++
As the worst of the pandemic recedes in the United States, we have an opportunity to take stock of the past two years and imagine a brighter future. The pandemic has been devastating for far too many Americans who did not enjoy the luxury of being able to work from home, lacked access to healthcare, lived in crowded spaces, relied on public transportation, and have not gotten vaccinated. The elderly, people of color, and those who live in rural areas have been disproportionately affected by the pandemic in terms of illness and death (Iyanda et al., 2022). Over 1 million people in the US—a once inconceivable number—have died from COVID-19. More than 200,000 children have lost a parent or caregiver to COVID-19, and the shutdowns and school closures have unleashed a parallel mental health and educational crisis among youth (Leeb et al., 2020). In short, the pandemic exposed long-existing health disparities in our country that have persisted for generations. The nursing field is also hurting. Many nurses who have cared for an unrelenting stream of patients with COVID-19 are burned out, exhausted, and leaving the profession (Auerbach et al., 2022).
++
What happened is unacceptable, and our country must do everything in its power to dismantle health inequities and promote well-being for all. The nursing profession has tremendous potential to advance health equity, and we must commit to making health equity our North Star. We are the most trusted profession and the first contact for the majority of people who seek healthcare. We are bridge builders and collaborators who connect with people, communities, and organizations to improve health and well-being, and we are well positioned to combat the many shortcomings of the US health system (Pittman, 2019). Taking Action: Top 10 Priorities to Promote Health Equity and Well-Being in Nursing offers insight and advice from some of nursing’s top minds about how we can unleash the potential of nurses to advance health equity. The authors, comprised of established and emerging leaders in public health, school nursing, health systems, and community settings, represent the diversity that we aspire to achieve in our profession. Achieving a more diverse workforce will ensure that our workforce reflects the US population and enable us to do a better job of providing culturally relevant care and eliminating persistent health disparities.
++
The contributors’ wisdom reflects their expertise and lived experiences in advancing health equity, and their ideas mirror the recommendations set forth in the landmark report The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity (National Academies of Sciences, Engineering, and Medicine, 2021). This report, released in May 2021 during the pandemic and sponsored by the Robert Wood Johnson Foundation, calls for the systems that educate, pay, and employ nurses to permanently remove barriers to allow them to do this work, value their contributions, prepare nurses to tackle and understand health equity, and diversify the profession. The report emphasizes that nurse well-being is paramount to advancing the recommendations.
++
The good news is that the nursing field is ready to take on an expanded role in advancing health equity. Our profession has spent the past decade building its capacity to transform the healthcare system by implementing the recommendations from the then-named Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health (Shalala et al., 2011). The nursing field and our many partners, led by the Future of Nursing: Campaign for Action, a nationwide initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation, have strengthened nursing education, advanced practice, improved workforce diversity, and promoted nursing leadership. Together, we built the capacity of the nursing workforce to expand high-quality care to more Americans. But no one profession can advance health equity alone. Nurses need to join or form multi-sector partnerships with stakeholders from within and outside of healthcare, including educators, social justice organizations, community groups, consumer organizations, faith-based organizations, advocacy groups, health systems, broader community partners, and populations who have been disproportionately affected by the pandemic.
++
This decade, as we climb out of the ashes of the pandemic, the nursing field must set its sights on advancing health equity using the blueprint from the second future of nursing report to guide us. The Future of Nursing: Campaign for Action will work to catalyze the nursing field and our many partners to advance the report recommendations. Coalitions in nearly every state are developing strategic plans. To join them, go to www.campaignforaction.org and select “Get Involved.”
++
There are many other ways for nurses to get involved. Nursing leaders can work to ensure that all nurses are able to practice to the full extent of their education and training. They can advocate for value-based payment reforms that better recognize and promote care coordination and transitional care. Nursing leaders can partner with schools of nursing to set up more clinical placements in the community. They can prioritize programs that promote nurse well-being, and they can serve as role models of well-being. They can keep abreast of what is happening on the front lines by spending time on floors and pitching in when necessary. Nursing leaders can form or join multi-sector partnerships and mentor and sponsor nurses from historically excluded backgrounds. They can set up seamless systems to screen for patients’ needs and then partner with services that can help to meet those needs.
++
Nursing educators can develop competencies to advance health equity, initiate dialogues in their classrooms about racism and inequities, and mentor and sponsor students from historically excluded backgrounds in nursing. Deans and directors can create policies and regulations to protect students most at risk for behavioral health challenges, including students who may be experiencing economic hardships or feel they are unsafe, isolated, or targets of bias, discrimination, and injustice. They can ensure that all students can engage in virtual learning. Deans and directors can identify and eliminate policies, procedures, curricular content, and clinical experiences that perpetuate structural racism, cultural racism, and discrimination among faculty, staff, and students. They can recruit and put systems in place to support diverse faculty with expertise in the social determinants of health, population health, and health equity, and offer trainings to develop the skills of current faculty in these areas. Deans and directors can also build a more diverse pipeline by collaborating with local elementary and high schools to expose students to nursing as a career.
++
Frontline nurses can get involved in advancing health equity by modeling behaviors to promote diversity, equity, and inclusion on their floors. They can view themselves as leaders and develop innovations to improve care. They might engage in their communities to understand their strengths and assets. They can advocate for adding an assessment tool that can systematically collect data on a patient’s social needs in the electronic health record. Frontline nurses can also advocate for themselves and others in the workplace, be effective team players, and develop coping and self-care skills.
++
Students can also play a role, from modeling behaviors that promote a culture of diversity, equity, and inclusion to getting involved in advocacy. Students can become aware of their own implicit biases and take trainings to address them, invest in their health, and identify and disseminate best practices to promote equitable care. Students can also seek out volunteer opportunities with organizations that are addressing the social determinants of health. They can also consider getting a PhD and conducting research to build the evidence base for advancing health equity.
++
The next decade offers tremendous challenges and opportunities for the nursing profession. More than ever, we need to tap the full potential of all nurses in every setting so that we can achieve what our county needs: for everyone—no matter who they are or where they live—to be able to experience good health and well-being. My hope is that Taking Action: Top 10 Priorities to Promote Health Equity and Well-Being in Nursing will inspire you to advance health equity.
++
+
Iyanda,
A. E., Boakye,
K. A., Lu,
Y., Oppong,
J. R. (2022). Racial/ethnic heterogeneity and rural-urban disparity of COVID-19 case fatality ratio in the USA: A negative binomial and GIS-based analysis.
Journal of Racial and Ethnic Health Disparities, 9, 708–721.
https://doi.org/10.1007/s40615-021-01006-7
[PubMed: 33638102]
+
Leeb,
R. T., Bitsko,
R. H., Radhakrishnan,
L., Martinez,
P., Njai,
R., Holland,
K. M. (2020, November 13). Mental health–related emergency department visits among children aged <18 years during the COVID-19 pandemic—United States, January 1–October 17, 2020. Centers for Disease Control and Prevention. Morbidity & Mortality Weekly Report, 69(45), 1675–1680. doi: 10.15585/mmwr.mm6945a3
+
Shalala,
D., Bolton,
L. B., Bleich,
M. R., Brennan,
T. A., Campbell,
R., Devlin,
L. (2011).
The future of nursing: Leading change, advancing health. National Academies Press.
https://www.nap.edu/catalog/12956/the-future-of-nursing-leading-change-advancing-health