DiversityNursing Blog

Source: https://bhw.hrsa.gov/data-research/access-data-tools/national-sample-survey-registered-nurses

May is mental health awareness month, a time to raise awareness and promote education about mental health, as well as reduce the stigma associated with mental illness. Did you know, 1 in 5 American adults experience a mental health condition in a given year?

• Get enough sleep: Aim to get 7-8 hours of sleep.
• Eat a healthy diet: Make sure to eat a balanced diet that includes plenty of fruits, vegetables, whole grains, and lean protein.
• Stay hydrated: Drink plenty of water.
• Exercise regularly: Aim to get at least 30 minutes of moderate exercise most days of the week.
• Take breaks: Take short breaks throughout your day to rest and recharge.
• Practice mindfulness: Try incorporating mindfulness exercises into your daily routine, such as deep breathing or meditation.
• Connect with colleagues: Connect with colleagues who understand the challenges of being a Nurse. You can talk to them about work-related stress and share coping strategies.
• Seek professional help: If you're struggling with your mental health, seek professional help from a mental health provider. This can be a therapist, psychiatrist, or psychologist.
• Use employee assistance programs: Many healthcare organizations offer employee assistance programs that provide confidential counseling and support services.
• Set boundaries: It's important to set boundaries and say no to additional responsibilities if you're feeling overwhelmed.
• Pursue hobbies and interests: Make time for activities that bring you joy and help you relax, such as reading, listening to music, or practicing a hobby.
• Take care of your physical appearance: Dress in clothes that make you feel comfortable and confident, and take pride in your appearance.
• Practice gratitude: Take time each day to reflect on what you're grateful for, whether it's a supportive colleague, a successful patient outcome, or simply the beauty of nature.

Resources

• Employee Assistance Programs (EAPs): Many hospitals and healthcare facilities offer EAPs that provide free, confidential counseling services to employees.
• National Alliance on Mental Illness (NAMI): NAMI offers support groups, educational resources, and advocacy for individuals and families affected by mental illness.
• Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA offers a national helpline, treatment referral service, and resources for mental health and substance abuse disorders.
• Crisis Text Line: This free, 24/7 text messaging service provides support for individuals experiencing a mental health crisis. Text "HOME" to 741741 to connect with a trained crisis counselor.
• Mindfulness apps: Apps like Headspace, Calm, and Insight Timer offer guided meditations and mindfulness exercises to help reduce stress and improve mental well-being.

Remember, self-care is an ongoing process, and it's important to make it a priority in your life. By taking care of yourself, you'll be better equipped to care for your patients and thrive in your career as a Nurse.

Healthcare should be accessible to everyone regardless of socioeconomic status, age, gender, race, or ethnicity. Unfortunately, many people across the nation struggle to access affordable and reliable healthcare. Health equity can only be achieved when every person, regardless of the situation, has a fair and equal opportunity to be as healthy as possible.

Many factors can influence health equity, including health disparities, social determinants of health, and cultural competence. Therefore, Nurses must understand these concepts strongly to identify health inequalities and implement changes so our patients can achieve optimal health.

Health Disparities

Unfortunately, health disparities in the United States are more common than you may realize. Health disparities are any barriers that limit a person's access to quality medical care. Population groups most affected by health disparities include ethnic minorities, immigrants, and low-income families. Common barriers that people may experience include socioeconomic status, geological location, sexual identity or orientation, ethnicity, race, age, or disability.

Health disparities can look different for everyone. For example, some people may live in rural areas where they cannot easily access routine health exams. Others may need help understanding health recommendations due to language barriers. Whatever the disadvantage, health disparities can lead to poor health outcomes that negatively contribute to health equity.  

Nurses have a unique advantage in identifying health disparities and implementing changes so that more people can access care. There are many ways Nurses can implement change, including:

• Supporting telehealth and mobile health units so people in rural areas can access medical services
• Ensuring patients have access to interpreter services so they fully understand medical recommendations
• Creating community health projects so those in under-educated populations can better access health education.

