Today is Certified Nurses Day, and the Board of Certification for Emergency Nursing (BCEN) is celebrating its over 50,000 “RN-credible” specialty-certified emergency, trauma, transport, and burn nurses and nationally certified nurses in every specialty.
In their 2023 Annual Report, BCEN revealed that over 60,000 BCEN credentials are held by nurses in 28 countries, with over 40,000 RNs possessing the Certified Emergency Nurse (CEN) credential.
Specialty-certified RNs are truly incredible, according to BCEN’s CEO and American Board of Nursing Specialties Past President Janie Schumaker. When you receive care from a nationally certified emergency, trauma, transport, burn, or other specialty nurse, you know you’re being treated by the best of the best.
Board-certified nurses go above and beyond their nursing license requirements to master advanced knowledge across their specialty, take a rigorous exam to prove it, and commit to staying on top of the latest advances and best practices. This is the kind of nursing care we all want and deserve, and that is worth celebrating!
To recognize and celebrate specialty-certified RNs on BCEN’s Certified Nurses Day page, they offer these free resources and assets:
-Free-to-download “You RN-credible” note card
-Free Nurse Recognition Toolkit for recognizing certified RNs on Certified Nurses Day or any day
-“Nurses RN-credible” t-shirt and stickers.
BCEN is dedicated to supporting nurses throughout their certification and recertification journeys and responding to the needs of their high-achieving community of nurses,” says Schumaker.
At this time in history, the American nursing profession and its leadership are in a state of flux. The November 2023 American Organization for Nursing Leadership (AONL) Nursing Leadership Insight Longitudinal Study leverages nursing leaders’ perspectives to shed light on where we are and where we’re headed as a nursing collective.
In coordination with the AONL Foundation and Joslin Insight, five longitudinal studies have been conducted since 2020. The collective data are a fascinating avenue into the hearts and minds of nursing leaders and how they perceive the healthcare industry and nurses’ places in it.
Leadership Identifies Top Challenges
According to the 2,477 nurse leaders surveyed for the current AONL study, the top ten challenges facing the profession are:
Focusing on workplace behaviors such as violence, bullying, and incivility, 68% responded that they had witnessed one or more incidents of bullying at work. In terms of having seen one or more incidents of violence, 53% said they had. When it comes to incivility and intimidation, a stunning 77% and 72% had witnessed such aberrant behavior, respectively.
AONL concludes:
Nurses frequently encounter verbal abuse, physical assaults, and other forms of violence and intimidation from patients, patient families, the public, and coworkers, including physicians, other nurses, administration, managers, supervisors, faculty, and other staff (Figure 6). This hostile environment not only jeopardizes the safety and well-being of healthcare workers but also impacts patient care. The rising instances of workplace violence can lead to increased stress, burnout, and a sense of insecurity among healthcare professionals.
Addressing workplace violence, intimidation, incivility, and bullying requires comprehensive strategies, including enhanced security measures, de-escalation training, fostering a culture of safety, and providing trauma-informed care to healthcare workers. It also requires advocacy to raise broader public awareness.
Assessing nurse leaders’ emotional health, whereas 44% rated themselves as emotionally healthy in 2021, 52% now see themselves as such, and the number who viewed themselves as emotionally unhealthy dropped from 14% to 11% as we get further from the height of the COVID-19 pandemic.
The researchers state:
Regarding emotional health, there has been a slight improvement from last year. However, the data still shows a mix of emotional health states, ranging from very emotionally healthy to not at all emotionally healthy….. It’s crucial to recognize the need for continued efforts to support nurse leaders, especially nurse managers who fare worse in cultivating and maintaining healthier emotional well-being. Creating a nurturing environment for nurse leaders is vital to ensure their resilience, support, and effectiveness in their roles.
Intent to Leave
Attrition from the nursing profession and the attempt to retain top talent continues to be a struggle. Reports of nurses’ intent to leave either a current position or the profession as a whole are constantly troubling, especially in light of the ongoing nursing shortage that can be found in many healthcare labor markets around the country.
