10 healthcare execs share predictions for nursing in the next 5 years

https://www.beckershospitalreview.com/nursing/10-healthcare-execs-share-predictions-for-nursing-in-the-next-5-years.html?utm_medium=email

The future of nursing infographic | Cipherhealth

The pandemic put nurses on the front lines of the battle against COVID-19 and caused shifts in the way they provide care.

During this year, nurses have adapted to increased adoption of telehealth and virtual patient monitoring, as well as constantly evolving staffing needs. 

These factors — and others, such as the physical and emotional conditions nurses have faced due to the public health crisis — are sure to affect nursing in the years to come. Here, 10 healthcare executives and leaders share their predictions for nursing in the next five years.

Editor’s note: Responses were edited lightly for length and clarity.

Beverly Bokovitz, DNP, RN. Vice President and Chief Nurse Executive of UC Health (Cincinnati): In the next five years, as we continue to encounter a national nursing shortage, I expect to see additional innovative strategies to complement the care provided at the bedside. 

One of these strategies will be some type of robot-assisted care. From delivery of medications to answering call lights — and completing simple tasks like needing a blanket or requesting that the heat be adjusted — we will see more electronic solutions. These solutions will allow for a better patient experience and help to exceed the expectations of our patients as customers.

Of course, nothing can take the place of skilled and compassionate bedside care, but many tasks could be automated — and will be — to supplement the professional nursing shortage.

Natalia Cineas, DNP, RN. Senior Vice President and Chief Nurse Executive of NYC Health + Hospitals (New York City): Nurses will continue to play a vital role in addressing the health inequities and social determinants of health among vulnerable populations as the nursing workforce itself becomes more diverse and inclusive. As the largest segment of the healthcare workforce — with some 4 million nurses active in the U.S. — nurses represent the faces of the communities in which they serve. As America becomes a more diverse and inclusive society, so too will the nursing profession become more diverse and inclusive. Currently, industry estimates indicate that between one quarter to one-third of all U.S. nurses identify as a member of a minority group, with between 19 percent and 24 percent of U.S. nurses identifying themselves as Black/African-American; 5 percent to 9 percent identifying themselves as Hispanic; and about 3 percent identifying themselves as Asian. The percentage of minority nurses has been rising steadily for the past two decades and is expected to continue to climb in the coming years.

Blacks and underserved minority populations face numerous genetic, environmental, cultural and socioeconomic factors that account for health disparities, and the impact is particularly visible in the areas of cardiovascular disease, diabetes, pregnancy and childbirth mortality, and cancer outcomes, as well as the enormous toll of the current novel coronavirus global pandemic, where communities of color have been among the hardest hit populations. 

In New York City alone, statistics compiled by the city’s health department show Blacks and Hispanics together account for 65 percent of all COVID-19 cases; represented 70 percent of all hospitalizations due to COVID-19; and, sadly, 68 percent of all deaths caused by COVID-19. As demonstrated during this pandemic, in the future, technology such as telehealth and virtual patient monitoring will play a major role in the care of patients. There will be a vast need to address social determinants of health by educating and providing resources to allow utilization of this technology such as using “wearable tech” to monitor ongoing health issues, such as high blood pressure, diabetes, heart conditions and other chronic illnesses.

Ryannon Frederick, MSN, RN. Chief Nursing Officer of Mayo Clinic (Rochester, Minn.): Nursing research will experience extraordinary demand and growth driven by a realization that both complex and unmet patient needs can often be best served by the role of a professional registered nurse. Nurses are uniquely positioned to implement symptom and self-management interventions for patients and their caregivers. Significant disruption in healthcare, including increasing use of technology, will lead to a dramatic shift to understand the role of the RN in improving patient outcomes and implementing interventions using novel approaches. Nursing researchers will provide a scientific body of evidence proving equivalent, if not better, patient care outcomes that can be obtained at a lower cost than traditional models, leading to an even greater demand for the role of the professional nurse in patient care. 

Karen Higdon, DNP, RN, Vice President and Chief Nursing Officer of Baptist Health Louisville (Ky.): The value of nursing has never been more apparent. Nurses have led the front line during this pandemic. In the next five years, we must be flexible and creative in establishing new models of care, specifically around roles that support nursing, such as assistant and tech roles. Creating roles with clear role definition, that are attractive and meaningful for nursing support will help build consistent, high-quality models for nursing to lead. This consistency, along with IT capabilities that enhance workflow, will better allow nurses to work at the top of their scope.

Karen Hill, DNP, RN. COO and Chief Nursing Officer of Baptist Health Lexington (Ky.): 2020 was declared the “Year of the Nurse” and this reality has never been more true than realizing the personal and professional sacrifices of nurses in dealing with issues surrounding the pandemic. The next five years will require nursing professionals to be flexible to address new, unknown emerging issues in all settings, to be open to new opportunities for leadership in hospitals, schools and communities and to use technology and telehealth to provide safer care to patients. Nurses need to evaluate our practices and traditions that are value-added and leave behind the task orientation of the past. We need to honor our legacy and create our path.

