University of Nebraska Medical Center College of Nursing (UNMC CON) developed a summer camp for students in the Northern Division Campus located in Norfolk. Funded by Health Resources Services Administration (HRSA), the Generation Link to Learn Grant (LTL) links high schoolers from educationally disadvantaged backgrounds to nurse mentors, nursing student mentors, and adult relatives/guardians so that students have role models of success as they consider a career in nursing. During the two-day summer camp, campers actively learn about the role of the RN in today's health care arena. Activities serve to excite campers as they experience various aspects of the nurse's role for future success in a college of nursing program of study. In addition, interactions with nursing students help the high school summer camper understand educational expectations that are a normal part of learning the RN role. This paper discusses structure, process, and outcome factors that are essential for the creation of a successful high school summer camp for educationally disadvantaged learners who are interested in a career in nursing.

Keywords: Registered nurse; Nursing students; Nursing career

Introduction

As a state, Nebraska is largely rural and agriculturally based, with the largest number of RNs located in the two major metropolitan areas of Omaha and Lincoln. Recent Nebraska Center for Nursing data from the 2016 licensing renewal process indicate that 61.2% of RNs work in either Douglas or Lancaster Counties (Omaha and Lincoln), and the remaining 38.7% of RNs work in the rest of the counties of the state. Further examination of the data reveals that six counties in the state have no RN working in them (Grant, Arthur, McPherson, Loup, Wheeler, and Hayes).

Given recent reports regarding the need for more BSN prepared nurses, community leaders from Northeast Nebraska collaborated with legislators, the local community college, and UNMC CON to raise 12 million dollars in 12 months. These funds, obtained entirely from private and public donations of businesses, families, and health care organizations, were used to build the new College of Nursing building, which houses the Northeast Community College (NCC) LPN and Associate Degree nursing program as well as the UNMC CON BSN through PhD degrees. The building is located on the campus of NCC in the community of Norfolk, Nebraska, a community of 24,444. Students can literally begin their education by taking certified nursing assistant (CNA) courses at NCC and progress through UNMC CON PhD program without leaving the rural community. In the years since the beginning of the partnership, Madison County (location of the College) has seen a growth of 135 RNs with a nurse to population ratio growth from 15.3 RN per 1000 in 2008 to 18.7 per 1000 in 2016.

The UNMC CON’s attempt to address the state’s need for nurses recognized the challenges of educating the local diverse student population. The city of Norfolk, located 60 miles south of the South Dakota border in the Northeast part of the Nebraska, has an population of 24,444 (2014) and serves as the main campus of NCC/ UNMC CON. Racial/ethnic groups are Caucasian (80.6%) followed by Hispanic (13.6%) and two or more ethnicities (1.9%) or other not reported (3.9%) [2]. To the north and east of Norfolk along the Missouri River, the Santee Sioux, the Omaha Nation, Ponca, and Winnebago tribes are located within a 75-mile radius. The Ponca tribe has a regional office in Norfolk. Fifteen miles to the south of Norfolk, the community of Madison is nearly 48.8% Hispanic [3]. Along with challenges of addressing the needs of the diverse population within the college’s service area, there are also issues related to the educational disadvantages that students from this area typically face. The average household income in 2015 was $47,995, which is lower than the state average of $54,996 during that same period, and rates of free and reduced lunches in areas schools routinely exceed 30%. Many students are first generation college students and have graduated from schools where student assessment scores fall below state standards. These challenges created the opportunity to engage area students in a career path toward nursing.

Because UNMC CON Northern Division was a new entity in this part of the state in the fall of 2010, it was essential to initiate a recruiting campaign to reach out to the diverse students in the region. After a permanent campus Dean joined the campus in 2011, the UNMC CON Northern Division began planning for a high school summer camp for the summer of 2012, so that area students could learn about careers in nursing and the availability of a BSN program in their regional community. During the first two years of the summer camp planning and implementation, the primary goal was to market the program to a broad range of high school students without focused attention on diverse populations. Since 2014 however, this yearly summer camp has reached out to educationally disadvantaged and ethnically diverse students, as well as the larger Northeast Nebraska region. With funding from HRSA in 2015, this summer camp has been extended to all five campuses of UNMC CON. These five campuses are located in all regions of the state of Nebraska, which makes it easy for individuals to participate in a summer camp close to home.

