Nursing: The Ever-Changing, Totally Rewarding Profession

Happy Belated Nurses’ Week! Congratulations on choosing the best profession ever!
May 6-12 is celebrated as "National Nurses Week" each year to honor our profession and the vital roles we play in caring for and educating patients and their families, and to recognize our overall commitment to promoting and improving healthcare.

History of National Nurses Week
Let’s take a look at a brief history of how National Nurses Week evolved over the years.
1954 – The first nurse week celebration was observed October 11-16 to celebrate the 100th anniversary of Florence Nightingale’s mission in the Crimean War.
1955 – A bill was introduced in Congress for a nurse week, but no action was taken and Congress discontinued resolutions for national weeks of any kind.
1972 – A resolution for "National Registered Nurse Day" was presented, but no action was taken.
1974 – In January the International Council of Nurses proclaimed May 12 (Florence Nightingale’s birthday) as "International Nurse Day." In February, President Nixon issued a proclamation designating "National Nurse Week."
1978 – May 6 was declared "Nurses Day" by Brendon Byrne, Governor of New Jersey, and the date was listed in the national calendar of annual events.
1981 – The American Nurses Association (ANA) and other various nursing organizations supported a resolution submitted by Congressman Manuel Lujan of New Mexico to designate May 6, 1982 as "National Recognition Day for Nurses."
1982 – A joint resolution of the US Congress and a proclamation by President Ronald Reagan designated May 6 as "National Recognition Day for Nurses."
1990 – ANA expanded the recognition from a day-long celebration to "National Nurses Week," beginning on May 6 and ending on May 12, Florence Nightingale’s birthday.
1994 – The dates of May 6-12 were designated as permanent dates for "National Nurses Week."

Nursing Roles and Expectations

The nurse’s role remains a focal point of healthcare delivery and patient care, and the general public holds nurses in high esteem, as evidenced by the Gallup Poll on Honesty and Ethical Standards. This poll has rated nursing as the top profession for the 16^th year in a row! Eighty-two percent of the respondents rated the honesty and ethical standards of nurses as "very high" or "high."

Why do nurses rank consistently high with the general public, and is that expected to change?

Years ago, the majority of nursing positions were in direct patient care settings, e.g., hospitals, physician’s offices, ambulatory care facilities, community nursing, home care, etc. That has changed today, with more nurses working in areas away from the bedside that are not providing direct patient care and do not have direct face-to-face contact with patients, e.g., health plans, call centers, telehealth programs, remote monitoring, nursing schools, and healthcare technology companies. These new nursing roles may change the dynamics of the patient-nurse relationship, since there will be less direct interaction.

However, working in a large variety of settings, nurses touch almost all areas of healthcare. They are very connected with the patients and their families, and they interface on a much more intimate level than other healthcare workers. Due to the decrease in the number of physicians, nurse practitioners are taking on a larger role in preventive care, working with non-English-speaking patients, managing patients with chronic conditions like diabetes and those living in rural areas or inner cities. These factors provide positive interactions and experiences, which tend to increase the public’s level of trust, confidence and admiration for nurses.

Nursing Statistics

Healthcare is 18 percent of the U.S. economy. Nine percent of employed Americans (12.3 million) work in the healthcare sector (providers, related technical positions and support positions). Nursing is the largest single profession in the U.S. healthcare workforce. The number of professional active nurses in the U.S. in October 2017 was 3.3 million.

According to Peter Bauerhaus, a healthcare economist and professor of nursing at Montana State University, one of the most significant challenges occurring in the nursing profession is the impending retirement of 1 million nurses (one-third of the nursing workforce) within the next decade at the same time that 70 million baby boomers will also be retiring, many with chronic conditions and degenerative diseases. In addition, the Association of American Medical Colleges estimates that by 2025, the demand for all physicians will exceed the supply by 62,000–95,000, and it could account for a shortage of 36,000 primary care physicians.

The "National Nursing Workforce Study," conducted every 2 years by the National Council of State Boards of Nursing and the National Forum of State Nursing Workforce Centers, is done to determine the supply of nurses to assure safe and effective healthcare. The newest 2017 study is due in July, 2018, but the 2015 results for RNs found:

• 50 percent are over 50 years of age
• Males account for 14 percent of the RN workforce – an increase from 6 percent in 2000 and 3 percent in 1970
  
• 20 percent identify as ethnic or racial minorities (other studies have shown up to 30 percent identify as racially diverse); in the future, this diverse workforce will help decrease health disparities and increase access to quality care).
  
• 55 percent have BSN degrees, while 65 percent have a baccalaureate or a higher degree in any field. 80 percent of the nursing workforce is expected to have a BSN degree by 2020. The benchmark for RN training is the 2 year Associate Degree program.
  

The ANA predicts we will need an average of 113,000 new nurses each year through 2022. That means we need more university programs, which means we need more nurse instructors/faculty. Since 10,000 nurse educators are expected to retire, we will need to replace them with 34,200 additional nursing instructors by 2022 in order to meet the demand. And if we pull active RNs from the workforce to move them to an instructor position, we will just be increasing the overall nursing shortage.

Even though the situation sounds dire, I am sure we will be able to manage the situation. There are more opportunities for those of you who will not be retiring. Current nursing roles will be changed to meet the demands and new roles will be developed, as needed. Ancillary healthcare workers will be used to help perform some of the more routine nursing tasks.

There are challenges that will need to be addressed:

• We need to find a way to care for the influx of baby boomers while retirements decrease active nurses and physicians.
• Legal restrictions placed on nurse practitioners need to be restricted to allow them to practice effectively and efficiently.
  
• Integration, collaboration, and coordination will need to be improved with providers and other care members so everyone works together efficiently as a team.
  

However, there are also many opportunities that will be available during this time of change:

• Additional nursing roles will be created in preventive care, patient education, social determinants of care to increase access to care, and improve cost and the quality of care.
• Additional nursing roles will also be created in new specialties, e.g., geriatrics, data and informatics, care coordination, telehealth, remote monitoring, etc.
  
• The increased use of telehealth and remote monitoring will provide more efficient care to more individuals.
  
• The new diverse nursing workforce will better mirror the general population, thereby helping to reduce health disparities and increase access to quality care.
  
• Nursing educational programs will be revised and improved, as changes are made to meet the ongoing needs.
  
• Technology will be used to make some of the processes quicker, easier, and more efficient.
  

These things will definitely change nursing as we know it today, but that is what makes the profession even more exciting and rewarding. Who would have thought years ago when I was starting out in nursing that we would be documenting everything in a computer instead of in a paper medical record? Who would have envisioned all the automated tools and devices that we have now? Who would have imagined we would be using the internet or an app to look up information or a mobile phone to communicate with others instantly without having to find a landline? These inventions hadn’t been developed yet, but can you even imagine what it would be like without them?

You have a lot of things to look forward to. You chose the right profession and you now have the opportunity to fill the jobs we are retiring from or to work in a new role not even thought of yet.

NOTES:

Are you going to the annual conference next month? For those of you who have gone, you know what a great experience it is. For those of you who haven’t gone, you really should try it – you’ll love it. The sessions, discussions, learning, and networking are definitely worth it. I hope to see you there!

If you have any ideas for topics for my articles, please let me know. I’d love to research areas that are of interest to you. Just send me an email and let me know what you are interested in.

Pat Stricker, RN, MEd, is senior vice president of Clinical Services at TCS Healthcare Technologies. She can be reached at pstricker@tcshealthcare.com.