Therese Hudson-Jinks, MSN, RN. Chief Nursing Officer and Chief Patient Experience Officer at Tufts Medical Center and Tufts Children’s Hospital (Boston): Over the next five years, I expect that the support and retention of clinical nurses will become the top priority of every CNO and executive team, given nurses’ direct impact on supporting the business of healthcare. This will be particularly critical because there will be a concerning shortage of experienced clinical nurses as a result of advancing technologies increasing complexity in care, additional nurse roles created outside traditional areas, fierce competition for talent between large healthcare systems, aging baby boom workforce retiring at higher rates year over year, and a lack of sufficient numbers of PhD-prepared nurses working in academia and supporting higher enrollments.

I also believe that CNOs will be laser-focused on creating the practice environment that enhances retention of top, talented clinical nurses, and we will put a greater emphasis on the influence of effective nursing leadership in reaching that goal. In addition, I fully expect that nurses will be seen more as individuals with talents and experience than ever before — not just a number on a team, but rather a professional with specific, unique, talents that are highly sought after in competitive markets.

Finally, I anticipate that nursing innovation will blossom, given the exposure of the “innovation/solutionist superpower” within nurses during the pandemic. Philanthropy will grow exponentially in support of nursing innovation as a result.

Carol Koeppel-Olsen, MSN, RN. Vice President of Patient Care Services at Abbott Northwestern Hospital (Minneapolis): During the COVID-19 pandemic nurses have been working in difficult physical and emotional conditions, which may lead to significant turnover after the pandemic resolves. Nurses have a commitment to serving others and will persevere until the crisis is past; however, when conditions improve, many nurses may decide to pursue careers outside acute care settings. A possible turnover, coupled with a service economy that has been devastated, may result in large numbers of former service workers seeking stable jobs in nursing. Hospitals will have to be nimble and creative to onboard an influx of new nurses that are not only new to the profession but new to healthcare. Tactics to onboard these new nurses may include the use of retired RNs as mentors, instructor-model clinical groups in the work setting, job shadowing and aptitude testing to determine the best clinical fit.

Jacalyn Liebowitz, DNP, RN. Senior Vice President and System Chief Nurse Officer of Adventist Health (Roseville, Calif.): Over the next five years, I see nurses providing more hospital-based care in the home using remote technology. Based on that shift, we will see lower-acuity patients move into home-based care, and higher-acuity care in hospitals will increase. With that, hospital beds will be used at a different level. My bold prediction is that we will not need as many beds, but we will need higher acute care in the hospitals.

Nurses will learn differently. As we are seeing now, nurses have not been able to train in the traditional way. They are already using more remote technology to educate, onboard and orient to their roles. It looks and feels vastly different, and nurses need to be comfortable with that.

As for patient care, I think data that can be gleaned from wearable biometrics, and the use of artificial intelligence will help predict patient care on a patient-by-patient basis. Nurses will work with AI as part of their thought process, instead of completely focusing on their own judgment and assessment. 

I also believe we are going to face a nursing shortage post-COVID for a few reasons. Due to the emotional and physical toll of responding to a pandemic, some nurses will decide to retire, and another group will leave based on the risks that go hand-in-hand with the profession. 

As for patient care, we are going to collaborate differently. There will be more video conferencing regarding collaboration around the patient. And I think in the future we will see that the full continuum of care will include a wellness plan.

Debi Pasley, MSN, RN. Senior Vice President Chief Nursing Officer of Christus Health (Irving, Texas): I believe the demand for nurses will become increasingly visible and newsworthy throughout the pandemic. This could drive increases in salaries and numbers of qualified candidates seeking nursing as a profession in the medium and long term. The shortage will, however, continue to be a factor, leading to more remote work options to both supplement nursing at the bedside and substitute for in-person care.

Denise Ray, RN. Chief Nursing Executive of Piedmont Healthcare (Atlanta): Nursing schools will need to focus on emergency management and critical care training utilizing a team nursing model. While nursing has become very specialty-driven, the pandemic has demonstrated gaps in our ability to adapt as quickly utilizing a team model where nurses lead and direct care teams. By implementing a team model and enhancing education in the areas of emergency management and critical care, nursing can adapt quickly to the ever-changing environment.

Also, communication with patients and families will take on different dimensions with wider use of tele-therapeutic communication. Nurses will be leaders and liaisons in the process, connecting physicians, patients and patient families virtually. Nurses will play a key role in integrating patient family members as true patient care partners — making sure they have the information they need to serve an active caregiving role for their family members during and after hospitalization. We’ll also see more nurses becoming advanced nurse practitioners, playing an expanded role in all healthcare settings.

Have we forgotten the true meaning of Labor Day?

https://theconversation.com/have-we-forgotten-the-true-meaning-of-labor-day-64526

Labor Day is a U.S. national holiday held the first Monday every September. Unlike most U.S. holidays, it is a strange celebration without rituals, except for shopping and barbecuing. For most people it simply marks the last weekend of summer and the start of the school year.

The holiday’s founders in the late 1800s envisioned something very different from what the day has become. The founders were looking for two things: a means of unifying union workers and a reduction in work time.

