Growing healthy workers

1
Growing health(y) workers

• by
• Alison Taylor and Susan Brigham

2
History of internship

• Provincial committee in late 1990s concerned with
  recruitment and retention in health occupations
• Approach made to CAREERS (broker)
• Funding provided by 2 urban RHAs (300,000) and
  Alberta Health Wellness (470,000) for 3 yr
  pilot

3
Data

• Interviews 3 RHAs, 3 unions, 2 field directors,
  school coordinator, government
• Focus groups 14 students and 8 mentors in
  Calgary and Edmonton
• Surveys of 268 students and 214 mentors

4
Research Questions

• How does the internship program work and to what
  extent is the recruitment goal reflected in the
  organization of the program?
• What are the reasons for occupational shortages
  in health services and does this make sense as a
  policy solution?
• Given this analysis, what type of learning about
  work in health care should such programs promote?

5
Theoretical assumptions

• Ensuring a high quality of work for young
  people should be as important to policy-makers as
  preparing employable students. (Lowe, 2000)
• The social policy question of how work can be
  reformed to permit fuller use of peoples current
  education and learning capacities is as important
  as asking what work requires of schools
  (Livingstone, 1998)

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Snapshot of program in 2003(from surveys)

• 84 female interns
• 91 had achieved an average grade of 70 or
  more in last year of HS
• 90 planned to go to university
• Future work enjoyable, satisfying, fulfilling,
  working with others

7
The recruitment goal

• Limited educational aims of program
• Competitive nature of student selection
• Focus on ROI in evaluating the program
• x Articulation with post-secondary
• x No formal tracking of students
• (with exception of 1 RHA)

8
Why shortages in health care?

• Lack of interest on part of students? NO!
• Demographic changes
• Provincial policy in 1990s
• Credentials creep
• Workforce management issues

9
Extent of shortage

• When Im talking about a shortage I might be
  talking about 2 or 1.05 or 2.75 FTE. Now for me
  thats huge because that may mean we cant
  deliver our service. But you know, youre talking
  about 200 kids applying for those post-secondary
  seatsthere may be only 5 seats. (Interview,
  urban RHA)

10
Provincial policy

• 25 per capita decline in total health care
  spending between 1992 and 1998 (Plain 1997)
• Between 1993 and 95, between 2,000 and 3,000
  nurses laid off in Alberta
• (Scott-Findlay et al. 2002)
• Decline in post-secondary seats
• 1990-2000 nursing seats down 26 (CNAC 2002)
• Existing seats are oversubscribed
• Lack of workforce planning data

11
Credentials creep

• There is a move afoot in many of the
  disciplineswe call it credential creep. So
  physical and occupational therapy are moving
  to a mandatory masters degree. Technical
  disciplines are moving toward a degree-based
  training. Pharmacy technicians, again, very
  much used to be trained on the job. Now you need
  a credential.
• (Interview, union)
• Response of employers

12
Workforce management

• x Increase in part time and casual work (and
  increase in involuntary underemployment)
• 1/3 1/3 1/3 (full time, part time, casual)
• x Performance gap
• Supernumerary programs

13
Increase in part time and casual

• Since the cutbacks in the 90s, theres been
  very few full time positions posted. If you
  talk to new grads, if you talk to students out
  there full time positions are as scarce as
  hens teeth. Theyre working part time and
  trying to pick up shifts here and there. And that
  creates a lot of angst, not knowing if youre
  going to get that extra shift this month and
  youve got a mortgage, youve got a student
  loan. (Interview, union)

14
Performance gap

• The gap between educational attainments and
  actual technical job skill requirements
  (Livingstone 1998).
• Some of the shortages that afflict health care
  workplaces could be eliminated if nurses and
  other health care practitioners were permitted to
  work to their full scope of practice.
• (CNAC Report, 2002)

15
Implications for HS internships

• Encouraging young people to encourage careers in
  health care is not enough
• Too little attention paid to the implications of
  the recruitment focus of the organization
  outcomes of internship for students
• Educator and other partners need to pay more
  attention to what kind of learning about work in
  health care should be promoted through internships