The AONL longitudinal study reveals the following:
This survey shows a marginal improvement in nurse leaders’ intent to leave with a 5% decrease in those planning to leave from 2022 to 2023. The survey examined intent to leave based on roles. The largest cohort of nurse leaders reporting intent to leave exists in the C-Suite with 15% of CNOs/CNEs planning to leave their positions within the next six months, contrasting with 12% of managers and 10% of directors. Among nurse leaders contemplating leaving, a notable 25% report considering leaving nursing altogether. Previously, 27% of respondents reported considering leaving nursing altogether.
The most often reported reasons for nurse managers and CNOs/CNEs leaving their roles include:
The negative impact of work on health and well-being
Pursuit of new opportunities
Challenges with other leaders or colleagues
Identified strategies for nurse leader retention include facilitating time off for work-life balance, opportunities for professional growth, and the perception that the employing organization understands leaders’ concerns, cares for their well-being, acknowledges and responds to their concerns, notices their contributions, and takes pride in their accomplishments. In fact, employers would do well to enact these strategies universally for all staff consistently in the interest of retention and employee satisfaction.
Conclusions Abound
Many conclusions can be made from the data available from the ongoing series of AONL longitudinal studies. As AONL concludes, there is a “nuanced landscape for nurse leaders, tracking shifts in their challenges and perceptions since July 2020”, with a focus on well-being, retention, financial resources, and workplace violence.
This study demonstrates the need for interdisciplinary collaboration, innovative solutions, and consistently addressing challenges of staffing and retention. And while cookie-cutter solutions can sometimes be helpful, progressive and forward-thinking healthcare organizations would be prudent to create tailor-made solutions based on their challenges on the ground.
The researchers’ conclusions say a great deal regarding what lies ahead:
In conclusion, while certain issues have shown improvement over the course of this survey series beginning during the pandemic in July 2020, nurse leaders continue to face complex challenges. Addressing work-life balance, navigating staffing shortages and innovating models of care remain pivotal. This requires a blend of strategic interventions, policy support and inclusive organizational cultures to strengthen nursing’s future and, ultimately, improve the equitable delivery of quality patient care.
Racism in nursing affects all of us—whether we have witnessed it, experienced it firsthand, or examined our own biases rooted in race. Likewise, confronting racism that is decades in the making requires collective action. In the summer of 2022, the American Nurses Association (ANA) unanimously voted “yes” to adopt the ANA Racial Reckoning Statement. This momentous action began as an overdue journey to acknowledge a racist past and recognize that the actions of today will impact the future of nursing as a whole.
The statement was only a first step to lead nursing to an equitable future—and requires change and allyship across the nursing profession. According to the National Commission to Address Racism in Nursing (the Commission)—launched in early 2021 by the American Nurses Association (ANA), National Black Nurses Association, National Coalition of Ethnic Minority Nurse Associations, and National Association of Hispanic Nurses—allyship is an ethical duty through intentional interventions, advocacy, and support to eliminate harmful acts, words, and deeds. It includes creating space to amplify voices that are not traditionally heard, recognized, or welcomed.
What Is Allyship?
“It’s easy to call yourself an ally, but putting your words into action is paramount to making a real impact,” says Cheryl Peterson, MSN, RN, Vice President of Nursing Programs at the ANA, is helping to lead these efforts. “Allyship is about supporting colleagues and patients from marginalized backgrounds by recognizing your privilege and speaking out against discrimination and racism.”
“Nurses of color face discrimination, isolation, and unequal treatment that affect their mental and physical health and can drive them out of the nursing profession for good,” says Peterson. “Allyship imparts these nurses—who we work alongside every day—with support, reassurance, and solidarity, knowing that they are not alone and what is happening to them is wrong.”
“As a white nurse, it is natural to feel uncomfortable and initially believe that maybe you don’t have a place in this conversation,” says Peterson. “Looking within oneself and recognizing your personal and institutional biases is the first step to becoming an authentic ally. Without this discomfort, we aren’t propelling ourselves and the profession towards true inclusion and diversity.”
Anyone can and should be an ally to those facing discrimination. This can include using privilege, resources, or influence to challenge injustices and advocate for fairness and equality.
Where To Start?
