Logo

HRSA Leadership Listening Session on the Nursing Workforce - Shared screen with speaker view
Juan Gordon
36:15
YES
Teresa Villaran
45:07
I agree incentives to front line workers must be present, but they also should not be tied to working more hours in already overwhelming situations.
Sharon Goldfarb
48:55
My email is sharonannegoldfarb@yahoo.com
Martha Smith, MO MCH Director & Public Health Nursing Manager
49:36
Federal and state leaders and decision-makers must be informed and understand the essential role of nurses beyond the bedside/clinical environment. We are seeing a mass exodus of nurses from public health at the state and local levels and decisions are being made not to fill vacant positions. Local public health leaders are hiring unlicensed personnel to replace licensed nurses.
Martha Smith, MO MCH Director & Public Health Nursing Manager
50:22
Those incentives should be offered beyond the hospital setting.
Kae Livsey
50:24
Nurses have got to be reconceptualized as value not COST to healthcare organizations
Sharon Goldfarb
50:25
#ThisIsOurShot
Katie Boston-Leary
50:29
I agree with you Connie!
Jill Forcina, NC AHEC Program
50:32
I agree with Teresa and would add that it also should not be tied to direct pandemic care. The pandemic is invasive to the entire nursing community, and the issue arising from it will continue for years to come. Increased base pay for nurses, not just hazard pay. The government and health systems need to show, with $$$, that nurses are valued.
Teresa Villaran
50:48
Misinformation is a huge issue and is affecting the safety of nurses, and other healthcare providers
Terri Hinkley
50:55
100% Connie. I couldn't agree more. On behalf of medical-surgical nurses (and all nurses) around the country, and the world, we agree wholeheartedly. It is dire!
Linda Shepherd
50:57
Agreed Teresa!!
Martha Smith, MO MCH Director & Public Health Nursing Manager
51:17
@Kae - yes!!
Robyn Begley
51:21
agree, Connie!
Katie Boston-Leary
51:45
The numbers do not add up. We don't have enough "soldiers" for this battle and our nurses are at their breaking point
Sandi Kellogg Chemeketa Community College
51:46
threatening nurses with their jobs is not the answer
Jenny Jensen
51:58
We need safe nurse patient ratios. We need Biden support for the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act.
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
52:06
I agree Katie!!
Dawna Cato
52:10
Strutured Residency and Fellowship programs to support professoinal growth.
Jill Forcina, NC AHEC Program
52:17
Establishing and reimbursing team-based care models
Mila Mason, Transitions Lifecare
52:32
Public health emergency indeed. We cannot get nurses in the field of community hospice and palliative care. I am an educator (nearing retirement) who is being pulled to now see patients. Our agency is in crisis - resiliency is headed down the drain quickly.
Jenny Jensen
52:35
I will absolutely put my life on the line to care for my COVID+ patients. I am not willing to put their life on the line by working under unsafe working conditions (too many patients per nurse).
Karen Doyle
52:47
Cash out some vacation or PTO time.
Gina Leath- SoutheastHEALTH
52:47
Need improved health insurance reimbursement to increase pay for healthcare workers. We continue to see major decreases in reimbursement year over year, especially in managed care contracts.
Jana Bitton, Oregon Center for Nursing
52:53
Incentive-based pay: we are hearing traveling nurses being offered bonuses of $60,000 to take assignments. How long can that last?
Kae Livsey
53:00
Is it just me but is it horrifying that food (basic human need) is considered a way to support- doesn’t that say volumes about what nurses are being asked to do in their practice setting? forego basic human needs?
Jana Bitton, Oregon Center for Nursing
53:14
Not just you @Kae.
Anne Steele, AI JHH
53:17
Peer Responder support was tremendously helpful to support clinicians throughout the pandemic
Teresa Villaran
53:28
Nursing is the largest healthcare workforce, but we are always woefully underfunded. Fund nursing leadership, education, nurse led policy, but also mental health care for nurses.
Amishi Shah HRSA/BHW
53:31
The
RADM Aisha Mix, USPHS
53:40
Thank you for highlighting the public health nursing role as well.
Dawna Cato
53:50
Provide practice environments that allow nurses to work to the full extent of their license and education.
Jill Forcina, NC AHEC Program
53:55
Nurse educators need to be considered advanced practice nurses.
Lillian Pryor
54:07
Public Health, Community Health and School Nurses should absolutely receive more support and recognition
Serena Bumpus
54:07
Transformational change of the system needs to take place in order to combat burnout. All of these are wonderful, but if the day to day work does not change, nurses will continue to get frustrated and leave. EHR's are burdensome, workflows are outdated, students are unprepared for the complexity of the current work environments. So many factors play into this.
Dawna Cato
54:10
Agree Jill!
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
54:20
Yes, Jill!!!!
