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DiversityNursing Blog

What the Pandemic Taught Us About the Changing Role of Nurses

Posted by Dr. Susan Stone CNM, DNSc, FAAN, FACNM President, Frontier Nursing University

Tue, Jan 11, 2022 @ 02:15 PM

frontierEven before the start of the COVID-19 Pandemic, it was well-known that the U.S. was facing a health care provider shortage. This trend was verified in a June 2020 report by the Association of American Medical Colleges^, which estimated the U.S. faces a potential physician shortage of 37,800 to 124,000 by 2034.

Partly because of this growing need, nurses are increasingly serving as primary caregivers in hospitals and clinics across the country. There are more than 3.8 million registered nurses in the United States and nurses comprise the largest component of the nation’s healthcare workforce*.

Necessity is not the only reason more patients are turning to nurses for primary care. Nurse-midwives and nurse practitioners have a core focus on promoting optimal health, not only caring for the sick but also providing guidance to assist in long-term health. This model of care forms a partnership between nurse and patient with a focus on promoting ongoing health in addition to treating illness. The focus on health maintenance is a core characteristic of the practice of nurse-midwives and nurse practitioners. A study on the prevention of chronic disease by Ritsema TS, Bingenheimer JB, Scholting P, et al.+ concluded that “across all conditions, NPs provide health education to patients more frequently than physicians.” Midwifery care as defined by the American College of Nurse-Midwives includes health promotion, disease prevention, wellness education and counseling, and full-scope primary care services including maternity care. Midwifery care has been shown to decrease cesarean section rates, decrease interventions and decrease preterm birth^^.

Midwifery and nurse practitioner care do not replace physician care. Health care services are complex and one type of provider cannot provide all services needed. It takes a team of different types of providers to provide the full complement of services needed. One study demonstrated that patients receiving care from primary care physicians received only 55% of recommended chronic and preventive services. The gap is attributed to physicians being overworked. The study further estimated that 50-70% of preventative services and 25%-47% of chronic care services could be done by nurse practitioners or physician assistants. By working together, we can assure that patients receive all of the recommended and preventive and chronic care services**.

Nurses’ expertise and versatility were brought into focus during the height of the pandemic. As hospitals and clinics overflowed, the healthcare system was stretched to its limit. Nurses were called on to assume additional responsibilities and leadership roles, such as organizing drive-through testing and vaccination sites or directing clinics. Some traveled, leaving their families for weeks or months at a time to care for patients in locations both rural and urban where additional care was most needed.

While provider shortages have been amplified during the pandemic, this shortage was a known issue before the pandemic and will persist after. Most at risk due to the provider shortage are those in underserved populations and rural communities. The previously mentioned report by the Association of American Medical Colleges concluded that “If underserved populations were to experience the same health care use patterns as populations with fewer barriers to access, current demand could rise by an additional 74,100 to 145,500 physicians. This analysis underscores the systematic differences in annual use of health care services by insured and uninsured individuals, individuals in urban and rural locations, and individuals of differing races and ethnicities.”

Frontier Nursing University is proud to be a leader in the changes needed to address healthcare provider shortages. Frontier’s mission is “to provide accessible nurse-midwifery and nurse practitioner education to prepare competent, entrepreneurial, ethical, and compassionate leaders in primary care to serve all individuals with an emphasis on women and families in diverse, rural, and underserved populations.” Our students are graduate-level students seeking advanced nurse practitioner and nurse-midwifery degrees. For many, taking two years off work to pursue an advanced degree is not an option. They must be able to continue to work where they live while pursuing advanced degrees at the same time.

FNU was founded in 1939 in rural Hyden, Kentucky, and our impact, though significant, was limited in scope due to our remote location. In 1989 we introduced a distance learning model that allowed students nationwide to attend FNU from their home communities, requiring only a few trips to campus. Today, 70% of FNU’s more than 2,500 students live in health professional shortage areas (HPSA) as defined by the Health Resources and Services Administration (HRSA), demonstrating the potential impact of FNU graduates within these underserved communities.  

Many of our 8,000 alumni have been serving on the front lines of the pandemic. Some have worked as travel nurses in pandemic hot zones, while others delivered the first vaccine doses by boat to remote villages in Alaska. Some developed procedures to help patients avoid crowded lobbies. Others accomplished the remarkable feat of opening their own clinics during the height of the pandemic. Meanwhile, FNU’s distance learning model allowed the majority of our students to continue their progress without interruption.  

