As the largest contingent within the health care workforce, nurses are vital to shaping the future of not just their profession but medicine as a whole. Even during the COVID-19 pandemic, seasoned nurses and those currently studying to join their ranks must come together to tackle the issues that are critical to the future of nursing.
The first step is gathering information and seeking to understand complex issues such as antibiotic resistance, environmental sustainability, and remote accessibility. Nurses who work in clinical environments must collaborate with nurses in non-clinical roles to formulate evidence-based action plans that include educating the general public.
The public places great trust in nurses, and while the media may choose to feature doctors in its coverage, regular people generally reach out to nurses for honest information and level-headed advice. Simply put, when nurses talk, people listen. The public trust they’ve cultivated puts them in a unique and powerful position to bring about change in nursing and propel the health care industry into the future. It is a challenging yet exciting time to be in the nursing profession.
Ask any nurse what their primary responsibility is, and they will likely answer that they have to protect their patients from otherwise preventable harm. The rise in antibiotic-resistant bacteria, also known as “superbugs,” is making this task more difficult. One of the most vital issues to the future of nursing is understanding how to protect patients from superbugs and educate the public about antibiotic resistance.
Antibiotic resistance occurs when, over time, bacteria adapt to drugs that are formulated to kill them. When the bacteria changes as a means of ensuring survival, this renders widely-used treatments for infections significantly less effective, and in some cases, completely ineffective. Medical professionals have linked drug-resistant bacteria to pneumonia, urinary tract infections, and skin infections. In some extreme cases, the patient has even died.
Unfortunately, because it is a naturally occurring phenomenon, antibiotic resistance cannot be stopped. However, it can be slowed. For this to happen, the public must be educated on the proper use of antibiotics. As one of society’s most trusted voices, nurses must lead the educational charge and raise awareness. Furthermore, since they make up the majority of the health care workforce, nurses’ commitment to proper cleaning, disinfecting, and sanitizing would go a long way in combating antibiotic resistance.
Like antibiotic resistance, another issue vital to the future of nursing is environmental sustainability. All industries have an ecological footprint, and the health care industry is no exception. In fact, the health care industry is one of the primary culprits. Currently, industry practices account for a large percentage of the country’s energy consumption and pollution emissions including 10% of the nation’s greenhouse gases.
When nurses treat patients with environmental-related illnesses, there’s a chance that it was the health care industry’s ecological impact that made them sick in the first place. Over the years, nurses and other health care providers have made efforts with sustainability, but there’s still more that needs to be done.
Nurses, perhaps better than any other medical professional, understand the limited resources their industry must contend with. This puts them in an influential spot to enact eco-friendly strategies such as using plastic more intentionally and promoting renewable energy.
One strategy nurses can use to embrace environmental sustainability and provide better care to more patients is prioritizing remote accessibility. Telemedicine, which relies on telecommunications, allows health care professionals to evaluate, diagnose, and treat patients without needing to be face to face.
Even before the era of social distancing, remote accessibility was in high demand. Cost and location force people to choose between their health and spending time and money to attend regular checkups. People living in rural communities disproportionately have inadequate access to health care. Nurse educators teach other nurses that preventative care is essential to the health and well-being of the communities they serve.
Improving accessibility could also help improve the overall efficiency of a health care organization. Nurses wouldn’t need to spread themselves as thin since people with symptoms that can be managed from home could be treated via telemedicine. With more people attending their regular checkups and showing up (albeit virtually) for follow-ups, there are more opportunities for preventive care that could also lighten nurses’ workload in the long run.
Remote accessibility, environmental sustainability, and antibiotic resistance are three of the most important issues demanding the attention of the health care industry. Change needs to happen, and nurses are the ones to lead it. Because of their trusted position, nurses can positively influence their medical colleagues as well as the general public. The future of nursing runs parallel to that of the health care industry, and if nurses step up and make a strong case for a particular course of action, they can determine the direction of both.
With the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, or more commonly, COVID-19), healthcare workers were thrown headlong into the fray of managing healthcare protections. In many cases, this occurred without adequate preparation and supplies.
In a survey conducted by National Nurses United, only 30% of healthcare workers reported that their employer had enough PPE on hand to sufficiently protect staff in the event of a COVID-19 outbreak. Another 38% did not know. At the time of the survey, only 19% reported knowing that their employer had a plan to address when an employee contracted the virus.
