{"issues":[],"legislators":[],"articles":[{"title":"COVID-19 as a Force for Change: Nurses and the Public Co-Designing Better Healthcare","id":1,"slug":"1-covid-19-force-change-nurses-public-designing-better-healthcare","links":{"self":"https://www.nurseseverywhere.com/articles/1-covid-19-force-change-nurses-public-designing-better-healthcare","article_comments":"/api/article_comments?article_id=1","signatures":"/api/v3/articles/1/signatures?include=user"},"content":"

As a nurse in the midst of this pandemic, I practice one of what I consider to be a critical leadership characteristic--acknowledging vulnerability and its role in building resiliency in people and systems. It is applicable to us all whether we lead a nation, a health system or our family. On any given day I am a mix of emotions, pride, sadness, inspiration, concern, anger and hope, but mostly fervent determination. Determined, that we, together can carry the torch for what is right, what is best and what we know to be morally correct. My greatest hope is that we can all come together to understand and codify the lessons we have learned as a nation and what we must carry forward into a brave new world for healthcare, schools and public health to work to protect one another through achieving equity for all.

Like many nurses, having walked through the fire of previous outbreaks and epidemics, and now this pandemic, we have and will have our scars that no one can see or understand directly. We are forever changed as nurses, leaders and human beings. My colleague, Dr. Rose Sherman perhaps captured it best on her blog on emerging nurse leadership https://www.emergingrnleader.com/never-again

Shortages in needed healthcare existed before the pandemic and have exaggerated by this crisis. All the more reason for a call to action to ensure that our country makes the best use of its entire healthcare workforce by providing the public easier access to nurses and other healthcare providers and in more convenient settings such as telehealth visits from our homes and with nurses in schools. The NursesEverywhere Expand Nursing Care Survey fielded by the Harris Poll shows 75% of the public believe nurses should be able to treat patients via telehealth in their homes and 86% believe school nurses are necessary to safely re-open schools. As a force for social justice, 88% of the public believe that many healthcare disparities in this country could be improved by increased access to nursing care. https://3aaa9248-e569-4da8-ada5-c4c9b14e503e.filesusr.com/ugd/d52815_ea23c1bba67c46eebe9692cf2b69a54b.pdf

The call to action is to come together, understand our shared experience and to create a path forward to hold the gains we have seen for our patients, to heal the wounds, to celebrate our impact and to be accountable to our country for a progressive remaking of the system. Almost 90% of the public believe that patients should be able to receive the same level of care from nurses after the pandemic is over as they did during the pandemic. https://3aaa9248-e569-4da8-ada5-c4c9b14e503e.filesusr.com/ugd/d52815_ea23c1bba67c46eebe9692cf2b69a54b.pdf

The nursing profession and the public in partnership have a unique opportunity to make sure that lessons are learned from the pandemic and our health care system is made better. This means changing some of the old rules in healthcare that were interfering with needed care; changing rules requires that we all contribute to educating our elected officials about what works for us and what doesn’t. The Covid-19 pandemic has clearly demonstrated the opportunities and inequities that exist in health care today, and it has given us the possibility for positive change. In my recent opinion to the editor of Houston Chronicle that was published, it highlights a real world example of how the public is not served well by a lack of modernization of licensing rules that prevent qualified and competent healthcare providers from caring for patients in desperate need of nursing care. https://www.houstonchronicle.com/opinion/editorials/article/Opinion-Nurses-need-a-national-license-to-heal-15543753.php

We must not waste this opportunity to co-create better, more accessible, and more just healthcare, in honor of those on the frontlines that keep us safe, who’s struggles are clear, who’s sacrifice’s are real and for those we have lost in our profession, our families, as a nation and global community.

Please wear a mask, social distance, wash your hands, if not for you then for everyone else including nurses everywhere.

This post was authored by:

Cole Edmonson, DNP, RN, NEA-BC, FACHE, FAONL, FNAP, FAAN

Founding Member, NursesEverywhere

Local Global Citizen

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Please wear a mask, social distance, wash your hands, if not for you then for everyone else including nurses everywhere.