Quality in summer camp development

As with any successful endeavor, planning is essential. The first steps in planning for a successful summer camp in the summer of 2012 included selecting the best team for the job. Two administrative staff, one student services coordinator and two faculties worked together in planning the program, with the administrative staff serving as lead on the project. Their detailed planning skills and knowledge of the community, based on having lived in the region for many years, were an immense help in accessing community resources needed for the summer camp project.

The first year of planning included the essential development of tools and forms necessary for a safe and effective summer camp. Medical release forms, parental permission for activities, the logistics of bus rental, and volunteer community group participation provided the necessary foundation for a safe, effective experience for campers. Local EMS providers from two communities volunteered to provide an educational session for the campers on the first evening of the camp, which has continued to this day. The local air life team was contacted, so that they could land on the campus premises, and students could learn about flight nursing. Vendors were contacted regarding the provision of snacks, meals, and free supplies for the campers. A partnership between UNMC CON and NCC provided students the opportunity to stay overnight in the dormitory at a reduced cost.

Because the first few years of the camp were implemented with a very limited budget, volunteers in the community were an essential part of the success of the camp. One volunteer partnership included a network with the University of Nebraska County Extension Office and their college bound program, which reaches out to educationally disadvantaged students. Information regarding the camp was sent to educationally disadvantaged students through this partnership, so that a more diverse population of learners could be reached. The Area Health Education Center (AHEC) office also assisted by providing information to their health career high school students. Student recruitment continues through these two major sources. In addition, high school counselors in the 24 county region of UNMC CON Northern Division were provided information about the camp and were encouraged to notify their respective high school students about the event. The target audience for the camp is students from 16-18 years of age, although one campus seeks out students who are 14-15 years of age.

Another structural element is the development of a timeline in planning. Given the level of detail required for a successful summer camp, it is recommended that preliminary work and contact with partners begin at least 5 months before the event. If the event is held in a location other than the campus, space may need to be reserved a year ahead of time. Other structural planning essentials include ordering t-shirts and medical supplies in sufficient quantity, making arrangements for food services and lodging, and other supplies that may be needed for specific activities in the camp.

Once individuals are recruited for the summer camp opportunity, they have the opportunity to submit applications for the event. The application process includes references from two individuals, including their high school counselor or a teacher who knows them well. For the first year of the camp, students were charged $25.00 to cover a portion of the cost of meals and supplies. The cost of the camp was supported through the use of foundation funds which were designated to be used for individuals from the Northeast Nebraska region in their pursuit of a career in nursing. Funding from HRSA has enabled students to participate for no cost during the 2015, 2016 and 2017 summer camps.

Students are selected based on references, high school GPA, and class size availability. In the Northern Division, up to 24 students are selected each year. The Western Division, which is located in Scottsbluff, typically selects 8 students for the camp, while other campuses select 15-18 students for their events.

Quality process considerations

Creating quality in the implementation of the LINK to LEARN Summer Camp requires attention to the essential components (LINKs) of the program. These include creating a sense of belonging, establishing professional partnerships with area businesses, effective communication, relevant mentoring processes, meaningful parental involvement, realistic nursing-specific activities, and the creation of stories of success.

Multiple sources document the role of belongingness in programs of nursing [4,5]. In order to foster a sense of belonging in the LTL Summer Camp, students are provided nursing scrubs free of charge for use during the camp. These nursing scrubs include the LTL logo and are a gift to the students for their personal use during and after the camp. Summer campers are also divided into small groups, with a different color bandana or camp shirt representing each group (including the BSN mentor). Campers and BSN mentors wear these items during the camp to designate group membership. These simple steps initiate a sense of being part of a team during the event. In addition, the intentional inclusion of BSN students in the event (discussed later) provides an avenue for high schoolers to have a sense of community during the camp.

Professional partnerships in the implementation of the LINK to LEARN Summer Camp included the AHEC office, which matches high schoolers to mentors and clinical locations before the summer camp for job shadowing experiences with RNs in practice. Originally a part of the early years of the LTL Summer Camp, this job shadowing experience is now a required component of the camp before the actual two-day event. This provides the opportunity for campers to spend 4 hours of dedicated time with a RN in practice and then reflect on this experience during the camp. Other partners include area hospitals, volunteer emergency services personnel, high school counselors, and health career counselors.

