On Wednesday, the American Nurses Association (ANA) released a statement to express nurses’ concerns regarding the trial of former Nashville nurse RaDonda Vaught. Former Vanderbilt University Medical Center nurse RaDonda Vaught is being charged with reckless homicide and abuse of an impaired adult after mistakenly administering the wrong medication that killed an elderly patient in 2017.
ANA believes that the criminalization of medical errors could have a chilling effect on reporting and process improvement. The Code of Ethics for Nurses states that while ensuring that nurses are held accountable for individual practice, errors should be corrected or remediated, and disciplinary action taken only if warranted.
COVID-19 has already exhausted and overwhelmed the nursing workforce to a breaking point. Nurses are watching this case and are rightfully concerned that it will set a dangerous precedent. ANA cautions against accidental medical errors being tried in a court of law.
Health care is highly complex and ever-changing, resulting in a high risk and error-prone system. Organizational processes and structures must support a “just culture”, which recognizes that health care professionals can make mistakes and systems may fail. All nurses and other health care professionals must be treated fairly when errors occur. ANA supports a full and confidential peer-review process in which errors can be examined and system improvements and corrective action plans can be established. Swift and appropriate action should and must always be taken as the situation warrants.
Transparent, just, and timely reporting mechanisms of medical errors without the fear of criminalization preserve safe patient care environments. ANA maintains that this tragic incident must serve as reminder that vigilance and open collaboration among regulators, administrators, and health care teams is critical at the patient and system level to continue to provide high-quality care.
Nurses’ mental health and well-being has been and remains a pressing issue, with the ongoing stressors of the pandemic taking a significant toll on younger nurses. Nearly half of nurses surveyed under age 35 said they have sought professional mental health support since March 2020. Of the survey respondents under age 25, 69% say they have been suffering from burnout, which is more than double than those older than 25 (30%). Additionally, nurses under age 25 (47%) and nurses between 25- 34 (46%) consider themselves as being not or not at all emotionally healthy compared to nurses over the age of 55 (19%) and were more likely to have experienced an extremely traumatic, disturbing, or stressful event due to COVID-19. The number of workplace violence incidences against nurses are on the rise, according to the survey. Specifically, 2/3 of nurses surveyed said they have experienced increased bullying at work while 1/3 of nurses report increased incidents of physical violence at work.
“Mental health challenges endured by nurses is a serious ongoing dilemma that will have long-term impacts on the profession as this younger generation of nurses have been hit the hardest, as noted in the survey. As we think about the future of nursing, this is particularly disturbing because nurses are our most valuable resource in health care, remaining a constant force in the recovery efforts to end this relentless pandemic by administering COVID-19 vaccines, educating communities, and providing safe and quality patient care to millions. The key to ending this pandemic is having and sustaining a robust nursing workforce operating at peak health and wellness,” said Foundation Board of Trustees President, Wilhelmina M. Manzano, MA, RN, NEA-BC, FAAN. “The Foundation continues to be committed to providing resources and the necessary support to all nurses through the Well-Being Initiative and the Coronavirus Response Fund for Nurses. We need to ensure nurses are consistently and completely protected and supported. There is too much on the line.”
Lack of robust support systems feeds staffing crisis
Among respondents who say that their organization is experiencing a staffing shortage (89%), more than half (53%) say that it is a serious problem. Younger nurses are leaving their current positions and roles in increasing numbers. According to the survey findings, nurses ages 25-34 and 35-44 were more likely to change positions than nurses over age 55. Similarly, 60% of nurses under age 25 and 57% of nurses 25-34 do not believe their organization cares about their well-being and generally feel unsupported. The lack of support and work negatively affecting their mental health and well-being were major contributing factors to this sentiment of younger nurses who were more likely to experience negative and unhealthy emotions.
“As we enter the third year of this incessant pandemic, the survey findings are even more alarming than what we found in the survey done last year. It’s extremely disheartening that we are still seeing and hearing about the same issues nurses have been burdened with since the start of the pandemic in 2020,” said Foundation Executive Director, Kate Judge. “Nurses are still struggling with mental health issues, feeling unsupported, and suffering from severe burnout and post-traumatic stress because of their sustained response to the COVID-19 pandemic. The nurse staffing shortage has had a domino effect on the profession and it’s only going to worsen if we don’t address the chronic, underlying work environment issues. The Foundation continues to work tirelessly on behalf of the nation’s nurses who deserve our full support and respect for their efforts in improving public health and pulling our nation out of the grip of this pandemic.”
