Sustaining and Inspiring the Capacity of the Nursing Profession: The Case for Transformative Practice Education Models.

Decades of commissioned reports have pointed to solutions for nurturing nursing practice environments as essential to sustaining a nursing workforce. Beyond salary compensation and other solutions, we discuss the critical need for collaborative leadership in practice and education as a priority policy agenda aimed at confronting the shortage of nurses. The COVID-19 pandemic has intensified the nursing shortage and shortage of capacity in practice education, and we explore some learning in this context. Our paper draws on two initiatives in the province of British Columbia: the development of a transformative practice education model and an expanded Collaborative Learning Unit initiative. We propose building the following learning cultures: formal collaborative governance processes, intentional supports for graduate transitions and implementation of advanced nursing practice leadership and educator roles across the system. While transformative solutions are a tough sell in crisis-oriented contexts, this paper is a call for nurse leaders in all sectors to advance deep policy solutions with lasting impact on sustainable nursing human resources.

A novel and practical care process framework to inform model of care development.

Breaking free of pre-existing assumptions to achieve transformative change in care delivery remains challenging. This article presents a care process framework using a rapid task analysis tested with healthcare teams across five communities in British Columbia, Canada, to provide leaders a novel and practical approach to care model development. The study's goals were to determine if the framework was replicable even though the population care needs differed for each community. The results showed the framework was replicable, informed the care model development, and identified ideal scopes of practice and team composition given the context of care. The framework also captured expert tacit knowledge and decision-making to build capacity given our current workforce challenges. For operational leaders and government agencies, the use of the framework may influence a shift in historical approaches that better aligns health and human resources capacity to population health and service needs.

Commentary: The Nursing Workforce: Who Will Be Left to Answer the Call?

Nursing leaders play a critical role in responding to health human resource challenges. Innovative approaches are needed to retain and support the nursing workforce; recruitment alone is unlikely to address the gap. Actions to robustly support the onboarding of new graduate nurses, ongoing professional development opportunities and creative scheduling arrangements are all required to retain nurses. Shifting to a widened definition of the "health team" and a move from the traditionally siloed scope of practice models will require a transformational shift in thinking, and nursing leaders must lead that change. Health human resource planning must also occur in lockstep with population health planning.