As the summer camp nears, communication is essential. Students, as well as family members and guardians, are kept informed regarding any required medical release forms or media release forms that are due before the actual day of the event. Accommodations for dietary or other health needs are gathered from students via application forms. This is accomplished through email, Facebook and tweets with participating high schoolers. Considering that most educationally disadvantaged students have access to smartphones, this has been an effective strategy for ongoing communication [6]. Attending to the published schedule of activities and communicating with students about plans throughout the two-day event keeps the program running smoothly. In addition, daily “huddle” meetings with staff and faculty ensure reflection on best implementation strategies in the camp, while preparing for each day.

During the Link to Learn Summer Camp, current BSN students who have self-identified as educationally disadvantaged participate as mentors to the high schoolers in the camp. These BSN students have been instrumental in the success of the program each year. Through intentional mentoring events during the two-day event, high schoolers have an opportunity to learn first-hand about nursing school. BSN mentors participate in an orientation session before the Summer Camp is offered. The orientation session includes strategies to foster a sense of inclusion and open communication. During the camp, these BSN student mentors are paired with a small group of 4-5 participants in the camp and serve as a mentor/facilitator during the entire summer camp experience. The mentors participate in ice-breaking activities with participants and work closely with them throughout the summer camp. Lunches and breaks with their BSN mentor occur, with focused conversations about overcoming challenges and opportunities in nursing education. Mentors also serve as helpers during the overnight stay in the dormitory, as this is often the first overnight stay in a dorm for the high schoolers. Students relate best to BSN students, who are generally close in age and of similar background to them. Both summer campers and BSN students have expressed positive interactions as a result of this mentor-mentee experience, which has been shown to be an effective strategy for educationally disadvantaged students [7].

An additional quality element in the delivery of a successful summer camp includes the involvement of the parent or guardian in activities. Grandparents, parents, or adult guardians are invited to attend the first day of camp. During this time, they participate in activities using simulation and learn about key science concepts that underpin nursing education. They also attend separate events during the camp related to supporting their student while in college and financial aid planning. Some students invite grandparents, while others invite parents or other adult relatives to the event.

Recent literature supports that high schoolers may not have a full understanding of the role of a RN [8]. Therefore, it is important to provide realistic examples and activities demonstrating the role of a RN. During the LTL Summer Camp, students perform psychomotor skills such as vital signs, listening to heart and lung sounds, changing dressings, ambulation, and basic first aid. They also discuss the cognitive aspects of professional nursing such as dealing with a person with a mental health concern. Use of a high school science consultant has been invaluable in creating activities that capture knowledge expected in high school, while relating this knowledge to a career in nursing. For example, one activity includes “building” a set of lungs from an empty one-liter soda bottle and balloons, which then leads to a simulation activity on pediatric asthma.

In order to promote intrinsic motivation for success in nursing school, one event during the camp is a shared activity between the high schooler and the adult relative related to sharing a story of success. The adult relative is asked to share one of his/her own personal stories of success with their family member/high schooler, and then together they create a box of success. This box of success is decorated by the high schooler and contains keepsakes of the camp for future reference. Students are encouraged to reflect on how they can be successful in nursing school with their adult relative through the creation of this box. A journal entry that is written by the adult relative and student is also placed in the box for future reference.

The use of technology in the summer camp helps to capture the interest and excitement of high schoolers regarding a future in nursing. Simulated manikins, computers, and other technologies reach to multiple learning approaches that are evident in today’s media rich learners. Being able to touch, feel, hear, smell and discuss aspects of nursing make a career goal more of a reality for students. This fosters a student-focused learning environment.

Providing information to guardians about resources that are available to help high schoolers prepare for college is helpful as they consider how to navigate a future in nursing through college education. Guardians who attend the LTL Summer Camp may have little knowledge about financial aid, college life or student health issues. Professionals from the office of admissions and financial aid provide sessions during this two day camp that are directed to the guardians, so that they have the opportunity to ask questions about health and safety and finances related to college education.

