It's Time! The Path for Nursing Reimbursement Reform.

Since the COVID-19 pandemic, nurses and nurse leaders are increasingly vocal about chronic understaffing and the impact the staffing crisis continues to have on nurses' well-being and patient outcomes. The American Nurses Association's Nurse Staffing Task Force addressed the importance of staffing standards as a critically needed step toward improving patient and population health outcomes. Against the backdrop of ongoing nursing shortages, hospital leaders have been hesitant to embrace staffing ratios, expressing concerns about their ability to hire and retain sufficient nursing staff, as operational revenue margins remain thin and nursing labor is costly. This article explicates structural issues within the current nursing reimbursement model that harms hospitals' business case for investments in nurse staffing and work environments. We argue that nurses must advocate for nursing reimbursement reform to increase the nursing workforce and improve nurse staffing and work environments. Such reform is necessary to support sustained hospital investments, financial philosophies, and approaches to meaningfully address and improve nurse staffing.

Leveraging Maslow's Hierarchy of Needs to Build Nursing's More Inclusive Future.

There is growing evidence that nurses have not seen meaningful change because of their employer's diversity, equity, inclusion, and belonging (DEIB) programs. At the same time, efforts are increasing to end DEIB programs and education in academic and work settings. These dynamics present a myriad of challenges negatively impacting any efforts to course correct and progress to build a diverse, inclusive, and pluralistic future. It is critical to urgently address these headwinds and challenges since there is evidence that discriminatory and racist acts germinate in schools of nursing. Almost half (44%) of nurses recently surveyed stated that a culture of racism in nursing schools exists; 60% of Black/African American respondents reported racism/discrimination and nearly 80% believed that more DEIB training was needed. The lack of diversity and inclusion in nursing conflicts squarely with an increasingly diverse and globalized health care consumer base. The overall goal of this article is to leverage a well-embraced framework such as Maslow's Hierarchy of Needs to generate more awareness, understanding, and acceptance of DEIB principles, which directionally sets up a positive future for everyone. Equality, diversity, equity, belonging, mattering, and human flourishing set up a more positive outlook for improved nurse and patient outcomes and for health care overall. With the harms that continue in nursing and society overall, comes emotion and discomfort that must be better understood, distributed, and not quelled. Aligning Maslow's Hierarchy of Needs and DEIB helps leaders recognize the human's needs in everyone and apply Maslow's theory to all therefore increasing inclusiveness.

No Health Equity Without Diversity: Strengthening Nursing Programs in Historically Black Colleges and Universities.

In April 2022, Adtalem Global Education sponsored a virtual summit entitled Advancing Equity in Healthcare, in which several of the authors of this article and other prominent health-care professionals examined the need to diversify the health-care profession. Topics included educational justice and its impact on health care, the business case for transforming and advancing health equity, and addressing systemic inequities and improving health outcomes for historically marginalized persons. The summit inspired the authors to write this paper to advocate for authentic, sustainable partnerships led by Historically Black Colleges and Universities, as a means to diversify nursing leadership and to stem systemic and structural inequities in health care.

The relationships between the healthy nurse, Healthy Nation program, RN perceptions of their work system, and health-related quality of life.

BACKGROUND: There is limited research on the effects of nationally oriented health care workforce interventions on RNs' perceptions of their work systems and health-related quality of life (HRQOL). PURPOSE: Guided by a systems framework, we examined the association of being affiliated with an organization partnered with the American Nurses Association's Healthy Nurse, Healthy Nation (HNHN) program on RNs' perceptions of their work systems and HRQOL. METHODS: We performed a correlational, cross-sectional secondary analysis of a national RN sample (N = 2,166) with case-control matching. We used multiple linear and logistic regressions to evaluate our research questions. DISCUSSION: Affiliation with an HNHN partner organization was directly associated with more desirable work system perceptions, and indirectly associated with greater HRQOL. Organization-level workplace interventions hold promise to improve RN working conditions and well-being. CONCLUSION: There is an ongoing need to continue developing and evaluating scalable workplace well-being interventions for health care organizations.