Steven Brockman-Weber
54:21
We have to do basic support, provide lunch break, develop wellness areas for them to get away.
Anne Steele, AI JHH
54:30
We are noticing many staff felt embraced by the community in the early part of the pandemic and now feel as if they are alone because the food and other day to day help has dropped off.
Kae Livsey
54:31
I would love to partner with HBCUs to help with vaccine efforts- get with other universities to leverage resources?
Terri Correia
54:33
Agree Serena
Krysti Coppock
54:35
Agree, Jill!!
Linda Shepherd
54:39
Our organization is doing all of these items. Unfortunately, they have not resulted in retention. We need to do more. We need legislative support on multiple levels to address the value of nursing as a whole.
Amishi Shah HRSA/BHW
54:43
The virtual 'Hand Raise' feature is available within the 'Reactions' button found at the bottom of your screen.
Katie Boston-Leary
54:45
Incorporate programs to support nurses mental health and well being as a standard but also address what is at the root of these issues. Our data at Healthy Nurse Healthy Nation indicated that burnout and mental health was an issue prior to the pandemic and became more pronounced afterwards.
Jenny Jensen
54:53
PAY your HBCU teams.
Juan Gordon
54:58
If there were incentive plans developed around student loans this may assist in the HBCU partnerships.
Laura Bliley
55:10
There are short-term incentives but no pension or long-term rewards to stay at one agency.
Clark Ruttinger- Utah Nursing Workforce Information Center
55:18
https://www.deseret.com/indepth/2021/2/28/22208271/covid-19-revealed-about-nursing-health-care-pandemic-wages-utah-intermountain-health-care
Steven Brockman-Weber
55:25
We also can't forget about our leaders We are doing Schwartz rounds for leaders They too are in moral distress
Jill Forcina, NC AHEC Program
55:32
Nurses do not leave if they are compensated fairly in a good working environment (and culture).
Debra Funk
55:59
Assistance with controlling price gouging by agencies supplying nurses.
Lily Chen
56:12
@kae, thanks . I posted the question and please email me jchen@nccu.edu and love to collaborate.
Martha Smith, MO MCH Director & Public Health Nursing Manager
56:12
@Clark - Did your study include nurses across a variety of settings, or was it primarily focused on the inpatient setting?
Serena Bumpus
56:15
Agree Steven - leaders are burned out too
Alyson Hanish
56:23
As a nurse researcher and educator, our primary solution often feels like just “produce” more nurses. We already have a major faculty shortage, and burnout for faculty is also rampant.
Kae Livsey
56:24
In my utopian nursing world, nurses are not considered shift workers but practicing professionals who provide healthcare services
Jana Bitton, Oregon Center for Nursing
56:32
Agree, @Clark.
Teresa Villaran
56:34
We also must be more focused on wellness care instead of illness care. That also takes funding, and wellness isn’t as sexy as illness care.
Alma Thompson
56:37
Regarding the pay the salaries for nursing educators is not increasing as well, and it getting more and more difficult to find qualified educators. Need support for this.
Anne Steele, AI JHH
56:43
This is a huge point and it's impacting care now even in areas that are moderately stable.
Sharon Goldfarb
56:55
We need to address the SDOH- COVID disproportionately hurt poorer communities
Sarah Delgado
57:02
Well said Connie and agree with @Katie Boston-Leary too. It’s not facing moral dilemmas, it’s moral distress and moral injury and nurses are human. They can’t continue this. We need broad sustained concerted effort to offload pressure on acute care services. Attention to work environment is essential- hear nurses voices, staff to a level where nurses can give the care they know is needed, and provide opportunities for professional development and contributions.
Cynthia McDaniel
57:04
Recognizing and funding support for nursesin community based long term care - assisted living and memory care.
Lily Chen
57:24
we are experiencing high level of stress among minority students nurses and 62%+ has stress level of 4-5
Megan Kilpatrick
57:25
What I haven't seen mentioned here is the need for investments in quality childcare for nurses and their families. And how can we ensure that those nurses can come home at the end of shift and keep their families safe?
Lillian Pryor
57:43
Agree Sarah
Jenny Jensen
57:44
Nurses are considered a “cost” to the health care administration. We are on the wrong side of the balance sheet. Create CMS incentives for hospitals that implement safe staffing ratios, that retain nurses, and other nursing quality metrics.
Linda Shepherd
57:52
You are on spot. I entered nursing 38 years ago and started at $11.00/hr and today the starting rate, in some cases only doubled throughout this time in some areas of the country. So sad.
Dawna Cato
58:03
Meaningful Recognition, not superficial recognition. Thank you Rebekah!
Diane Hountz
58:15
Agreed....we need more meaningful nurse recognition!