Allyship is an ongoing commitment that requires continuing education, self-reflection, and action to help foster safe and liberating environments. Nurses and nurse leaders can assess their allyship with just five questions developed by the Commission and ANA—the self-assessment scores participants across a spectrum to identify where they are in their journey to allyship.
Get curious about the people you work with to understand them better and avoid making assumptions about who they are. Ask yourself: “Why am I thinking this about this person? Where did this originate from, and do I know it to be true?” By first challenging your preconceived notions, you can then work to create a safe environment where underrepresented people feel comfortable sharing their experiences and how they have been affected by racism.
Be Genuine
Do what you say you are going to do and keep your word. If you do not practice trust, you cannot be an ally. Actively listening to the lived experiences, concerns, and needs of others without judgment or interruption will build trust. Authenticity and sincerity are essential qualities of an ally. Without these qualities, you cannot create a safe space for others to feel secure opening up to you.
Support Authenticity
Allow people to be authentic by accepting them for who they are—not what you want or expect them to be based on your own biases. Authenticity in allyship is crucial for building trust and fostering meaningful relationships with marginalized individuals or groups. If nurses are expected to be from the same background, innovation within the nursing profession will cease. Without new perspectives, we rob ourselves of the opportunity to propel the workforce into the future.
Allyship requires self-awareness to recognize and address implicit biases affecting your thoughts and interactions with colleagues. The path to allyship begins with education and staying informed about issues related to diversity, equity, and inclusion, as well as the unique challenges marginalized populations face. The following steps include deciding how you can use your unique position to support colleagues, stand up to discriminatory acts, and work to make your workplace more inclusive.
Clinicians need to have a better understanding of the potential impact of patients’ anxiety sensitivity, or “fear of fear,” according to an article published in American Journal of Critical Care (AJCC).
When a patient has anxiety sensitivity, they misinterpret nonthreatening symptoms as threatening, assessing the potential meaning across physical, social or cognitive domains. These “what if” thoughts may trigger a spiral effect, stimulating the nervous system and resulting in stronger sensations and further catastrophic misinterpretations.
It may lead to a patient avoiding activities they associate with anxiety-related sensations, such as physical activities or social situations. While in the hospital, they may resist interventions, such as repositioning or being weaned from sedatives. They may avoid physical or occupational therapy or struggle with efforts to help their recovery.
“Patients with anxiety sensitivity may falsely believe that their symptoms are the early signs of something bad, such as a heart attack, cognitive decline or social isolation,” she said. “It’s important for clinicians to be able to identify the difference between anxiety sensitivity and other medical conditions,” says Leanne Boehm, PhD, RN, ACNS-BC, FAAN, assistant professor at Vanderbilt University School of Nursing, Nashville, Tennessee, and investigator at the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center at Vanderbilt University Medical Center.
For example, patients who have difficulty weaning from mechanical ventilation should first undergo a detailed workup to search for any underlying medical causes before anxiety sensitivity is considered as a primary cause.
ICU clinicians should be aware of patients’ possible anxiety sensitivity so they can use clear communication and implement pain management or relaxation techniques to mitigate distress and improve patient outcomes.
The Anxiety Sensitivity Index (ASI-3) is one tool clinicians can use to measure the extent of a patient’s physical, cognitive and social concerns about their anxiety. Providing basic psychoeducation to ICU patients on common symptoms may temper anxiety sensitivity, reassuring them their feelings are not unusual and putting their symptoms into context.
After discharge from the hospital, patients may continue to experience anxiety sensitivity and need increased assessment time, detailed explanations and extra demonstrations before participating in physical therapy or other activities.
Research specific to anxiety sensitivity in the critical care setting is limited, and future studies should incorporate assessment and management techniques across the critical care recovery continuum.
Nursing does not always get the glory that it deserves and sometimes gets portrayed in a negative light, but it is one of the best professions in the world. If you are a nurse looking to make an impact, you surely can.
Here are five ways you can make a positive impact in the nursing profession.
1. Join a Nursing Organization
There are many nursing organizations, from local, state, and national. So, how do you select the right organizations?