Social Determinants of Health (SDOH)

Social determinants of health can often be confused with health disparities. Although similar, SDOH refers to an individual's personal circumstances apart from medical care and genetics that can affect health outcomes.

Social determinants of health fall into 5 groups that define how people are born, grow, work, live, and age. These groups are interwoven, causing them all to overlap and relate to each other. The five groups include healthcare, economic stability, education, social life, and neighborhood.

• Healthcare encompasses a person's access and quality of medical care, including access to primary care services, health insurance coverage, and understanding of health literacy.
• Economic stability is the connection between finances and access to healthcare. Employment, poverty, food, and housing security can all affect economic stability and access to healthcare.
• Education focuses on the link between access to quality education and how it relates to health. People who do not have access to secondary or higher education may not have the necessary language and literacy to understand medical needs and care.
• Social life has contributed to learned behaviors around healthcare access. How people live, work, play, and learn within their communities can change how people feel about medical care.
• The neighborhood considers how a person's quality of housing, transportation, access to healthy foods and clean water, as well as exposure to crime and violence play a role in a person's health.

Nurses play a significant role in addressing social determinants of health. You can promote health equity by getting involved in public policies and decision making. Advocating for better care can help prevent illness in underserved populations and improve health equity for all.

Cultural Competence

A strong understanding of cultural competency is essential to achieve health equity. Cultural competency is when healthcare providers provide effective healthcare, even if there may be cultural differences between the provider and the patient.

Nurses can become more culturally competent by learning to engage with a wide range of patients with different cultural, religious, and societal backgrounds. Nurses can show cultural competency by speaking to patients in language and terms they understand or by respecting a patient's cultural or religious values or beliefs.

As a Nurse, providing culturally competent Nursing care can break down communication barriers and improve the health outcomes of our patients.

To better serve our communities, Nurses must be able to identify inequalities in healthcare and implement the necessary changes to improve patient experiences and outcomes. Nurses have a unique position on the frontlines of healthcare to positively improve health equity by helping to provide effective and accessible medical care to all.

There is a growing need for more Nurse Educators to address the current shortage of Nurses and ensure the future generations of Nurses are well-trained and prepared to provide quality care.

According to the Bureau of Labor Statistics’ Employment Projections 2021-2031, the Registered Nursing (RN) workforce is expected to grow by 6% over the next decade. The RN workforce is expected to grow from 3.1 million in 2021 to 3.3 million in 2031, an increase of 195,400 Nurses. The Bureau also projects 203,200 openings for RNs each year through 2031 when Nurse retirements and workforce exits are factored into the number of Nurses needed in the U.S.
 
The Advanced Practice Registered Nurse (APRN) workforce, including Nurse Practitioners, Nurse Anesthetists, and Nurse Midwives, is expected to grow much faster than average for all occupation, by 40% from 2021 through 2031, according to the BLS’ Occupational Outlook Handbook. Approximately 30,200 new APRNs, which are prepared in master’s and doctoral programs, will be needed each year through 2031 to meet the rising demand for care.

Nurse Educators play a vital role in the education and training of Nursing students and are responsible for developing and delivering curriculum, designing and implementing clinical experiences, and evaluating student progress.

The shortage of Nurse Educators at Nursing schools across the country are limiting student capacity at a time when the need for Nurses continues to grow.

According to the American Association of Colleges of Nursing (AACN), budget constraints, an aging faculty, and increasing job competition from clinical sites have contributed to this crisis.

However, increasing the number of Nurse Educators is critical to addressing the Nursing shortage and ensuring that there are enough qualified Nurses to meet the needs of patients. 

There are several strategies that can be implemented to increase the number of Nurse Educators:

Increase Funding

Providing increased funding for Nursing education programs can help schools hire additional faculty and offer competitive salaries and benefits packages.

It's recommended, Congress pass legislation that would invest in Nursing faculty, clinical placements, and Nursing program facilities so that colleges and universities have the resources to enroll and graduate more students. 