Such a lack of preparation — when a pandemic of one form or another was inevitable — is unacceptable. Negligence in care facilities and at a federal level put healthcare workers at more undue risk, and the future demands better solutions.
With the right culture shifts and policies in place, we can ensure that the next public health crisis is met with a prepared and protected workforce.
Actionable Items for Healthcare Worker Protection
After the failure that has been the COVID-19 response, healthcare workers are demanding better protection now and in the future. Care facilities and government institutions alike must come together to create an actionable approach in providing the proper equipment and policies to frontline workers. This means equitable, widespread material solutions, and culture shifts that make for a safer America.
Here, we have outlined five of these actionable items to better ensure healthcare worker protections come the next public health crisis.
1. Create a More Equitable System of Care Resources and Delivery
A functioning safety net for health care does not discriminate based on locale or access to wealth. To provide proper protection to our healthcare workers, it is vital that access to resources is not placed behind a barrier of marginalization. This means taking lessons from global health exemplars to improve systems of community care and streamline emergency resource usability.
Community care workers in Malawi, for example, are funded at a national level and provide care outside of traditional clinics. Government agencies should come together with communities to create safety nets like these—especially for the most underserved and disenfranchised areas. With a comprehensive approach to healthcare solutions, governments can more equitably distribute resources. As a result, healthcare workers will be better protected against the overwhelming tides of future public health crises when they inevitably arrive.
2. Strengthen and Encourage the Growth of the Healthcare Industry
A fundamental aspect of worker protection facing the next health care crisis is the support of the industry through respect, growth, and education. CNAs, for example, are vital healthcare providers who bridge gaps in care for what is often a one-to-one-thousand ratio in terms of patients to physicians. Information about the nobility and necessity of these roles must be spread through public education systems and through incentives offered in both the public and private sectors.
With a sufficiently staffed facility, hospitals need not fear the breakdown of their ability to care for patients in the event of staff exposure. Of course, all staff should also be provided sufficient PPE to avoid exposure wherever possible.
3. Institute Price Controls on Essential Medical Equipment like PPE
One outcome of the coronavirus pandemic has been the consolidation of medical institutions as losses over $200 billion cripple the industry. When these consolidations occur, costs of medical care and equipment trend upwards. This is why a national movement to institute price thresholds and cost controls for medical equipment and pharmaceuticals will be an essential aspect of ensuring healthcare worker protection.
In the event that costs of healthcare continue to climb as they have been, care providers will be hard-pressed to purchase and maintain an inventory of PPE capable of protecting their employees. A national push to institute price controls will better prepare healthcare workers for the next crisis.
4. Shift the National Culture Towards Hygiene and Safety
Keeping not just frontline healthcare workers but all Americans safe during the next public health crisis will require a shift in culture towards the practice and celebration of better health and safety standards. We have potentially seen the beginnings of this shift in the response to COVID-19, with the embracing of masks and efficient hand washing hygiene. However, long-term protective practices will need to run deeper.
Shifting the national culture towards better hygiene must begin in early education. Children should be taught good personal hygiene habits that protect them and others. This includes staying home when they are sick.
Rather than incentivizing perfect attendance, institutions of education can incentivize the protection and care of health instead, reinforcing safe habits for life. Then, when a new pandemic emerges, the odds are better for less-overwhelmed care facilities and healthcare workers.
5. Develop Waste Reductive, Sustainable Medical Equipment Solutions
Medical waste is a problem in environmental sustainability as well as a contributor to high medical costs and limited supplies. Reportedly, care facilities spend $10 billion per year on waste management. Hazardous and regulated biochemical waste is barely a factor in this expense as well, with 85% being often-recyclable standard trash generated by hospitals.
Finding solutions to reduce hospital waste and recycle equipment can help care facilities save on costs while maintaining readiness for a greater need. In the future, healthcare workers will require a profusion of sustainable and reusable medical equipment such as N95 respirators to ensure they are well equipped in a crisis.
Preparing for the Next Public Health Crisis
COVID-19 caught the medical industry unprepared. This placed millions unnecessarily at risk when better protections could have been created through a culture of care and community support.