Nurses cannot solve the longstanding challenges facing the profession alone. It is imperative that the Administration and all other stakeholders utilize all available authorities to address these issues and collaborate with nurses to forge a path forward to ensure a strong nursing workforce now and in the future.
The full survey results and findings are available online (PDF).
*Data collected through a non-incentivized survey administered by the American Nurses Foundation. Between January 8 – January 29, 2022 – 11,964 nurses completed this survey. *
Vice President, Health Equity and Social Impact, Vidant Health
Kasheta Jackson developed Community Pop-Ups: A Rural Approach, an innovative health care delivery model implemented as community-based pop-up clinics across Eastern North Carolina to address social and economic health care barriers . This program makes health care both more accessible and approachable by directly providing preventative services, improving health care equity, and offering resources within communities with the greatest need. This is done through a system-level collaboration at Vidant Health with community-focused intervention. Through partnerships with community leaders and other Vidant Health team members, these clinics have evolved from solely offering health care screenings to providing COVID-19 testing, vaccinations, mental health resources, access to fresh produce, and employment opportunities.
Community Pop-Ups have been held in a variety of informal community settings, including baseball fields, farms, and parks, to build trust and improve community engagement. Designed and led by nurses, Community Pop-Ups follows the tenets of a holistic nursing care plan, addressing the community’s physical, mental, and environmental needs. In 2021, Community Pop-Ups provided care to more than 400 community participants, identified acute diseases, provided numerous jobs, gave away 500 produce boxes, and delivered 500 health passports in rural locations across Eastern North Carolina. In 2022, Community Pop-Ups plans to make a more substantial impact in the communities it reaches and establish a model for addressing the social determinants of health through qualitative data.
Winners of the Nurse-led Team Award
Michael Pickett, MSN, APRN, CPNP, Pediatric Nurse Practitioner at Texas Children’s Hospital
Marilyn Hockenberry, PhD, RN, FAAN, Professor of Pediatrics and Director of Global HOPE Nursing at Baylor College of Medicine
Jaime Choate, MSN, RN, NPD-BC, Nursing Professional Development Specialist at Texas Children’s Hospital
Tadala Mulemba, BScNM, RN, Global HOPE Nursing Assistant Director at Baylor College of Medicine
Jeannie Eggers MSN, RN, CPN, CCRN, Simulation Education Specialist, Quality Education & Simulation Team at Texas Children’s Hospital
A multidisciplinary team of frontline nurses developed the RediStik® Wearable Simulation Task Trainers. They identified educational gaps in the lack of realistic, versatile, and engaging training tools for nurses to learn skills in peripheral intravenous (PIV), Port-a-Cath, and Central Venous Catheter (CVC) care and maintenance. Nurses and other health care professionals are trained to insert peripheral and central venous catheters to administer fluids, draw blood, and deliver medications. The RediStik® innovation offers nurses the opportunity to have hands-on practice while receiving real-time feedback from instructors via zoom. Nurses have access to a system of individual and wearable simulation trainers as well as immersive skills videos filmed from the nurses’ point of view, which are accessible on YouTube® and through a QR code found on the RediStik® Kits.
The RediStik® Wearable Simulation Task Trainer project exceeded initial design goals and has proven to be an asset to the nursing community, according to survey data. Prior to training, 15% of nurses surveyed said they were “confident” on starting PIV lines. After training, 96% of nurses surveyed were “confident”. Nurse confidence and patient outcomes improved not only in Houston, Texas, but in Sub-Saharan Africa through Texas Children’s Hospital’s partnership with the Global HOPE (Hematology Oncology Pediatric Excellence) initiative, which is dedicated to treating and dramatically improving the prognosis for children with cancer and blood disorders in sub-Saharan Africa. The funds from this award will support the distribution of the RediStik® trainers to additional health care systems and nursing schools both locally and internationally.
Nurse innovators made incredible strides in turbulent times
“The 2022 ANA Innovation award winners have proven that nurses are able to make incredible strides and improve health while navigating turbulent times. These nurses created solutions that scaled beyond their organizations, into their communities, and globally,” said ANA Vice President of Nursing Innovation, Oriana Beaudet, DNP, RN, PHN. “Nurses are the conduits of positive change across health care through their work and advocacy, which was solidified by the Gallup ranking as the Most Honest and Ethical Professions for the 20th consecutive year.”
“As a loyal advocate and supporter of the nursing community, we are honored to partner with ANA and the Foundation as a proud sponsor of the ANA Innovation Awards,” said Stryker’s Vice President and General Manager, Jessica Mathieson. “This year’s winners truly embody the meaning of nurse-led innovation, and we can’t wait to see their ideas expand and grow.”
