WEBVTT 00:00:05.335 --> 00:00:11.077 position:50% align:middle - [Dr. Maryann] I'd like to begin by extending to each and everyone of you a very warm welcome from the 00:00:11.077 --> 00:00:14.290 position:50% align:middle National Council of State Boards of Nursing. 00:00:14.290 --> 00:00:22.610 position:50% align:middle It is indeed an honor to have such a distinguished group of healthcare leaders today here with us 00:00:22.610 --> 00:00:29.380 position:50% align:middle to attend this very important event and hear these data that we're going to be presenting to you. 00:00:29.380 --> 00:00:31.540 position:50% align:middle My name is Maryann Alexander. 00:00:31.540 --> 00:00:36.400 position:50% align:middle I am the Chief Officer of Nursing Regulation at NCSBN. 00:00:36.400 --> 00:00:43.310 position:50% align:middle I provide oversight over the Division of Nursing Regulation, which includes all activities related 00:00:43.310 --> 00:00:52.080 position:50% align:middle to licensure practice, nursing education, discipline, our research department, and legislation and policy. 00:00:52.080 --> 00:00:55.250 position:50% align:middle I will be moderating the panel today. 00:00:55.250 --> 00:00:59.226 position:50% align:middle Let me tell you a little bit about NCSBN. 00:00:59.226 --> 00:01:06.390 position:50% align:middle We are an independent not-for-profit organization and a global leader in regulatory excellence. 00:01:06.390 --> 00:01:13.440 position:50% align:middle Our mission is to empower, serve, and support the state boards of nursing across the U.S. 00:01:13.440 --> 00:01:14.090 position:50% align:middle and the U.S. 00:01:14.090 --> 00:01:15.660 position:50% align:middle territories. 00:01:15.660 --> 00:01:19.030 position:50% align:middle We have an extensive research program. 00:01:19.030 --> 00:01:24.890 position:50% align:middle We are leaders in regulatory research and we are experts in nursing policy. 00:01:24.890 --> 00:01:33.830 position:50% align:middle We are also experts in exam development and we are known internationally for the NCLEX examinations, 00:01:33.830 --> 00:01:38.580 position:50% align:middle which are the preeminent licensure examinations for nursing. 00:01:38.580 --> 00:01:43.730 position:50% align:middle Now, without further ado, I will pass the microphone to Dr. Martin, 00:01:43.730 --> 00:01:51.750 position:50% align:middle who is going to quickly present the research which provides the most complete and unparalleled snapshot 00:01:51.750 --> 00:01:55.900 position:50% align:middle of the state of today's nursing workforce. 00:01:55.900 --> 00:02:02.624 position:50% align:middle Brendan. 00:02:02.624 --> 00:02:03.557 position:50% align:middle - [Dr. Martin] Thank you, Maryann. 00:02:03.557 --> 00:02:04.992 position:50% align:middle And good morning, everyone. 00:02:04.992 --> 00:02:08.740 position:50% align:middle As Maryann mentioned, I'm here today to briefly recap research that we 00:02:08.740 --> 00:02:10.110 position:50% align:middle recently completed on the U.S. 00:02:10.110 --> 00:02:15.640 position:50% align:middle nursing workforce and really in doing so to set the stage for a vital discussion on possible policy 00:02:15.640 --> 00:02:22.560 position:50% align:middle solutions to foster a more resilient and safer healthcare system now and in the future. 00:02:22.560 --> 00:02:28.970 position:50% align:middle Since 2013, NCSBN has partnered with the National Forum of State Nursing Workforce Centers to collect timely 00:02:28.970 --> 00:02:30.800 position:50% align:middle and accurate supply side U.S. 00:02:30.800 --> 00:02:33.150 position:50% align:middle nursing workforce data. 00:02:33.150 --> 00:02:39.000 position:50% align:middle Our stratified random sampling approach allows us to derive population-weighted national estimates and 00:02:39.000 --> 00:02:44.740 position:50% align:middle to project observed trends to all levels of the nursing workforce, from licensed practical and vocational 00:02:44.740 --> 00:02:48.234 position:50% align:middle nurses to advanced practice registered nurses. 00:02:48.234 --> 00:02:53.490 position:50% align:middle The National Nursing Workforce Survey utilizes a multi-mode survey study design, 00:02:53.490 --> 00:02:58.150 position:50% align:middle leveraging both direct mail and email outreach, as well as data collected systematically 00:02:58.150 --> 00:03:01.480 position:50% align:middle through NCSBN Nursys e-Notify System. 00:03:01.481 --> 00:03:06.630 position:50% align:middle Combined, as you will see in the slide in front of you, NCSBN researchers were able to analyze data submitted 00:03:06.630 --> 00:03:13.580 position:50% align:middle by more than 300,000 licensed nurses located across all 50 states, the District of Columbia, and select U.S. 00:03:13.580 --> 00:03:16.040 position:50% align:middle territories. 00:03:16.040 --> 00:03:22.630 position:50% align:middle As a result, the 2022 report stands as the largest, most comprehensive, and rigorous examination 00:03:22.630 --> 00:03:23.180 position:50% align:middle of the U.S. 00:03:23.180 --> 00:03:29.073 position:50% align:middle nursing workforce since the onset of the COVID-19 pandemic in March 2020. 00:03:29.073 --> 00:03:34.320 position:50% align:middle In fact, as stewards of the only nursing workforce data bookending the pandemic, 00:03:34.320 --> 00:03:38.710 position:50% align:middle we assembled you all here today to ensure that the critical trends that we rigorously documented are 00:03:38.710 --> 00:03:42.550 position:50% align:middle at the forefront of policy discussions. 00:03:42.550 --> 00:03:47.810 position:50% align:middle To begin, I want to start with a closer examination of the more than a quarter million nurses who have left 00:03:47.810 --> 00:03:50.497 position:50% align:middle the workforce since 2020. 00:03:50.497 --> 00:03:57.700 position:50% align:middle Our findings confirm that roughly half of that total, or approximately 100,000 registered nurses and 34,000 00:03:57.700 --> 00:04:02.050 position:50% align:middle licensed practical and vocational nurses left the workforce over the past 2 years, 00:04:02.050 --> 00:04:05.510 position:50% align:middle specifically due to the COVID-19 pandemic. 00:04:05.510 --> 00:04:11.970 position:50% align:middle Alarmingly, 41% of the RN total is comprised of nurses with a mean age of 36 and fewer 00:04:11.970 --> 00:04:15.640 position:50% align:middle than 10 years experience. 00:04:15.640 --> 00:04:20.850 position:50% align:middle Furthermore, increased workloads, stress, and burnout have strained the U.S. 00:04:20.850 --> 00:04:25.720 position:50% align:middle nursing workforce, compounding observed attrition over the past few years. 00:04:25.720 --> 00:04:33.440 position:50% align:middle In total, 62% of nurses across all levels reported an increase in their workload over the past 2 years. 00:04:33.440 --> 00:04:39.810 position:50% align:middle Similarly, half of all nurses reported feeling emotionally drained, used up, fatigued, 00:04:39.810 --> 00:04:44.117 position:50% align:middle and burned out at least a few times a week, if not every day. 00:04:44.117 --> 00:04:51.180 position:50% align:middle Over a quarter of the workforce reported feeling at the end of the rope at similar intervals. 00:04:51.180 --> 00:04:59.200 position:50% align:middle Looking ahead, 800,000 registered nurses and an additional 184,000 licensed practical and vocational 00:04:59.200 --> 00:05:03.770 position:50% align:middle nurses indicated that they intend to leave the workforce by 2027. 00:05:03.770 --> 00:05:09.020 position:50% align:middle To put those numbers into perspective, that is equivalent to roughly 20% of the licensed 00:05:09.020 --> 00:05:14.270 position:50% align:middle RN and LPN, LVN workforces in the United States, respectively. 00:05:14.270 --> 00:05:19.250 position:50% align:middle Again, a particular concern, younger early-career nurses account for roughly a 00:05:19.250 --> 00:05:23.390 position:50% align:middle quarter of the total. 00:05:23.390 --> 00:05:29.380 position:50% align:middle In addition, an imperiled to the workforce survey, we also recently completed a 2.5-year-long study 00:05:29.380 --> 00:05:34.470 position:50% align:middle of over 50 pre-licensure RN programs, including over 1,100 participants located 00:05:34.470 --> 00:05:37.070 position:50% align:middle across 27 states. 00:05:37.070 --> 00:05:44.920 position:50% align:middle This cross-sectional study utilized a four-phased longitudinal design to assess academic learning, 00:05:44.920 --> 00:05:49.050 position:50% align:middle standardized examination, and early career outcomes for pre-licensure RN students 00:05:49.050 --> 00:05:53.970 position:50% align:middle entering the core of their nursing curriculum in fall 2020 and with an anticipated graduation 00:05:53.970 --> 00:05:56.456 position:50% align:middle in spring, 2022. 00:05:56.456 --> 00:06:00.927 position:50% align:middle Similar to the workforce survey and what that represents for the current nursing workforce, 00:06:00.927 --> 00:06:06.200 position:50% align:middle this study stands as the most comprehensive assessment of pre-licensure RN education in the United States 00:06:06.200 --> 00:06:09.720 position:50% align:middle since the onset of the pandemic. 00:06:09.720 --> 00:06:14.510 position:50% align:middle Overall, our findings confirmed that the effects of the pandemic were obviously not limited 00:06:14.510 --> 00:06:16.560 position:50% align:middle to the current workforce. 00:06:16.560 --> 00:06:22.150 position:50% align:middle Rather, we documented significant declines in the clinical preparedness of pre-licensure RN students and 00:06:22.150 --> 00:06:28.288 position:50% align:middle similar drop-offs in the practice proficiency of early career nurses, specifically due to shifts to more 00:06:28.288 --> 00:06:35.190 position:50% align:middle remote and virtually simulated educational models required by the pandemic. 00:06:35.190 --> 00:06:37.290 position:50% align:middle So, what does this all mean? 00:06:37.290 --> 00:06:41.130 position:50% align:middle Increased workloads, stress, and burnout have significantly strained 00:06:41.130 --> 00:06:42.280 position:50% align:middle the current U.S. 00:06:42.280 --> 00:06:47.651 position:50% align:middle nursing workforce, and the pandemic has disrupted traditional educational models. 00:06:47.652 --> 00:06:53.520 position:50% align:middle As a result, we project critical staffing shortfalls and reductions in the practice readiness of new nurse 00:06:53.520 --> 00:06:58.440 position:50% align:middle graduates at a time when more nurses than ever are needed to address the increase in inpatient demand 00:06:58.440 --> 00:07:03.870 position:50% align:middle from and related to COVID-19 and an aging population. 00:07:03.870 --> 00:07:07.770 position:50% align:middle And here's the silver lining, there's always a silver lining. 00:07:07.770 --> 00:07:12.700 position:50% align:middle The projections that I've presented here this morning are not static, but rather manipulable outcomes based 00:07:12.700 --> 00:07:17.130 position:50% align:middle on the decisions that policymakers make today and in the near future. 00:07:17.130 --> 00:07:21.720 position:50% align:middle The presentation of these critical results in the panel discussion that will follow serve as an urgent call 00:07:21.720 --> 00:07:27.470 position:50% align:middle to action to tailor policy solutions aimed at fostering a more resilient, sustainable, and safer U.S. 00:07:27.470 --> 00:07:28.600 position:50% align:middle nursing workforce. 