The pandemic has brought to light much of what we already knew. It has further demonstrated the need for change in our healthcare system and proved that nurse-midwives and nurse practitioners must play increased roles in the health and well-being of our communities. The pandemic reminded us that primary care services provided by advanced practice nurses and nurse-midwives are safe and effective. It is now more clear than ever that nurse-midwives, nurse practitioners, and physicians must work together to attain optimum health outcomes for our country.

^ IHS Markit Ltd. The Complexities of Physician Supply and Demand: Projections From 2019 to 2034. Washington, DC: AAMC; 2021.

*Smiley, R.A., Lauer, P., Bienemy, C., Berg, J.G., Shireman, E., Reneau, K.A., & Alexander, M. (October 2018). The 2017 National Nursing Workforce Survey. Journal of Nursing Regulation, 9(3), supplement (S1-S54).

+Ritsema TS, Bingenheimer JB, Scholting P, et al. Differences in the delivery of health education to patients with chronic disease by provider type, 2005–2009. Prev Chronic Dis 2014; 11: 130175. - PMC - PubMed

^^ Loewenberg Weisband Y, Klebanoff M, Gallo MF, Shoben A, Norris AH. Birth Outcomes of Women Using a Midwife versus Women Using a Physician for Prenatal Care. J Midwifery Women’s Health. 2018 Jul;63(4):399-409. doi: 10.1111/jmwh.12750. Epub 2018 Jun 26. PMID: 29944777.

**Altschuler J, Margolius D, Bodenheimer T, Grumbach K. Estimating a reasonable patient panel

size for primary care physicians with team-based task delegation. Ann Fam Med.

2012;10(5):396-400. doi:10.1370/afm.1400

++IHS Markit Ltd. The Complexities of Physician Supply and Demand: Projections From 2019 to 2034. Washington, DC: AAMC; 2021

Topics: Frontier Nursing University, nursing, nurses, FNU, pandemic, role of nurses, nurse role

Frontier Nursing University Virtual Event to Focus on Healthcare Team Communication and Perinatal Mental Health

Posted by Frontier Nursing University

Wed, Sep 25, 2019 @ 12:28 PM

frontierVERSAILLES, Ky.—National Midwifery Week is the first week of October, and Frontier Nursing University (FNU) is celebrating by hosting a virtual event dedicated to nurse-midwifery. Featured topics include healthcare team communication and perinatal mental health. Nurse-midwives, prospective midwives and others can participate online at Frontier.edu/MidwiferyWeek

From September 29 to October 5, the Empower 2019 FNU Virtual Event: Nurse-Midwives Improving Patient Care Through Teamwork will bring together leaders in nurse-midwifery to present the following sessions:

·         Celebrating National Midwifery Week - Susan Stone, CNM, DNSc, FACNM, FAAN, President, Frontier Nursing University and President, American College of Nurse-Midwives (ACNM)

·         It’s a Beautiful Day in the Neighborhood: A Community-Based Approach to Improving Perinatal Mental Health - Kalena Lanuza, DNP, MSN, APRN, FNP-C, PHN, CLCI 

·         We’re All in It Together - Midwives, Nurses and Physicians: A Team Solution for a Team Problem - Cathy Collins-Fulea, DNP, CNM, FACNM, Faculty Member, Frontier Nursing University

·         Maybe there is an “I” in TEAM: IPECS - Audrey Perry DNP, CNM, Clinical Director, Women’s Health Care Nurse Practitioner and Nurse-Midwifery programs, Frontier Nursing University and Mark B. Woodland, MS, MD, Chair, Department of OBGYN, Reading Hospital 

·         I Wanna Be Part of the Team! Becoming a Nurse-Midwife - Tonya Nicholson, DNP, CNM, WHNP-BC, CNE, FACNM, Associate Dean of Midwifery and Women’s Health, Frontier Nursing University

Dr. Collins-Fulea will present a certified nurse-midwife-designed quality improvement project aimed at decreasing the length of stay in an obstetrical triage unit. She will discuss how improved team communication and patient engagement and the use of nurse-driven orders decreased patient time in triage and increased client and staff satisfaction. 

Dr. Lanuza’s session will explore how empowering women through a shared decision-making process, coupled with community collaboration, can improve the implementation of effective perinatal mental health practices in the obstetric setting and society at large. Perinatal Mood and Anxiety Disorders (PMADs) can occur in up to 20 percent of women during the perinatal period and are among the leading cause of complications associated with childbearing.