Tuition Forgiveness

Providing tuition forgiveness or loan repayment programs for Nurses who pursue advanced degrees in Nursing education can help incentivize Nurses to become Educators. Learn more about loan forgiveness or loan repayment programs here. 

Mentorship Programs

Providing mentorship programs to support new Nurse Educators can help with their retention and success in the field. These programs are meant to encourage mutual professional growth between both the mentor and the mentee through a dynamic and supportive relationship.

Flexible Scheduling

People everywhere are demanding a shift toward work-life balance. Healthcare professionals are constantly working long hours, with little to no flexibility in their schedules. Offering flexible scheduling options can help attract individuals who may be interested in teaching but have other commitments, such as family or outside work.

Professional Development

Nurse Educators are tasked with nurturing the growth and education of Nurses, but they also need opportunities for growth and development. Offering opportunities for ongoing professional development, such as attending conferences or pursuing advanced degrees, can help keep Nurse Educators up-to-date on the latest Nursing practices and research.

Collaborations with Healthcare Facilities

Partnerships between Nursing schools and healthcare facilities can help provide clinical experiences for Nursing students and provide opportunities for Nurses to transition into teaching roles.

Katie Boston-Leary, PhD, RN, Director of Nursing programs at the American Nurses Association, told Becker's Hospital Review, she views it as "building a bridge" between schools and hospitals to train Nurses in real-world healthcare situations. Additionally, she said, growing an in-house team of Nurse Educators provides a pipeline for hospitals who can be actively involved in cultivating their own future workforces.

By implementing these strategies, Nursing schools and healthcare organizations can work together to address the shortage of Nurse Educators and make sure future generations of Nurses receive the education and training they need to provide high-quality patient care.

Many people look forward to the holidays, however it can be a stressful time for Nurses working through the holiday season and missing festivities. Here are several tips to help make working through the holidays a little brighter.

Holiday Feast

Take time during a shift to fuel up with some yummy foods. Have everyone bring in their favorite meal or side dish, holiday treat, or order some take out. 

Work Fun

Organize a secret Santa with your unit or you may also consider planning a holiday party outside of your work setting. It’s nice to take the time out to blow off steam and enjoy your co-workers’ company. 

Decorate

With permission from your manager, decorate your work station, the hallways or even yourself with some holiday swag. Hang up paper pumpkins and turkeys. String twinkle lights and set up a holiday tree. Just be sure to be sensitive and inclusive of everyone’s holidays, not just your own. 

Celebrate On A Different Day

If you can't celebrate a holiday on the actual date, pick another day that works for your family or friends. Being with the people you love is what's important, no matter the date. 

Spread Holiday Cheer

This season is all about giving and as you know, giving makes you feel good. Try giving small gifts like scented hand sanitizers, cards, or decorative trinkets to your coworkers. Brighten patient's day with a note, little ornament, or holiday craft. 

Stay Connected

Make the most of your breaks during your shift. If able, FaceTime or Zoom with friends and family, follow their posts on social media, or ask someone to share videos of the holiday gatherings with you. Utilize available technology to stay as connected as possible. 

Silver Lining

Focus on the bright side, there may be benefits to working a holiday shift, such as extra pay or the next holiday off. You may also, hopefully, get to enjoy a slower work pace or less traffic during your commute.

Remember You're Important

Healthcare will always be 24/7 and someone must be there to care for patients. You're saving and changing lives by showing up to work. During the holidays that care can mean the world to a patient especially if their family or friends aren't able to visit or stay long. What you do as a Nurse is so important, don't you forget it! 

Across the entire patient experience, Nurses have a hand in almost every aspect of the patient's healthcare journey. Nurses are compassionate, and dedicated, and work tirelessly to meet the needs of their patients. Because Nurses are at the forefront of every patient interaction, there are many things that we wish our patients knew and understood about how we work and handle our everyday tasks.  