History of Labor Day

The first Labor Day occurred in 1882 in New York City under the direction of that city’s Central Labor Union.

In the 1800s, unions covered only a small fraction of workers and were balkanized and relatively weak. The goal of organizations like the Central Labor Union and more modern-day counterparts like the AFL-CIO was to bring many small unions together to achieve a critical mass and power. The organizers of the first Labor Day were interested in creating an event that brought different types of workers together to meet each other and recognize their common interests.

However, the organizers had a large problem: No government or company recognized the first Monday in September as a day off work. The issue was solved temporarily by declaring a one-day strike in the city. All striking workers were expected to march in a parade and then eat and drink at a giant picnic afterwards.

The New York Tribune’s reporter covering the event felt the entire day was like one long political barbecue, with “rather dull speeches.”

Why was Labor Day invented?

Labor Day came about because workers felt they were spending too many hours and days on the job.

In the 1830s, manufacturing workers were putting in 70-hour weeks on average. Sixty years later, in 1890, hours of work had dropped, although the average manufacturing worker still toiled in a factory 60 hours a week.

These long working hours caused many union organizers to focus on winning a shorter eight-hour work day. They also focused on getting workers more days off, such as the Labor Day holiday, and reducing the workweek to just six days.

These early organizers clearly won since the most recent data show that the average person working in manufacturing is employed for a bit over 40 hours a week and most people work only five days a week.

Surprisingly, many politicians and business owners were actually in favor of giving workers more time off. That’s because workers who had no free time were not able to spend their wages on traveling, entertainment or dining out.

As the U.S. economy expanded beyond farming and basic manufacturing in the late 1800s and early 1900s, it became important for businesses to find consumers interested in buying the products and services being produced in ever greater amounts. Shortening the work week was one way of turning the working class into the consuming class.

Common misconceptions

The common misconception is that since Labor Day is a national holiday, everyone gets the day off. Nothing could be further from the truth.

While the first Labor Day was created by striking, the idea of a special holiday for workers was easy for politicians to support. It was easy because proclaiming a holiday, like Mother’s Day, costs legislators nothing and benefits them by currying favor with voters. In 1887, Oregon, Colorado, Massachusetts, New York and New Jersey all declared a special legal holiday in September to celebrate workers.

Within 12 years, half the states in the country recognized Labor Day as a holiday. It became a national holiday in June 1894 when President Grover Cleveland signed the Labor Day bill into law. While most people interpreted this as recognizing the day as a national vacation, Congress’ proclamation covers only federal employees. It is up to each state to declare its own legal holidays.

Moreover, proclaiming any day an official holiday means little, as an official holiday does not require private employers and even some government agencies to give their workers the day off. Many stores are open on Labor Day. Essential government services in protection and transportation continue to function, and even less essential programs like national parks are open. Because not everyone is given time off on Labor Day, union workers as recently as the 1930s were being urged to stage one-day strikes if their employer refused to give them the day off.

In the president’s annual Labor Day declaration last year, Obama encouraged Americans “to observe this day with appropriate programs, ceremonies and activities that honor the contributions and resilience of working Americans.”

The proclamation, however, does not officially declare that anyone gets time off.

Controversy: Militants and founders

Today most people in the U.S. think of Labor Day as a noncontroversial holiday.

There is no family drama like at Thanksgiving, no religious issues like at Christmas. However, 100 years ago there was controversy.

The first controversy that people fought over was how militant workers should act on a day designed to honor workers. Communist, Marxist and socialist members of the trade union movement supported May 1 as an international day of demonstrations, street protests and even violence, which continues even today.

More moderate trade union members, however, advocated for a September Labor Day of parades and picnics. In the U.S., picnics, instead of street protests, won the day.

There is also dispute over who suggested the idea. The earliest history from the mid-1930s credits Peter J. McGuire, who founded the New York City Brotherhood of Carpenters and Joiners, in 1881 with suggesting a date that would fall “nearly midway between the Fourth of July and Thanksgiving” that “would publicly show the strength and esprit de corps of the trade and labor organizations.”

Later scholarship from the early 1970s makes an excellent case that Matthew Maguire, a representative from the Machinists Union, actually was the founder of Labor Day. However, because Matthew Maguire was seen as too radical, the more moderate Peter McGuire was given the credit.

Who actually came up with the idea will likely never be known, but you can vote online here to express your view.

Have we lost the spirit of Labor Day?

Today Labor Day is no longer about trade unionists marching down the street with banners and their tools of trade. Instead, it is a confused holiday with no associated rituals.

The original holiday was meant to handle a problem of long working hours and no time off. Although the battle over these issues would seem to have been won long ago, this issue is starting to come back with a vengeance, not for manufacturing workers but for highly skilled white-collar workers, many of whom are constantly connected to work.

If you work all the time and never really take a vacation, start a new ritual that honors the original spirit of Labor Day. Give yourself the day off. Don’t go in to work. Shut off your phone, computer and other electronic devices connecting you to your daily grind. Then go to a barbecue, like the original participants did over a century ago, and celebrate having at least one day off from work during the year!