00:07:28.600 --> 00:07:31.550 position:50% align:middle Not only now, but in the future. 00:07:31.550 --> 00:07:35.790 position:50% align:middle So, with that and without further ado, I will turn the microphone back over to Dr. Maryann 00:07:35.790 --> 00:07:38.550 position:50% align:middle Alexander and our distinguished panelists. 00:07:38.550 --> 00:07:41.795 position:50% align:middle Thank you so much. 00:07:41.795 --> 00:07:49.369 position:50% align:middle - The panelists, please come forward. 00:07:49.369 --> 00:07:52.339 position:50% align:middle Thank you, Brendan, for your presentation. 00:07:52.339 --> 00:07:59.450 position:50% align:middle And I want to emphasize that one of the reasons and the reason, the most important reason we have gathered you 00:07:59.450 --> 00:08:10.290 position:50% align:middle here today is because these data telling us that 1 million nurses or more could leave the workforce in the 00:08:10.290 --> 00:08:13.870 position:50% align:middle next 5 years is reversible. 00:08:13.870 --> 00:08:18.140 position:50% align:middle And so, we are here today to talk about solutions. 00:08:18.140 --> 00:08:23.510 position:50% align:middle And so, before we get started, I would like to introduce our very illustrious group 00:08:23.510 --> 00:08:27.926 position:50% align:middle of panelists beginning at my left. 00:08:27.926 --> 00:08:28.723 position:50% align:middle - [Antonia] Hi, everybody. 00:08:28.723 --> 00:08:33.582 position:50% align:middle I'm Antonia Villarruel and I'm the Dean of Nursing at the University of Pennsylvania. 00:08:33.582 --> 00:08:34.720 position:50% align:middle - [Gay] And I'm Gay Landstrom. 00:08:34.720 --> 00:08:39.403 position:50% align:middle I'm the System Chief Nursing Officer for Trinity Health. 00:08:39.403 --> 00:08:41.470 position:50% align:middle - [Rayna] My name is Rayna Letourneau. 00:08:41.470 --> 00:08:47.110 position:50% align:middle I am on the board of directors for the National Forum of State Nursing Workforce Centers and the Executive 00:08:47.110 --> 00:08:49.863 position:50% align:middle Director of the Florida Center for Nursing. 00:08:49.863 --> 00:08:57.488 position:50% align:middle - And to my right on screen is a congresswoman, please introduce yourself. 00:08:57.488 --> 00:08:58.750 position:50% align:middle - [Lisa] Good morning, everyone. 00:08:58.750 --> 00:09:04.740 position:50% align:middle I'm Congresswoman Lisa Blunt Rochester from the state of Delaware, also a member of the Energy and Commerce 00:09:04.740 --> 00:09:07.770 position:50% align:middle Committee and specifically the health subcommittee. 00:09:07.770 --> 00:09:10.150 position:50% align:middle Glad to be with you. 00:09:10.150 --> 00:09:12.470 position:50% align:middle - And Robyn. 00:09:12.470 --> 00:09:13.730 position:50% align:middle - [Robyn] Good morning, everyone. 00:09:13.730 --> 00:09:18.300 position:50% align:middle I'm Robyn Begley, the CEO for the American Organization for Nursing Leadership. 00:09:18.300 --> 00:09:23.210 position:50% align:middle I also serve as chief nursing officer and senior vice president for workforce for the 00:09:23.210 --> 00:09:24.920 position:50% align:middle American Hospital Association. 00:09:24.920 --> 00:09:26.533 position:50% align:middle It's great to be with you. 00:09:26.533 --> 00:09:33.270 position:50% align:middle - One thing we can thank COVID for is we got this Zoom deal down and we're able to have our other 00:09:33.270 --> 00:09:35.460 position:50% align:middle panelists with us. 00:09:35.460 --> 00:09:45.370 position:50% align:middle So, I want to begin with the first and most obvious question, 100,000 RNs have already left the workforce 00:09:45.370 --> 00:09:48.480 position:50% align:middle due to COVID in the past 2 years. 00:09:48.480 --> 00:09:55.723 position:50% align:middle And another 800,000 intend to leave by 2027. 00:09:55.723 --> 00:10:03.360 position:50% align:middle One-third of them are younger than 40 years of age who we usually depend on to be the mentors and preceptors 00:10:03.360 --> 00:10:05.110 position:50% align:middle of the future. 00:10:05.110 --> 00:10:12.100 position:50% align:middle How are we going to address this and prevent a major crisis in our healthcare system in the 00:10:12.100 --> 00:10:13.746 position:50% align:middle very near future? 00:10:13.746 --> 00:10:15.982 position:50% align:middle And let me begin with you, Gay. 00:10:15.982 --> 00:10:17.480 position:50% align:middle - I'd be happy to answer that. 00:10:17.480 --> 00:10:21.150 position:50% align:middle It is something that I think about every day. 00:10:21.150 --> 00:10:24.980 position:50% align:middle We have an urgent call to action. 00:10:24.980 --> 00:10:27.640 position:50% align:middle Right now, our nurses are very stressed. 00:10:27.640 --> 00:10:32.710 position:50% align:middle And as that continues, they're making choices to leave the workforce and 00:10:32.710 --> 00:10:34.580 position:50% align:middle leave patient care. 00:10:34.580 --> 00:10:37.871 position:50% align:middle I really believe there are several things that we need to do. 00:10:37.871 --> 00:10:41.020 position:50% align:middle They need to have a different environment. 00:10:41.020 --> 00:10:47.830 position:50% align:middle Those working nurses need a different environment today that is safer, that is more flexible, 00:10:47.830 --> 00:10:49.990 position:50% align:middle that is more supportive. 00:10:49.990 --> 00:10:57.930 position:50% align:middle I think of those early career nurses who need mentoring more than ever before, 00:10:57.930 --> 00:11:07.120 position:50% align:middle and they also believe that when you look at the math, we do not have enough registered nurses and LPNs 00:11:07.120 --> 00:11:11.770 position:50% align:middle to continue with the care delivery models that we have had in the past. 00:11:11.770 --> 00:11:13.940 position:50% align:middle They just aren't enough. 00:11:13.940 --> 00:11:22.810 position:50% align:middle It calls for us to really look creatively at how can we provide excellent, high quality safe care 00:11:22.810 --> 00:11:24.817 position:50% align:middle in a different way. 00:11:24.818 --> 00:11:31.005 position:50% align:middle - Thank you. And I'd like to open this up to the other panelists as well because this is such an important 00:11:31.005 --> 00:11:33.760 position:50% align:middle question to begin this discussion with. 00:11:33.761 --> 00:11:40.660 position:50% align:middle - Sure. I'd like to add to Gay's comment here, is that as you are hopeful that this is an opportunity 00:11:40.660 --> 00:11:46.790 position:50% align:middle to really take a look at what we're doing in the care delivery system to address this particular issue. 00:11:46.790 --> 00:11:48.520 position:50% align:middle This is not just a nursing issue. 00:11:48.520 --> 00:11:52.880 position:50% align:middle This is as in the report a healthcare system issue. 00:11:52.880 --> 00:12:00.300 position:50% align:middle We're like the canaries in the coal mine here alerting the world that this is a particular issue here. 00:12:00.300 --> 00:12:06.630 position:50% align:middle This also is a great time for innovation for us to take a look at what we've been doing, how we've been doing. 00:12:06.630 --> 00:12:10.810 position:50% align:middle But it's important for us to think about not just short-term solutions, 00:12:10.810 --> 00:12:15.280 position:50% align:middle but what are the long-term impacts of whatever we do here, and importantly, 00:12:15.280 --> 00:12:20.630 position:50% align:middle keeping the focus on patient care outcomes and also on the well-being of our staff. 00:12:20.630 --> 00:12:28.160 position:50% align:middle So, I think lots of opportunities to innovate as long as we think not just about bodies in a place, 00:12:28.160 --> 00:12:30.990 position:50% align:middle but again, the care that they're able to deliver. 00:12:30.990 --> 00:12:37.610 position:50% align:middle I also think this is an opportunity to elevate the care system that we do. 00:12:37.610 --> 00:12:44.350 position:50% align:middle I think many times people devalue the work that nurses and other caregivers give. 00:12:44.350 --> 00:12:48.370 position:50% align:middle We're so stuck on the procedures and the high-tech components. 00:12:48.370 --> 00:12:51.140 position:50% align:middle A lot of that has to do with the financing as well. 00:12:51.140 --> 00:12:53.060 position:50% align:middle But we're more than a cost center. 00:12:53.060 --> 00:12:58.411 position:50% align:middle We really are the oxygen of the healthcare system and we need investments in that area. 00:12:58.411 --> 00:12:58.970 position:50% align:middle - Thank you. 00:12:58.970 --> 00:13:00.262 position:50% align:middle Rayna 00:13:00.262 --> 00:13:03.170 position:50% align:middle - I agree with everything that's been said already. 00:13:03.170 --> 00:13:09.500 position:50% align:middle And I would like to add and really emphasize what you're hearing is a call for systematic changes and 00:13:09.500 --> 00:13:13.740 position:50% align:middle what that really means, because I think people will hear us say we need 00:13:13.740 --> 00:13:17.190 position:50% align:middle systematic changes but not quite understand what that is. 00:13:17.190 --> 00:13:22.490 position:50% align:middle And when you mention changing the environment, making sure that our nurses have a safe place to go 00:13:22.490 --> 00:13:25.505 position:50% align:middle to work is going to be extremely important. 00:13:25.505 --> 00:13:29.742 position:50% align:middle And making sure that we have a culture change within the nursing workforce. 00:13:29.742 --> 00:13:33.900 position:50% align:middle Since before the pandemic, we have research and evidence from the American Nurses 00:13:33.900 --> 00:13:39.390 position:50% align:middle Association and the Healthy Nurse Healthy Nation campaign that about two-thirds of nurses report they 00:13:39.390 --> 00:13:42.187 position:50% align:middle put the needs of others ahead of their own. 00:13:42.187 --> 00:13:45.140 position:50% align:middle And that's something that nurses are known for doing. 00:13:45.140 --> 00:13:51.270 position:50% align:middle We care for our patients more than we take care of our own needs, and we cannot continue to pour from the 00:13:51.270 --> 00:13:52.910 position:50% align:middle empty cup, as the saying goes. 00:13:52.910 --> 00:13:58.720 position:50% align:middle So, really putting some culture changes and making environments changes that allow nurses to care 00:13:58.720 --> 00:14:04.691 position:50% align:middle for themselves so that we're healthiest to be able to care for our patients and our communities. 00:14:04.691 --> 00:14:09.026 position:50% align:middle - And Robyn. 00:14:09.026 --> 00:14:09.520 position:50% align:middle - Yes. 00:14:09.520 --> 00:14:10.820 position:50% align:middle I'd like to add a few things. 00:14:10.820 --> 00:14:14.700 position:50% align:middle First of all, my co-panel is so well said. 00:14:14.700 --> 00:14:19.390 position:50% align:middle Some of the work, you know, and before I start, actually, Dr. Martin, 00:14:19.390 --> 00:14:26.690 position:50% align:middle thank you for leading this really important study because these are, I think, 00:14:26.690 --> 00:14:28.820 position:50% align:middle for representing those in practice. 00:14:28.820 --> 00:14:33.880 position:50% align:middle I mean, this is what our nursing leaders and our nurses have been, you know, 00:14:33.880 --> 00:14:35.970 position:50% align:middle have been experiencing for the past two years. 