WEBVTT 00:00:11.300 --> 00:00:15.460 position:50% align:middle The State of the World's Nursing report is the most important nursing document ever 00:00:15.460 --> 00:00:19.320 position:50% align:middle published by the World Health Organization and it has been launched in the middle 00:00:19.320 --> 00:00:20.670 position:50% align:middle of a global pandemic. 00:00:20.670 --> 00:00:25.010 position:50% align:middle While the pandemic is not the main focus of this report, each and every one of the 00:00:25.010 --> 00:00:29.440 position:50% align:middle recommendations have relevance to the challenges being faced. 00:00:29.440 --> 00:00:32.947 position:50% align:middle As I consider the recommendations, I will highlight how nursing and nurse 00:00:32.947 --> 00:00:38.107 position:50% align:middle regulators can and are responding to the enormous challenges we face. 00:00:38.107 --> 00:00:43.017 position:50% align:middle I will offer brief comments on each of the recommendations and how NCSBN is learning 00:00:43.017 --> 00:00:47.337 position:50% align:middle from and responding with our partner boards of nursing and the wider nursing 00:00:47.337 --> 00:00:51.527 position:50% align:middle community in the issues we are facing during the crisis. 00:00:51.527 --> 00:00:56.607 position:50% align:middle The pandemic has exacerbated some shortages as nurses have fallen ill or 00:00:56.607 --> 00:01:00.886 position:50% align:middle have had to self isolate, some gaps in absolute numbers and 00:01:00.886 --> 00:01:03.056 position:50% align:middle distribution of nurses have been found. 00:01:03.056 --> 00:01:07.416 position:50% align:middle This provides important metrics to consider for future investment needs. 00:01:07.416 --> 00:01:11.386 position:50% align:middle These shortages have offered new insights into the need for better workforce 00:01:11.386 --> 00:01:15.236 position:50% align:middle planning such as more detail on the numbers of nurses in training, 00:01:15.236 --> 00:01:20.276 position:50% align:middle their likely precise completion date on their expected date of entry 00:01:20.276 --> 00:01:21.946 position:50% align:middle to the profession. 00:01:21.946 --> 00:01:26.166 position:50% align:middle It has also resulted in demands for detailed age-related information on those 00:01:26.166 --> 00:01:31.834 position:50% align:middle that have inactive licenses either due to a career break or through retirement. 00:01:31.834 --> 00:01:35.754 position:50% align:middle Regulators have been able to provide this information and have worked diligently 00:01:35.754 --> 00:01:39.284 position:50% align:middle with nurse leadership in education, service, and accreditation 00:01:39.284 --> 00:01:43.414 position:50% align:middle to propose solutions to protect the supply chain of new nurses, 00:01:43.414 --> 00:01:46.484 position:50% align:middle and to return inactive nurses to practice. 00:01:46.484 --> 00:01:50.994 position:50% align:middle Data has been at a premium during the COVID-19 crisis and the work that the 00:01:50.994 --> 00:01:55.224 position:50% align:middle profession has done in assembling data for submission to the State of the World's 00:01:55.224 --> 00:01:58.874 position:50% align:middle Nursing and Midwifery reports has been a great asset. 00:01:58.874 --> 00:02:03.605 position:50% align:middle Regulators have been asked to come to the table with data to enable jurisdictions 00:02:03.605 --> 00:02:08.125 position:50% align:middle to take informed decisions about the policy changes needed to respond to the 00:02:08.125 --> 00:02:13.445 position:50% align:middle emerging challenges as cases peak and services are required. 00:02:13.445 --> 00:02:17.925 position:50% align:middle Furthermore, some regulatory boards have been able to maintain their licensing and 00:02:17.925 --> 00:02:22.695 position:50% align:middle other functions totally remotely due to the features of our Optimal Regulatory 00:02:22.695 --> 00:02:25.365 position:50% align:middle Board System, the ORBS platform. 00:02:25.365 --> 00:02:29.545 position:50% align:middle This has maintained services to the profession and simultaneously supported 00:02:29.545 --> 00:02:33.102 position:50% align:middle social distancing guidelines. 00:02:33.102 --> 00:02:37.242 position:50% align:middle NCSBN has made good progress in introducing and implementing the 00:02:37.242 --> 00:02:39.372 position:50% align:middle Nurse Licensure Compact. 00:02:39.372 --> 00:02:43.832 position:50% align:middle Using a universal set of licensure requirements, nurses with an unencumbered 00:02:43.832 --> 00:02:47.622 position:50% align:middle license in one jurisdiction can work through a privilege to practice 00:02:47.622 --> 00:02:49.422 position:50% align:middle in other jurisdictions. 00:02:49.422 --> 00:02:53.692 position:50% align:middle This has increased the ability to respond to needs and there has been an increase 00:02:53.692 --> 00:02:56.942 position:50% align:middle in the use of telehealth provision during the crisis. 