What does 2021 hold for nurses and the nursing profession?

5 ways we can bolster the nursing profession for a future beyond Covid

Future of nursing
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As the Year of the Nurse, 2020 coincided with a pandemic that touched the lives of virtually everyone on the planet. It also highlighted the critical role nurses play in the entire care ecosystem. The pandemic continues to burden our global healthcare systems and test the resolve of doctors, nurses and allied healthcare workers, who continue to provide the best care possible while risking their own wellbeing.

But as we move into 2021, what does the future hold for nurses and the nursing profession?

Having started my career as a nurse, I can only imagine the challenges nurses today have to overcome. As frontline workers, they are putting themselves at significant risk to care for patients. The ever-growing numbers are staggering, with over 85 million infections and nearly 2 million deaths.

Leveraging our valuable but limited nursing resources

Today, nurses represent the largest healthcare workforce in the system. We will need nearly 6 million additional nurses to ensure healthcare standards rise again after the pandemic, according to a 2020 report by the World Health Organization. The biggest shortage is in Southeast Asia. Developed nations face an additional challenge of an aging nursing workforce, with several countries in the American, European and Eastern Mediterranean regions excessively dependent on international nursing mobility. With the rise in healthcare needs and the global aging population, action is needed now to improve the capabilities of our nursing workforce and avoid a healthcare upheaval.

When I started as a nurse a few decades ago, I realized that the nursing profession continually advances, with accountability resting on each nurse to contribute to professional excellence and career advancement. But what does it mean to truly be a transformative nursing leader? As an informaticist, my genuine passion lies in collaborating with healthcare organizations and colleagues across the globe to develop and advance clinical best practices with health information technology. When looking at nursing and the wider clinical team, technology is also an enabler. We have made significant progress in the last 200 years, buoyed by technology, yet there are still challenges ahead. Here are some of my reflections on how to push the nursing profession forward.

1. Democratizing knowledge using technology: Adoption and use

“The world, more especially this hospital world, is in such a hurry, moving so fast that it is too easy to slide into bad habits before we are aware.” — Florence Nightingale

Looking back on the career of Florence Nightingale, known as the founder of modern nursing, some of her quotes still convey the issues we are facing today. Implementing new technology in any health system must take into consideration the existing workflow to ensure it creates efficiencies. It’s crucial to make sure end-users, including nurses, are trained and equipped to use these technologies and incorporate them into everyday workflows.

Successful project implementation should not be where things end, especially when adoption among end-users, including nurses, determines the longer lasting impacts of the project. High level adoption can be achieved when:

  • Nurses understand how technology is enabling them to better care for their patients by providing context relevant information.
  • Through clinical reasoning, this information is translated into meaningful clinical knowledge.
  • That knowledge is then put into action and used in decision-making to improve patient outcomes.

2. Democratizing knowledge using technology: Minimizing administrative/bureaucratic burden

With the global shortage of nurses, it is critical to focus on building up the competencies of our existing nursing workforce to ensure nurses are working to their full potential. Healthcare organizations must make a concerted effort to design their technology systems in a way that does not overwhelm the care team with administrative tasks and bureaucratic stress.

From my experience working with healthcare organizations, my recommendation is to first assess the existing systems to identify those tasks and documentation requirements that are typically high volume and, when combined, take up valuable clinical time. Following this assessment, organizations need to determine if those elements are relevant to the care of the patient. Making the decision to remove the ones deemed irrelevant or, at minimum, shifting them to non-clinical resources leads to much needed efficiencies and clinician satisfaction.

3. Democratizing knowledge using technology: Clinical Decision Support (CDS)

After implementing electronic health records (EHRs) with a well thought out process and adequate training, EHRs can become significant support systems for nurses. However, we are only scratching the surface of the enabling power of technology, which has the potential to support nurses beyond their day-to-day work and improve productivity.

One of the missed opportunities I see when designing and implementing technologies such as an EHR is the ability to provide the right information to nurses to help them make better decisions at the point of care. Beyond the EHR, CDS tools are prime examples of how technology can democratize knowledge for nurses. When we focus on the adoption of evidence based CDS tools with the design intention of facilitating clinical decision making that is embedded into the everyday workflow, nurses can truly benefit from the technology.

An example of this is the care planning process with built-in documentation being a requirement for every patient. Typically, organizations designing this workflow approach it from the perspective of compliance, which becomes a task with minimal value. My recommendation to healthcare organizations is to commence the care planning process with the intent of empowering nurses with ready access to actionable knowledge. By implementing a CDS mentality upfront, the system will be oriented towards reducing unwarranted variability and delivering safer, higher quality patient care.

4. Recognizing, respecting and investing in nurses to grow into transformative leadership roles

Over the years, certain countries have made concerted efforts to build the nursing profession into one that is highly respected, and they tend to attract more talent to join the workforce. This positive shift in the perception of nurses is taking place in countries like Australia, New Zealand and Singapore. In the US, nurses are not only involved in patient care, but are also accountable to provide a high standard of care that incorporates research and innovation. When nurses take on more responsibilities and leadership roles, they tend to feel appreciated and motivated to stay in the field. This helps to attract more talent to the workforce.

On the contrary, in Latin America, the Middle East and other areas in Asia, nursing is not an aspirational profession. These regions lack provisions for advanced nursing education and training and have limited career progression pathways and a high turnover of skilled nurses.

Investing in nurse education and upskilling can enhance competency management, which translates to increased productivity and improved health outcomes. This becomes even more important as we continue to develop a digitized workforce where digital literacy will remain a pertinent issue. Organizations investing in upskilling the digital capabilities of their nurses will see the benefits of improved efficiencies in the delivery of care. In the same vein, at the hospital management level, by encouraging nurses to venture into areas such as health data analytics, we can pivot to a more holistic, patient-centered and data driven approach to care.

5. Committing to supporting nurses in their mission to care

Having visited numerous hospitals across five continents, I have seen nursing leaders and their teams strive towards advancing the nursing profession while not losing sight of their fundamental mission to care for their patients. It is truly gratifying to witness their passion and advocacy for patient care that drives them in their daily work.

Throughout history, nurses have always been the backbone of the health system. Their response to this pandemic has shown their value to the world. Leaders in healthcare today need to recognize nurses’ impact on our communities and their potential to drive meaningful change. It is a commitment we should all make to empower nurses in their mission to care.

This year, Elsevier has committed to supporting nurses through the pandemic by providing virtual training and access to free healthcare resources. We strive to work with many healthcare leaders across the globe to elevate the role nurses play.

We invite you to learn more about how Elsevier is supporting nurses’ mission to care.


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Contributors


Robert Nieves, JD, MBA, MPA, BSN, RN
Written by

Robert Nieves, JD, MBA, MPA, BSN, RN

Written by

Robert Nieves, JD, MBA, MPA, BSN, RN

As VP of Health Informatics for Clinical Solutions at Elsevier, Robert Nieves leads the global strategic direction for health informatics and the integration, delivery and optimization of Elsevier solutions within various HIT platforms. He has nearly three decades of clinical experience as a registered nurse working in critical care, emergency services, community case management, long-term care and home care, and 15 years of direct clinical informatics experience in the design and integration of evidence-based content within various electronic health records.

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