00:14:35.970 --> 00:14:43.070 position:50% align:middle So, the numbers that you shared really do validate what you know, anecdotally, 00:14:43.070 --> 00:14:53.480 position:50% align:middle we've been studying or what we've been hearing, rather, the AHA/AONL, we're not beginning our work right now. 00:14:53.480 --> 00:14:55.670 position:50% align:middle We've been working for several years. 00:14:55.670 --> 00:14:58.360 position:50% align:middle In fact, there's wonderful resources. 00:14:58.360 --> 00:15:05.280 position:50% align:middle But the work for this year, 2023, I think if I just review the topic areas, 00:15:05.280 --> 00:15:07.390 position:50% align:middle it will really tie into what's been said. 00:15:07.390 --> 00:15:16.950 position:50% align:middle So, the priority areas for the AHA Workforce Task Force in collaboration with AONL is culture of work, 00:15:16.950 --> 00:15:22.210 position:50% align:middle including work environment, well-being, safety, mental health, work, and workflow changes, 00:15:22.210 --> 00:15:24.857 position:50% align:middle and how to lead transformation. 00:15:24.857 --> 00:15:27.580 position:50% align:middle Second topic is care model exploration. 00:15:27.580 --> 00:15:33.080 position:50% align:middle And as Tony said, you know, it's really studying outcomes for the long-term 00:15:33.080 --> 00:15:39.040 position:50% align:middle quality safety, you know, patient experience, staff engagement, of course, 00:15:39.040 --> 00:15:43.000 position:50% align:middle as well as the economics of the model and scalability. 00:15:43.000 --> 00:15:45.280 position:50% align:middle The third topic is workforce planning. 00:15:45.280 --> 00:15:49.360 position:50% align:middle And I think this study really adds to that body of knowledge. 00:15:49.360 --> 00:15:51.740 position:50% align:middle What data do we need for the future? 00:15:51.740 --> 00:15:56.820 position:50% align:middle I think it's easy to extrapolate if we think about the "old model of care." 00:15:56.820 --> 00:16:01.840 position:50% align:middle But when we have to redefine what we're going to be needing in the future with new models, 00:16:01.840 --> 00:16:03.811 position:50% align:middle it gets a little more complicated. 00:16:03.812 --> 00:16:06.632 position:50% align:middle And finally, messaging the healthcare career. 00:16:06.632 --> 00:16:17.330 position:50% align:middle So, it's really important for our, you know, for our communities to understand that healthcare 00:16:17.330 --> 00:16:22.350 position:50% align:middle nursing is has been a lifelong profession for me that I am so proud of. 00:16:22.350 --> 00:16:25.480 position:50% align:middle And yes, we know we have, you know, I'm the eternal optimist, 00:16:25.480 --> 00:16:29.480 position:50% align:middle but we've got lots that we have to improve and transform. 00:16:29.480 --> 00:16:35.090 position:50% align:middle But it is such a meaningful career, and not just nursing, really any healthcare career. 00:16:35.090 --> 00:16:40.630 position:50% align:middle Real quickly, I'd like to note that AONL is doing deep dives on the role of the nurse manager, 00:16:40.630 --> 00:16:47.230 position:50% align:middle the frontline nurse manager, and also inventorying and assessing those innovative 00:16:47.230 --> 00:16:51.460 position:50% align:middle care models that we know have been developed over the course of the pandemic. 00:16:51.460 --> 00:16:53.070 position:50% align:middle What's good for the future? 00:16:53.070 --> 00:16:56.902 position:50% align:middle What was an innovation that really needs to evolve and change? 00:16:56.903 --> 00:16:59.819 position:50% align:middle And the use of technology is really key here as well. 00:16:59.819 --> 00:17:00.330 position:50% align:middle Thank you. 00:17:00.330 --> 00:17:00.930 position:50% align:middle - Thank you. 00:17:00.930 --> 00:17:05.024 position:50% align:middle Representative Blunt Rochester. 00:17:05.024 --> 00:17:05.500 position:50% align:middle - Yes. 00:17:05.500 --> 00:17:09.450 position:50% align:middle Well, first of all, I want to say thank you so much for having me at the table. 00:17:09.450 --> 00:17:18.350 position:50% align:middle I think one of the main issues that I hear when I think about even the record and the data that's shown is that 00:17:18.350 --> 00:17:21.456 position:50% align:middle nurses need to be seen. 00:17:21.456 --> 00:17:28.221 position:50% align:middle One of my concerns is that we already had these challenges before the pandemic, 00:17:28.221 --> 00:17:32.610 position:50% align:middle and the pandemic just exacerbated it and accelerated. 00:17:32.610 --> 00:17:34.670 position:50% align:middle I've talked to nurses in my state. 00:17:34.670 --> 00:17:36.159 position:50% align:middle We've had nursing roundtables. 00:17:36.159 --> 00:17:38.010 position:50% align:middle My grandmother was a nurse. 00:17:38.010 --> 00:17:42.980 position:50% align:middle And when I think back, things are so different now compared to when she was 00:17:42.980 --> 00:17:44.400 position:50% align:middle in the profession. 00:17:44.400 --> 00:17:50.150 position:50% align:middle You know, the things that you're dealing with, everything from workplace violence and people coming 00:17:50.150 --> 00:18:01.200 position:50% align:middle in that are more aggressive to a pandemic where the stress levels are at epic proportions to just the 00:18:01.200 --> 00:18:08.630 position:50% align:middle everyday concerns for a living like what we saw from the pandemic was that issues such as childcare and 00:18:08.630 --> 00:18:13.890 position:50% align:middle being caregivers at home also you're sort of like you never turn it off. 00:18:13.890 --> 00:18:19.900 position:50% align:middle And so, us as a society, as a country, recognizing that things like affordable housing, 00:18:19.900 --> 00:18:25.780 position:50% align:middle things like, you know, child care and elder care and caregiving are 00:18:25.780 --> 00:18:31.110 position:50% align:middle also important, as well as making sure that you have the tools that you need. 00:18:31.110 --> 00:18:37.670 position:50% align:middle I love some of the words that were said before safety, flexibility, the supportive environment, mentors. 00:18:37.670 --> 00:18:42.640 position:50% align:middle But data is also so important, which is why the work that you have done and what 00:18:42.640 --> 00:18:48.470 position:50% align:middle you're showcasing helps me and other policymakers really do the work we need to do. 00:18:48.470 --> 00:18:55.600 position:50% align:middle I'm proud that we passed the Lorna Breen Act that allowed, you know, really focused on...here's a doctor 00:18:55.600 --> 00:19:01.260 position:50% align:middle who in the heat of the pandemic was so stressed, got COVID, came back to work, 00:19:01.260 --> 00:19:06.640 position:50% align:middle and was embarrassed to talk about her own stress and therefore committed suicide. 00:19:06.640 --> 00:19:11.580 position:50% align:middle And so, we as policymakers, number one, need to see you. 00:19:11.580 --> 00:19:14.955 position:50% align:middle Number two, need to understand the data and the impacts. 00:19:14.955 --> 00:19:18.924 position:50% align:middle And as we talk about workforce planning, I was secretary of labor in Delaware and head 00:19:18.924 --> 00:19:22.470 position:50% align:middle of state personnel, as well as deputy secretary of health and social services. 00:19:22.470 --> 00:19:28.260 position:50% align:middle So, I think we already have an aging population as a country. 00:19:28.260 --> 00:19:31.490 position:50% align:middle So, for me, this conversation is very important. 00:19:31.490 --> 00:19:38.630 position:50% align:middle I'm looking forward to us talking about some of the silver-lining strategies that we can employ. 00:19:38.630 --> 00:19:45.818 position:50% align:middle But I want you to know as a silver-lining piece, that even our work is bipartisan. 00:19:45.818 --> 00:19:51.020 position:50% align:middle And I think people need to have some hope that your work, what you're putting forward, 00:19:51.020 --> 00:19:54.160 position:50% align:middle is going to have real and lasting impact. 00:19:54.160 --> 00:19:55.661 position:50% align:middle I'll turn it back over to you. 00:19:55.661 --> 00:19:58.264 position:50% align:middle - Thank you so much. 00:19:58.264 --> 00:20:02.930 position:50% align:middle Well, some of you have spoken about new models of healthcare. 00:20:02.930 --> 00:20:06.967 position:50% align:middle What might that look like? 00:20:06.967 --> 00:20:16.200 position:50% align:middle - I think when we look at, again, the numbers, we have to make sure that we are using this precious 00:20:16.200 --> 00:20:26.521 position:50% align:middle resource of registered nurses really well and looking at how can we relieve them of some of the work that 00:20:26.521 --> 00:20:31.430 position:50% align:middle they have been responsible for but really doesn't require the registered nurse. 00:20:31.430 --> 00:20:35.000 position:50% align:middle That's part of the analysis, understanding that. 00:20:35.000 --> 00:20:42.630 position:50% align:middle Other, I think, other caregivers need to be a part of that team supporting the registered nurse. 00:20:42.630 --> 00:20:47.090 position:50% align:middle Our models in the past, often, the registered nurse was caring for a group 00:20:47.090 --> 00:20:51.220 position:50% align:middle of patients, for instance, in a hospital or an emergency room 00:20:51.220 --> 00:20:53.470 position:50% align:middle largely by themselves. 00:20:53.470 --> 00:20:59.959 position:50% align:middle We really are going to have to use teams of people coming around the registered nurse. 00:20:59.959 --> 00:21:08.200 position:50% align:middle It was mentioned by one of the other panelists that we now have technology that can help bring together 00:21:08.200 --> 00:21:12.300 position:50% align:middle members of the team that previously it was more challenging. 00:21:12.300 --> 00:21:19.150 position:50% align:middle So, for instance, we know that we need more mentoring of a young workforce. 00:21:19.150 --> 00:21:20.940 position:50% align:middle They're asking for it. 00:21:20.940 --> 00:21:21.700 position:50% align:middle They're needing it. 00:21:21.700 --> 00:21:28.640 position:50% align:middle They're showing by the numbers that they're leaving nursing at an alarming rate. 00:21:28.640 --> 00:21:38.980 position:50% align:middle We can bring experienced registered nurses who perhaps can no longer hike up and down the floors or lift 00:21:38.980 --> 00:21:41.500 position:50% align:middle patients or do some of the heavy physical work. 00:21:41.500 --> 00:21:49.030 position:50% align:middle But we can bring them in through technology to be a part of the team, to help mentor early career nurses 00:21:49.030 --> 00:21:53.500 position:50% align:middle to be a part of decision-making, sharing their wisdom and their knowledge, 00:21:53.500 --> 00:21:56.630 position:50% align:middle and helping develop those who are early in their career. 00:21:56.630 --> 00:21:59.285 position:50% align:middle I think those are all pieces of this. 00:21:59.285 --> 00:21:59.670 position:50% align:middle - Yeah. 00:21:59.670 --> 00:22:05.610 position:50% align:middle And just to let you know how important one of the things that you said about support care workers, 00:22:05.610 --> 00:22:09.050 position:50% align:middle this is a strategic initiative for NCSBN. 00:22:09.050 --> 00:22:19.060 position:50% align:middle We're going to be looking at that and how we strengthen the support care worker, their competencies. 