00:02:56.942 --> 00:03:01.233 position:50% align:middle Patients can protect themselves and others by getting needed treatment by a 00:03:01.233 --> 00:03:06.003 position:50% align:middle telehealth consultation rather than having to visit a provider in person. 00:03:06.003 --> 00:03:11.223 position:50% align:middle However, with regards to wider mobility, some population data has suggested that 00:03:11.223 --> 00:03:16.093 position:50% align:middle global mobility is not a solution to workforce shortages at this time due 00:03:16.093 --> 00:03:20.063 position:50% align:middle to the risks that moving a person from one country to another can bring 00:03:20.063 --> 00:03:22.483 position:50% align:middle in COVID-19 spread. 00:03:22.483 --> 00:03:26.313 position:50% align:middle It is unclear whether the shift to using more telehealth provision during the 00:03:26.313 --> 00:03:31.246 position:50% align:middle crisis will be maintained in the longer term and this is perhaps one of the areas 00:03:31.246 --> 00:03:36.446 position:50% align:middle where the longer-term impacts on how a more primary care prevention-oriented and 00:03:36.446 --> 00:03:41.996 position:50% align:middle wellness-driven model can be embedded to provide universal health coverage in a 00:03:41.996 --> 00:03:44.386 position:50% align:middle more efficient and effective manner. 00:03:44.386 --> 00:03:48.436 position:50% align:middle This would clearly have implications for the preparation of new providers and 00:03:48.436 --> 00:03:53.596 position:50% align:middle supporting the continuing competence of existing staff. 00:03:53.596 --> 00:03:58.306 position:50% align:middle Nurse leaders have stepped up to the plate during this period reaching out to peers 00:03:58.306 --> 00:04:01.639 position:50% align:middle to quickly find agreed solutions that can then be disseminated 00:04:01.639 --> 00:04:03.269 position:50% align:middle through multiple channels. 00:04:03.269 --> 00:04:06.929 position:50% align:middle Nurses have regularly featured in the media and have been proactive in bringing 00:04:06.929 --> 00:04:10.049 position:50% align:middle solutions to local, state, and national government. 00:04:10.049 --> 00:04:14.859 position:50% align:middle In particular, regulators have played a central role in offering accurate data, 00:04:14.859 --> 00:04:19.319 position:50% align:middle evidence, and suggestions for legislative change and many of these changes provide 00:04:19.319 --> 00:04:23.159 position:50% align:middle solutions that should be sustained in the longer term. 00:04:23.159 --> 00:04:26.649 position:50% align:middle There has been for a long time overwhelming evidence that nurses need 00:04:26.649 --> 00:04:31.501 position:50% align:middle to be enabled to work to their full scope of practice. 00:04:31.501 --> 00:04:34.431 position:50% align:middle Regulators and professional associations have brought this evidence to the 00:04:34.431 --> 00:04:38.781 position:50% align:middle attention of government as a solution to increase capacity and access 00:04:38.781 --> 00:04:40.551 position:50% align:middle to needed quality services. 00:04:40.551 --> 00:04:47.351 position:50% align:middle The solution also reduce bureaucracy and costs as well improving efficiency and 00:04:47.351 --> 00:04:49.561 position:50% align:middle effectiveness of service provision. 00:04:49.561 --> 00:04:52.741 position:50% align:middle We are pleased to see barriers to restrictions on scope of practice being 00:04:52.741 --> 00:04:56.501 position:50% align:middle removed and hope that this new way of working becomes the norm. 00:04:56.501 --> 00:05:02.442 position:50% align:middle The crisis has also raised questions as to how the entire continuum of nursing care 00:05:02.442 --> 00:05:07.322 position:50% align:middle from support worker to advanced practice practitioner needs to be differentiated, 00:05:07.322 --> 00:05:10.162 position:50% align:middle organized, educated and delivered. 00:05:10.162 --> 00:05:14.602 position:50% align:middle This is a challenge we need to address particularly with changing demographics 00:05:14.602 --> 00:05:16.712 position:50% align:middle and disease profiles. 00:05:16.712 --> 00:05:22.082 position:50% align:middle Perhaps the biggest manifestation of the support for decent work has been concerns 00:05:22.082 --> 00:05:26.322 position:50% align:middle over the lack of personal protective equipment and other essential provisions. 00:05:26.322 --> 00:05:30.881 position:50% align:middle Nurses on the frontline are acutely aware that patient safety, 00:05:30.881 --> 00:05:34.921 position:50% align:middle as well as personal safety and capacity to offer needed services 00:05:34.921 --> 00:05:39.831 position:50% align:middle can be compromised through the lack of much-needed supplies while still 00:05:39.831 --> 00:05:43.771 position:50% align:middle colleagues in Italy and elsewhere are being confronted with major ethical 00:05:43.771 --> 00:05:46.781 position:50% align:middle dilemmas in terms of who gets treatment. 