The 2022 individual nurse and nurse-led team, ANA Innovation Award recipients, will receive monetary prizes of $25,000 and $50,000, respectively. These funds support translational research, development, prototyping, production, testing, and the implementation of these innovations. The award winners will have one year to further develop their innovation and will share their outcomes and findings in 2023. The ANA Innovation Awards are sponsored by Stryker.
You can celebrate these incredible nurse innovators at the 2022 Navigate Nursing Webinar. All are encouraged to attend – nurses, communities, industry members, health care leaders, health systems, innovators, schools of nursing and public health, and nursing advocates. The 2022 Webinar expands upon how nurses can lead in new ways moving into the future.
You can also learn more about how ANA is supporting nurse-led innovation by visiting the ANA Innovation website, where you will also find a list of resources, upcoming events, and nurse-led innovation stories.
According to the findings of a new national survey of nurses by the National Commission to Address Racism in Nursing (the Commission), nearly half reported that there is widespread racism in nursing, demonstrating a substantial problem within the profession. Comprised of leading nursing organizations, the Commission examines the issue of racism within nursing nationwide and describes the impact on nurses, patients, communities, and health care systems to motivate all nurses to confront systemic racism. Integrity calls on the profession and nurses to reflect on two realities, one as the most trusted profession while also being a product of our environment and culture. It is necessary to work toward connecting these two realities.
“My colleagues and I braced ourselves for these findings. Still, we are disturbed, triggered, and unsettled by the glaring data and heartbroken by the personal accounts of nurses,” said Commission Co-Lead and American Nurses Association (ANA) President Ernest J. Grant, PhD, RN, FAAN. “We are even more motivated and committed to doing this important work justice. Racism and those individuals who do not commit to changing their ways but continue to commit racist acts have absolutely no place in the nursing profession.”
According to more than 5,600 survey respondents, racist acts are principally perpetrated by colleagues and those in positions of power. Over half (63%) of nurses surveyed say that they have personally experienced an act of racism in the workplace with the transgressors being either a peer (66%) or a manager or supervisor (60%).
Superiority continues to surface as a primary driver from nurses representing predominantly white groups along with nurses who are advantaged and privileged by unfair structural and systemic practices. These survey findings move beyond the rhetoric to the reality and should serve as a call-to-action for all nurses to confront racism in the profession.
“Structural and systemic practices that allow the racist behaviors of leaders to continue to go unaddressed must be dismantled,” said Commission Co-lead and National Black Nurses Association (NBNA) President and CEO Martha A. Dawson, DNP, RN, FACHE. “As cliché as it sounds, it starts at the top. Leaders must be accountable for their own actions, set an example for their teams and create safe work environments where there is zero-tolerance for racists attitudes, actions, behaviors, and processes. Leaders must also create a climate that gives permission and support to dismantle institutional policies and procedures that underpin practice inequities and inequalities.”
Of those nurses who report that they have witnessed an act of racism in the workplace, 81% say it was directed towards a peer. Nurses say that they have challenged racist treatment in the workplace (57%), but over half (64%) said that their efforts resulted in no change.
“Nurses are ethically and professionally obligated to be allies and to speak up against racism, discrimination, and injustice for our patients and fellow nurses,” said Commission Co-Lead and National Coalition of Ethnic Minority Nurse Associations (NCEMNA) President Debra A. Toney, PhD, RN, FAAN. “Civil rights and social movements throughout history offer the blueprint, which demonstrates that diligent allyship is key to progress. To the nurses that challenge racism in the workplace, do not get dismayed by inaction, but continue to raise your voice and be a change agent for good.”
Many respondents across the Hispanic (69%) and Asian (73%) populations as well as other communities of color (74%) reported that they have personally experienced racism in the workplace. Overwhelmingly, the survey findings indicate that Black nurses are more likely to both personally experience and confront acts of racism. Most Black nurses who responded (72%) say that there is a lot of racism in nursing compared to 29% of white nurse respondents. The majority (92%) of Black respondents have personally experienced racism in the workplace from their leaders (70%), peers (66%) and the patients in their care (68%). Over three-fourths of Black nurses surveyed expressed that racism in the workplace has negatively impacted their professional well-being.
“The acts of exclusion, incivility, disrespect and denial of professional opportunities that our nurses have reported through this survey, especially our Black, Hispanic and Asian nurses, is unacceptable,” said Commission Co-lead and National Association of Hispanic Nurses (NAHN) President Adrianna Nava, PhD, MPA, MSN, RN. “Racism is a trauma that leaves a lasting impact on a person’s mental, spiritual, and physical health as well as their overall quality of life. As the largest health care workforce in the country, we must come together to address racism in nursing as the health of our nation depends on the health and well-being of our nurses.”