00:22:19.060 --> 00:22:24.485 position:50% align:middle And so, they are prepared to support registered nurses and the LPN as well. 00:22:24.485 --> 00:22:29.640 position:50% align:middle - So, if I could just add to that, in addition to supporting our ends, 00:22:29.640 --> 00:22:31.360 position:50% align:middle we learned a lot in COVID. 00:22:31.360 --> 00:22:36.310 position:50% align:middle We had to make a lot of adjustments in terms of the responsibilities of care workers. 00:22:36.310 --> 00:22:42.750 position:50% align:middle And one of the things that's important is that nurses and all healthcare providers are able to work at the 00:22:42.750 --> 00:22:46.060 position:50% align:middle top of their license, and sometimes that's restricted 00:22:46.060 --> 00:22:47.430 position:50% align:middle within hospital systems. 00:22:47.430 --> 00:22:50.480 position:50% align:middle Sometimes that's regulated by states. 00:22:50.480 --> 00:22:55.330 position:50% align:middle And again, that just causes a lot of bureaucracy and unneeded oversight. 00:22:55.330 --> 00:22:58.540 position:50% align:middle So, those are things that need...and I know Gay can talk other... 00:22:58.540 --> 00:23:02.830 position:50% align:middle that work in the health system and talk about that more tangibly. 00:23:02.830 --> 00:23:06.110 position:50% align:middle But that is an issue that we know that we're hearing from our health system partners. 00:23:06.110 --> 00:23:14.400 position:50% align:middle - And we need policymakers to listen to that because we have legislation throughout all the states really 00:23:14.400 --> 00:23:19.070 position:50% align:middle to get advanced practice nurses working at the top of their license. 00:23:19.070 --> 00:23:24.540 position:50% align:middle And there's a lot of opposition to that. 00:23:24.540 --> 00:23:26.372 position:50% align:middle Rayna, do you have anything to add? 00:23:26.372 --> 00:23:27.040 position:50% align:middle - I would. 00:23:27.040 --> 00:23:35.100 position:50% align:middle I would like to add from a workforce development point of view, looking at the pipeline coming in and as our 00:23:35.100 --> 00:23:41.390 position:50% align:middle evidence and research is showing the expertise leaving our workforce, whether that's early retirements or the 00:23:41.390 --> 00:23:47.330 position:50% align:middle stress that's causing people to leave the bedside or the profession, how can we bring that expertise back 00:23:47.330 --> 00:23:50.110 position:50% align:middle in and help us to rebuild the workforce? 00:23:50.110 --> 00:23:53.937 position:50% align:middle So, when you're talking about mentorship, I think that's the perfect opportunity to look 00:23:53.937 --> 00:24:01.590 position:50% align:middle at strategies and innovative strategies to be able to utilize the expertise of those experienced nurses and 00:24:01.590 --> 00:24:07.780 position:50% align:middle bring them back into the clinical setting to help train or mentor the pre-licensure nurses, 00:24:07.780 --> 00:24:09.900 position:50% align:middle both at the PN and RN levels. 00:24:09.900 --> 00:24:14.520 position:50% align:middle So, looking at innovative strategies to be able to do that and really to... 00:24:14.520 --> 00:24:19.725 position:50% align:middle I'm calling for academic practice partnerships as defined by the AACN. 00:24:19.725 --> 00:24:24.370 position:50% align:middle - And could you tell us a little bit more about those just so everyone knows? 00:24:24.371 --> 00:24:25.200 position:50% align:middle - Sure. Absolutely. 00:24:25.200 --> 00:24:26.110 position:50% align:middle Thank you. 00:24:26.110 --> 00:24:32.040 position:50% align:middle So, when I speak about academic practice partnerships, it's the two organizations coming together, 00:24:32.040 --> 00:24:36.041 position:50% align:middle academia and professional practice, or a clinical environment. 00:24:36.041 --> 00:24:41.110 position:50% align:middle And coming together not just for a clinical affiliation where I can send 00:24:41.110 --> 00:24:48.140 position:50% align:middle students to a hospital for an example, but really coming together with a shared goal and 00:24:48.140 --> 00:24:52.670 position:50% align:middle looking at how can we put our resources together to achieve that goal. 00:24:52.670 --> 00:24:58.400 position:50% align:middle And so, when I speak about academic practice partnerships, we can utilize that model to make sure 00:24:58.400 --> 00:25:05.860 position:50% align:middle that we have education systems and practice systems coming together with our shared goal of a safe nursing 00:25:05.860 --> 00:25:08.307 position:50% align:middle workforce to provide quality care. 00:25:08.307 --> 00:25:17.190 position:50% align:middle - And an example of us all working together related to that is during COVID-19 over 10 nursing organizations 00:25:17.190 --> 00:25:26.324 position:50% align:middle all came together to write a policy about that and the importance of that practice and academic relationship. 00:25:26.324 --> 00:25:32.564 position:50% align:middle Robyn and representative Blunt Rochester, do you have any thoughts? 00:25:32.564 --> 00:25:33.650 position:50% align:middle - Sure. 00:25:33.650 --> 00:25:41.180 position:50% align:middle Relating to academic practice partnerships, you know, we did see during the pandemic that our normal 00:25:41.180 --> 00:25:48.490 position:50% align:middle structures and our silos immediately just dissipated, which was a wonderful thing. 00:25:48.490 --> 00:25:58.270 position:50% align:middle Also, many of our hospitals and health systems were able to utilize their educationally prepared clinical 00:25:58.270 --> 00:26:07.860 position:50% align:middle staff to enhance the faculty or to be able to really do some precepting and some teaching 00:26:07.860 --> 00:26:09.401 position:50% align:middle for the nursing programs. 00:26:09.401 --> 00:26:13.300 position:50% align:middle And this is something, you know, whether it's called formally joint appointments. 00:26:13.300 --> 00:26:20.750 position:50% align:middle I mean, these are the kinds of partnerships that we really need to continue as we're seeing 00:26:20.750 --> 00:26:22.820 position:50% align:middle the pandemic wane. 00:26:22.820 --> 00:26:29.290 position:50% align:middle You know, when we looked at the numbers of nurses that we need, I mean, it is a wise investment strictly 00:26:29.290 --> 00:26:34.900 position:50% align:middle from a financial perspective to be able to say, yes, we are going to either, 00:26:34.900 --> 00:26:44.940 position:50% align:middle "loan or subsidize our qualified nursing educators to be able to participate in the educational process and 00:26:44.940 --> 00:26:48.990 position:50% align:middle to be on loan, if you will, to some of our colleges and schools of nursing." 00:26:48.990 --> 00:26:55.030 position:50% align:middle So, creative opportunities like that, I know in many of our states we also had pre-licensure 00:26:55.030 --> 00:27:03.780 position:50% align:middle students who were doing their clinical experiences but also had the opportunity to become part of staff, 00:27:03.780 --> 00:27:10.380 position:50% align:middle if you will, and also have some experience in the clinical setting before they became registered nurses, 00:27:10.380 --> 00:27:11.810 position:50% align:middle which was also very helpful. 00:27:11.810 --> 00:27:17.269 position:50% align:middle So, trends like this and pilot programs like this need to continue. 00:27:17.269 --> 00:27:18.792 position:50% align:middle - Representative Rochester. - Yeah. 00:27:18.792 --> 00:27:24.000 position:50% align:middle I was just going to add that, you know, I think as members of Congress, 00:27:24.000 --> 00:27:31.990 position:50% align:middle many of us also understand and value the fact that this kind of almost gets to the flexibility issue that was 00:27:31.990 --> 00:27:39.740 position:50% align:middle talked about as well that we saw during the pandemic things that used to be very rigid. 00:27:39.740 --> 00:27:42.480 position:50% align:middle We had to shift and change and be flexible. 00:27:42.480 --> 00:27:49.490 position:50% align:middle And I think one of my hopes and goals is that because of the things that we learned during the pandemic, 00:27:49.490 --> 00:27:55.280 position:50% align:middle some of those flexibilities that had to be put in place, that we don't go back to the rigid ways 00:27:55.280 --> 00:27:56.501 position:50% align:middle of doing things. 00:27:56.501 --> 00:28:01.220 position:50% align:middle And so, you know, for me, I know I've been supportive even at the University 00:28:01.220 --> 00:28:05.717 position:50% align:middle of Delaware, a letter of support in the same vein. 00:28:05.717 --> 00:28:15.380 position:50% align:middle But to me, this is an opportunity for us to see how these flexibilities help to not just strengthen 00:28:15.380 --> 00:28:21.733 position:50% align:middle the workforce, but expand because ultimately the goal is quality of care. 00:28:21.733 --> 00:28:23.540 position:50% align:middle I mean, that's the bottom line. 00:28:23.540 --> 00:28:27.140 position:50% align:middle And when we have shortages, we're going to have to be flexible. 00:28:27.140 --> 00:28:32.744 position:50% align:middle So, I think we're all on the same page here with this one. 00:28:32.744 --> 00:28:37.760 position:50% align:middle - And so, Representative, I want to actually just change this 00:28:37.760 --> 00:28:40.300 position:50% align:middle conversation to policy. 00:28:40.300 --> 00:28:48.050 position:50% align:middle Is there anything that can be done at the federal level to help this crisis or avert the crisis? 00:28:48.050 --> 00:28:49.877 position:50% align:middle - You know, Mary... 00:28:49.877 --> 00:28:54.210 position:50% align:middle And I think that's, again, sort of the foundational to this conversation is the 00:28:54.210 --> 00:28:56.424 position:50% align:middle fact that we need to intervene now. 00:28:56.424 --> 00:29:05.070 position:50% align:middle And I can say, as I think about some of the data that was shared, they're kind of like two main pillars that 00:29:05.070 --> 00:29:08.530 position:50% align:middle I think stand out to me for Congress. 00:29:08.530 --> 00:29:16.410 position:50% align:middle One is this whole notion of cultivating a supportive environment for nurses so that they can, number one, 00:29:16.410 --> 00:29:19.530 position:50% align:middle join the profession, but also stay in the profession. 00:29:19.530 --> 00:29:25.890 position:50% align:middle And then the second pillar is really promoting federal-state collaboration in understanding the 00:29:25.890 --> 00:29:32.020 position:50% align:middle workforce and the landscape so that our efforts are both well-informed but also supportive. 00:29:32.020 --> 00:29:37.550 position:50% align:middle On the first pillar, you know, as we think about the environment in Congress, 00:29:37.550 --> 00:29:44.280 position:50% align:middle we can do things such as supporting nursing education, retention, career development, scope of practice, 00:29:44.280 --> 00:29:50.850 position:50% align:middle and fair payment policies, which was actually mentioned earlier as we did last 00:29:50.850 --> 00:29:55.590 position:50% align:middle year with the passing of the Lorna Breen Act. 00:29:55.590 --> 00:29:59.740 position:50% align:middle Again, part of that was to focus on the mental health and the environment. 