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Nurses at the table for healthcare reform after COVID-19

By: Lisa Stand

COVID-19 is shining a light on nursing care and the extraordinary efforts of nurses in emergency departments and critical care units, frequently without the resources they need to be safe. The American Nurses Association (ANA) has been at the forefront advocating for adequate protections, and Congress and the Trump Administration have heard nurses’ voices loud and clear through our legislative, regulatory, and grassroots activities. COVID-19 also has revealed gaps in the healthcare system and the need for deeper public health investments.

It’s impossible to predict precisely how the COVID-19 experience will transform healthcare in the long run. But the time is right to recognize that nurses have an enormous role, and enormous stakes, in what happens next in terms of addressing the specific realities of COVID-19 and the larger issue of supporting access to healthcare.

Lasting impact

COVID-19 will have lasting effects for nurses. They’ll be caring for new inpatient cases and responding to the pandemic beyond hospital walls. Survivors will rely on nurses to help them with recovery, some with long-term issues, after they resume their lives. Nurses also are being deployed to support testing and contact tracing as communities learn how to reduce virus spread.

Value of nursing

As policymakers and stakeholders look to reform healthcare and fill public health gaps, nurses must be at decision-making tables. Federal healthcare programs should be funded to ensure adequate training, recruitment, and compensation for the nursing workforce. In healthcare delivery, the value of nursing care shouldn’t be left out of value-based solutions. In fact, Congress, the Administration, and private payers should make nursing a focal point when designing new care models that can meet future pandemics and public health emergencies.

Addressing disparities

A critical first step is to address health inequities. Historic health disparities made COVID-19 especially deadly in groups with a high incidence of chronic diseases such as diabetes and hypertension. In April 2020, ANA and key partners called on national leaders to direct COVID-19 resources appropriately to communities with higher risks. At that time, in cities like Atlanta and Milwaukee, African American patients accounted for nearly three-quarters of COVID-19 deaths, although they were less than one-third of residents. During and after the pandemic, healthcare leaders and stakeholders must address the underlying inequities that led to these results. The same inequities, due in part to discrimination and lack of access to healthcare, are associated with health disparities in the U.S. population at large.

The nursing workforce can play a tremendous role in efforts to create a more equitable healthcare system. Nurses provide the type of care and coordination that can help people manage their chronic conditions, including links to community resources they need to be healthy. Registered nurses and advanced practice registered nurses frequently are the main source of healthcare delivery in rural and underserved areas, providing access to primary care, maternity care, and prevention. These roles should be strengthened through meaningful reforms.

ANA will continue to engage with policymakers on healthcare reform that appropriately recognizes the value of nursing, consistent with ANA’s 2016 Principles for Health System Transformation. These principles call for expanded coverage and access to high-quality, cost-effective, and affordable care as well as steps to strengthen the nursing workforce to meet healthcare needs.

Visit to learn more about ANA’s advocacy for nursing priorities.

— Lisa Stand is senior policy advisor in Policy and Government Affairs at the American Nurses Association.

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