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Long before any of us had heard of COVID-19, the World Health Organization decided to designate 2020 as the “International Year of the Nurse and Midwife.” It was (and still is!) a fitting way to honor the 200th anniversary of Florence Nightingale’s birth. Nurses are in the spotlight this year, but not the way we had hoped or planned. The alarming and accelerating global coronavirus pandemic has largely put the festivities on hold. We can celebrate later, but right now nurses are laser-focused on one of the greatest health threats our country has faced in generations.
Here in North Carolina, there are more than 142,000 Registered Nurses. Nursing is the single largest population of health care providers in the world. From the bedside to boardrooms, they impact every aspect of health care delivery and help shape the way the entire health system evolves. That has never been more apparent than this year.
When the pandemic first took grip of the country, there was a massive economic impact due to the health threat to our society. Millions of people lost their jobs, including, I should point out, some in the nursing profession. We do not know how long it will take for the economy to dig out from this hole, but nurses are and will be a critical part of that recovery process. Businesses simply will not be able to return to normalcy until their customers feel safe, and that basic truth depends on the entire healthcare system’s ability to care for patients, educate people about forthcoming vaccination options, implement vaccination plans, and demonstrate confidence that the trends are steady, once they start heading back in the right direction, of course. Nurses are ideally suited for this role, having been rated the most trusted profession in the country for 18 consecutive years, according to Gallup polling organization.
There is a direct link between access to care and local economies, especially in rural areas, and you must build an adequate nursing workforce to even begin that calculus. This impacts both tangible statistics – such as health outcomes and cost – and some data that may be harder for many people to grasp, such as the importance of preventative care. Recent research published in the Wiley Journal of Clinical Nursing showed that nurse-led preventive health services have a positive economic impact on both health outcomes and clinical cost-effectiveness.
The nursing profession is growing quickly, although there is a looming shortage based on expected demand. The U.S. Bureau of Labor and Statistics projects an increase of more than 370,000 nursing jobs between 2018 and 2028. One major concern with those estimates could be a kink in the supply line. Many North Carolina schools of nursing currently need to cap attendance due to a shortage of faculty available to teach eager students. If the state could find a way to fully staff our schools, we would have a steady stream of new nurses ready and willing to work in every aspect of society: public health, school nurses, at the bedside in hospitals, in birth centers, in research, and so much more.
An important sub-header of those BLS statistics is that 50,000 of those jobs are expected to go to nurse practitioners, one of the most highly educated and flexible specialties in the profession. They can be educated to specialize in many facets of the healthcare universe and provide high quality care, often without any need for physician input on care plans.
In North Carolina, modernized regulations for Nurse Practitioners and other advanced nurses could mean savings of $400 million to $4.3 billion, according to a 2015 study from Duke University health care economist Chris Conover. What is known as “full practice authority” for advanced practice registered nurses would cut red tape and increase access to care in some of the communities within the state that need it most. Decades of research demonstrates the opportunity for improvement here, and even the Institute of Medicine began pushing for these changes a decade ago.
This could be a grim winter for North Carolina. Coronavirus cases are already beginning to spike and the supply of both hospital beds and the healthcare workers to staff those beds is becoming a critical metric to watch. The health of our economy depends on our collective ability to protect the health of our citizens. Hopefully, we can withstand this second wave and enter 2021 with a brighter picture ahead. Just how bright that view is will depend in large part on the nurses on the front lines of the pandemic.
The North Carolina Nurses Association sees the way people look toward nurses during the Year of the Nurse and Midwife. We appreciate the “hero” memes and are grateful for the admiration that many have expressed as nurses confront the pandemic head on. I suspect many of our members would reject the “hero” label, however, since they see this as a more complicated version of exactly what they signed up for when they chose this path. I would be willing to bet, however, that Florence Nightingale would be proud of the state of the profession she helped create.