00:29:59.740 --> 00:30:06.060 position:50% align:middle But, you know, I'm going to run down a couple of things that I think specifically under this first pillar. 00:30:06.060 --> 00:30:13.660 position:50% align:middle First, you all know that the Title VIII Funding is a major source of federal support for fostering training 00:30:13.660 --> 00:30:15.990 position:50% align:middle and employment opportunities for nurses. 00:30:15.990 --> 00:30:21.240 position:50% align:middle So, Congress must continue, first of all, robustly funding these programs. 00:30:21.240 --> 00:30:26.080 position:50% align:middle Secondly, we've got to ensure that there is a robust pipeline. 00:30:26.080 --> 00:30:32.264 position:50% align:middle So, a bill that I championed is called the TRAIN Act, which I worked on in partnership with Beebe Healthcare, 00:30:32.264 --> 00:30:35.067 position:50% align:middle one of our major hospitals in our state. 00:30:35.067 --> 00:30:40.720 position:50% align:middle This was passed into law in 2022, and the legislation really aimed to protect nursing 00:30:40.720 --> 00:30:47.210 position:50% align:middle schools from federal funding clawbacks so that we can continue to support the training of nurses and other 00:30:47.210 --> 00:30:52.700 position:50% align:middle allied health professionals in hospital-based nursing schools across the country. 00:30:52.700 --> 00:30:59.060 position:50% align:middle Third, we've got to make sure that nurses can practice at the top of their license and get fairly paid 00:30:59.060 --> 00:31:00.670 position:50% align:middle for their services. 00:31:00.670 --> 00:31:08.217 position:50% align:middle So, for example, I've introduced legislation with Congressman Adrian Smith to enable nurses to order and 00:31:08.217 --> 00:31:11.342 position:50% align:middle supervise cardiac and pulmonary rehab. 00:31:11.342 --> 00:31:17.260 position:50% align:middle And lastly in this pillar is, you know, a focus on National Health Service Corps. 00:31:17.260 --> 00:31:23.448 position:50% align:middle We need to support those who want to work in public health because this can be a tough field. 00:31:23.448 --> 00:31:30.540 position:50% align:middle And the National Health Service Corps provides scholarships and loan repayments, you know, 00:31:30.540 --> 00:31:32.080 position:50% align:middle for health providers. 00:31:32.080 --> 00:31:39.677 position:50% align:middle It also helps, you know, to be specifically targeted to underserved areas. 00:31:39.677 --> 00:31:46.840 position:50% align:middle I've introduced legislation, and that's bipartisan, to extend this program with representatives Joyce, 00:31:46.840 --> 00:31:53.180 position:50% align:middle Fletcher, and Stefanik and working on legislation to make sure that we can sustain the gains in this program 00:31:53.180 --> 00:31:54.446 position:50% align:middle that we've already seen. 00:31:54.446 --> 00:32:00.290 position:50% align:middle And then if you pivot to the workforce data that you released today, it's highly valuable in helping us 00:32:00.290 --> 00:32:04.416 position:50% align:middle to further understand, you know, what the national scope is. 00:32:04.416 --> 00:32:06.995 position:50% align:middle But we also know this is just the tip of the iceberg. 00:32:06.995 --> 00:32:12.330 position:50% align:middle We need to make sure that states can also understand what's happening to their workforce on the ground. 00:32:12.330 --> 00:32:19.000 position:50% align:middle And that brings me to the second pillar, which is to have Congress promote these federal-state 00:32:19.000 --> 00:32:24.710 position:50% align:middle collaborations and understanding the workplace landscape in order to address the shortages 00:32:24.710 --> 00:32:25.630 position:50% align:middle and retain nurses. 00:32:25.630 --> 00:32:29.000 position:50% align:middle And I can tell you this is also bipartisan work that we're doing. 00:32:29.000 --> 00:32:32.990 position:50% align:middle I joined Representative Young Kim, a Republican from California, 00:32:32.990 --> 00:32:38.560 position:50% align:middle and Senators Jeff Merkley of Oregon, and Thom Tillis of North Carolina to introduce the 00:32:38.560 --> 00:32:42.190 position:50% align:middle Nursing Workforce Shortage Act in Congress. 00:32:42.190 --> 00:32:49.050 position:50% align:middle This bill complements existing efforts to address the shortage and including those like the National Council 00:32:49.050 --> 00:32:55.120 position:50% align:middle of State Boards of Nursing and Nurse Workforce working centers, our hubs, as many of you know, 00:32:55.120 --> 00:32:58.090 position:50% align:middle to advance nursing education, training, and leadership. 00:32:58.090 --> 00:33:01.530 position:50% align:middle And so, this is one of the areas that we have focused on. 00:33:01.530 --> 00:33:08.850 position:50% align:middle And we believe that it will bring localized on the ground support for states like Delaware and establish 00:33:08.850 --> 00:33:14.800 position:50% align:middle new nursing workforce centers or support the current ones that already exist, 00:33:14.800 --> 00:33:18.060 position:50% align:middle and then also formalize a national one. 00:33:18.060 --> 00:33:24.480 position:50% align:middle Because, you know, again, for us, we're looking to reduce barriers to get understanding 00:33:24.480 --> 00:33:31.472 position:50% align:middle about these shortages and really to be able to make sure that we do something that deals with the whole 00:33:31.472 --> 00:33:34.170 position:50% align:middle landscape across the country. 00:33:34.170 --> 00:33:41.130 position:50% align:middle I'm excited and I will announce that our bill will actually be in the health subcommittee 00:33:41.130 --> 00:33:42.550 position:50% align:middle hearing next week. 00:33:42.550 --> 00:33:50.040 position:50% align:middle And for me, that's a really incredible start and portion of what the work is that we have to do. 00:33:50.040 --> 00:33:52.870 position:50% align:middle But I'm glad and just check out next week. 00:33:52.870 --> 00:33:54.760 position:50% align:middle It'll be in the health subcommittee. 00:33:54.760 --> 00:33:56.130 position:50% align:middle - Well, thank you so much. 00:33:56.130 --> 00:33:58.750 position:50% align:middle We'll be anxious to see that. 00:33:58.750 --> 00:34:05.180 position:50% align:middle I would be remiss if I did not turn this topic now to nursing education. 00:34:05.180 --> 00:34:13.220 position:50% align:middle Our nursing students were hit very hard and suffered consequences during the pandemic. 00:34:13.220 --> 00:34:21.600 position:50% align:middle Antonia, what can we do now moving forward to prepare our nursing students for the challenges that lie ahead 00:34:21.600 --> 00:34:22.620 position:50% align:middle and the workforce? 00:34:22.620 --> 00:34:23.950 position:50% align:middle - Sure. 00:34:23.950 --> 00:34:29.970 position:50% align:middle First of all, I think from the survey results, it's not a surprise that students don't feel clinically 00:34:29.970 --> 00:34:32.970 position:50% align:middle ready to enter the healthcare system. 00:34:32.970 --> 00:34:37.800 position:50% align:middle Any graduating nurse from the beginning of time will tell you they don't feel that they have those 00:34:37.800 --> 00:34:39.540 position:50% align:middle clinical skills ready. 00:34:39.540 --> 00:34:45.730 position:50% align:middle Certainly, it was exacerbated during COVID when they didn't have the same opportunities, 00:34:45.730 --> 00:34:48.840 position:50% align:middle but they were provided with incredible opportunities. 00:34:48.840 --> 00:34:55.880 position:50% align:middle I mean, to be able to practice population health in the middle of a pandemic and see the leadership and 00:34:55.880 --> 00:34:59.580 position:50% align:middle innovation of nurses was absolutely phenomenal. 00:34:59.580 --> 00:35:05.740 position:50% align:middle We had students placed in settings that we had never imagined before, working hand in hand with our 00:35:05.740 --> 00:35:11.330 position:50% align:middle healthcare system partners, I think specifically one condition is how do we support 00:35:11.330 --> 00:35:15.940 position:50% align:middle the nurses and healthcare providers that were on the frontlines of COVID. 00:35:15.940 --> 00:35:23.050 position:50% align:middle One of the nurses and other folk decided to do a hotline for people that anybody could call during the 00:35:23.050 --> 00:35:25.830 position:50% align:middle pandemic to talk them through whatever happened. 00:35:25.830 --> 00:35:30.036 position:50% align:middle And this was a great training opportunity for our nurse practitioner students. 00:35:30.036 --> 00:35:33.550 position:50% align:middle So, again, opportunities that they had never had before. 00:35:33.550 --> 00:35:38.750 position:50% align:middle That being said, we've talked a lot about the academic practice partnerships. 00:35:38.750 --> 00:35:40.720 position:50% align:middle Those are absolutely key. 00:35:40.720 --> 00:35:45.220 position:50% align:middle We're fortunate at Penn working with our academic health partners and others in the community that we 00:35:45.220 --> 00:35:52.570 position:50% align:middle have a robust partnership and we speak regularly about what is it that we need to do on the education side 00:35:52.570 --> 00:35:56.010 position:50% align:middle to make sure that our students are practice ready. 00:35:56.010 --> 00:36:02.510 position:50% align:middle On the other hand, we get feedback from our components, from our practice partners to ensure that we're 00:36:02.510 --> 00:36:07.500 position:50% align:middle providing the skills that are needed and also help students in the transition. 00:36:07.500 --> 00:36:14.990 position:50% align:middle I think Robyn mentioned before that we are looking at nursing as well as other healthcare professions as this 00:36:14.990 --> 00:36:21.500 position:50% align:middle is lifelong learning and we have to be able to prepare and to be able to support nurses at whatever level they 00:36:21.500 --> 00:36:28.290 position:50% align:middle are at, to inform them of what other opportunities there are to both improve the practice that they have, 00:36:28.290 --> 00:36:31.770 position:50% align:middle as well as to be able to take a look at other components. 00:36:31.770 --> 00:36:38.670 position:50% align:middle We also take a look at what we're doing in our education setting to make sure that we are, again, 00:36:38.670 --> 00:36:40.760 position:50% align:middle looking at practice-ready components. 00:36:40.760 --> 00:36:46.680 position:50% align:middle So, one of the things that we have done that causes our grads a lot of angst isn't necessarily in the 00:36:46.680 --> 00:36:49.351 position:50% align:middle assessment skills, but it's in the use of technology. 00:36:49.351 --> 00:36:52.273 position:50% align:middle The electronic health record is one. 00:36:52.274 --> 00:36:57.328 position:50% align:middle We are one of the few schools that prepare students in the use of the 00:36:57.328 --> 00:37:00.885 position:50% align:middle electronic health record that's used in our health system. 00:37:00.885 --> 00:37:07.050 position:50% align:middle And so, when people know that our students know how to work in Epic, they are like, "What!" 00:37:07.050 --> 00:37:12.080 position:50% align:middle That cuts a number, at least two weeks of training time from that period. 00:37:12.080 --> 00:37:17.840 position:50% align:middle So, again, that's an example of an innovation and a partnership that serves both our students and also 00:37:17.840 --> 00:37:20.185 position:50% align:middle facilitates people being practice ready. 