More nurses will not only sit at the table; they will also be gripping the national policy podium in 2021. As President Biden’s Acting Surgeon General, Nurse of the Week Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN is going to be one of the key US health officials—and Orsega is ready for duty. She’s spent much of her career handling health emergencies and disasters ranging from AIDS to 9/11 to the 2015 Ebola outbreak. The Rear Admiral and infectious disease specialist has been Director of Commissioned Corps Headquarters (CCHQ) at the Office of the Surgeon General (OSG) since 2019.
RADM Orsega’s areas of expertise seem almost to be designed for the tumults of the Covid era. After receiving a BSN at Towson University, she began her career at the US Public Health Service (USPHS) in 1989, while the world was coming to grips with the AIDS pandemic. Orsega plunged into HIV/AIDS nursing practice, international operations, health diplomacy, epidemics, and disaster response, while fitting in an MSN in 2001 at the Uniformed Services University (USU) Graduate School of Nursing Nurse Practitioner program. She has been deployed on 15 national and international disaster/humanitarian deployments, including the elite USPHS medical team after 9/11.
In 2016, when she was named Chief Nurse of the US Public Health Service, Orsega addressed nursing students at her alma mater. According to the Towson news post, she told students to “think about how their passions, interests and strengths and their work experiences intersect to find their career focus, an area she called ‘the sweet spot.’ She also challenged them to think beyond direct patient care to what their vision is for their career, how they can grow into leaders on the local, state, national and international levels…”
Prior to joining the Surgeon General’s office, she worked at the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). At the height of the devastating 2015 Ebola epidemic, Orsega was appointed to the NIH/NIAID Ebola trial operations team and helped lead the first human vaccine and treatment Ebola trials in Liberia and Sierra Leone.
Orsega served as the Chief Nurse Officer of the USPHS from May 2016 to March 2019. As CNO, she advised the Office of the Surgeon General and the U.S. Department of Health and Human Services (HHS) on everything from recruitment and assignment to retention and career development of nurse professionals and 4,500 Commissioned Corps and civilian nurses. Orsega has been a Fellow in the American Association of Nurse Practitioners since 2013, and in 2016, she was inducted into the American Academy of Nursing.
Previous nurse Surgeon Generals have included Rear Admiral Sylvia Trent-Adams, PhD, RN (appointed in 2017), and Richard Henry Carmona (appointed 2002). The White House is expected to announce Orsega’s appointment next week.
Our first Nurse of the Week in 2021 is a nursing icon. On December 27—the day before her 100th birthday—AAN Living Legend Loretta C. Ford, EdD, RN, PNP, NP-C, CRNP, FAAN, FAANP was awarded the Surgeon General’s Medallion for exceptional achievement in the cause of public health and medicine.
Dr. Ford, who helped to create the first NP program at the University of Colorado in 1965, is regarded as a co-founder of the Nurse Practitioner (NP) profession. As a public health nurse in the 1940s and 1950s, she became concerned about Colorado’s underserved rural communities, and came to believe that with specialized training, nurses could help to fill the gap. Ultimately, Ford and pediatrician Henry Silver joined forces to found the University of Colorado pediatric NP program and the NP profession itself. Ford’s pathblazing role has led to numerous honors. She was the inaugural member of the Fellows of the AANP (FAANP), a special title reserved for providers that have made a lasting impact on the NP profession, and in 2003, she received a Lifetime Achievement Award from the journal Nurse Practitioner. In 2011, she was inducted into the National Women’s Hall of Fame, which acclaimed her for having “transformed the profession of nursing and made health care more accessible to the general public.”
Ford’s latest award, the Surgeon General’s Medallion, is the highest honor granted to a civilian by the Public Health Service and the U.S. Public Health Service Commissioned Corps. AANP President, Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP-BC, FNAP, FAANP commented, “Dr. Ford has received this recognition for her vision and commitment to the health of our nation. Thanks to her trailblazing efforts, millions of patients have access to high-quality health care from NPs, the provider of their choice, and the profession has grown to more than 290,000 strong.”
David Hebert, JD, Chief Executive Officer of AANP, added, “As we celebrate Dr. Ford’s 100th birthday, I can’t think of a more fitting tribute to this titan of American health care. From co-creating the NP profession to advocating for patient access to NP care, she has played a profound role in strengthening health care access and choice for America’s patients.”
The Medscape 2020 nurse job satisfaction survey dove into fears, PPE woes, and other highs and lows of life in the workplace during the pandemic. Medscape surveyed 10,400 nurses across all regions of the US and analyzed responses from 5130 RNs, 2002 NPs, 2000 LPNs, 500 clinical nurse specialists (CNS), 401 nurse-midwives (NMs), and 391 CRNAs. Most respondents fell within the 35-54-year-old age group.
Despite the hardships of 2020, most respondents are still quite happy with their choice of career. A full 98% of NMs and CRNAs are glad they chose nursing, closely followed by 96% of CNS, 95% of LPNs and NPs, and 93% of RNs.
Given the chance of a do-over, though, some are not sure they would make the same choice. 85% of NMs and CNS say they would pick nursing again. Among RNs and CRNAs, 76% and 78% would stick with nursing.
The Impact of Covid-19
Among CRNAs, 73% have treated Covid-19 patients. Midwives came in second, with 60% of NMs saying they had treated Covid patients, followed by NPs (57%), RNs (53%), LPNs (50%), and CNS (38%). Have they had sufficient PPE? Responses were almost evenly divided, with a majority of LPNs (59%) and RNs (56%) affirming that they have enough PPE.
Who was furloughed? CRNAs were at the front of the line, with 34% saying they had been furloughed during the pandemic. NPs came in second, at 18%, followed by LPNs (15%) and RNs (14%). On average over 30% of the nurses surveyed lost income last year, but CRNAs took the biggest hit, with 59% saying they lost money in 2020.
Telehealth is becoming routine for nurse-midwives and NPs. In the 2020 survey, 77% of NMs and 75% of NPs told Medscape that they met with patients online or by phone, and 53% of the LPNs surveyed made virtual visits.
Fears and worries during this scary year were to be expected, of course. Nurses’ greatest concerns during the pandemic were concentrated on the fear of transmitting Covid to family and oneself, but 38% singled out the discomfort of wearing extra PPE as their main woe, and 23% worried most about higher patient loads.
Best and Worst Parts of the Job
Asked about their main source of job satisfaction, nurses offered a range of answers, but helping people and making a difference in their lives was the top choice for RNs, LPNs, and APRNs (click charts to enlarge).
Least satisfying aspect of the job: Workplace politics ranked first for RNs and LPNs at 23% and 21% respectively, and for 26% of CNS’s. LPNs also pointed to their paychecks as a source of dissatisfaction.