Carol McDonald, APHN
58:18
Non-medical persons are being utilized in place of nurses as team leads and clinic coordinators. This has been an issue in staffing outreach clinics. The host facilities would much rather have nurses as team leads and coordinators of clinics.
Michael Bleich
58:47
We are at a true crossroads. The experience of front line nurses is beyond being "tired" and "burned out". These words do not capture what usually describes a bad day or event. Sustained chronic stress and fear of life and limb . . . many are angry at anti-vaxxers. Nursing schools continue to face clinical restrictions and more restrictions are anticipated. There are levels of priorities, so we must consider the AD and BS student learning needs. For the nurse speaking right now, my heart goes out to you.
Karen Doyle
58:56
Your comments about pay are interesting. In the C-Suite, CNOs are not paid at the level of a COO or CFO despite the impact of nursing on the organization. It is a statement about nursing and the value.
Martha Smith, MO MCH Director & Public Health Nursing Manager
59:02
Not all nurses were appreciated at the beginning of the pandemic. Public Health nurses have literally had their lives threatened, their property vandalized, their children bullied, etc. because of local public health mandates, contact tracing/case investigations, etc.
Clark Ruttinger- Utah Nursing Workforce Information Center
59:04
@Martha Smith, This was an investigative news article. However, my office does study distribution of nurses by specialty and employer demand across the state. We will be updating this demand study in November with a loopback at the past year on nursing employment demand in the state https://umec-nursing.utah.gov/wp-content/uploads/UtahRNEmploymentDemand2020.pdf
Jana Bitton, Oregon Center for Nursing
59:05
@Rebekah, my heart is breaking for you.
Lily Chen
59:17
Thanks for your passion and urgent call ❤️❤️ . nurse educators are under tremendous stress too
Alma Thompson
59:37
We need help on the education side (salaries)
Martha Smith, MO MCH Director & Public Health Nursing Manager
59:40
Thank you, Clark!
LT Monica Geiger (HHS/OASH)
59:43
I think we need more nursing representation in the media. We see doctors on TV often and in news articles, where are the stories from nurses?
Tanisha Leonard
59:50
Thank you for the information provided today. It is very informative. I support shared governance and believe nurses should be involved in decision making and policy making issues, even in times as now. Besides the patient, who knows the patient better than the nurse? Who can give a better report on what nurses want and need than the nurses.? I think nurses should be invited to meetings to discuss proposed changes. I think all nurses (including those working in disciplines such as outpatient dialysis and LTC) be invited to be heard in meetings with policy makers and government officials. It helps to know we are actually being heard.
Katie Boston-Leary
59:52
Value Based Purchasing Reimbursement for healthcare institutions must to have measures requiring continued assessment of mental health and wellness, retention, diversity recruitment and evidence based programs.
Hiyam Nadel
59:53
Yes a seat at the table!!!
Anne Steele, AI JHH
01:00:08
Very well said.
Linda Shepherd
01:00:15
Others need to treat nursing as a profession, which has been a challenge for many years.
Katie Boston-Leary
01:00:16
Rebekah - thanks for being brave and sharing your story.
Lillian Pryor
01:00:18
Well said Rachel... it's not just money
Sarah Delgado
01:00:21
Well said Rebekah!!
Diane Hountz
01:00:23
Do we have any specific data that speaks to # of nurse vacancies in US or per state that is recent?
Alma Thompson
01:00:33
Yes seats at tables
Michael Bleich
01:00:34
Peter Buerhaus recently reported his current studies to AONL. That session provides critical patterns of data from various points of view both pre-and during COVID,
Marijo Johnson Fresenius Medical Care
01:00:53
Rebekah, Thank you for sharing your experiences. I agree 100%. Nursing is at a critical crossroads. Pay and incentives should be fair and just, however, the work environment is crucial. Without a safe, quality workplace that incorporates work / life balance, we will continue to see good and caring nurses leave the field.
Sharon Goldfarb
01:01:28
There are also scary shortages in nurse educators- so no new nurses without nurse education. In research here of 91 community colleges has shown a 30% reduction in the nursing education workforce
Dawna Cato
01:01:36
Thank you Rebekah, unfortunately your story is being played out across our nation and as you state Globally!
Lillian Pryor
01:01:39
Great point Marijo
Jenny Jensen
01:01:53
Yes, a seat at the table is not only needed in hospitals - it is needed at every level of government.
Michelle Borrelli
01:02:02
it is not just appreciation and burn out. These medical professionals CHOSE to serve sick people and they are being condemned for choosing not to vaccinate. being threatened and persecuted rather than appreciated. i have lost 17% of my staff due to mandates.
Karen Doyle
01:02:10
Will you discuss opening up visas for international nurses?
Donna Mazyck
01:02:55
@Rebekah - I hear you and appreciate what you shared. Beyond listening, we need action as we are hearing on this call and in this chat.