Since its inception in January of 2021, the Commission has been intentional and bold in leading a national discussion to address racism in nursing. The Commission has convened listening sessions with Black, Indigenous, and People of Color (BIPOC) nurses and hosted a virtual summit focused on activism with foremost subject matter experts. Collaborating with top scholars on the issue, the Commission developed a new definition of racism to establish a baseline for holding conversations, reflecting on individual or collective behaviors, and setting a foundation for the work ahead.
“The collective voices and experiences of BIPOC nurses nationally have provided a call for overdue accountability within the nursing profession to acknowledge and address the structural racism rooted within nursing, especially policies that have anti-Black and anti-Indigenous histories,” said Commission Co-lead and Member-at-Large Daniela Vargas, MSN, MPH, MA-Bioethics, RN, PHN. “The next generation of BIPOC nurses deserve more than performative activism and empty words that continue to yield no progress toward structural changes within the nursing profession or racial equity. The breadth of the nursing profession through the Code of Ethics for Nurses holds all nurses accountable for calling out racism and replacing racist policies rooted in white supremacy with ethical and just policies that promote and implement accountability, equity, and justice for nurses and the communities that we serve.”
Nursing’s challenges with the issue of racism are reflective of the larger society. As a profession, we need to confront these same challenges with racial inequities within the profession. As such, the Commission’s work is urgent to create safe and liberating environments for all nurses so that the profession exemplifies inclusivity, diversity, and equity. The Commission urges all nurses across every health care setting and environment to join us in boldly confronting systemic racism. We must address upstream sources of racism in order to build sustained safe and effective environments of optimal care delivery ideal for every nurse and every patient regardless of race, origin or background. Nurses can learn more and share a story of experiencing racism or being an ally for change today.
*Data was collected through a survey administered by the National Commission to Address Racism in Nursing Between October 7-31, 2021, 5,623 nurses completed this survey. *
Nurses seem to have a lock on the #1 spot in Gallup’s annual Most Honest and Ethical Professions Poll. Since 2001, the American public has rated them the highest among a host of professionals, including medical doctors, grade-school teachers, and pharmacists.
The profession’s two-decade record in Gallup’s top spot directly reflects the trust the American public has in nurses and the work they continue to do to earn that trust. In their responses to the poll, 81 percent of Americans rated nurses’ honesty and ethical standards as “very high” or “high.” The second highest-rated profession, medical doctors, was rated 14 percentage points behind nursing.
“2021 was an incredibly difficult year for individual nurses, and the nursing profession. Many suffered greatly while playing a critical role in the colossal response and recovery efforts to end the COVID-19 pandemic.”
—Ernest Grant, President, American Nurses Association
“I want to congratulate every nurse across the nation for earning this well-deserved recognition,” said ANA President Ernest Grant, PHD, RN, FAAN. “The fact that this is the 20th year in a row that the American public has voted nurses #1 is a testament to your consistent professionalism, despite the challenges of the persistent pandemic. We are all indebted to you and will continue to acknowledge and honor your courage, commitment, and expertise during the COVID-19 pandemic and well beyond.”
The trust Americans have in nurses is due to their holistic approach to providing high-quality, patient-centered care to individuals, families, and communities.
The COVID-19 pandemic has placed a spotlight on nurses, reinforcing the critical contributions they make to our health care system, while also highlighting the devasting impact it has had on their mental health and well-being.
Grant underlined the “dire” urgency of the staffing crisis and urged private and public sectors to consult with nurses and take action: “I am deeply concerned about not only the impact of the pandemic on the mental health and well-being of individual nurses, but on the health of the entire nursing profession. The pandemic has exacerbated a long-standing nursing shortage, especially in areas experiencing high numbers of COVID-19 cases. The long-term repercussions and consequences for the profession, the entire health care delivery system, and ultimately, on the health of the nation are potentially dire.”
“It is imperative that the federal and private sectors work with nurses and seek their input to provide solutions that lead to action to solve this crisis and do so with a sense of urgency,” Grant said. “On behalf of the nation’s nurses, ANA continues to work with Congress, the Administration, and key stakeholders to identify and address long and short-term solutions to the shortage.”
During 2022, the American Nurses Association (ANA), which represents the interests of the nation’s 4.3 million registered nurses, will continue to educate the public about who nurses are, what they do and how they contribute their vast knowledge and indisputable expertise in every health care setting during the COVID-19 pandemic and beyond.