With more equitably distributed resources, price controls, and sustainable solutions, healthcare facilities can better be protected against health crises of any kind. These protections should be instituted at every level, through joint efforts of the public and private sector. Only then can we build a culture that celebrates health and hygiene, and in turn ensure that more lives are saved. Support frontline healthcare workers in the inevitable healthcare challenges of the future by striving for these community safety nets wherever you are.
Pro bono is defined as “being, involving, or doing professional and especially legal work donated especially for the public good.” Pro bono work has traditionally been relegated to attorneys. This was before the increasing cost of health care, the number of uninsured patients, and the economic slowdown. Now, more and more nurse practitioners are providing discounted rates, offering free services, or volunteering their time to free clinics and charities.
Let’s examine pro bono work and things you should consider when deciding how much pro bono work is appropriate for you. We’ll also delve into the advantages of pro bono work: for the patient, our societal image, and for you, both personally and professionally.
Why Should You Consider Pro-Bono Work?
Statistics indicate that roughly 10% of Americans under 65 do not have health care coverage, with a full 45% stating that they cannot pay for such coverage. Due to this, some 79 million Americans have medical bills that they cannot pay, and they are dealing with medical debt, which can destroy their credit rating and make it impossible for them to secure a new credit card, refinance the mortgage on their house, or apply for a personal loan.
As nurse practitioners see more patients struggling to pay for their health care, some providers, like Dr. Mary Newman, have started discussing their patients’ financial conditions during routine office visits. Additionally, many have cut fees or have devised creative payment arrangements. Dr. H. Lee Adkins of Ft. Myers, FL, for example, charges a flat fee to patients with chronic illnesses that covers monthly office visits, routine labs, and some vaccinations. Others are basing their costs on a sliding scale, providing free telephone consultations, or seeing two members of a household at the same time and charging for only one office visit. Still others donate their time to charitable organizations that run free clinics for uninsured or underinsured individuals.
The Many Options of Pro Bono Work
According to the AMA Journal of Ethics, when deciding whether to take on pro bono work, you have many options to consider:
- You may decide to devote all of your time to underprivileged patients. Should this be the case for you, transfer all of your affluent patients to colleagues … but be aware of the consequences of your actions. While you may experience a great deal of satisfaction serving those in need, you will also have to make financial sacrifices, including giving up your expensive office for something more modest.
- You may conclude that you want to help the indigent but just can’t afford the tremendous reduction of income to do it full-time. Set aside one day a week to treat the uninsured or those on Medicaid in your office, or work one day a week at a free clinic. The option of working in a free clinic would allow you to volunteer your time without your having to also volunteer your staff’s services.
- Maybe serving the underprivileged is just too costly for you at present, but you would like to pursue it in the future. While you gain financial stability and shore up your expenses in preparation for the big jump into pro bono work, you can convince a colleague to accept low-income patients or advocate for better access to health care services within your local community.
How much pro bono time you volunteer should be ethical and appropriate for you. Just keep in mind your professional responsibility and recognize your conscience. What do you need and aspire to be as a nurse practitioner? Also consider your personal situation and finances.
If you wish to serve the underprivileged population, but you just can’t justify the loss of income at the moment, there are things that you can do to make yourself better able to take the plunge in the future. For one, take a good look at how you use your supplies and resources. You may find that through hospital resource management, a system whereby you more effectively utilize your resources, you can remain financially solvent while devoting time to help those who need it most.
When you decide to volunteer your time and do pro bono work, you are allowing an economically disadvantaged patient to seek health care who might otherwise go without. A 2018 survey showed that roughly 40% of Americans passed up a medical test or treatment that was recommended within the past year because of the exorbitant cost, even when they were injured or suffering from an illness. Additionally, over 30% took less prescription medication than prescribed or did not fill a medication at all due to cost.
Regardless of your personal decision whether or not to pursue pro bono work, a highly debated topic is whether, like attorneys, providers should be required to do pro bono work by the medical societies to which they belong. At this time, most perform at least some pro bono work, but it often goes unrecognized by the public. Society as a whole used to admire doctors, but due to malpractice suits and increasing public scrutiny, the reputation of health care has been severely tarnished. Requiring pro bono work could restore some of the faith the public once had in providers.
Volunteering your medical services also has numerous personal benefits. It boosts your mental health in the following ways:
- The meaningful connection with others helps to relieve stress and anxiety.
- It boosts your happiness. Studies have revealed that human beings are programmed to help others, and the more we do so, the happier we feel.