You can select an organization according to:
Specialty
Broad categories such as education, quality, leadership
Academic excellence
Particular interests, such as business
Examples of nursing organizations:
-ENA – Emergency Nurses Association
-ANA – American Nurses Association
-AONL – American Organization for Nursing Leadership
-ANPD – Association for Nursing Professional Development
-NLN – National League for Nursing
-Sigma Theta Tau International Honor Society of Nursing
-GNYC BNA-Greater New York City Black Nurses Association
-NNBA – National Nurses in Business Association
I have been or still am a member of all these wonderful organizations. If you can afford it, you can belong to several organizations. There are many benefits to being a part of an organization, and they are usually listed on the membership page.
2. Join a Board
There are many opportunities for nurses to join boards, become an advocate, and let their voices be heard.
Check out this link from the ANA website to learn more about nurses on boards, and to be counted, visit nursesonboardscoalition.org.
3. Power in Unity. Join ANA Hill Day
The American Nurses Association holds its annual Hill Day in Washington D.C., where nurses from all over the U.S. can visit federal legislators and present policies and bills that the ANA is advocating to pass for the future of our nursing profession, and this is powerful.
Even if you cannot go to Washington, D.C., there are other ways that you can get involved in advocacy and policy. Please go to the American Nurses Association website to learn more.
4. Be a Mentor, Seek a Mentor
Be a positive influence on other nurses and help support each other. Being a mentor is rewarding and can help reignite your passion. You can have multiple mentees and help shape the new generation of nurses. Seeking a mentor is also another way to advance in your career and get some clarity about your next moves in nursing.
If you are still looking for a quality mentor, check out formal mentorship programs and connect with other nurses on social media platforms like LinkedIn. Going to conferences and different nursing events is also another great way to network. You can also invest in your professional development and career advancement by hiring a nurse career coach for the guidance you need, saving you time.
5. Educate Others and Highlight the Positive Aspects of Our Profession
We need to promote our profession and educate the public. Yes, we have many opportunities for improvement in our industry. However, we need to recruit more people into nursing. It is a wonderful profession that is very rewarding. The job outlook is amazing, and there are so many different opportunities for nurses.
Nurses are highly skilled, very knowledgeable, and adaptable. Nurses can work in a wide variety of settings and areas, such as hospitals, home care, communities, government, associations, policy, law, wellness, and the list goes on. Many nurses are selecting nontraditional roles such as nursing entrepreneurship.
Some nurses are leaving the bedside and choosing roles that can afford them more flexibility and freedom. Roles such as freelance writers, med spa owners, and consultants are gaining more interest. Nursing can give you financial stability while allowing you to explore different career paths to keep it exciting and fresh.
So, go ahead and make an impact on the nursing profession. You got this.
From flight nurses to military members and mayors to parents, emergency nurses go beyond the call of duty and the 2023 ENA Connection 20 Under 40 class has it all.
ENA announced the third class of 20 extraordinary nurses as part of the celebration of Emergency Nurses Week.
Each honoree in the 2023 class has achieved significant milestones in their healthcare careers and demonstrated positive contributions beyond their professional work. One nurse from Bhutan created the BEAR, or Bhutan Emergency Aeromedical Retrieval Team, which uses his country’s only helicopter for rescue missions. Another helped launch a program called “Caring for the Caregiver” to help nurses cope with critical incidents. Those are just the beginning of what this class of honorees has accomplished.
Many in the new class were inspired by nurses they had encountered in the past. Some followed in their family’s footsteps, while others fell into the profession later. One thing they all have in common is the goal of helping people and inspiring and teaching the next generation of nurses.
“Having seen what these 20 nurses have accomplished, I can say with certainty that the future of emergency nursing is in good hands,” says ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN. “The amount of knowledge, passion, drive, and skill we have among the ENA membership is outstanding. I can’t wait to see how these young professionals continue to contribute to emergency nursing throughout their careers.”
Meet the ENA Connection’s 2023 class of 20 Under 40 honorees featured in the magazine’s October issue.
Jessica Wilson, MS, RN, CEN, CPEN, TCRN, EBP-C, of Maryland
Each class of honorees is chosen by a panel of reviewers who assess their accomplishments in their profession and communities, their contributions to emergency nursing, and how they plan to shape the future of the specialty. Their peers nominated 44 nurses, and 75 nurses submitted applications.
