While nearly every industry has felt the impact of COVID-19, our health care workers, including our nurses, have been on the front lines for more than 18 months. While the proliferation of vaccines mercifully stemmed new cases for a short while, the rise of the Delta variant has demonstrated this fight is far from over.
What makes the task placed before our nurses all that more impressive is the fact that even before the pandemic began, many in the health care industry were actively concerned about a worldwide nursing shortage. After all, nurses can’t treat patients if the nurses don’t exist.
As this public health crisis drags on, now must also be the time to prepare for the next one to avoid fighting such threats shorthanded once again. This issue cannot go unaddressed any longer.
Nursing has long been recognized for its importance of health promotion and disease prevention. This recognition has most recently been validated by the Future of Nursing 2020-2030 report issued recently by the National Academies of Medicine; a document which advocates for nurses to focus practice, service, and research on social determinants of health.
The lack of large-scale programs to educate, train, and support nurses remains among the major hurdles to achieving equitable health care for all.
If only there were the resources to accommodate all qualified applicants wanting to pursue a career in nursing. In recent years, according to the American Association of Colleges of Nursing, U.S. nursing schools have turned away hundreds of thousands of qualified candidates from baccalaureate and graduate nursing programs “due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.” As an educator, I’ve witnessed the impact of these constraints, situations where students want to fill these roles, and institutions want to admit them, but their hands are tied.
There are no easy solutions, and competing needs translate to oftentimes limited resources. In 2019, the Trump administration proposed significant reductions to Title VIII Nursing Workforce Development funding that supports federal health care workforce and research programs. Even with compelling data on the disastrous impact of too few nurses, the World Health Organization itself has cut its nursing-related activities in recent years, with reductions in posts and funding in all six of its regions and at its headquarters in Geneva.
Despite the federal government’s dearth of fiscal attention to the nursing shortage, initiatives are underway elsewhere in the Washington, D.C. region to fill the void. Philanthropists Bill and Joanne Conway have pledged to give away at least $1 billion to support the education of 20,000 new nurses through scholarships and new facilities at The Catholic University of America and five other D.C.-area universities. Of that $1 billion pledge, more than $157 million has been gifted since 2013, and is already hard at work to open the pipelines so our region can enjoy fully staffed hospitals and other care facilities.
It should not have taken a pandemic to see the tremendous need that already existed. This is the kind of “urgent action” that the International Council of Nurses says is necessary to help mitigate, even marginally, the “alarming predictions of a shortfall of 18 million healthcare professionals worldwide by 2030, 50% of whom will be nurses.” After a year battling a pandemic, 2030 is the least of our worries. Our nurses need reinforcements as soon as they’re ready to do the job.
Up to 1.2 million of those nursing vacancies could occur in the United States before 2022, meaning that patient care settings and other organizations that depend on well educated nurses “will face a significant loss of nursing knowledge and expertise that will be felt for many years to come.”
Today’s nurses provide complex assessment and monitoring, administer life-saving medications and treatments, lend critical emotional, educational and counseling support to patients and families, and serve humankind in myriad other ways. They help preserve and prolong life, and contribute to the advancement of evidence-based science, the formation of public policy, and the economic efficiency of the nation’s health care system. Importantly, nurses are the “high-touch” in an often impersonal high-tech health care environment.
An extra 20,000 nurses will impact the care and outcomes of millions of patients and families over their careers, long after this crisis has eased. Can you imagine the impact the remaining 1.18 million nursing vacancies will pose if there’s still no one qualified to fill them?
Patricia McMullen, Ph.D., J.D., C.R.N.P, FAANP, FAAN is dean of the Conway School of Nursing at The Catholic University of America and a Fellow of both the American Association of Nurse Practitioners and the American Academy of Nursing.