- It provides a sense of purpose that you may have lost in your practice.
- It increases your self-confidence and provides a feeling of accomplishment.
- It allows you to create new friendships and strengthen the friendships you already have.
- It can give you a sense of pride and positive identity.
Volunteering can also benefit your professional life:
- You gain more experience and competence.
- You further develop your current skill sets.
- You expand your network of other medical professionals.
- You gather positive exposure for your personal business.
And if you prefer to donate your time in a nonclinical way, that is also possible. You can join the board of directors of a non-profit group, for example, or mentor others. Hippocrates, the founder of the Hippocratic Oath, stated that one of the primary responsibilities of a medical professional was to be a teacher. If you choose to mentor junior nurse practitioners, for example, you will help them with their personal growth and make them better nurses.
There are so many in society who cannot afford health care insurance and are drowning in medical debt. Medical professionals can improve patients’ health without adding to their financial burden. And it can also do you a world of good, both personally and professionally.
Seven in 10 professionals these days are working remotely to reduce the risk of spreading COVID-19. Thanks to an internet connection and teleconferencing software, nearly everyone can work from home. Why shouldn’t nurses and other medical professionals work remotely, too, when transitioning to telemedicine is an option?
Industry forecasts say that telemedicine is “set for a tsunami of growth.” If you’re a nurse (or currently studying to become one), embracing the tech evolution in the medical industry not only elevates nursing as a whole — but will ensure you’re not left behind. Consider the following points about telehealth and how it could improve the quality and longevity of your nursing career:
Working From Home
The nursing field can be extremely demanding on your time. Hospitals and medical facilities are strained from the coronavirus pandemic, requiring nurses to work longer and harder. A recent study found that nurses in hospital settings are being pressured to work longer than they’d like to, typically wearing uncomfortable protective gear which causes discomfort and fatigue.
Having the opportunity to work from home in a telemedicine position could be a good solution to having more control of your time. Stepping away from a high-pressure environment such as an emergency room or intensive care unit to work from home as a nurse could feel liberating. Additionally, nurses who are raising families may appreciate the flexibility of being more available for their kids. Some of the most sought-after work from home positions for a registered nurse include:
- Clinical appeals nurse: Reviews denied insurance claims and conduct the appeals reviews.
- Health informatics nurse: Gathers, stores, and manages patient data.
- Telephone or telehealth triage nurse: Consults with patients over video or phone call.
- Nursing instructor/educator: Teaches nursing students to prepare them for tests and their nursing careers.
Reductions in Stress
As mentioned, nurses are being pushed out of their comfort zones to work longer hours in challenging conditions. Nurses are often naturally empathic and care deeply for the well-being of the patients they’re helping. If feelings about every loss, death, or injury are not managed correctly, they may contribute to a sense of stress or worry. Many frontline nurses are already close to (or experiencing) burnout and mental health issues due to the rise in COVID-19 patients.
Self-care is critical for nurse practitioners at this time. It’s often difficult when working in a high-pressure setting, such as a hospital. Telehealth may be the ideal solution, giving some autonomy back to nurses so they can take charge of their mental health by setting their own schedules, controlling their work surroundings, and regulating the amount of stress they allow around them.
A Larger Client Base
Telemedicine has many benefits and is set to experience explosive growth. One of the most significant benefits is the opportunity to expand your business by taking on patients outside of your local area. All you need is a reliable internet connection, teleconferencing software (if you’d like to offer face-to-face video consultations), or a phone for audio calls.
Telehealth benefits go both ways — if you build a remote nursing practice and provide telemedicine services, you could increase your patient base by taking on clients during expanded hours and from varying locations. Additionally, patients who live in rural or underserved communities could get the quality care they need by opting for a phone or video consultation.
Expanded Work Opportunities
Most medical fields could benefit from expanded telemedicine services. Even the vision care industry can make use of telemedicine. A typical vision consultation may require a test or diagnostic you would need to be present for, but some exams have been adapted and made available through online web portals.
Consumers are receptive to the concept — 61% of patients reported that they received the same level of care from a vision telemedicine consultation, and 20% said: “the quality of telemedicine was better.” And as a telenurse, you may be able to expand into other medical fields of interest that you wouldn’t typically receive patients for in a specialized hospital or clinical setting.