Terri Correia
01:02:58
Spot on Connie
Mila Mason, Transitions Lifecare
01:03:05
Agree - money is NOT the issue. I care for dying patients through a non-profit. Our Where are the nurses going to come from?! How is CMS going to support Hospice and Palliative care?
Sandi Kellogg Chemeketa Community College
01:03:07
Agree @conniebarden
Jenny Jensen
01:03:07
Snaps for everything Connie said
Barbara Lutz
01:03:07
Well said Connie
Serena Bumpus
01:03:08
Spot on Connie!
Marijo Johnson Fresenius Medical Care
01:03:10
Yes, Connie! Thank you!!!
Anne Steele, AI JHH
01:03:12
I think the difference now is that there is an element of work impacting our families more than there has been before. The burden is home, work and society at large
MERRY HEATH
01:03:14
Thank you so much for mentioning the regulatory burden!
Clark Ruttinger- Utah Nursing Workforce Information Center
01:03:17
@ Diane Hountz States can match nurse license records to a national Employment records database called WIRS2 however most states aren’t able to do this because they keep license data separate from employment reporting and few know how to get the connection established. Not to mention there would need to be a way to do this across regions/ states so that analysis could be done.
Katie Boston-Leary
01:03:21
Agree Connie!
Kae Livsey
01:03:26
👏yes Jenny re nurses seen as labor cost and on the wrong side of balance sheet!
Edna P Cortez
01:04:41
Agree with the stories!
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
01:04:42
Absolutely what I have been saying!!! I am currently working on more representation of nurses and the stories are the key!!
Lily Chen
01:04:49
Is there anything being done to help include nurses on the tables
Lily Chen
01:04:52
?
Terri Hinkley
01:05:01
nurses are not often able to share their stories due to employer action. We have had several requests from the media to speak with nurses, but nurses are unable to speak due to employer restrictions
Terri Hinkley
01:05:42
we should foster their ability to share their stories and not limit their voices
Kae Livsey
01:05:53
Here is an idea- provide disaster grant funding to bolster hiring of RNs for workforce support- across community and acute settings- the market for travelers is also going to bust the budget of the system-
Cynthia McDaniel
01:06:12
Yes Kae!
Mila Mason, Transitions Lifecare
01:06:13
@Kae - YES!!! AGREED!!!!
Mila Mason, Transitions Lifecare
01:06:49
We are paying travelers which will "kill" us as a non-profit agency
Barbara McNeill
01:07:11
I think it's very important that nurses who are given "a place at the table" are those who are in direct care positions that can report real time experiences.
Kae Livsey
01:07:21
NCSBN needs to work with state BONs to provide some grace on programs so they can be creative- and also accrediting agencies
Katie Boston-Leary
01:07:26
@Lily - nurses on boards is helping address having more nurses at the table. However, within institutions that provide care, nurses do not have the same power and influence as physicians and donors. That needs to change. CNOs are treated as representatives and are seen but not always heard and heeded to with new ideas and organizational strategies.
Jill Forcina, NC AHEC Program
01:07:33
YES!
Terri Correia
01:07:35
as CNO of a CAH hospital, I cannot find travelers, money is not everything. Great wage, housing means nothing it seems, they are just not there for some rural areas
Megan Kilpatrick
01:07:55
Well said. Not just Scope of Practice, but reimbursement parity as well.
Heidi Lucas, Missorui Nurses Assoc.
01:07:58
Preach Michael!
Terri Correia
01:07:59
Which really stresses our already exhausted staff
Sandi Kellogg Chemeketa Community College
01:08:12
hero today, fired tomorrow
Gina Leath- SoutheastHEALTH
01:08:19
Nurses are leaving to travel for 4x the market salary and leaving their peers behind, limited capacity and straining the system leading to more stress. Agency price gouging and decreasing insurance reimbursement will force hospitals to close.
Sarah Delgado
01:08:30
A link to AACN Healthy Work Environment Standards : https://www.aacn.org/nursing-excellence/healthy-work-environments. This offers a framework for addressing some of the chronic problems in health care that drive nurses’ intent to leave. As Connie and others pointed out- it’s not a new problem. It’s ongoing problems made drastically worse
Michelle Borrelli
01:08:44
I am CAH also surrounded by 4 CAH. we all use the same travel pool. it is empty.
Gina Leath- SoutheastHEALTH
01:09:02
Agree with Michael to recognize APRNs as independent practitioners.
Teresa Villaran
01:09:06
He is right. The emergency order for NPs to practice at their full education, should be permanent.
Jenny Jensen
01:09:20
Every time the hospital talks about mindfulness in a group setting, I raise my hand and ask what institutional policies they are putting in place to prevent stress and burnout in the first place
Cynthia McDaniel
01:09:23
Community based long term care is at acrisis point for nurses. So many outbreaks. Expanded roles and responsibilities for nurses and we can’t find them or afford them.