This post was authored by:

Cole Edmonson, DNP, RN, NEA-BC, FACHE, FAONL, FNAP, FAAN

Founding Member, NursesEverywhere

Local Global Citizen

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To: #Nurses

This one’s just for you.

We know you are growing tired of the hero talk, the discounts, and the applause. We know you want to shout every time you see someone out in public who isn’t wearing a mask. We know it feels like people aren’t listening or providing you with what you want the most. Respect. Respect for your expertise, the care you provide, and your own well being.

So, this is one of a thousand ways we are trying to make your voice heard.

Through a collaboration with country music stars Brown & Gray and the #ThankANurse #WearAMask movement from NursesEverywhere, I am proud to support the music video for the single, You Didn’t Have To. It is our hope that through this song and its powerful music video our voice will be heard. This one goes out to you. Thank you for your courage, commitment, and the expertise you share with all of us.

From: #NursesEverywhere

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To: #Nurses

This one’s just for you.

So, this is one of a thousand ways we are trying to make your voice heard.

From: #NursesEverywhere

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Findings from the Expand Nursing Care Survey commissioned by NursesEverywhere and fielded by the Harris Poll show that 91% of the public agree that hospitals should be required to meet safe minimum nurse staffing standards. A new study “ Chronic Hospital Nurse Understaffing Meets Covid-19” published in the BMJ Quality & Safety by NursesEverywhere member Linda Aiken, University of Pennsylvania School of Nursing Center for Health Outcomes and Policy Research, shows huge variation between hospitals in patient-to-nurse staffing ratios in New York state and Illinois with serious adverse consequences for patients and nurses. The public could bring this new study to the attention of their state elected officials regarding public policies requiring hospitals to meet safe minimum nurse staffing standards.

Multiple studies highlight that proper staffing leads to improved patient outcomes, yet California is the only state to set patient-to-nurse staffing standards. Aiken’s recent study examined how staffing numbers varied across hospitals in Illinois and the State of New York. Coincidentally, the study was planned in advance and just happened to launch in the three months leading up to the COVID-19 outbreak, providing a unique window into the impact of chronic hospital nurse understaffing during a public health crisis.

The study surveyed nurses and patients from 254 hospitals in Illinois and New York from December 2019 through February 2020, looking for associations between nurse staffing and nurse burnout, patient experience and quality of care. The data showed that staffing of medical-surgical units varied widely from 3.3 to 9.7 patients per nurse. Average staffing was worst in New York City, which became the epicenter of Covid-19, with 6.6 patients to every nurse.

Further, over half of the nurses surveyed expressed they were experience high levels of burning just weeks prior to the first wave of COVID-19 hitting the country’s largest city. Studies on burnout paint a clear picture of how patient outcomes are negatively impacted by burnt out clinicians. The full article for Aiken’s study can be accessed at https://qualitysafety.bmj.com/content/early/2020/08/13/bmjqs-2020-011512

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The year 2020 has been devastating ─ from the COVID-19 pandemic to racial injustice to wildfires and hurricanes. Nearly all of us are struggling. Many of us have lost jobs and face economic hardship and hunger. If you’re a parent, you’re likely attempting to provide child care, oversee remote learning, and work simultaneously. If you live alone, you may be experiencing profound loneliness from social distancing. If you live with family members, you may be noticing rising tensions in your home from spending a lot of time together. While all of us have been affected by the pandemic, we have not been affected equally: Black, Indigenous and Latinos have been disproportionately affected by the virus compared with whites, with higher infection, hospitalization, and death rates. They are dying from COVID-19 at disproportionate rates because they are more likely to rely on public transportation, lack basic resources such as food and clean water, live in crowded housing with multigenerational families, be essential workers who cannot work from home, and lack access to health insurance.