Every Patient is a Priority, but You May Have to Wait 

Nursing is a busy and fast-paced profession. Our days are jam-packed with patient care tasks, documentation, and care coordination. More often than not, it can be challenging to find time to eat, drink water, or even use the bathroom during our shifts. We hate having to make our patients wait for things they may want or need, but sometimes we wish our patients understood that we take great consideration in prioritizing our patient's needs. So, if you are asked to wait or have been waiting for something longer than you think you should have, please understand that your Nurse may have a more pressing matter to attend to, and every patient deserves our complete attention. 

Nurses are People Too 

Nurses often sacrifice their personal needs to care for their patients. As mentioned earlier, we often forgo meals and bathroom breaks to ensure we can complete all our tasks and care for your needs. Nursing can often be a thankless job. Nurses understand that you want the best quality care, and we strive to provide that to every one of our patients. Patience, understanding, and respect are all that we ask for in return. 

We Care More Than You Think We Do 

Nurses are multitaskers. At any given time, we can be juggling more tasks than you may even realize. Sometimes Nurses may come off as flustered or in a hurry, but that does not mean we do not value your wants or needs. Nurses stay late and come in on their days off to ensure their patients receive excellent care. We even think about you long after we've met because you have touched our lives. Patients are what make the Nursing profession so rewarding. We do what we do for you. 

We May Not Know Everything

We encourage our patients to ask questions, but that does not mean we have all the answers. Sometimes we may need to find the answer for you by speaking to a Doctor or collaborating with other Nurses. This does not mean we do not know what we are doing. It simply means that every patient has a different healthcare journey, and often situations arise that we may not have experience with. Our top priority is that you receive the best quality care, so if you ask a question and we do not know the answer, please rest assured that we will do everything within our power to get you the information you are looking for. 

We Do Not Judge  

Nurses do not do their jobs to judge our patients. Please always be honest when answering questions or providing your health history. Withholding information because you may be embarrassed or may not think it relevant can significantly impact the care we can provide. We care about you and want to ensure that you are cared for in the best possible way. Nurses are also prepared to take care of all your personal needs. We do not mind doing ‘gross’ or ‘embarrassing’ tasks. You do not have to say sorry for natural bodily functions. We understand and are ok with it, I promise!

The Nursing profession is a delicate blend of knowledge, compassion, and critical thinking. We strive every day to make a positive impact on the lives of our patients. A strong Nurse-patient relationship improves your healthcare experience and helps us provide you with the best quality care.

A career as a Nurse Case Manager gives you the opportunity to make a huge impact on patient's lives and develop rewarding relationships.

The Case Manager's (CM) role is centered around working with patients and their families to make sure they are provided with appropriate health care providers, resources, and services so they receive the proper care they need. 

Primary responsibilities include:

• Evaluating a patient's medical history

• Acting as a liaison between patients, health care providers, and health insurers

• Creating care plans and scheduling appointments

• Educating patients and their families on relevant health-related matters

• Keeping track of health outcomes and suggesting possible treatment changes

“Because Nurses are trained to work on interdisciplinary teams and understand how to deal with patients’ psychosocial needs, they are the perfect choice to manage their care,” says Tracy Towne, PhD, faculty member at Purdue University Global School of Nursing. “It’s a more holistic approach to care and services, and it is an incredibly valuable role when it comes to supporting those with chronic illnesses.”

You’ll also be able to choose which area you would like to specialize. According to Western Governors University, some of the most common Case Management Nursing specializations are:

• Patient specialty—focuses on a specific patient population such as the elderly (geriatrics) or children (pediatrics).
• Service specialty—focuses on a specific service area such as hospice, home healthcare, or rehabilitation.
• Duration specialty—focuses on the length of patient care such as short-term injury rehabilitation or long-term illness management.
• Disease specialty—focuses on patients suffering from a specific disease or chronic illness such as diabetes, cancer, substance abuse, or mental illness.

Choosing to become a CM is a great choice for Nurses, since it is less physically demanding, has great pay, and is in high demand. 