Serena Bumpus
01:09:23
Tim Porter O'Grady and Joanne Clavelle wrote an excellent article titled "Transforming Shared Governance: Toward Professional Governance for Nursing" It was very eye opening for me. We have not achieved autonomy as a profession. Great article. Highly recommend reading!
Kae Livsey
01:09:30
Yes CAH are getting pounded-need to support deployment of faculty and student groups for immersive training and to support them
Katie Boston-Leary
01:09:36
@Dr. Sharf-Bell - we need a national task force to address the issues with the profession. It is a national emergency!
Kae Livsey
01:09:41
Residency programs with SUPPORT
Cynthia McDaniel
01:09:44
Thank you Michael!
Jill Forcina, NC AHEC Program
01:09:48
residency programs
LT Monica Geiger (HHS/OASH)
01:10:05
We also need to encourage and incentivize nurses to become professors to increase the capacity of nursing classes to be able to train more students. There is a nursing educator shortage because they are not incentivized.
Rachel Stevenson
01:10:10
To those guests on the call would flag the Future Advancement of Academic Nursing (FAAN) Act (S.246/H.R.851) that supports our current and future nursing workforce and schools of nursing for infrastructure needs, faculty, student support, clinical etc.
Pamela Galehouse
01:10:12
Thank you Michael Bleich. Well said for nurses in all specialty areas.
Linda Cassidy
01:10:18
Great point Sarah, the pandemic has highlighted long-standing issues of systemic problems in the health care work environment. The pandemic has caused a tipping point!
Sharon Goldfarb
01:10:25
Great ideas but if there is not enough faculty is a huge problem
Tamara Kear
01:10:35
The impact of the pandemic and the current conditions will impact the profession of nursing for decades to come if we don’t intervene now. And ultimately this will impact the health of our country and world.
Sarah Delgado
01:10:44
Excellent idea @Katie Boston-Leary!
Dawna Cato
01:11:13
Yes, backlog of Nurse Educators....
Patti McCue
01:11:24
Well said Michael! Remember me from our J&J Wharton days back in 1996?? Best to you!!
Jill Forcina, NC AHEC Program
01:11:28
As nurses advance, they get farther away from the bedside. Programs like the Clinical Nurse Leader are important to keep nurses at the bedside (staff nursing) while allowing advancement.
Katie Boston-Leary
01:11:47
And a nursing faculty workforce that is diverse...
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
01:11:49
I agree @Katie Boston Leary that we need a national taskforce!!! Let’s do something about it.
Teresa Villaran
01:11:51
I left because nursing education did not pay for the amount of hours I had with face to face educator/student time.
Colleen Leners AACN
01:11:57
We need better data on workforce and where the nurses are and where they are practicing.
Rebekah LaDuke
01:11:59
Guaranteed safe patient ratios will help nurses feel better about coming back to bedside. And new nurses don’t feel supported because experienced staff are leaving. We have to retain experienced staff to pass the knowledge onto the new nurses.
Mila Mason, Transitions Lifecare
01:12:29
Totally Megan!
Shawn Houck
01:12:30
What is being effectively done to integrate the AHA, AMA leadership to provide robust support for nurses practicing at their full scope and uplifting the value they bring? Mega-corporate level health systemMergers are swallowing up the nurses voice and value proposition and creating overwhelming bureaucracy in our overall healthcare forefront.
Katie Boston-Leary
01:12:30
Agree Megan!
Lori Byrd
01:12:36
Same here in NC Community Colleges. We need nurse educators to educated nurses.
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
01:12:46
I agree Megan!!!!
Teresa Villaran
01:13:13
I read one system is “getting nurses off of orientation as fast as possible.” This is not the solution. They will not stay
Lily Chen
01:13:33
@katie , agree nursing educators need to be diverse as well .
Karen Doyle
01:13:41
We need to re-engineer the work of the nurse so they are practicing at their maximum scope of practice. How are we developing the support staff around the nurse, teaching nurses how to work with the support staff. etc...
Kae Livsey
01:13:52
SONs need to be running new grad residencies so they can provide ongoing support for new grads after graduation Need model like GME!
Linda Taylor
01:13:56
Mentorship is not enough. With the limitations of clinical practice sites and changes in lab practice for students, internships/residencies that are several months in length are critical to help new nurses move from novice.
Tamara Kear
01:14:11
One area not address on this list of what could be done to support new and practicing nurses is “loan forgiveness” programs. Nursing students and RNs often work long and excessive hours to pay for their nursing education and loans.
Katie Boston-Leary
01:14:17
Our survey of 110K nurses indicate that are early careerist and novices are suffering more than our incumbents. https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/year-one-covid-19-impact-assessment-survey/
Dawna Cato
01:14:38
We need to standardize nurse residency programs. Perhaps programs developed at the state or national level.