00:37:20.185 --> 00:37:26.140 position:50% align:middle - I want to go back to something you said in the beginning about how the pandemic afforded students 00:37:26.140 --> 00:37:30.578 position:50% align:middle an opportunity to have some unique clinical experiences. 00:37:30.578 --> 00:37:39.030 position:50% align:middle One of the things we hear all the time from educators is, there's just not enough clinical sites. 00:37:39.030 --> 00:37:45.710 position:50% align:middle Do educators need to start really thinking more innovatively about the clinical experiences they 00:37:45.710 --> 00:37:47.610 position:50% align:middle give to students? 00:37:47.610 --> 00:37:48.400 position:50% align:middle - Absolutely. 00:37:48.400 --> 00:37:56.440 position:50% align:middle So, the strain on clinical sites and I was talking to someone before is not just in our healthcare systems or 00:37:56.440 --> 00:37:59.844 position:50% align:middle academic health centers, but it's also in the community as well. 00:37:59.844 --> 00:38:05.590 position:50% align:middle And so, we are already asking stressed nurses to undertake the education initiative. 00:38:05.590 --> 00:38:09.454 position:50% align:middle So, we have to figure out some way to alleviate that. 00:38:09.454 --> 00:38:15.400 position:50% align:middle In our state, our governor is looking at tax credits for precepting models, which again, 00:38:15.400 --> 00:38:21.230 position:50% align:middle I think is a great model that benefits folk who in their pockets, you know, 00:38:21.230 --> 00:38:23.600 position:50% align:middle really rewards them for the work that they need to do. 00:38:23.600 --> 00:38:25.220 position:50% align:middle That's one strategy. 00:38:25.220 --> 00:38:30.341 position:50% align:middle The second strategy that we learned through the pandemic was the use of simulation, 00:38:30.341 --> 00:38:36.640 position:50% align:middle simulation and telehealth, all fabulous learning issues, learning opportunities. 00:38:36.640 --> 00:38:43.670 position:50% align:middle However, as the Representative alluded to, we're going after the pandemic has passed. 00:38:43.670 --> 00:38:49.220 position:50% align:middle We're going back to past practices that because they are regulated by some by state boards, 00:38:49.220 --> 00:38:55.810 position:50% align:middle some by who knows who, about how many clinical hours, how simulation can only count for a number 00:38:55.810 --> 00:38:56.950 position:50% align:middle of certain hours. 00:38:56.950 --> 00:39:05.590 position:50% align:middle So, again, it prohibits us from using the evidence to make the policies that can again facilitate that work. 00:39:05.590 --> 00:39:15.060 position:50% align:middle So, use of simulation is high and again should be allowed to the full extent that it can be to ensure 00:39:15.060 --> 00:39:20.600 position:50% align:middle that we meet the competencies in education and then looking for a way to reward those that are actually 00:39:20.600 --> 00:39:22.680 position:50% align:middle providing that clinical education. 00:39:22.680 --> 00:39:24.086 position:50% align:middle - Could I add a couple of thoughts to that? 00:39:24.087 --> 00:39:24.929 position:50% align:middle - Sure. 00:39:24.929 --> 00:39:33.950 position:50% align:middle - In our country, we fund the education of physicians in a very different way than the way we fund the 00:39:33.950 --> 00:39:35.530 position:50% align:middle education of nurses. 00:39:35.530 --> 00:39:42.000 position:50% align:middle And so, for instance, nurses who are practicing are asked to help develop and 00:39:42.000 --> 00:39:47.920 position:50% align:middle educate students, whether that's at the graduate level or the undergraduate level, 00:39:47.920 --> 00:39:53.030 position:50% align:middle without any additional compensation, just part of their professional practice that's very 00:39:53.030 --> 00:39:55.450 position:50% align:middle different in medicine. 00:39:55.450 --> 00:40:02.680 position:50% align:middle And then with residencies, we know that it's a critical time period when a student 00:40:02.680 --> 00:40:10.330 position:50% align:middle has graduated and they are now a brand-new nurse, and that first year is absolutely critical to help them 00:40:10.330 --> 00:40:16.470 position:50% align:middle successfully transition, to practice, to learn some additional things and to feel confident 00:40:16.470 --> 00:40:20.400 position:50% align:middle enough to see a long career in front of them. 00:40:20.400 --> 00:40:26.210 position:50% align:middle Residency programs transition to practice programs for nursing are not funded. 00:40:26.210 --> 00:40:28.420 position:50% align:middle It's very, very different. 00:40:28.420 --> 00:40:35.560 position:50% align:middle And I think we really as a country have to look at learning from some of what we've done with medicine 00:40:35.560 --> 00:40:41.372 position:50% align:middle that has been successful and look at supporting nursing in the same kind of way. 00:40:41.372 --> 00:40:45.620 position:50% align:middle - So, Rayna, I know this is an area of expertise of yours. 00:40:45.620 --> 00:40:46.744 position:50% align:middle - A lead-in for you. 00:40:46.744 --> 00:40:53.651 position:50% align:middle - Let me ask you, transition to practice such an important time in a nurse's career. 00:40:53.651 --> 00:40:57.240 position:50% align:middle - So, absolutely, everything that you just said, thank you. 00:40:57.240 --> 00:40:59.424 position:50% align:middle So, now I can build on. 00:40:59.424 --> 00:41:06.360 position:50% align:middle It's important to make sure that we focus on that critical time frame when new nurses are coming 00:41:06.360 --> 00:41:11.000 position:50% align:middle from academia into their professional practice and their clinical practice. 00:41:11.000 --> 00:41:13.260 position:50% align:middle We know evidence of supporting that. 00:41:13.260 --> 00:41:15.500 position:50% align:middle They don't feel as prepared as they need to. 00:41:15.500 --> 00:41:23.600 position:50% align:middle We have objective evidence that also supports the competency level of new nurses has declined over the 00:41:23.600 --> 00:41:30.740 position:50% align:middle past 15 years as healthcare organizations are becoming more and more complex and our patients are becoming 00:41:30.740 --> 00:41:37.190 position:50% align:middle more sick, we have to look at innovative strategies to better prepare the nursing workforce, 00:41:37.190 --> 00:41:40.300 position:50% align:middle but then to support them once they're there. 00:41:40.300 --> 00:41:47.830 position:50% align:middle The transition to practice programs or nurse residency programs are an innovative solution that can help 00:41:47.830 --> 00:41:53.900 position:50% align:middle to better prepare these new nurses for the complex healthcare organizations in which they will work. 00:41:53.900 --> 00:41:59.970 position:50% align:middle I think it's really important also to go back to and thank the representative for the work you're doing 00:41:59.970 --> 00:42:07.890 position:50% align:middle to bring state and federal collaboration together and making sure that we continue both the National Forum 00:42:07.890 --> 00:42:14.020 position:50% align:middle of State Nursing Workforce Centers and the NCSBN working together to say what's happening nationally and 00:42:14.020 --> 00:42:20.180 position:50% align:middle taking those deep dives into the state data to be able to look at the evidence and then be able to build our 00:42:20.180 --> 00:42:21.820 position:50% align:middle solutions based on the evidence. 00:42:21.820 --> 00:42:28.940 position:50% align:middle So, when we're looking at our national levels of the new nurses and their turnover rates after year one or 00:42:28.940 --> 00:42:31.820 position:50% align:middle year two, is that the same in most states? 00:42:31.820 --> 00:42:37.360 position:50% align:middle Is it even the same within the states and geographical areas? And making sure that we're building all of this 00:42:37.360 --> 00:42:39.357 position:50% align:middle out based on our evidence. 00:42:39.357 --> 00:42:42.130 position:50% align:middle - So, let's turn now to the state. 00:42:42.130 --> 00:42:47.110 position:50% align:middle Several of you have mentioned that, what is important at the state level, 00:42:47.110 --> 00:42:48.800 position:50% align:middle what do we need to do? 00:42:48.800 --> 00:42:52.240 position:50% align:middle What type of policies laws do we need to enact? 00:42:52.240 --> 00:42:57.790 position:50% align:middle What do you want to tell your policymakers, your legislators at the state level? 00:42:57.790 --> 00:43:04.950 position:50% align:middle - I would say that I lead a health system that is across 26 states. 00:43:04.950 --> 00:43:12.924 position:50% align:middle And so, I regularly am dealing with needing to look at every single state's laws and regulations before I 00:43:12.924 --> 00:43:19.500 position:50% align:middle can explore, for instance, an innovative care delivery model and enacting that 00:43:19.500 --> 00:43:21.080 position:50% align:middle in different places. 00:43:21.080 --> 00:43:29.330 position:50% align:middle I have to figure out how a nursing assistant is not allowed to work in the hospital in some states or 00:43:29.330 --> 00:43:36.730 position:50% align:middle an LPN is not allowed to do a whole set of patient care in this state and that state, 00:43:36.730 --> 00:43:38.770 position:50% align:middle but they can in another state. 00:43:38.770 --> 00:43:41.840 position:50% align:middle It's very complex. 00:43:41.840 --> 00:43:52.820 position:50% align:middle And the variation between the states and the regulation within the state will impede our ability to figure 00:43:52.820 --> 00:44:02.450 position:50% align:middle out new ways to provide care in this situation that we're in with not enough caregivers. 00:44:02.450 --> 00:44:04.370 position:50% align:middle We have to do that work. 00:44:04.370 --> 00:44:10.820 position:50% align:middle But it's much more difficult when we have all of these varying regulations between the states and 00:44:10.820 --> 00:44:11.530 position:50% align:middle within the state. 00:44:11.530 --> 00:44:20.740 position:50% align:middle So, I urge flexibility, we had it to a much higher degree during the pandemic. 00:44:20.740 --> 00:44:28.610 position:50% align:middle We saw what we were able to do quickly to care for our population in the U.S., 00:44:28.610 --> 00:44:33.670 position:50% align:middle but it's because some of those restrictions were loosened just a bit safely, 00:44:33.670 --> 00:44:38.540 position:50% align:middle but loosened a bit to allow us to be creative and explore some new things. 00:44:38.540 --> 00:44:41.837 position:50% align:middle We need that flexibility desperately. 00:44:41.837 --> 00:44:42.670 position:50% align:middle - I would echo that. 00:44:42.670 --> 00:44:51.290 position:50% align:middle As I said before, full scope of practice, the ability to I say loosen regulations but to allow 00:44:51.290 --> 00:44:56.280 position:50% align:middle everyone to practice the full extent of their license would be important. 00:44:56.280 --> 00:45:00.449 position:50% align:middle I think looking at strategies, I think thinking about how nursing education 00:45:00.449 --> 00:45:02.220 position:50% align:middle is funded, excellent point. 