During the camp, it is critical that students’ needs are addressed quickly. For example, one year a student was sent to an urgent care clinic at the urging of the RN in charge of the camp because of symptoms of abdominal distress and possible appendicitis. This was confirmed when the guardian later reported that the summer camper had an emergency appendectomy. In another situation, a camper did not have a ride home-a three-hour drive from the campus. The RN in charge of the camp worked with the student to arrange with family friends and provided a safe transport to home.

After the event, campers are invited to return to campus for social events in the fall and spring. This permits the development of an ongoing relationship with BSN mentors and the high school students interested in a career in nursing.

Quality outcomes and lessons learned

The LTL Summer Camp has been offered in the Northern Division since 2012. In 2015, the Western Division of UNMC offered the camp, and, in 2016, four of the five campuses offered the camp. In the summer of 2017, all five campuses will offer the camp. This expansion has permitted UNMC CON to have a state-wide reach of opportunities for high schoolers interested in nursing. In the first year, a total of 24 students participated, while the 2016 year saw a total of 67 students enroll in the LTL Summer Camp. Although actual enrollment in a school of nursing has not been tracked, at least 2 have enrolled in the Northern Division in the past 2 years.

Qualitative pre and post assessment of high schoolers’ and guardians’ perceptions of the LTL Summer Camp have been gathered. Comments have been highly positive for the past five years, with minor constructive suggestions for improvement which have been incorporated into future camps (Table 1).

2015 Summer Camp
-The job shadowing was cool. It gave students the ability to see nurses in action.
-Overall, GREAT CAMP!
-The camp should have more days added and different types of activities added to it as well.
-The lecture was not very fun but interesting
2016 Summer Camp
-Anything to do with the medical field I always count myself in, so I'm glad that I was accepted to this summer camp because it did expand my knowledge and it really does help a lot. Also you get the college experience and how it is to be away from home and your family.
-Thank you for making this possible, it’s the first time I got an experience like this, and it was honestly awesome and I learned so many things that I am going to share with my science teacher.
-Overall I loved my experience from attending the camp. I really liked how things were explained and how I was informed on the whole overall role of a nurse.

Table 1: Qualitative Comments from High School Summer Campers.

On some of the campuses, one of the lessons learned relates to the participation of guardians due to work obligations. These camps planned for an evening BBQ with guardians invited, so that they could participate. Only one guardian was not able to attend.

In addition, anecdotal evidence from planners of the LTL Summer Camp has recognized the need to use a variety of methods to stay connected with high school participants after the event each summer. Although it was desirable to have these high school students return for a one day event each fall and spring, this has been challenging to complete due to the many competing schedules. It is recommended that a combination of face to face and electronic methods be used to keep in touch with individuals who are interested in a career in nursing. In addition, inviting students to return to camp the following summer has been effective. Although the summer camp planners perceived that students wouldn’t be interested in returning, we have in fact had students who return to summer camp a second year. This has challenged the team to modify the content of the camp so that there are new elements each year.

Another quality improvement planned for future camps includes the use of a theoretical approach to the camp. For example, a thematic analysis [9] found that after exposure to a 90 hour shadowing experience, students perceived five themes to be relevant to the profession of nursing (professional role responsibility, teamwork, caring relationships, tools and technology, and medication management). These themes can serve as an organizing framework for the camp. Other ways to organize the camp could include a focus on a particular nursing concept or major area/setting of practice (community or inpatient care). Thoughts regarding a session I and session II camp offered in the same summer have been considered, with learning experiences that increase in complexity from one session to another.

The overall outcome of the LTL Summer Camp has been very positive and serves as a motivator for the staff and faculty to continue to offer this program each year for high school students. Helping high school students gain an accurate perception of the role of the RN in the United States can help to entice students into the profession. Attending to key elements of structure, process and outcome assures a quality event that is impactful for our future generation of nurses.

Acknowledgements

The authors wish to acknowledge the generous funding from Health Resources Services Administration (HRSA) for the Generation Link to Learn project. This two-year project includes a summer camp for high school students, a summer externship program, academic mentoring and coaching of BSN students, and scholarships for educationally disadvantaged nursing students.

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