The August 2021 Longitudinal Study focuses on new data and major shifts that have occurred in health care going back to the first survey conducted in July 2020. The new data from this survey indicates access to PPE and the ability to communicate and implement changing policies have improved, while staffing shortages and the emotional health and well-being of nurse leaders have worsened. The August report also offers new insights into nurse leaders’ needs and tactics being used to address the growing staffing shortage. The report continues to identify a gap between roles, with focus on chief nursing officers, directors, and managers.

The COVID-19 pandemic has taken a toll on the emotional, psychological, and spiritual well-being of healthcare workers. This article presents 14 strategies nurse leaders can use to help safeguard nurses’ mental health. Covid Long Haulers

This article reviews a nursing leadership development program that was developed at Yale New Haven Health System (YNHHS) in Connecticut. This article follows the development of this program and highlights how it helped retain nursing leaders.

Article Link: Nursing Leadership Academy Develops Current and Future Leaders | AONL

An analysis from Versant Database compared new graduate nurses from 2018-2021 and it revealed a widened practice gap for new graduates in critical care, perinatal, and the emergency center.

The link:  Where do we go from here? The Impact of COVID-19 on Practice Readiness and Considerations for Nurse Leaders

The study’s findings reveal new changes to nurse leaders’ primary challenges and critical data concerning staffing shortages and nurse leader well-being.

The link: AONL COVID-19 Longitudinal 3 Written Report.pdf

Adaptation of an article by Salvage and White, 2019.

As nurse leaders, we desire to see the big picture, yet can imagine the consequences at the micro level of patient care. Most of us would say we are better with the micro level of nursing than of healthcare policy and decision-making at the macro level. We all experience, daily, the influences of politics and policy with the funding of our systems, the daily COVID-19 health challenges we tackle, the socio-economics policies that affect the health of the communities we serve, and the widening debate on so many other issues. Nurses generally want to just get on with their job and not worry about the macro level of policy and politics. We are most often bystanders to decision-making but end-users of the decisions. “In recent decades, nurses have become increasingly knowledgeable, skilled and well-educated, but this progress has not been matched with a significant growth in influence and status, and in some respects is going backwards” (Salvage & white, 2019). The window of opportunity is always open and now is the time to take even a small step toward influencing the macro level of nursing and healthcare. One topic that is coming forward in this legislative year is the nursing compact. Where do you stand on this issue? What are the arguments for both sides? How might you and your organization benefit from this legislation? MOLN’s Policy and Advocacy Committee is a great place to come and learn about this and other issues that affect all nurses. Then, you can build your effectiveness as an instrument of influence and understand how you can help on the macro level of nursing and healthcare which will, in turn, improve the micro level that we all know so well. Good fortunes to you on the Journey!

Salvage, J. & White, J. (2019). Nursing leadership and health policy: everybody's business. Int Nurs Rev, 66: 147-150. https://doi.org/10.1111/inr.12523

https://onlinelibrary.wiley.com/doi/full/10.1111/inr.12523

Closing date for submissions is Wednesday, September 16, 2020, at midnight ET.

WHO Publishes the State of the World's Nursing 2020 Report

The World Health Organization has published the State of the World's Nursing 2020: Investing in Education, Jobs and Leadership report. The report provides new insights into the nursing profession and further reinforces the world's need for nurses to work to the full extent of their education and preparation. Although the focus of the report is not the COVID-19 pandemic, its recommendations are extremely relevant in this time of crisis. Access now.

Effective March 16, The Joint Commission suspended its regular surveying to avoid interfering with the ability of health care organizations to prepare for and treat patients during the COVID-19 pandemic. Only a small number of surveys prompted by high-risk situations will continue. All postponed surveys will occur once operations resume. Accreditations that lapse in the interim will be extended to avoid disruptions in care. According to the commission, the Centers for Medicare & Medicaid Services has given assurances Medicare payment status will not be affected by these actions. (Joint Commission Online story, 3/18/20)

When should we start social distancing? Now.
By Nicole Basta and Jessica Nordell 
MARCH 11, 2020 — 7:30PM
http://www.startribune.com/when-should-we-start-social-distancing-now/568717662/

Nurse Leaders are urged to add this resource to your list of places to get good information on COVID-19 that is relevant to nurse leaders.

