Modern Healthcare

Nurses have solutions to the staffing crisis, if leaders will listen

- Kate Judge is the executive director of the American Nurses Foundation, the philanthro­pic arm of the American Nurses Associatio­n. TO SUBMIT A DRAFT dmay@modernheal­thcare.com

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 farreachin­g 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.

“Nurses deeply understand the issues within their profession. Therefore, they are best positioned to transform it.”

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.

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