The 2019 virtual event is sponsored by Southern Cross Insurance Solutions. National Midwifery Week was created by the American College of Nurse-Midwives (ACNM) to celebrate and recognize midwives and midwife-led care. ACNM and its 7,000+ midwife members, physicians and women’s health organizations observe National Midwifery Week each year. FNU President Dr. Susan Stone is currently serving as president of the ACNM Board of Directors. 

Frontier Nursing University is the birthplace of nurse-midwifery in the United States and has 80 years of experience in delivering graduate nursing and midwifery programs. This is the fifth consecutive year FNU has hosted a virtual event in support of National Midwifery Week. 

Register for the virtual event and learn more at Frontier.edu/MidwiferyWeek

Topics: nursing school, Frontier Nursing University, FNU, healthcare team communication, Perinatal Mental Health, National Midwifery Week, Midwifery

Frontier Nursing University Awarded $1,998,000 Nursing Workforce Diversity Grant

Posted by Pat Magrath

Tue, Jul 25, 2017 @ 11:46 AM

blobid1_1500648981783.jpgHyden, KY -- Frontier Nursing University (FNU) has been awarded the Nursing Workforce Diversity grant from the Health Resources and Services Administration (HRSA). The grant totals $1,998,000 in funding in support of a four-year project that will be led by FNU with assistance from several key partner organizations.

The goal of the Nursing Workforce Diversity (NWD) program is to increase access to high quality, culturally-aligned advanced practice nurses and midwives that reflect the diversity of the communities in which they serve. The grant, which provides $499,500 per year, supports a proposed project in which FNU will implement a comprehensive systems approach to implementing five evidence-based strategies to support disadvantaged advanced practice nursing students from recruitment through graduation. The social determinants of education will be used as a framework to assess student needs and guide activities throughout the course of the project.

The overall aim of the program is to increase the recruitment, enrollment, retention, and graduation of students from disadvantaged backgrounds. Through education and training in Frontier Nursing University’s advanced nursing and midwifery programs, these students will be prepared to provide advanced practice nursing and midwifery health care services across the U.S.

Findings from an American Association of Colleges of Nursing policy brief (2016) found that racial and ethnic minority groups accounted for 37% of the country’s population, yet minority nurses represent only 19% of the total registered nurse workforce (National Council of State Boards of Nursing Survey, 2013).  As minority population growth rises, so does the likelihood of these populations experiencing greater health disparities such as increased rates of maternal morbidity and mortality related to childbirth, infant mortality, chronic diseases, and shorter life spans compared to the majority of Americans. There is growing evidence that greater racial diversity in the health care workforce is an important intervention to reduce racial health disparities.  

“We are extremely proud and excited to receive this grant and to be a part of such an important project,” said FNU president Dr. Susan E. Stone. “We are deeply committed to the goals of the NWD program and helping to overcome barriers that hinder the success of our underrepresented students, from recruitment through graduation.”

The project’s primary objectives are: 1) to achieve minimum of 30 percent minority student enrollment by June 2021, the end of the project period; 2) to increase the racial and ethnic minority retention rate and 3) to graduate an average of 100 new nurse-midwives and nurse practitioners representing racial and ethnic minorities underrepresented in nursing each year of the project period. 

Grant funding will support personnel, consultants, and diversity training for faculty and staff.  Retention activities, including mentor programs and writing support will also be funded.  FNU students will also benefit from substantial scholarship support and professional development opportunities.  To achieve the goals of the program, FNU will formally partner with the American Association of Colleges of Nursing (AACN), the American College of Nurse-Midwives, Midwives of Color Committee (ACNM-MOCC), the National Black Nurses Association (NBNA) and Mona Wicks, a multicultural sensitivity and diversity training expert consultant.

View the grant announcement on Frontier Nursing University's website.
 
Contact: Brittney Edwards, Director of Marketing and Communications
 
###
 
About Frontier Nursing University:
FNU is passionate about educating nurse-midwives and nurse practitioners to serve women and families in all communities, especially rural and underserved areas. FNU offers graduate Nurse-Midwifery and Nurse-Practitioner distance education programs that can be pursued full- or part-time with the student’s home community serving as the classroom.  Degrees and options offered include Doctor of Nursing Practice (DNP), Master of Science in Nursing (MSN) or Post-Graduate Certificates. To learn more about FNU and the programs and degrees offered, please visit Frontier.edu.

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Topics: Frontier Nursing University, funding, Diversity and Inclusion, Health Resources and Services Administration, Nursing Workforce Diversity Grant, FNU

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