Today’s health care leaders understand the linkages among nurse staffing, patient outcomes and high-value health care. The relationship between nursing care and patient outcomes, in particular, is now widely accepted. Nevertheless, it is often difficult to achieve an evidence-based allocation of nursing resources that is understood and accepted by all.

Recognizing the potential value added by optimizing nurse staffing—and the and the downside risks of failing to do so—AONL, ANA and HFMA teamed up to chart a path forward. 

This document explores the evolution from conventional, quasi-adversarial nursing/finance working relationships to the patients-first interprofessional collaboration that is a reality for nursing and finance leaders at some health care organizations and aspirational for others.

The document also sets forth an action plan for improving allocation of nursing resources that includes:

• Pioneering creative approaches.
• Conducting broad-based technology assessments.
• Working toward joint accountability.
• Agreeing on shared principles. 
• Promoting interprofessional collaboration.

Collaboration between those who deliver care and those who ensure the financial viability of care delivery is the key to success in developing outcomes-based nurse staffing models and improving the value of care that patients receive.

Structural Urbanism Contributes To Poorer Health Outcomes For Rural America

 PUBLISHED: Health Affairs December 2019

 ANA Adopted Recommendations: 

• Removal of the religious exemption, and require mandated annual medical exemption recertification
• ANA and the State Nurses Associations:
• Advocate for increased funding for social marketing education campaigns, incentives for vaccine-compliant parents, and reimbursements to providers who have high vaccination compliance.
• Advocate for the establishment of standardized, state and/or federal immunization database.
• Promote use of existing immunization resources, like ANA’s Immunization materials and the Centers for Disease Control and Prevention (CDC).

State health officials who make unannounced inspections of hospitals will start reviewing nurse staffing levels. Some California hospitals disregard the state’s current nurse-to-patient ratio requirements, Leyva, the bill’s author, argued. SB-227 establishes penalties for violations: $15,000 for the first offense and $30,000 for each subsequent violation.

That extra time can prove disastrous in emergencies like heart attacks and car crashes.

"There’s a golden hour of getting care in that first hour of trauma," Dr. Nancy Dickey, president of the Rural and Community Health Institute at Texas A&M, told NBC News, noting that, "if you don't get care in that time, it can have a negative impact on morbidity as well as mortality."

One contributor to these health facility closings: there is often a larger number of under- or uninsured in rural areas.

“These problems are exacerbated in rural areas, especially due to the recent economic downturns and job losses leading to outmigration and shrinking populations, leaving behind populations that are older, sicker and more reliant on Medicaid and Medicare,” the researchers wrote.

Politics also often compounds the financial strains on these institutions. In a 2018 study from the University of Colorado, published in Health Affairs, researchers stated, “we found that the ACA’s Medicaid expansion was associated with improved hospital financial performance and substantially lower likelihoods of closure, especially in rural markets and counties with large numbers of uninsured adults before Medicaid expansion.”

To date, 14 states have refused Medicaid expansion, according to NBC.

"So there is evidence to show that is true," George Pink, deputy director of the Rural Health Research Program at the University of North Carolina's Sheps Center, told the news site, regarding that study. But that feeling is not universal, he added, "anecdotally, I present a lot around the country and have found CEOs of hospitals are of mixed opinion. Some hospitals in California believe Medicaid expansion and the Affordable Care Act was the savior of many rural hospitals — you find diehard believers out there. CEOs in other states, even states that have expanded Medicaid, are less sanguine."

NOTE: No official action will be taken on these bills at the hearing

HF2152 (Freiberg) - End-of-life option for terminally ill adults established, and criminal penalties imposed.
HF1400 (Morrison) - Health care interpreters spoken language registry system established, report required, and money appropriated.
HF1741 (Zerwas) - Living organ donors; status discrimination prohibited, paid leave benefits extended, unpaid leave required, and a conforming change made.
HF1247 (Baker) - Anatomical gift that is an eye or an eye part required to be passed on to the Lions Gift of Sight at the University of Minnesota.