Sarah Delgado
01:15:25
Experience - complexity gap- new grads do not adequately replace experienced nurses. It takes time to develop nursing expertise.
Katie Boston-Leary
01:15:42
Absolutely @Sarah!
Teresa Villaran
01:15:44
There is a gap between nursing schools and private sector hospitals. There needs to be coordination between the two areas. No silos
Lily Chen
01:15:47
@katie, not surprise at all and that is why we started peer support and mental health first aide training for our students (and staff )!
Martha Smith, MO MCH Director & Public Health Nursing Manager
01:15:49
Excellent point regarding not repaying nurse loans for public health nurses!
Dawna Cato
01:16:10
Agree Teresa!
Kae Livsey
01:16:10
Whille we are on the loan forgiveness discussion have been teaching in state schools for more than 12 years and CANNOT get PSLF forgiven- nightmare educators also need forgiveness
Jana Bitton, Oregon Center for Nursing
01:16:11
Public health nurse data is so difficult to get. It's almost impossible to even accurately quantify how many nurses work in public health
Carol McDonald, APHN
01:16:11
Thank you for your comments Jenny. I have worked in public health over 34+ years.
Donna Mazyck
01:16:14
@Jenny - agree with you on loan repayment - true for school nurses too!
Michelle Borrelli
01:16:19
Montana looses more than 1/2 new grads to states who pay more.
patricia zindler wernet
01:16:19
As a retired Army nurse- we have dealt with PTSD in my lifetime since Vietnam is when I entered the service. Though not perfect the VA health has researched on major health. You could contact them for some co programs . I also suggest letters to congress, local agencies for advocacy. I belong to several military/veteran groups to intensive advocacy. Also was USPHS, nurse professor and school nurse
Traci Murray
01:16:35
@Jenny, absolutely right on the value of nurses at HDs. I worked in the epi dept and helped develop critical Zika guidance. My nursing knowledge was key.
Katie Boston-Leary
01:16:41
Thanks @Lily! Yep, and nurses of color have even worse numbers in terms of moral injury and financial impact
Marijo Johnson Fresenius Medical Care
01:16:44
Each issue discussed thus far related to recruiting and retaining a knowledgeable and skilled workforce during the pandemic and at all times. We must retain our current staff to adequately prepare novice nurses.
Shawn Kneipp
01:16:46
Thank you for that, Jenny Jensen. We need to start valuing public health nursing in the same way. That is one pragmatic place to begin — we should be repaying loans for nurses who go to work in local health departments and other public health settings.
Barbara McNeill
01:17:04
Providing well-designed, structured on-boarding programs that allow for well-prepared, educated preceptors who are given the autonomy to perform the role well. This needs to include not only teaching patient care skills but providing ongoing support strategies for the new grads. This can be done, for example, through residency programs. Organizations need to be willing to put their resources on the front-end.
Karen Doyle
01:17:33
Completely agree David! Thank you!
Erin Maughan
01:17:34
Great point @ Sarah!! This is a perpetual issue. Much of training and reimbursement programs from HRSA related to nursing if focused on primary care (hospitals and clinics)--public health and school nursing are incredibly important fields of nursing that often is not eligible for training programs and reimbursement programs. Yet-as was mentioned-they are the frontline of the ENTIRE population to address inequities, social factors, and identifying at risk populations early.
Lily Chen
01:17:54
And help nursing students especially minority nursing students pay tuition too . many of my students have to work full time including at McDonald ! hard for them to succeed but they have to work to pay for school
Amy Kohl
01:18:01
Thank you, this is also the issue with international midwives that wish to practice in the U.S.
Gina Leath- SoutheastHEALTH
01:18:03
Need more clinical time in nursing schools like the former diploma programs.
Pamela Guthman
01:18:11
The same is happening in regard to a severe nursing educator workforce issue in WI. https://wicenterfornursing.org/education-faculty-survey-reports/ And, as a community/public/population DNP prepared nurse and as pointed out previously, there is a lack of equitable salary and workload, and a lack of value and respect for public health nurses and prevention which is not a wise economic structure given the costs of tertiary care.
Amy Kohl
01:18:15
They have to repeat their education.
Colleen Leners AACN
01:18:22
As covid is International pandemicI am not sure visa’s are the best answer
Katie Boston-Leary
01:18:22
@Sarah - great point about the complexity gap.
Tim Thomas
01:18:48
Organizations need to understand the return on investment of properly onboarding of staff and retaining the current workforce.
Lily Chen
01:18:53
We need to invest in primary prevention and up
Teresa Villaran
01:18:56
International nurses if they come here then leave their home countries without the nursing experience they need there.
