A larger more diversified nursing workforce is needed over the next decade to better care for patients in different settings, address the lasting effects of the COVID-19 pandemic, break down structural racism, address the root causes of poor health, and better respond to future public health emergencies, the National Academy of Medicine (NAM) noted in the report The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.1,2   

“This is a transformational time for the field of nursing. While the pandemic has changed nearly every aspect of health care, the impacts on nursing may be the most profound, as demand for their skills is at an all-time high,” said Mary Wakefield, PhD, RN, FAAN, visiting professor at Georgetown University and The University of Texas at Austin, and co-chair of the committee that wrote the report.2 “Policymakers and health system leaders must seize this moment to strengthen nurse education and training, integrate health equity into nursing practice, and protect nurses’ physical, emotional, and mental well-being, so they can provide the best care possible.”

The report identified priorities to meet the needs of the US population and the nursing profession including nurse practitioners (NPs; Table). Recommendations for achieving these priorities are included in the report.


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Table. Priorities in the Nursing Profession1,2

PriorityRationale and Solutions
Strengthening nursing education• Integrating content on SDOH throughout nursing educational programs
• Training is needed not only for hospital-based care, but also for primary care, community settings, schools, workplaces, home health care, Federally Qualified Health Centers, Rural Health Clinics, and Indian Health Service site
Promoting diversity, inclusivity, and equity in nursing education and the workforce• Nursing schools should improve recruitment, hiring, and advancement of diverse faculty with expertise in SDOH; support nurse leaders in mentoring and sponsoring nurses from underrepresented communities; and identify students who may need financial assistance early in the recruitment and admission process
• Nursing education programs should also expand remote learning and build partnerships with community and tribal colleges
Investing in school and public health nurses• A school nurse may be the only health professional some children see regularly
• State and local governments should apportion more general funds for school nursing, or identify other dedicated revenue streams
Protecting nurses’ health and well-being• Employers should prioritize improving nurse well-being and hold leadership accountable for making necessary changes to workplace culture, environment, and policies
• Equity and antiracism initiatives should be embedded into every aspect of nursing and not treated as separate from everyday activities and responsibilities
Preparing nurses for disaster and public health emergency response• The CDC should fund a National Center for Disaster Nursing and Public Health Emergency Response, along with regional centers, to provide relevant education, training, and career development
• Licensing examinations should cover the responsibilities of nurses in disaster and public health emergency response
Increasing the number of PhD-prepared nurses• More PhD-prepared nurses are needed to conduct research, and serve as faculty, and focus on the connection among SDOH, health disparities, and health equity to help build a knowledge base for other nurses to translate to practice
• Foundations should fund programs focused on building the PhD pipeline
CDC, Centers for Disease Control and Prevention; SDOH, social determinants of health

NAM called for all state and federal policy changes that expanded scope of practice for NPs during the COVID-19 pandemic to be made permanent by 2022, along with telehealth eligibility, insurance coverage, and equal payment for services provided by nurses, NAM noted.

NAM highlighted a particular need for nurses who hold bachelor’s and PhD degrees, as well as nurses in specialties with significant shortages, including public and community health, behavioral health, primary care, long-term care, geriatrics, school health, and maternal health.

Nurse practitioners have full practice authority in 23 states and DC, allowing them to prescribe medication, diagnose patients, and manage treatments without a physician present. These states have shown improved quality of care and access to primary care, as noted in the report. Federal authority should be used where available to supersede restrictive state laws in the remaining 27 states, including those addressing scope of practice, according to NAM.

The study — undertaken by the Committee on the Future of Nursing 2020-2030 — was sponsored by the Robert Wood Johnson Foundation. 

References

1. National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.

2. The National Academies of Medicine. To achieve health equity, leverage nurses and increase funding for school and public health nursing, says new report. News Release. May 11, 2021. Accessed June 7, 2021. https://www.nationalacademies.org/news/2021/05/to-achieve-health-equity-leverage-nurses-and-increase-funding-for-school-and-public-health-nursing-says-new-report