The Future of Nursing report calls for greater health equity and variety

The Covid-19 pandemic has highlighted serious inequities within the country’s healthcare system, with frontline healthcare employees often lacking the vital personal protective equipment and other equipment to do their jobs safely and effectively. The social justice movement that emerged within the wake of George Floyd’s death has make clear the structural racism that also exists within the workplace and throughout society. Susan Hassmiller, RN In the face of those many challenges, the National Academy of Medicine’s recent report on the longer term of nursing, “The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity,” lays out key issues and goals for the nursing occupation across the years for the following 10 years, with a specific concentrate on reducing inequities in healthcare and improving health outcomes. According to Susan Hassmiller, PhD, RN, FAAN, the report was originally scheduled for release in December 2020 but was delayed until May to deal with lessons learned from the Covid-19 crisis and the racial and social justice issues which have arisen in over the past 12 months. , senior nursing advisor on the Robert Wood Johnson Foundation and senior fellow on the Foundation National Academy of Medicine. Dr. Regina Cunningham, RN, NEA-BC, FAAN, who served on the committee that helped prepare the Future of Nursing report, said the Covid-19 pandemic has highlighted lots of the disparities that exist within the nation’s health care delivery system as low-income communities incomes and minorities have been hit particularly hard by the pandemic.

“COVID-19 didn’t cause these problems, but it showed us where many health disparities exist,” Cunningham said. “It was devastating, but incredibly clear.”

Hassmiller gave a presentation on the report during a June 2 webinar hosted by the Columbia University School of Nursing. Other nursing leaders and experts also participated within the webinar. She noted that the predominant themes of the report were the necessity for greater health equity within the U.S. and a more diverse nursing workforce. Hassmiller also said the report made a complete of 54 specific recommendations, but an important conclusions may very well be divided into 4 predominant areas:

1. Permanently remove barriers to nursing practice

This includes removing regulatory barriers in nursing laws to present APRNs full authority to practice and ending restrictive workplace policies or practices that prevent nurses from pursuing the total scope of their education and training.

2. Value nurses’ contributions

This includes establishing sustainable and versatile payment mechanisms to support health care nurses, including public health nurses and faculty nurses, to advance health equity.

3. Prepare nurses to deal with and understand health equity

This includes addressing systemic racism within the workplace, increasing the variety of minority students in nursing schools, and attending to the needs of an aging and diverse population.

4. Fully support nurses

This includes implementing evidence-based systems, structures and interventions to advertise the health and well-being of nurses.

Diversification of the workforce

Hassmiller said the necessity for greater diversity within the nursing workforce is clearly visible within the “Future of Nursing” report. Today, she said, the nursing workforce is predominantly white and ladies, and about 90% of nursing leaders within the U.S. are white. These numbers don’t properly reflect the present demographic structure of the country.

“We need to understand that black and brown people have been treated differently in the past,” she said.

The report also takes a daring stance on the necessity to eliminate structural and institutional racism in nursing. “The fact that this report identified racism in nursing and said we need to dismantle it is very important to nurses of color,” Cunningham said. “It’s time to get on with it.” Cunningham, CEO of the Hospital of the University of Pennsylvania and assistant and assistant professor on the University of Pennsylvania School of Nursing, said some progress has been made lately in increasing the variety of minority and male nurses. In 2018, African-American nurses made up roughly 12% of the nursing workforce, Latino nurses made up 7.4%, and Asian nurses made up 9.1%, a rise from 20 years earlier. Despite this, the report found that 69% of registered nurses were still white and over 87% were women.

“We have made some progress, but not enough and not fast enough,” she said.

The report makes several recommendations for increasing diversity in nursing, including calling on nursing schools to extend the representation of minority students and college. It also calls for the creation of mentoring and academic programs to assist minority students consider nursing careers and urges health care systems to advertise more minority nurses to leadership positions.

Catherine Georges, EdD, RN, FAAN, professor and chair of the Department of Nursing at Lehman College in New York, one in all the speakers on the Columbia University webinar who has done research on health care disparities, said the report has many excellent goals , but it is necessary that the actions identified within the report are implemented. “It’s not just about advocacy, we have to take action,” she said. “Nursing in this country is still overwhelmingly white, mostly women. Where will the next generation of nurses come from? Why aren’t there more nurses on hospital boards? I think nursing is uniquely positioned to take control and lead on these issues.”

A brand new generation of nurses

The next decade is anticipated to bring unique challenges to the nursing occupation as many baby boomer nurses move away from their roles. The need for more highly expert nurses shall be crucial. Georges, a former national volunteer president of AARP, said it’s estimated that by 2030, greater than 1 million people within the U.S. shall be over the age of 100, and more nurses shall be needed to satisfy the needs of an aging population. On a positive note, Georges said there was a major increase in nursing school enrollments over the past 12 months, but those nurses also must be properly trained to reflect the range of the communities they serve.

“It’s not just about younger nurses,” she said. “It’s about better-prepared nurses. We need a different workforce. We need a well-educated workforce that reflects the communities they serve and care for.”

Promoting community nursing

Georges said that because the population ages, there shall be a greater need for more nurses working directly in communities to enhance health care outcomes, especially in low-income and marginalized communities. This means greater investment at school and public nursing. Hassmiller said school nurses and public health nurses are sometimes undervalued for the work they do. “School nurses and public health nurses are not paid as much as hospital nurses or nursing staff, yet their work is just as important,” she said. The Future of Nursing report calls for nursing to focus more broadly on the social determinants of health to deal with health inequities in underserved communities, reminiscent of lack of access to health care and food insecurity. Cunningham said that in preparing materials for the report, committee members visited several cities, including Chicago, Seattle and Philadelphia, where nurses were introducing modern solutions to advertise health equity of their communities. In one example in Chicago, a nurse and nursing students established a health clinic as a part of a housing project to supply needed health care to low-income residents. In one other case, nurses developed a highschool program to supply health care and education to pregnant teenagers and recent moms. “These are incredible examples of nurses’ work on social determinants of health and health equity,” Cunningham said. Hassmiller believes that millennial nurses and other younger generations of nurses are very socially aware and prepared to deal with lots of the health equity issues identified within the Future of Nursing report. “I honestly think this younger generation of nurses may be more willing to learn and understand health equity because they grew up in a more diverse society,” she said.

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