Lily Chen
01:19:00
stream for workforce
Jill Forcina, NC AHEC Program
01:20:42
The Future of Nursing 2030 report provides a comprehensive action plan, with evidence, for to support, protect, and develop the nursing workforce.
Lily Chen
01:20:53
This is what our students face , listen to Ashley ‘s story :,
Lily Chen
01:20:58
https://m.youtube.com/watch?v=cTkL9D5noJw&list=PLNirpHjOJoGmxlofJqKtdj6hyqKaC9gTP&index=14
Kae Livsey
01:21:00
Please provide funding support for RNs to be engaged out in communities with CHWs to get to the people Look at history- this is how we got out of the TB nightmare!
Tamara Kear
01:21:18
It is interesting the prior slide states “building a resilient nursing workforce”. This approach puts the pressure on nurses to be resilient. We need a redirection that builds environments and programs that support nurses and moves away from nurses being ones who have to “save themselves” .
Teresa Villaran
01:21:41
Agree Tamara
Rebekah LaDuke
01:22:23
Absolutely. This problem requires a multidisciplinary approach for sure
Dawna Cato
01:22:48
Agree Tarmara, we need a re-messaging on "help" for psychological well-being as well. Must decrease the sigma around our mental health.
Rebekah LaDuke
01:22:50
Respiratory therapy shortage is real too
Sarah Delgado
01:23:05
So well said, Tamara!! Resilient individuals in bad work environments with little hope for change make the choice to leave. That’s how you stay resilient. We need system level change
Katie Boston-Leary
01:23:12
@Tamara - great article to underscore your point https://www.nytimes.com/2020/08/19/health/resilience-overrated.html
Tamara Kear
01:23:46
Thanks Katie
Dawna Cato
01:23:54
School Nursing is critical!
Katie Boston-Leary
01:24:19
@Natalia is an amazing nurse executive. I follow her work in NY. She is making a major difference with her team.
Barbara Lutz
01:24:34
I think we need to remember that COVID has just uncovered the systemic issues within our healthcare delivery system. We must address the core issues related to a woefully underfunded/understaffed public health system and nurses within that system; poor management and unsafe staffing practices in our institutions including hospitals and long-term care; poor pay, restrictions on the use of benefits, mandatory overtime, etc. Covid has just uncovered these and many other issues with the way we deliver HC and the value we place on nurses, nursing, and public health.
Lillian Pryor
01:25:00
Well said Barbara
Kae Livsey
01:25:00
Agree totally @Barbara!
Jill Forcina, NC AHEC Program
01:25:09
We have had a ton of trouble getting nursing students into volunteer efforts that require nursing skills because of legal and regulatory red tape. It was easier to get med students than nursing students. We need help with universal MOUs with government agencies, need the boards and accrediting bodies to re-examine nursing education -- has simulation resulted in prepared nurses? Can nursing students be supervised in a different model?
Tim Thomas
01:25:10
Resiliency should not be an individual issue to solve. It is an organizational issue to solve.
Dawna Cato
01:25:28
Agree Natalie and multi-dimensional approach is needed.
Jana Bitton, Oregon Center for Nursing
01:25:33
Jill - We had the same problem.
Teresa Villaran
01:25:55
We talk about SDOH, but I heard someone say Political determinants of health, this is really the issue. We are here, on purpose.
Pamela Guthman
01:25:55
Agree Barbara Lutz! Social determinants of health and intervening upstream are the focus of community and public/population health nursing, where 35 plus years ago used to have adequate funding for a team of community/public health nurses to be in communities and in schools to improve health at the community and population level, and back then was a significant component in nursing curriculum.
Linda Cassidy
01:25:58
Ratios are not the full answer to the systemic problems. Evidence shows that simply addressing nurse-patient ratios without addressing the conditions of the work environment is futile. Healthy work environments in which nurses and all members of the healthcare team can experience fulfillment in their work and work to the full extent of their knowledge and abilities is a must for both ending a shortage and for optimal patient outcomes. Healthy work environments are a must!
Shawn Kneipp
01:26:00
Here here, Dr. Lutz. The core issues have been laid bare, and visible to all now with COVID. Not addressing the core issues, and continuing to fill the pipeline with new nurses will keep us in this place of never really being prepared or able to care for our population.
Katie Boston-Leary
01:26:28
Great point Tim. That is at the core of the socioecological model for self care. It is a team effort for nurses to be well that starts at the individual level to the organizational and systemic level.
Kae Livsey
01:26:29
Again perhaps NCSBN can draft up standard MOU to share with work the BONs to reduce red tape for student-faculty team deployment
Jill Forcina, NC AHEC Program
01:26:45
Yes, @Kae!
Barbara Lutz
01:27:14
TY Linda Cassidy -- totally agree about the healthy work environment -- in all areas of nursing practice
Katie Boston-Leary
01:28:21
Agree with @Linda!
