Twelve strategies to enhance nursing practice in a community hospital

Strengthening professional practice in a community hospital with a predominately associate degree-prepared workforce can be an overwhelming challenge. This article presents the processes and early outcomes from an initiative of Saint Alphonsus Regional Medical Center (SARMC), a 383-bed community hospital in Boise, Idaho, and a member of the Trinity Health System of Novi, Michigan, to overcome this challenging nursing demographic to engage the nursing staff and enhance practice. Similar to other community hospitals, the challenges of low levels of professional involvement and identification with nursing, coupled with a high proportion of casually employed nurses, were present. A service line structure existed for 15 years that promoted a strong marketing focus, but the organization lacked the counterbalancing forces of a strong nursing professional practice environment. It is hoped that other facilities with similar challenges will be able to replicate this process in their facilities.