Promoting health equity with HBCUs: Breaking away from structural racism.

BACKGROUND: The United States continues to be plagued with pervasive health disparities. Leading health and professional organizations acknowledge structural racism as a contributing factor for the lack of a racially diverse nursing workforce particularly those serving in leadership roles which could help to mitigate health disparities among historically stigmatized populations. PURPOSE: Purpose Lack of funding for Historically Black Colleges and Universities (HBCUs) and lack of meaningful partnerships, stymie efforts that can be made by nursing programs at HBCUs. DISCUSSION: Discussion This position paper examines collaborative actions that can address upstream factors that perpetuate healthcare disparities through deep engagement between the policymakers, professional associations, industry, and educational institutions. METHODS: Faculty representing HBCU's and predominately White institutions, professional organizations, and staff met via videoconference to refine the focus of the paper, determine topic areas for writing teams, and refine details which occurred during weekly meetings. CONCLUSION: To disengage from structural racism, three critical recommendations are amplified with associated examples.

The nursing profession circa 2030.

ABSTRACT: The COVID-19 pandemic has forced immediate change and hopefully for the better. Navigating through this new world of care delivery warrants developing new maps to reach a new and acceptable normal. This article outlines urgent issues and necessary steps for measurable change, in nursing practice and work environments by 2030.

Trends in mental health indicators among nurses participating in healthy nurse, healthy nation from 2017 to 2021.

BACKGROUND: American healthcare workers face unprecedented stress and trauma in the workplace during COVID-19, putting nurses at increased risk for poor mental health. Examining trends of mental health from before and during COVID-19 can illuminate the toll of the pandemic on nurses well-being. METHODS: Nurses enrolled in Healthy Nurse, Healthy Nation receive a prompt to take an annual survey (n = 24,289). Mental health was assessed by active diagnoses of anxiety and depressive disorder, and feeling sad, down or depressed for two or more weeks in the past year. Logistic regression models were used to calculate predictive probabilities of health outcomes in year 4 (May 1, 2020 - April 30, 2021) compared to years 1-3 (each from May 1 to April 30), controlling for age, sex, race/ethnicity, and nurse type. Models were also stratified by work setting and nurse type. RESULTS: In year 4, nurses had a 19.8% probability of anxiety disorder, significantly higher than year 3 (16.3%, p < .001), year 2 (13.7%, p < .001), and year 1 (14.0%, p < .001). Similarly, nurses had a 16.7% probability of depression disorder in year 4, significantly higher than year 2 (12.9%, p < .001) and year 1 (13.9%, p < .01). Year 4 nurses had a 34.4% probability of feeling sad, down or depressed for two weeks, significantly higher than previous years (year 1 = 26.8%, year 2 = 25.9%, year 3 = 29.7%, p < .001). Trends in probabilities of mental health indicators were similar among each nurse type and work setting. Nurses in medical/surgical work settings and those with licensed practical nurse and licensed vocational nurse titles consistently had the highest probability of poor mental health. LINKING ACTION TO EVIDENCE: In 2020-2021, nurses faced challenges unlike any experienced in previous years. Unsurprisingly, nurses reported increased instances of poor mental health indicators. Positive disruptive strategies are needed to systemically change organizational culture and policy to prioritize and support nurses' well-being.

The US COVID-19 crises: facts, science and solidarity.

The United States leads the world in COVID-19 cases and deaths. The government's poorly coordinated response has lacked national mandates, failed to deploy adequate personal protective equipment, supplies and testing and devalued advice of science experts. COVID-19 exposed racial disparities in health care and as protests against racial injustice erupted, nurses have responded to the call to confront racism as a public health crisis. Nurses also suffer from lack of personal protective equipment, burnout, extreme workloads, overwhelming deaths and fear of contracting COVID-19. While facing danger, nurses have implemented practice changes and fostered new roles and teamwork to provide safer care. Advancing policy to provide personal protective equipment as well as financial and mental health support for nurses is a priority nationally and globally.