00:45:02.220 --> 00:45:07.750 position:50% align:middle I think thinking about creative strategies like tax credits to reward all of those who are involved 00:45:07.750 --> 00:45:11.475 position:50% align:middle in health professions education or in shortage areas is another. 00:45:11.475 --> 00:45:20.330 position:50% align:middle And I will just say one other concern that I have as there are many, I want to say creative opportunistic 00:45:20.330 --> 00:45:23.480 position:50% align:middle solutions that people are coming with to address the shortage. 00:45:23.480 --> 00:45:30.155 position:50% align:middle One that concerns me is the number of nursing schools at the AD, at the associate degree level and diploma 00:45:30.155 --> 00:45:33.670 position:50% align:middle level that are rising in different states. 00:45:33.670 --> 00:45:40.410 position:50% align:middle And that causes...it may be a short-term solution, but without the right planning and the right 00:45:40.410 --> 00:45:47.120 position:50% align:middle articulation of these programs to ensure that there can be progression of these students into other healthcare 00:45:47.120 --> 00:45:50.430 position:50% align:middle careers is a concern of mine. 00:45:50.430 --> 00:45:51.790 position:50% align:middle - May I build on that? 00:45:51.790 --> 00:45:52.751 position:50% align:middle - Sure. 00:45:52.751 --> 00:45:53.700 position:50% align:middle - Thank you. 00:45:53.700 --> 00:46:02.630 position:50% align:middle So, at the state level we definitely identify the nursing shortage and some people may think it's 00:46:02.630 --> 00:46:03.550 position:50% align:middle an easy fix. 00:46:03.550 --> 00:46:06.200 position:50% align:middle If you need more nurses, just produce more nurses. 00:46:06.200 --> 00:46:10.370 position:50% align:middle And I think that we all understand it's so much more complex than that. 00:46:10.370 --> 00:46:16.080 position:50% align:middle And so, if we are opening new programs to increase the capacity of nursing students so that qualified 00:46:16.080 --> 00:46:22.260 position:50% align:middle candidates aren't turned away from our programs, we have to also look at the contextual factors or the 00:46:22.260 --> 00:46:23.760 position:50% align:middle complexity surrounding that. 00:46:23.760 --> 00:46:30.700 position:50% align:middle And so, how do we ensure that the new programs are of quality and meet maybe an accreditation standard is 00:46:30.700 --> 00:46:32.530 position:50% align:middle going to be very important. 00:46:32.530 --> 00:46:39.770 position:50% align:middle And then also looking at the number of faculty that are available to be able to train these new nurses as we're 00:46:39.770 --> 00:46:45.390 position:50% align:middle increasing the capacity of the pre-licensure students and the pre-licensure programs. 00:46:45.390 --> 00:46:48.370 position:50% align:middle We have a nursing shortage the evidence supports. 00:46:48.370 --> 00:46:50.780 position:50% align:middle We also have a faculty shortage. 00:46:50.780 --> 00:46:56.890 position:50% align:middle And it is very, very difficult to be able to recruit faculty members into those vacant positions 00:46:56.890 --> 00:46:57.950 position:50% align:middle for several reasons. 00:46:57.950 --> 00:47:04.030 position:50% align:middle A lot of times we just don't have enough qualified candidates at the credentialing level that's needed 00:47:04.030 --> 00:47:06.350 position:50% align:middle to be able to teach in these programs. 00:47:06.350 --> 00:47:14.390 position:50% align:middle And also, the salary is not competitive for those nurses who have the increased credentials to allow them 00:47:14.390 --> 00:47:18.220 position:50% align:middle to teach, identified their expertise. 00:47:18.220 --> 00:47:22.560 position:50% align:middle The salary is not competitive, especially in the public schools. 00:47:22.560 --> 00:47:24.920 position:50% align:middle - They would have to take a pay cut in many cases. 00:47:24.920 --> 00:47:31.700 position:50% align:middle I have really talented nurses who would be excellent faculty, but they would have to take a significant pay 00:47:31.700 --> 00:47:33.090 position:50% align:middle cut in order to teach. 00:47:33.090 --> 00:47:35.386 position:50% align:middle And that's an impediment. 00:47:35.386 --> 00:47:42.647 position:50% align:middle - And, you know, I want to talk about too, when we talk about at the state level licensure, 00:47:42.647 --> 00:47:47.650 position:50% align:middle 39 states, and we're on the verge of 40, have passed the nurse licensure compact. 00:47:47.650 --> 00:47:55.639 position:50% align:middle And surely that has to be of assistance to you with having facilities across 26 states. 00:47:55.639 --> 00:48:00.144 position:50% align:middle The Nurse Licensure Compact allows a nurse to care for patients. 00:48:00.144 --> 00:48:08.550 position:50% align:middle Either telephonically, digitally, or physically on one license, one multistate license, 00:48:08.550 --> 00:48:14.420 position:50% align:middle instead of having to get multiple licenses in every one of those states. 00:48:14.420 --> 00:48:19.970 position:50% align:middle And in this day and age, more and more patients are seeking care 00:48:19.970 --> 00:48:22.090 position:50% align:middle across a state line. 00:48:22.090 --> 00:48:31.030 position:50% align:middle Nurses are doing even a lot of telehealth, and we need to have the Nurse Licensure Compact passed 00:48:31.030 --> 00:48:41.826 position:50% align:middle in 50 states so that we can relieve this burden and this extra cost and time involvement of these multiple 00:48:41.826 --> 00:48:50.240 position:50% align:middle licenses and just allow them to work on one license, which is actually even safer than the waivers 00:48:50.240 --> 00:48:57.040 position:50% align:middle during the pandemic because those nurses that have a multistate license are very well vetted 00:48:57.040 --> 00:48:59.717 position:50% align:middle by the state board. 00:48:59.717 --> 00:49:06.311 position:50% align:middle - Two quick points, the first is that, you know, as we look at more states that are passing the 00:49:06.311 --> 00:49:08.860 position:50% align:middle compact licensure, that's a wonderful thing. 00:49:08.860 --> 00:49:14.290 position:50% align:middle But it really begs the question of, are we looking at the Nurse Practice Acts in all the states 00:49:14.290 --> 00:49:15.060 position:50% align:middle and comparing them? 00:49:15.060 --> 00:49:21.590 position:50% align:middle Because when you think about a nurse, you know, perhaps, going over the bridge to Pennsylvania or 00:49:21.590 --> 00:49:29.790 position:50% align:middle from New Jersey or to Delaware, you know, to be knowledgeable of the differences is really can 00:49:29.790 --> 00:49:31.450 position:50% align:middle be burdensome, so that's number one. 00:49:31.450 --> 00:49:36.970 position:50% align:middle And the second point I wanted to make on behalf of our colleagues in academia, 00:49:36.970 --> 00:49:42.090 position:50% align:middle the American Association of Colleges of Nursing, as I think most of us know, 00:49:42.090 --> 00:49:50.480 position:50% align:middle endorsed the new essentials model for curriculum for baccalaureate, actually for all levels of pre-licensure 00:49:50.480 --> 00:49:54.127 position:50% align:middle as well as graduate study. 00:49:54.127 --> 00:50:01.970 position:50% align:middle And that will be helpful to the field as they are fully implemented because the expectations of a new 00:50:01.970 --> 00:50:06.570 position:50% align:middle graduate nurse, a newly licensed nurse, will be more consistent across the country. 00:50:06.570 --> 00:50:11.750 position:50% align:middle So, I just think that that's work that's been evolving over the past several years and will be very positive 00:50:11.750 --> 00:50:13.773 position:50% align:middle for the field. 00:50:13.773 --> 00:50:18.800 position:50% align:middle - Representative Blunt Rochester, I know you have to leave at 10:30, 00:50:18.800 --> 00:50:26.039 position:50% align:middle so I want to give you an opportunity to make some closing remarks and final thoughts. 00:50:26.039 --> 00:50:28.400 position:50% align:middle - Well, first of all, thank you so much for having me. 00:50:28.400 --> 00:50:34.000 position:50% align:middle I actually have been taking notes here and learned a lot even just from this conversation. 00:50:34.000 --> 00:50:40.520 position:50% align:middle I think as you think about sort of what are the actions moving forward, I talked about some of the legislative 00:50:40.520 --> 00:50:42.460 position:50% align:middle things that we're doing. 00:50:42.460 --> 00:50:52.000 position:50% align:middle But I guess as a call to action to everyone listening, I think about the fact that as we were sitting here, 00:50:52.000 --> 00:51:00.391 position:50% align:middle on my phone an alert from CNN came over about the nursing shortage, and I think the call to action is 00:51:00.391 --> 00:51:03.827 position:50% align:middle to sound the alarm across the country. 00:51:03.827 --> 00:51:06.820 position:50% align:middle You know, you were just talking about the state level, and we're fortunate, 00:51:06.820 --> 00:51:14.305 position:50% align:middle I did a nursing roundtable in my state, and at the table was a state legislator who is a nurse. 00:51:14.305 --> 00:51:17.880 position:50% align:middle And so, she could speak intimately about the issues. 00:51:17.880 --> 00:51:20.760 position:50% align:middle She could say, "Yeah, that's a great idea, but it's not going to work." 00:51:20.760 --> 00:51:23.280 position:50% align:middle She could tell the real lived experiences. 00:51:23.280 --> 00:51:30.670 position:50% align:middle So, what I would encourage as a step for everyone as a call to action is to sound that alarm and 00:51:30.670 --> 00:51:31.780 position:50% align:middle be that advocate. 00:51:31.780 --> 00:51:37.610 position:50% align:middle Every one of us has a representative and a senator at state and local levels. 00:51:37.610 --> 00:51:43.790 position:50% align:middle They need to hear from you and depend and rely on you as the experts. 00:51:43.790 --> 00:51:45.039 position:50% align:middle Use your power. 00:51:45.039 --> 00:51:47.430 position:50% align:middle That's my message right now. 00:51:47.430 --> 00:51:50.840 position:50% align:middle People need to know, and I'm glad that you're doing what you're doing. 00:51:50.840 --> 00:51:54.850 position:50% align:middle And I wanted to let you know I will continue to be a champion with you. 00:51:54.850 --> 00:52:01.300 position:50% align:middle And I'm looking forward to us not only finding those silver linings, but making sure that everyone in our 00:52:01.300 --> 00:52:03.325 position:50% align:middle country is healthy and has sunny days. 00:52:03.325 --> 00:52:04.980 position:50% align:middle Thank you so much for the opportunity. 00:52:04.980 --> 00:52:10.965 position:50% align:middle - Thank you so much for being here. 00:52:10.965 --> 00:52:15.890 position:50% align:middle And now let me ask the same question to each of our panelists. 00:52:15.890 --> 00:52:20.343 position:50% align:middle What are your final thoughts and what can we do moving forward? 00:52:20.344 --> 00:52:21.359 position:50% align:middle Rayna. 00:52:21.360 --> 00:52:23.807 position:50% align:middle - Oh, I can start. 00:52:23.807 --> 00:52:24.630 position:50% align:middle Thank you. 00:52:24.630 --> 00:52:31.286 position:50% align:middle So, I have a lot of final thoughts. 00:52:31.286 --> 00:52:37.790 position:50% align:middle And so, if I had to focus on that, absolutely, my final thoughts are when we're looking 00:52:37.790 --> 00:52:40.340 position:50% align:middle at innovative solutions. 