According to Zippia, CMs in the Nursing field are expected to rise nearly 16% over the next ten years. This increase is due to the growing elderly population as well as a rise in those with chronic illnesses. 

The estimated average salary for a RN Case Manager is $107,568 per year in the United States, according to Glassdoor.

Becoming a Nurse CM requires a Registered Nurse (RN) license. It is more common to switch to case management later on in your RN career.

This role requires experience so it is suggested you advance your career with certification programs. Certifications aren't mandatory for employment, but they can increase your pay and make you more eligible for future job opportunities.

Interested in learning more about Case Management? Check out these resources:

Case Management Society of America

National Association of Case Management

American Case Management Association

The Higher Education Case Managers Association

Nursing is a profession that requires compassion as well as expertise, making it both an art and a science. Empathy and compassion are critical characteristics of an excellent Nurse. These qualities help us to connect with patients on an individualized basis and improve patient outcomes.

Nurses must also be educated, motivated, and have a strong understanding of evidence-based practice. Nurses must find a unique balance between using their heads and hearts, as well as the balance between the art and science of Nursing to provide our patients with the highest quality care.

The Art of Nursing

Florence Nightingale was the first to coin the phrase, the Art of Nursing. She understood that Nursing is a profession in which physical tasks must be adapted into individualized patient care, making Nursing an educated art form. Empathy and compassion are at the forefront of what makes Nursing an art. Although compassion and empathy are similar concepts, they are vitally different and often confused with one another.

Empathy is the ability to feel the emotions of others. As Nurses, we care for patients when they are most vulnerable. When patients seek medical attention, they can often be fearful, sad, or even angry. To care for these patients respectfully and efficiently, Nurses must be able to empathize with patients to facilitate a strong Nurse-patient relationship to promote healing.

Compassion is the ability to feel the emotions of others while experiencing a desire to help. Nursing is a helping profession and to be an excellent Nurse, you must genuinely want to help others. The task-oriented approach to Nursing can sometimes challenge Nurses to maintain a human connection to our patient. Still, we must always strive to connect with and understand our patients to ensure they are cared for comprehensively. The emotions behind why we do the things we do is what makes Nursing an artform.

The Science of Nursing

The science of Nursing is the ‘why’ behind the tasks we carry out daily. The Nursing profession is built on evidence-based practice. Evidence-based practice collects, processes, and implements research findings into clinical practice and improves patient outcomes.

As Nurses, we strive to provide our patients with the best care possible, so we must ensure that our actions and tasks are well researched and have been shown to improve the health and safety of our patients. This is what the science of Nursing is all about, having a reason behind our actions and an understanding that our interventions improve the outcomes of patients.

Education is also at the foundation of the science of Nursing. To become a Nurse, we must complete coursework that prepares us to meet the diverse needs of our patients and become safe healthcare professionals. Nursing coursework includes detailed education on the intricacies of the human body, disease processes, health policy, and hands-on instruction to develop clinical skillsets.

The nursing curriculum has been well studied and tailored to ensure that new graduate Nurses can provide safe patient care. We know that Nursing programs are effective in producing safe healthcare workers because we have been able to research and understand what education and skills are needed to produce safe novice Nurses.

Once a Nurse has graduated from a Nursing program, they must complete continuing education courses to continue to improve their knowledge and skills. And as medicine is constantly ever-changing, Nurses can never stop learning and growing.

The Nursing Profession

Nursing is not just a career option. It is a true craft where individuals must be able to incorporate evidence-based practices into compassionate and individualized patient care. It is truly a scientific art that must be carried out precisely and efficiently for our patients to receive the highest quality and most up-to-date care.

Nursing is as much of a science as it is an art. The science of Nursing explains a Nurse’s daily work and why tasks are performed, while the art of Nursing is centered around the human connections needed to truly be an effective Nurse.

The art and science of the Nursing profession is ever evolving as we are continually developing new healthcare interventions and continuing to improve upon our human approach to healthcare.