These health inequities – coupled with the murder of George Floyd at the hands of Minneapolis police and the failure of authorities to press charges against the three police officers who killed Breonna Taylor while she was sleeping in her own home -- have forced us into a reckoning over racial injustice. We’re also increasingly forced to grapple with the realities of climate change, as wildfires ravage communities on the West Coast and hurricanes ruin homes and lives in the South and on the East Coast.

In the midst of seemingly endless despair, it can seem futile to wonder what one person--or one profession--can do to create a more just path moving forward. But it is only when enough of us come together to recognize our shared humanity and commit to changing the present situation that we can create a more just world.

Nurses have the potential to offer much needed solutions to the problems facing our country: We make up the largest segment of health professionals, we are repeatedly ranked the most trusted profession overall, and we are the first point of contact for most people seeking health care. You probably know a nurse, and you may even be friends with one that you call for advice when your child has a cut or a fever. But you may not have a good sense of who we are, what we do, and how we are well positioned to take on larger roles in tackling the many problems facing our country. The way that we think about nurses is the way that we need to think about health care if we are to address the rampant inequities that are plaguing our country.

The Nursing Myth vs. The Nursing Truth

One of the barriers to nurses taking on a more pronounced role in addressing health equity is that relatively few people have an accurate idea of what nurses do. We are largely absent from media stories about health care, and portrayals of us on television are often stereotypical or inaccurate. While we have gotten involved in policy-making, more of us should be invited to sit at leadership tables and advocate for those invitations. By gaining a full understanding of the role that nurses can play in addressing health equity, we can start to reimagine a better and more just world. Let’s debunk a few of the pervasive myths about nurses:

Myth: Nurses are physicians’ personal assistants.

Truth: Nurses are professionals in their own right.

Nurses are educated to see you in the context of your life, with all of the factors that impact your life and well-being, whereas medicine has focused principally on disease. This holistic approach to health promotion recognizes your experiences and your relationships with family and community members in the context of your whole life. Nurses are educated to consider health issues within a broad context that includes all of the social and economic factors that affect health. We know that if you don’t have a grocery store in your community or reliable transportation to a medical appointment, you will have difficulty staying healthy. Our chief responsibilities include educating you about how to stay healthy and prevent disease, and advocating for you, your family, and your community ─ skills critical to tackling health inequities.

Myth: Nurses practice in hospitals and clinics.

Truth: Nurses practice everywhere.

Many of you probably picture nurses working in hospitals and doctors’ clinics, but you may be less likely to think of us practicing at your child’s school; your office, church, community center, or home; or in all branches of the U.S. military. But we practice in all of those places. Most of what determines your health happens outside a health care facility, including whether you have access to a good job that pays a living wage, safe housing without mold or lead poisoning, reliable transportation, walkable neighborhoods, fresh food, clean water, and adequate green spaces to exercise. This understanding of health is already built into the nursing profession.

For example, an exciting nurse-led program that improves the health of new mothers and babies is the Nurse-Family Partnership. Highly trained nurses regularly visit young, first-time moms-to-be, beginning early in the pregnancy and continuing through the child’s second birthday. During these visits, nurses help to ensure that expectant moms receive good prenatal care and any needed treatment for pregnancy-related complications. After the baby is born, the nurse focuses on ensuring the child stays healthy by supporting the mother in providing responsible and competent care during early childhood. The program enhances educational and employment opportunities for parents and gives advice on how to plan future pregnancies.

Because nurses work in a wide variety of settings, you probably know a nurse in your community. You may even have a nurse that you go to when you have questions about your health or your loved one’s health. Nurses are the connective tissue between the broader community and the health care system. Don’t be afraid to ask a nurse to advocate for better health for you, your family, and your community.

Myth: Nurses are selfless heroes.

Truth: Nurses are citizens like you, and we’re feeling the same stresses that you’re feeling.