00:05:46.781 --> 00:05:51.581 position:50% align:middle This coupled with the short and long term psychological impact on the nurse kind 00:05:51.581 --> 00:05:55.911 position:50% align:middle of increase workload related stress and raises issues as to the adequacy 00:05:55.911 --> 00:05:59.181 position:50% align:middle of current ethical and conduct guidance. 00:05:59.181 --> 00:06:03.415 position:50% align:middle While the State of the World's Nursing Report has not highlighted this specific 00:06:03.415 --> 00:06:07.735 position:50% align:middle problem that many nurses face during the pandemic, the following issue should 00:06:07.735 --> 00:06:09.185 position:50% align:middle not be lost. 00:06:09.185 --> 00:06:13.705 position:50% align:middle Many nurses are women and have additional caring responsibilities either 00:06:13.705 --> 00:06:19.415 position:50% align:middle for children or elderly parents. Nurses and indeed other health workers, 00:06:19.415 --> 00:06:24.455 position:50% align:middle in addition to all the work pressures, must juggle finding emergency childcare 00:06:24.455 --> 00:06:29.465 position:50% align:middle alongside the worries of getting infected and taking the infection back home. 00:06:29.465 --> 00:06:33.396 position:50% align:middle With such high levels of women in the nursing workforce, policies that recognize 00:06:33.396 --> 00:06:38.166 position:50% align:middle and address the issue also need to be considered when developing response 00:06:38.166 --> 00:06:42.706 position:50% align:middle solutions and longer-term plans. 00:06:42.706 --> 00:06:47.606 position:50% align:middle NCSBN has been calling for the modernization of the regulatory model 00:06:47.606 --> 00:06:51.996 position:50% align:middle for a number of years and has already taken bold steps in highlighting a path 00:06:51.996 --> 00:06:58.336 position:50% align:middle forward through a series of publications such as the regulation 2030 acting in 00:06:58.336 --> 00:07:03.500 position:50% align:middle the public interest and most recently a global profile of nursing regulation, 00:07:03.500 --> 00:07:04.910 position:50% align:middle education, and practice. 00:07:04.910 --> 00:07:09.360 position:50% align:middle We have also made great progress through the development of technologies to support 00:07:09.360 --> 00:07:14.140 position:50% align:middle collaboration of regulators across jurisdictions and introduced agreements 00:07:14.140 --> 00:07:18.880 position:50% align:middle that facilitate the delivery of modern interventions at a distance but it must 00:07:18.880 --> 00:07:20.400 position:50% align:middle not stop there. 00:07:20.400 --> 00:07:25.140 position:50% align:middle The various emergency measures that have been taken are a rich source of 00:07:25.140 --> 00:07:29.540 position:50% align:middle low-hanging fruit that need to be harvested and consolidated into permanent 00:07:29.540 --> 00:07:34.314 position:50% align:middle legislative change once the current crisis is over. 00:07:34.314 --> 00:07:39.624 position:50% align:middle NCSBN in its regulation 2030 report identified collaboration as one of the 00:07:39.624 --> 00:07:44.434 position:50% align:middle four focusing concepts needed to bring about a new regulatory model fit 00:07:44.434 --> 00:07:47.774 position:50% align:middle for today's complex global digital age. 00:07:47.774 --> 00:07:52.674 position:50% align:middle This crisis has reinforced our belief that collaboration is the way forward. 00:07:52.674 --> 00:07:57.374 position:50% align:middle Collaboration builds trust and respect, it increases efficiency and effectiveness 00:07:57.374 --> 00:08:02.652 position:50% align:middle of reach and offers a means to ensure that nursing plays its full role 00:08:02.652 --> 00:08:07.742 position:50% align:middle in influencing the future design of health and social care systems where nurses play 00:08:07.742 --> 00:08:12.552 position:50% align:middle an equal and respected part in modern collaborative teams. 00:08:12.552 --> 00:08:16.262 position:50% align:middle This is only an initial assessment of lessons we are learning 00:08:16.262 --> 00:08:18.382 position:50% align:middle in response to COVID-19. 00:08:18.382 --> 00:08:22.702 position:50% align:middle The State of the World's Nursing report must be seen as a launching platform 00:08:22.702 --> 00:08:26.292 position:50% align:middle for increased visibility, contribution, and impact. 00:08:26.292 --> 00:08:29.772 position:50% align:middle As nurses, we all have a role to play. 00:08:29.772 --> 00:08:35.656 position:50% align:middle So in the middle of this challenging time, capture your learning and use it to build 00:08:35.656 --> 00:08:39.436 position:50% align:middle better global health in the years ahead. 00:08:39.436 --> 00:08:44.036 position:50% align:middle If you have any questions or comments, please do not hesitate to contact me. 00:08:44.036 --> 00:08:48.946 position:50% align:middle It is, after all, through working together that we will create the future that we 00:08:48.946 --> 00:08:52.166 position:50% align:middle desire: a healthier world for all.