Nursing is a delicate balance of skill, expertise, compassion, and empathy. Without each other, the Nursing profession would not be the respected profession it is today.

One of the greatest benefits of the Nursing profession is that there are always new and emerging ways to improve our skills and reach new occupational heights. Medicine is ever-changing and with that, Nurses are also ever-changing. We must learn to adapt to new procedures, medications, technology, and equipment. These changes often unlock the potential we have to grow within the Nursing profession and there are many opportunities to grow right at our fingertips. Wherever you are in your Nursing journey there is always room to grow professionally.

Continuing Education Opportunities

Most states require Continuing Education Units (CEUs) for Nurses to renew their RN licenses. Although many Nurses may feel that completing CEUs can be a tedious and unnecessary task, they are a great opportunity to advance knowledge and skills. There are many different ways to fulfill CEU requirements including conferences, online classes, on-the-job training, independent study programs, and post-secondary degree programs. Completing CEUs with the intention to advance your skillset can be a great step in advancing your career.

 Seek a New Certification

Getting a Nursing certification is an excellent way to advance your career. There are hundreds of Nursing certification options available to all Nurses regardless of their current Nursing position. Holding certain certifications will make you more marketable to employers and allow for more opportunities. There is no limit to the number of certifications you can hold as a Nurse and each certification can help you gain a competitive advantage in your Nursing field. Some of these certifications include basic life support (BLS), advanced cardiovascular life support (ACLS), trauma Nursing core course (TNCC), and Wound Care Certification (WCN-C).

Organize or Join a Unit-Based Council

Unit-based councils are a professional practice model that facilitates shared decision-making between staff Nurses and Nursing management. These councils can impact policies, procedures, and processes in everyday patient care. Organizing or joining a unit-based council will promote evidence-based practices, improve patient-centered care, increase job satisfaction, improve Nurse retention, and foster professional growth and development. Participating in a unit-based council also looks great on a resume.

Join a Professional Organization

There are many benefits to joining a professional organization that can support your advancing career. Whatever your Nursing specialty, there is most likely a professional organization you can join to support your growing skills and knowledge. These organizations help Nurses achieve personal growth and development by supplying educational opportunities such as CEUs, education conferences, occupational networking, and academic scholarships. Taking an active part in these types of organizations can offer Nurses professional development opportunities including mentoring and leadership development. To choose an organization that will be the right fit for you look for a group that focuses on your chosen specialty or area of interest. 

Consider Specialization

Nurses have the opportunity to become specialized in their chosen Nursing field. Nursing certifications are a formal process in which clinical knowledge and skills are tested to demonstrate competence in a chosen specialty. Nurses can become specialized in various fields including but not limited to emergency Nursing, medical-surgical Nursing, rehabilitation Nursing, and critical care. Achieving board certification in your chosen specialty demonstrates that you are an expert in your chosen field and can lead to increases in pay, management positions, and more.

Take the Next Step in Your College Career

Educational advancement in the Nursing profession is endless and there is always room to climb the professional ladder. The Nursing profession offers a wide variety of job opportunities and with every new degree achieved, new doors can be opened. Going back to school is a big decision to make and there are many aspects to consider. There are many different paths that can be taken to advance your degree. Classes can be taken online or in-person as well as part-time or full-time. These options allow Nurses the flexibility they need to continue working while achieving their degrees.

Registered Nurses who have achieved a bachelor’s degree can decide to enroll in a graduate Nursing program and receive a master’s degree in Nursing. There are several different areas of focus Nurses can choose including a Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Leader (CNL), and Certified Nurse-Midwife (CNM). The benefits of obtaining a graduate degree in Nursing include a pay increase as well as teaching and leadership opportunities.

In closing

Knowledge, skill, and passion are what can really drive a Nurse forward in the Nursing profession. What is most important is that you find what you are passionate about and go for it with integrity. By doing this, you will find yourself opening the door to new opportunities that will lead to your own personal journey of growth and development in Nursing.

Even 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