While health systems continually praise nurses as heroes during this pandemic, many of us are not getting adequate support to feel safe at work and to maintain our own health and well-being. We are experiencing unprecedented stress during the pandemic ─ caring for multiple critically ill patients without always having enough masks and other protective equipment to protect ourselves, our patients, and our loved ones. Some of us have been fired for speaking out about unsafe working conditions. We are sometimes the only person present when patients die. Many have also had to “float” to other units and care for patients without adequate training.

We’re also feeling the same stresses that you’re feeling, whether it’s difficulty finding child care while we’re working, financial hardship for those of us who were furloughed during the economic shutdown last spring, or despair during the pandemic. It’s been unbelievably hard, and a smile, kind words, and patience when you see us can go a long way.

By understanding what nurses do and supporting us, you can elevate our skills and expertise so that we can take on larger roles in addressing health equity. Nurses are everywhere, we care about everything, and we want you to see that we have solutions for addressing the challenges facing our country. We have enormous potential to help to give everyone a fair and just opportunity for health, and we are a crucial component to creating a more just world.

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The Nursing Myth vs. The Nursing Truth

Myth: Nurses are physicians’ personal assistants.

Truth: Nurses are professionals in their own right.

Myth: Nurses practice in hospitals and clinics.

Truth: Nurses practice everywhere.

Myth: Nurses are selfless heroes.

Truth: Nurses are citizens like you, and we’re feeling the same stresses that you’re feeling.

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New Survey Finds Nine out of 10 of Americans Agree: We Should Continue to Have The Same Level of Nursing Care After the Pandemic

A new survey released today found 87% of Americans say nurses have been indispensable during the Covid-19 pandemic. The “Expand Nursing Care” survey also found that 89% feel patients should be able to receive the same level of care from nurses after the pandemic is over as they did during the pandemic.

The survey uncovered high demand by the public for nurses to address urgent societal needs related to enhanced hospital care, reopening schools, providing safety in nursing homes and greater equality in healthcare including via telehealth:

· 91% agree that hospitals should be required to meet safe minimum nurse staffing standards for nurses

· 90% agree that nursing homes should be required to meet minimum safe staffing standards for nurses

· 86% say school nurses are necessary to safely reopen schools

· 75% believe nurses should be able to treat patients via telehealth

The online survey was sponsored by NursesEverywhere and fielded by The Harris Poll from July 23 – 27, 2020, queried 2,039 U.S. adults ages 18 and above.

Why Nurses Matter

Even before the pandemic, the Journal of the American Medical Association reported that 1 in 4 Americans – 82 million people – did not have regular access to a doctor. With the pandemic spreading quickly, Congress recognized the Nation’s need to rely on its 4 million nurses to ensure people received timely critical healthcare services and passed the CARES Act. This new law, as well as support from governors across the country, suspended previous regulatory barriers that had historically prevented nurses from providing healthcare services for which they were educated and qualified. Nurses were also released to practice across state lines to the highest need regions for critical COVID-19 care.

“This pandemic has changed health care in America. The survey shows that people are overwhelmingly in favor of keeping recent critical improvements, like telehealth and greater access to nurses after the pandemic is over,” said Professor Linda Aiken, Ph.D., RN, Director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing and member of NursesEverywhere. “While temporary emergency measures have enabled nurses to fill gaps exacerbated by COVID-19, access to quality health care delivered by nurses and their physician colleagues has never been more important.”

NursesEverywhere, is a non-partisan coalition of healthcare leaders focused on enhancing access to nurses to improve care delivery, lower costs and help people achieve better physical, emotional and economic outcomes.

Broad based support for the expansion of nursing care

Americans don’t just want more nurses during the pandemic, 79% of U.S. adults said they would like nurses to play a greater role in their future healthcare.

There is wide support for reducing unnecessary practice restrictions and barriers to accessing nursing care. The National Governors Association supports full access to nurse practitioners, as does the Federal Trade Commission.

During the pandemic, Medicare has been expanded to enable nurses to support patients via telehealth, to provide patients with home healthcare and provided greater practice reach as it allowed nurses to be providers in a wider range of settings, such as nursing homes and hospitals.