00:52:40.340 --> 00:52:42.150 position:50% align:middle We've discussed a lot of strategies. 00:52:42.150 --> 00:52:49.677 position:50% align:middle We've spoken about the importance of making sure that policy and decisions are data-driven. 00:52:49.677 --> 00:52:58.910 position:50% align:middle I'd also like to open up the thought of allowing the general population and our public to really understand 00:52:58.910 --> 00:53:02.283 position:50% align:middle who a nurse is and what nursing does. 00:53:02.283 --> 00:53:08.570 position:50% align:middle And I think that there's not enough education out there for those who are not involved in the healthcare 00:53:08.570 --> 00:53:13.160 position:50% align:middle industry or those who are not nurses or who have family members who are nurses, 00:53:13.160 --> 00:53:19.750 position:50% align:middle to understand really what it is and the value that we bring to healthcare and the health and wellness 00:53:19.750 --> 00:53:20.964 position:50% align:middle of the community. 00:53:20.964 --> 00:53:25.890 position:50% align:middle So, I think that's going to be an important step in addition to everything that we've spoken about today 00:53:25.890 --> 00:53:30.590 position:50% align:middle and the specific strategies that we would like to see scaled across the nation, 00:53:30.590 --> 00:53:38.710 position:50% align:middle to really look at how do we educate our population to recognize the importance of nurses more than just a 00:53:38.710 --> 00:53:45.220 position:50% align:middle hero lives here or a hero works here, but really to understand the value that we bring 00:53:45.220 --> 00:53:50.485 position:50% align:middle to quality and safety and the health and well-being of our nation. 00:53:50.485 --> 00:53:52.336 position:50% align:middle - Okay. 00:53:52.336 --> 00:53:57.520 position:50% align:middle - I do have a number of thoughts, but I'll try to be concise. 00:53:57.520 --> 00:54:04.660 position:50% align:middle I really agree with what you said about the general populace not really understanding what a nurse does 00:54:04.660 --> 00:54:07.930 position:50% align:middle unless they've had a very specific experience. 00:54:07.930 --> 00:54:15.805 position:50% align:middle And nurses are both the safety net and the glue for our health system. 00:54:15.805 --> 00:54:23.840 position:50% align:middle And I think there's little understanding of what a shortage of this magnitude could mean 00:54:23.840 --> 00:54:25.730 position:50% align:middle for the United States. 00:54:25.730 --> 00:54:29.470 position:50% align:middle It is a crisis and we need to act. 00:54:29.470 --> 00:54:34.080 position:50% align:middle We cannot ignore this data that we have seen today. 00:54:34.080 --> 00:54:38.630 position:50% align:middle We need to address a number of things, at the same time. 00:54:38.630 --> 00:54:43.181 position:50% align:middle I mentioned we need to address the environment that nurses are working in right now. 00:54:43.181 --> 00:54:48.548 position:50% align:middle There are a number of issues there, but one of them is safety, and nurses, 00:54:48.548 --> 00:54:55.910 position:50% align:middle particularly those, not only but particularly those in the emergency room face danger every day. 00:54:55.910 --> 00:54:57.090 position:50% align:middle They should not have to. 00:54:57.090 --> 00:54:59.840 position:50% align:middle And we need to do something about that. 00:54:59.840 --> 00:55:10.860 position:50% align:middle We know that we do not have enough RNs, enough LPNs, enough other supportive workers to provide care in the 00:55:10.860 --> 00:55:13.470 position:50% align:middle way we have done it in the past. 00:55:13.470 --> 00:55:23.710 position:50% align:middle We have to develop and study really well new care delivery models and we need to not add additional 00:55:23.710 --> 00:55:27.200 position:50% align:middle regulation that makes that more challenging. 00:55:27.200 --> 00:55:30.394 position:50% align:middle We need to find ways to support that. 00:55:30.394 --> 00:55:35.910 position:50% align:middle And then we've talked about a number of areas where funding is still a challenge. 00:55:35.910 --> 00:55:42.680 position:50% align:middle Nursing education is still expensive for many people who would be wonderful nurses. 00:55:42.680 --> 00:55:49.610 position:50% align:middle We need to help individuals with that funding, whether it's loan forgiveness or whatever mechanism. 00:55:49.610 --> 00:55:54.980 position:50% align:middle We have a barrier to nurses moving into faculty positions. 00:55:54.980 --> 00:56:02.740 position:50% align:middle We need to address that and we do not fund residency programs, those transition to practice programs. 00:56:02.740 --> 00:56:09.577 position:50% align:middle And so, every nurse who graduates does not get a residency program in this country. 00:56:09.577 --> 00:56:15.780 position:50% align:middle Some organizations offer great ones and others cannot afford to do so. 00:56:15.780 --> 00:56:22.120 position:50% align:middle That should be a consistent element of healthcare within the United States. 00:56:22.120 --> 00:56:24.530 position:50% align:middle So, those are just a few of my highlights. 00:56:24.530 --> 00:56:26.750 position:50% align:middle - Thank you very much. Antonia. 00:56:26.750 --> 00:56:32.400 position:50% align:middle - I think I'm going to start where you started today to say that this is an alarm, 00:56:32.400 --> 00:56:34.810 position:50% align:middle but it also is a fabulous opportunity. 00:56:34.810 --> 00:56:39.940 position:50% align:middle And there is work that all of us need to do at every single level from the healthcare system to the 00:56:39.940 --> 00:56:44.740 position:50% align:middle educational level, to state boards of nursing, to federal and state policy. 00:56:44.740 --> 00:56:52.020 position:50% align:middle And we need to use this time to develop the innovative models, to develop innovative approaches, 00:56:52.020 --> 00:56:58.054 position:50% align:middle to get rid of the regulatory regulations that prohibit us from practicing to the top of license. 00:56:58.054 --> 00:57:01.870 position:50% align:middle Again, addressing this as a system, not just as an educational issue, 00:57:01.870 --> 00:57:06.995 position:50% align:middle not just a nursing issue, but a healthcare system issue are critically important. 00:57:06.995 --> 00:57:11.200 position:50% align:middle The second thing, this afternoon I'm going back to Penn to talk to a group 00:57:11.200 --> 00:57:13.070 position:50% align:middle of incoming students. 00:57:13.070 --> 00:57:17.850 position:50% align:middle I'm not going to tell them about this, but I am going to tell them that this is your time. 00:57:17.850 --> 00:57:22.790 position:50% align:middle This is a time for nursing, not because we need you at the bedside, which we do, 00:57:22.790 --> 00:57:24.900 position:50% align:middle but we need innovators and leaders. 00:57:24.900 --> 00:57:28.820 position:50% align:middle And that's what we do in baccalaureate programs. 00:57:28.820 --> 00:57:35.700 position:50% align:middle Nurses are well equipped because of the centrality that they have of patients and family and care and context 00:57:35.700 --> 00:57:40.500 position:50% align:middle to lead the changes that we need to have happen in our healthcare system. 00:57:40.500 --> 00:57:43.373 position:50% align:middle That's why they need to come into nursing. 00:57:43.373 --> 00:57:45.362 position:50% align:middle - Robyn. 00:57:45.362 --> 00:57:49.950 position:50% align:middle - Wow, I don't know if I have much to add. 00:57:49.950 --> 00:57:52.400 position:50% align:middle Just great final thoughts. 00:57:52.400 --> 00:57:58.090 position:50% align:middle The one thing we did not get a chance to talk about this morning, probably because of time, 00:57:58.090 --> 00:58:05.820 position:50% align:middle is the slow progress that's being made around diversity of our workforce. 00:58:05.820 --> 00:58:10.150 position:50% align:middle I believe that you know, and I was encouraged to see that we are moving 00:58:10.150 --> 00:58:11.940 position:50% align:middle in the right direction. 00:58:11.940 --> 00:58:15.840 position:50% align:middle You know, when I reviewed the numbers and I'm sure as everyone dives into the report, 00:58:15.840 --> 00:58:20.180 position:50% align:middle they'll be able to see that, but it's not enough and it's not fast enough. 00:58:20.180 --> 00:58:27.660 position:50% align:middle And that actually creates a wonderful opportunity to do all those things to expand our programs. 00:58:27.660 --> 00:58:33.970 position:50% align:middle We really need to reach into our communities and promote our profession, you know, 00:58:33.970 --> 00:58:40.780 position:50% align:middle we're nurses and believe in the power of nursing, but other healthcare careers as well. 00:58:40.780 --> 00:58:45.230 position:50% align:middle So, it's a really wonderful opportunity and time for us to be talking about this. 00:58:45.230 --> 00:58:51.220 position:50% align:middle And it's not just, you know, those of us that work in healthcare, 00:58:51.220 --> 00:58:57.540 position:50% align:middle I was so encouraged to hear everyone talk about all the stakeholders and how we really need to reach out and 00:58:57.540 --> 00:58:58.760 position:50% align:middle pull them into this work. 00:58:58.760 --> 00:59:00.846 position:50% align:middle Time to sound the alarm. 00:59:00.846 --> 00:59:01.705 position:50% align:middle Thank you. 00:59:01.705 --> 00:59:06.900 position:50% align:middle - Thank you so much for bringing that up, because that was a question that we really didn't get 00:59:06.900 --> 00:59:07.930 position:50% align:middle to on the agenda. 00:59:07.930 --> 00:59:11.080 position:50% align:middle So, I'm so glad we were able to end with that. 00:59:11.080 --> 00:59:17.650 position:50% align:middle I will conclude the panel today, and I want to thank you all very much for your 00:59:17.650 --> 00:59:20.970 position:50% align:middle participation and your wonderful thoughts. 00:59:20.970 --> 00:59:29.060 position:50% align:middle This is the first step and a journey that we all have to take together, and in the end, hopefully, 00:59:29.060 --> 00:59:32.600 position:50% align:middle we will have maintained our nursing workforce. 00:59:32.600 --> 00:59:34.810 position:50% align:middle It will be better for nurses. 00:59:34.810 --> 00:59:38.310 position:50% align:middle It will be just as safe for patients. 00:59:38.310 --> 00:59:45.630 position:50% align:middle And we will be able to say at the end of the day, we as healthcare leaders faced a huge crisis and 00:59:45.630 --> 00:59:47.840 position:50% align:middle diverted it from happening. 00:59:47.840 --> 00:59:48.650 position:50% align:middle So, thank you. 00:59:48.650 --> 00:59:55.247 position:50% align:middle And I want to thank our NCSBN research staff and those who participated today. 00:59:55.247 --> 01:00:03.280 position:50% align:middle Our staff worked tirelessly on these data and getting it out and the National Forum of Nursing Workforce 01:00:03.280 --> 01:00:09.760 position:50% align:middle Centers worked collaboratively with us on the workforce study, we thank them as well, 01:00:09.760 --> 01:00:15.990 position:50% align:middle and all of you for your attention, your time, and your interest in this very important subject. 01:00:15.997 --> 01:00:27.007 position:50% align:middle So, thank you all.