The nursing shortage is having a devastating impact on the nation’s fragile healthcare system. The COVID-19 pandemic has highlighted why nurses are critical to healthcare, but it’s also exposed a harsh reality—nurses are undervalued and undersupported. And the challenges they face are unprecedented.
Nurses deeply understand the issues within their profession. Therefore, they are best positioned to transform it. With leadership support and ongoing investment in their knowledge and expertise, nurses can create radical breakthroughs that maximize patient outcomes while minimizing the strain on their colleagues.
Hospitals and health systems, much like the nurses and other healthcare professionals they employ, are stretched incredibly thin. Inflation, rising labor costs and other operational challenges might make decision-makers wary of backing bold initiatives, but it will take flexibility, creativity and collaboration to fix this broken system.
Based on more than 30 years of experience working with and around nurses, I propose three approaches to improve the nursing profession:
Listen first, then act. Listen to nurses and identify how organizations can better support them. That’s what the American Nurses Foundation did through its Reimagining Nursing Initiative. Nurses told us they had ideas, and we showed up with money. Out of hundreds of applications, the initiative funded 10 exciting nurse-led projects that promised more than a one-time solution. With our $14 million in grants over the next three years, the projects aim to demonstrate far-reaching change is possible. Organizations need to identify their nurse leaders and embrace their ideas about how to address the critical gaps in nursing. Leaders might be invigorated by what they learn.
Tap into nursing knowledge. Nurses are care experts, and their expertise is valuable in related fields. For example, several funded projects use technology developed by nurses to allow care teams to use their time more efficiently.
One nurse informaticist realized there were patterns in the way nurses document in electronic health records when they are worried about potential changes in a patient’s health. The insight led to the creation of CONCERN (COmmunicating Narrative Concerns Entered by RNs), a predictive tool that analyzes those patterns to help prevent organ failure and other critical conditions in hospitalized patients.
With funding from the initiative, that nurse and her team are partnering with several healthcare organizations to test CONCERN’s scalability: Mass General Brigham in Massachusetts, Vanderbilt University Medical Center in Tennessee and Washington University School of Medicine/Barnes-Jewish Hospital in Missouri. The project will focus on collecting data—specifically for best practices on how to implement CONCERN across new sites while mitigating any racial, ethnic and insurance-level biases.
Let go of what isn’t working. A persistent gap exists between what practicing nurses need to know and what they are trained to do in nursing school. Students need to graduate with the skills and confidence to work in diverse and complex settings. They should never feel surprised by what awaits them post-graduation.
Several projects are changing how nurses learn to ensure students have the competencies they need to be successful. The Ohio State University’s Disrupting Nursing Education with XR, AI and ML uses extended reality to expose students to more realistic practice scenarios. The goal is to improve the practice readiness of graduate nurses by educating them at a more individualized pace.
Extended reality provides a risk-free environment for students to learn from their mistakes. They get to view healthcare from a patient’s perspective, which often allows the aspiring nurses to work through implicit biases and find exciting new ways to deliver care. So far, students have engaged in more than 2,000 simulations designed to prepare them for a world with evolving and demanding healthcare needs.
Moving to a competency-based model while utilizing new educational tools will allow each student to demonstrate they understand what they are being taught, what’s expected of them and how to care for different patient populations before they reach practice.
While the foundation was able to fund 10 projects in the Reimagining Nursing Initiative, the real story is about the 334 ideas it could not. It will take more leadership buy-in to support projects that can empower nurses to stay in the profession and work alongside physicians, staff, and administrators to fix the entrenched issues that led to this crisis. The profession and the industry are ready for change. Nurses can get us there.