“The facts show that greater access to nurses providing their full expertise improves healthcare outcomes. Hundreds of studies have documented that care by nurse practitioners is safe, effective, and convenient. Patients are highly satisfied with care by nurse practitioners,” continued Professor Aiken.

The new poll also shows a strong consensus with almost three-quarters of U.S. adults saying nurses should be able to help patients in ways they have been educated for without requiring a doctor’s oversight. “Better access to nurses means better care for everyone,” says Tim Raderstorf DNP, RN Chief Innovation Officer at The Ohio State University College of Nursing and member of NursesEverywhere. “Nurses work in teams and follow evidence-based practice to refer patients to physicians and other specialists as needed.”

Also, at this time of national reflection and action about racial justice, it is noteworthy that 88% of the public believe that many healthcare disparities in this country could be improved by increased access to nursing care. Nurses work in all settings and all communities and have a historical commitment to rural, inner-city, and other vulnerable populations.

Nurses ranked the #1 profession in public trust but full access to them is opposed by physicians groups

Nurses have been ranked as the “most trusted profession” by the US Gallup Poll for the past 18 years. Building on this foundation of trust, the “Expand Nursing Care” survey also found that in the midst of the COVID-19 crisis, the public strongly supports maintaining and increasing access to nurses, especially to help communities open schools and their economies.

The pandemic is causing daily infections over 50,000 and more than 1,000 Americans' deaths. Despite this ever-growing need, doctors’ groups, led by the American Medical Association, are lobbying to roll back nurses' enhanced patient care roles. In a letter sent to the Centers for Medicare & Medicaid Services, physician groups called for the federal government and state governors to reverse the access patients gained to nurses during the pandemic. Responding to pressure from state medical societies, governors in Kansas, Tennessee and Michigan have already rescinded emergency measures for greater public access to nurses despite the continued critical needs for healthcare services.

“Going backwards by withdrawing emergency measures to make healthcare more available would wipe out access to essential care for millions of Americans overnight. It would drastically worsen our already strained healthcare system at a time when we need every health professional to save American lives” said Rebecca Love, MSN, RN, President of SONSIEL and member of NursesEverywhere.

Nurses Everywhere is a voluntary nonpartisan coalition based in New Orleans comprised of nationally and internationally recognized nursing and healthcare leaders and innovators committed to improving health outcomes. The organization is dedicated to educating the public about their rights to access nursing care. To find out more at www.nurseseverywhere.com

For additional information contact:

tim@nurseseverywhere.com

About the Survey

This survey was conducted online within the United States by The Harris Poll on behalf of NursesEverywhere from July 23-27, 2020 among 2,039 U.S. adults ages 18 and older. For complete survey methodology, including weighting variables and subgroup sample sizes, please contact Wendy Salomon (Managing Director, The Harris Poll; wendy.salomon@harrisinsights.com).

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New Survey Finds Nine out of 10 of Americans Agree: We Should Continue to Have The Same Level of Nursing Care After the Pandemic

· 91% agree that hospitals should be required to meet safe minimum nurse staffing standards for nurses

· 90% agree that nursing homes should be required to meet minimum safe staffing standards for nurses

· 86% say school nurses are necessary to safely reopen schools

· 75% believe nurses should be able to treat patients via telehealth

The online survey was sponsored by NursesEverywhere and fielded by The Harris Poll from July 23 – 27, 2020, queried 2,039 U.S. adults ages 18 and above.

Why Nurses Matter

Broad based support for the expansion of nursing care

Americans don’t just want more nurses during the pandemic, 79% of U.S. adults said they would like nurses to play a greater role in their future healthcare.

Nurses ranked the #1 profession in public trust but full access to them is opposed by physicians groups

For additional information contact:

tim@nurseseverywhere.com

About the Survey

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Thank a Nurse. Wear a Mask.

Record your message thanking a nurse in your life.

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Thank a Nurse. Wear a Mask.

Record your message thanking a nurse in your life.

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