A World of Possibilities
There will always be a market for in-person nurses. They’re needed to respond to emergencies in hospitals and to provide rehabilitation or care to seniors and recovering patients. The problem is, working in high-demand positions such as an emergency room or intensive care unit tends to be physically and emotionally taxing. Many nurses may experience fatigue or burnout, which could cut the longevity of their careers short.
Being open to working in telemedicine opens up a new world of possibilities. You could be more location independent, having the flexibility to set your own schedule and better balance your personal life. You may even decide after working in a hospital setting or clinic to transition into telemedicine. Having the option allows you to leverage your experience into nursing work with less proverbial “wear and tear” without entirely leaving a career you put so much energy and effort into.
When you decided to become a nurse, you knew it wouldn’t be easy. You knew there would be hard days, probably many of them. You were prepared for brutal shifts. You expected to have your heart broken sometimes.
But you probably never expected anything like COVID-19. The reality is that the pandemic is testing you in ways you never could have imagined — physically, mentally, and spiritually.
As much as you have always loved your job, nowadays, signing in for each shift feels like a test of strength and willpower. And when you are not exhausting your every moment fighting to save your patients from this merciless enemy, you are thinking of the ones who have been lost and those whom you may lose.
You are in constant fear for your family, your friends, yourself. Your faith in a tomorrow that is brighter than today may be faltering.
And in the face of so much turmoil, you might feel like there’s simply no time and energy left to take care of yourself. But prioritizing your physical and mental health is precisely what needs to be top of mind at this moment.
As a nurse, you are the foundation. And if we’re going to keep from collapsing, we must keep our foundation strong!
Why It Matters
As a nurse, you’re undoubtedly all too familiar with the effects of significant stress on the body as well as the mind. When you’re anxious, overwhelmed, worried, and sleep-deprived, your health is going to suffer.
Your immune system pays a particularly high price for all this stress. And when you spend your days on the frontlines of a brutal war against a highly contagious virus, the last thing you need is a compromised immune system.
An Overburdened System
Let’s face it: the American healthcare system wasn’t exactly running like clockwork even before the pandemic hit. We were struggling with a shortage of care providers and shrinking financial resources, even as an aging and increasingly sick population is increasing the demands on the system day by day.
The virus has only exponentially magnified these systemic challenges. But, for nurses in the war against COVID, it’s not just the shortage of healthcare providers that’s so overwhelming.
It’s the fact that the lack of resources with which the system was struggling before the pandemic now means the nurses and other care providers simply do not have access to the tools they need to take care of patients, let alone themselves.
And the problem isn’t just with having the capacity to care for patients’ — and caregivers’ — bodies. It’s also about not having the tools to care for their minds. In fact, a recent study found that nearly 95% of more than 1400 nurses surveyed in the United States felt that the healthcare industry did not support or prioritize their mental well being. More than 35% of those surveyed felt that their psychological health was significantly worse since the outbreak of the virus.
What to Do
Right now, you might feel too physically or mentally exhausted to add something more to your to-do list. Taking steps to nurture your mental health might just feel like a bridge too far when you’re doing well right now just to keep it together.
But carving time each and every day for a bit of self-care is exactly what’s going to help you keep it together — or your family, your patients, and yourself.
Best of all, it doesn’t have to be difficult. In fact, the purpose is for it not to be difficult. The goal is to incorporate something that you can look forward to into each day. That might be just ten minutes spent jumping on the mini-trampoline or doing a little dancing or some other aerobic exercise to get those endorphins flowing and work off some of the day’s stress.
Self-nurturing should also include some emotional and psychological support, which you can literally access at the touch of a button right now. There’s a whole library of free and low-cost apps that are specifically designed for nurses, to help them manage the stress, anxiety, and depression that can accompany this most important of jobs.
And don’t forget about the things you’ve always loved, things that have nothing whatsoever to do with the pandemic. When you come home, be at home. Turn off the news reports, and turn on a favorite funny movie. Get away from the headlines and into some tunes that always bring back good memories.
Video chat with friends and family. Have virtual a virtual cocktail hour or game night. Basically, take time every day to find yourself again. Not the pandemic nurse. But you, the person.
Even under the best of circumstances, nursing is selfless and important work. But to do it during a pandemic is to transform from a good person into a great one, to morph from hero to superhero. And yet even our superheroes need care. After all, how can you possibly take care of anyone else, if you’re not first taken care of yourself?