“In The Midst of Change Lies Opportunity”
Albert Einstein’s words are heartwarming in the wake of 2020-2021, which also saw the 200th anniversary of Florence Nightingale’s birth. The British woman who shaped the face of modern nursing would be hard pressed to find a more difficult year in recent history. Healthcare professionals and nurses in particular faced the most challenging and life-threatening crisis in modern history. Nurses risked their lives and that of their families while performing extraordinary acts of compassion and courage. The COVID-19 pandemic intensified the stress and workload already experienced by many nursing professionals and contributed to elevated levels of burnout and PTSD. Interestingly, the American Nurses Association recently released a survey stating 51% of nurse respondents had experienced exhaustion but 85% would not alter their career path. The pandemic shone a bright light on many long-standing issues as well as dramatic trends already on the horizon. Things like education quality and accessibility, working conditions, safety, gender roles, specialization and expanded roles are now being addressed with greater urgency. Some of the insights from the Association of Medical Colleges, American Nurse Today and the American Association of Nurse Practitioners are as follows:
Access and affordability to a nursing degree are not new topics but as the demand for nurses increases, the pool of nurse educators has diminished. There is also the push for higher education qualifications for nurses. Back in 2010 The Institute of Medicine recommended nurses with a BSN increase from 50 to 80% by 2020. In 2018 New York was the first state to require nurses acquire a BSN within 10 years of licensure. In addition, the Doctor of Nursing Practice and PhD programs in nursing are gaining widespread support.
The education piece feeds into this area. An Association of American Medical Colleges recent surveys indicate the US will face a 55,000 plus shortage of primary care physicians by 2032 due in part to the aging population of both patients and physicians. Closures of rural hospitals in the wake of the pandemic make healthcare access to the sixty million plus Americans living in rural areas challenging. Granting nurse practitioners full practice authority may alleviate this shortage. Currently 26 states and territories grant this while other states still require collaboration between an RN and supervising MD. In addition, as nurses found themselves as frontline responders to COVID-19, their role as patient advocates expanded exponentially to include providing education and counseling to family members and other caregivers.
Minority and Gender Roles
In 2015 the US Census reported 350 languages spoken in US homes. 40 million US residents speak Spanish in the home. Clearly the need for bi-lingual or multi-lingual nursing is on the rise. In 1960 only 2.2% of nurses in the US were male. That figure rose to 12% in 2019. Men increasingly are realizing the benefits of this career as gender norms and discrimination are being challenged in addition to male patient preferences.
There is a growing expectation that today’s RN’s have a specialty. The need for geriatric nursing specialists is on the rise. It is estimated that by 2050 1/5 of US citizens will be age 65 or older. Currently less than 1% of RNs and 3% of Advance Practice RNs are geriatric specialists. Travel nursing is another specialization that will continue to rise. Thousands of our US nurses poured into hotspots around the world. Opportunities for those professionals who enjoy travel, challenge and change are projected to rise. The increased usage of the Nurse Licensure Compact will impact this as well. In 2020 Indiana became the 34th state to enact this. NJ, MA, MI, OH, PA, RI and Vermont have legislation pending.
Telehealth and chatbot services are here to stay. These services made access to healthcare professionals easier and more time responsive. The services have eased appointment setting, routine questions and prescription refills requests freeing up valuable professional time. Currently ¾ of US healthcare providers utilize some form of telehealth or chatbot service.
Job Growth and Salaries
The Bureau of Labor and Statistics project RN’s to be one of the top occupations for growth through 2028, up 12% or 370,000 by then. By 2034 more of the US population will be over age 65 than under 18. This aging population will need access to medical professionals and nurses are uniquely qualified to fill this void. US News and World Report ranked 6 healthcare professions in the top 10. Nurse Practitioners ranked 3rd. The same report cited the median salary for an RN at $73000 with projected growth of 7% by 2029. Nurse Practitioner median salary of $110,000 is also expected to increase and employment needs will rise 50%.
Safety and Staffing
The experiences with the pandemic have underlined the need for adequate staffing for a number of reasons. Patient mortality rates, length of stay, rates of preventable incidents like falls or infection, readmittance rates and patient satisfaction were all under the microscope lately. Addressing nursing physical safety and mental/emotional wellbeing also came to the fore of our collective consciousness. In 2021 the International Council of Nurses reported many cases of nurses experiencing mass trauma from the pandemic resulting in what has been called “The COVID-19 Effect”. There seems to be a need for deliberate activity to address the mental, emotional, spiritual, and physical burnout nurses are reporting. The trickle-down effect of this could have lasting repercussions on the future of nursing.
The lasting impact of the pandemic is undetermined. The effects of an aging population, interest in higher education, credentialing, and flexibility, working conditions, staffing and salary concerns are not novel issues. By 2030 it is projected that 18 million more healthcare professionals will be needed to meet the needs of our worldwide population and 6 million of these will be nursing professionals.
NHS Solutions has experienced an increased demand for Interim Managers and Directors of Case Management. These healthcare professionals are key leaders in assuring patient safety and hospital staffing levels are optimized. We are also experiencing increased credentialing requirements mentioned above such as BSN as well as COVID vaccination status. Contact us with questions, comments or to discuss your hospital’s interim nurse leadership needs.