Ramon Lavandero
01:28:21
Linda Cassidy. Agree entirely about healthy work environments. They're not a nice accessory.
Sarah Delgado
01:29:17
Agree @Barbara Lutz and @Linda Cassidy. Need healthy Work environments in all settings- nursing education, acute care, public health- across the board
Donna Meyer
01:29:27
Thank you for the comment regarding the importance of the community college nursing programs. Many areas of our country would not have a nursing workforce without the over 1100 community colleges that provide the ADN pathway, and yes academic progression is imperative.. Many nursing leaders today began at the ADN level. Much of the diversity in the nursing workforce is from the community colleges. Community colleges often have challenges accessing HRSA funding.
Pamela Guthman
01:29:39
Academic practice linkages grounded and focused in community/public/population health nursing for students is something we need additional support to bring academia and practice closer together in understanding and practicing the competencies needed in community/public/population health nursing and are skills used in other areas. https://www.cphno.org/wp-content/uploads/2020/08/QCC-C-PHN-COMPETENCIES-Approved_2018.05.04_Final-002.pdf
Megan Kilpatrick
01:30:01
When we talk about healthy work environments, we also need to talk frankly about the increasing incidence of violence against healthcare workers in the healthcare setting
Katie Boston-Leary
01:30:08
Thanks @Natalia!
Traci Murray
01:30:12
Healthcare orgs/systems need to acknowledge the trauma we face and implement a trauma-informed culture to better support staff.
Colleen Leners AACN
01:30:13
AACN has a partnership with FEMA. FEMA connects to Schools faculty students in specific areas where they need the most help.
Linda Cassidy
01:30:40
Great point re violence @Megan
Tamara Kear
01:30:40
HRSA—I hope you will do these sessions from time to time to hear from nurses.
Jill Forcina, NC AHEC Program
01:30:42
@Colleen can you send your email?
Kae Livsey
01:30:55
thank you HRSA!
Sarah Delgado
01:30:57
Thanks for being a strong voice for nurses, @Natalia!
Amishi Shah HRSA/BHW
01:31:09
For more information you can visit https://bhw.hrsa.gov or https://grants.gov to apply
Natalia Cineas
01:31:10
Thank you everyone
Dawna Cato
01:31:28
Will this recording be provided for us to share with our stakeholders?
Michael Bleich
01:31:48
PLEASE consider policies and programs that go BEYOND URBAN solutions. There are rural and frontier areas that have special needs that also need desparate attention.
Dr Vivienne Pierce McDaniel, Virginia Nurses Foundation
01:31:50
Thank so much Dr. Mack and HRSA!
Amishi Shah HRSA/BHW
01:32:30
For more information you can visit https://bhw.hrsa.gov/data-research/access-data-tools/national-sample-survey-registered-nurses
Katie Boston-Leary
01:32:37
HRSA - thanks for organizing! We hope we will start developing sustained solutions that will urgently address these issues. ANA intends to apply for one of these grants for our Healthy Nurse, Healthy Nation Program.
Amishi Shah HRSA/BHW
01:32:39
PRF main page: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/
Barbara McNeill
01:32:53
It's great to have grants but some organizations do not have staff who have the time or experience to write them.
Amishi Shah HRSA/BHW
01:33:04
https://www.hhs.gov/sites/default/files/personnel-recruitment-retention-fact-sheet.pdf
Rebekah LaDuke
01:33:05
Thank you for listening.
Linda Taylor
01:33:11
I am concerned that the systematic problems will not be addressed and that resiliency will become an expectation for practice. We cant fix what is wrong by dressing wounds.
Amishi Shah HRSA/BHW
01:33:16
Sign up for HRSA eNews www.hrsa.gov/enews
Serena Bumpus
01:33:34
Well said LInda!
Rachel Stevenson
01:33:35
Look forward to working with you going forward as thoughtful and impactful solutions are implemented.
Terri Hinkley
01:33:35
agreed, Linda. There are significant system issues that resilience cannot address.
Steven Brockman-Weber
01:33:42
will this be shared with us?
Amishi Shah HRSA/BHW
01:33:46
Send any additional comments to Winnie Chen at wchen@hrsa.gov.
Dr Helga Scharf-Bell
01:33:55
Thank you all for your input
Shawn Kneipp
01:33:56
@Linda Taylor - same concern here.
Steven Brockman-Weber
01:34:13
Thanks Dr Mack
Pamela Guthman
01:34:20
Thank you, and agree there are systemic issues
Shawn Houck
01:34:21
I serve as an RN on the National Area Health Education Center Board of Directors and work closely with HRSA to develop the AHEC Scholars Program which has been seriously impactful in a short time to address training recommendations that have been shared today. There are AHECs in more than 400 centers in 46 states and 85% counties to look to
Michelle Borrelli
01:34:24
thank you