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What’s the economic value of nursing?

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By: Evelyn M. Olenick, DNP, RN, NEA-BC

Addressing the nursing shortage requires healthcare policy change.

How do you approach a massive problem with many confounding variables to achieve improvement and measurable outcomes? That’s the question we face with regard to the long-existing nursing shortage, which only increased during the COVID-19 pandemic.

Experienced nurse leaders know that some problems require collaboration and partnership with leaders outside of nursing. As the chief nursing officer (CNO) in my organization, I responded to the many changes within our RN workforce by partnering with the chief human resources officer and the senior vice president for revenue cycle and organizational improvement. Together, we lead a team along with other nursing leaders to develop a strategic nursing workforce action plan.

The overall goal is to stabilize our nursing workforce with employed nurses and reduce reliance on high-cost travel nurse labor for day-to-day staffing. We’re also addressing the practice environment to support and retain nurses with top-of-license practice and investigating who can provide some essential tasks.

We know overburdening nurses at the bedside serves as a turnover driver. To address nurse well-being, we’ve developed an overarching program focused on seven distinct wellness categories—physical, social, intellectual, financial, emotional, occupational, and spiritual. Other actions include making compensation adjustments, adding paramedics as RN extenders in the emergency department, and increasing recruitment for certified nursing assistants (CNA) and safety partners to provide basic patient care needs and support for those who require direct observation when remote telemonitoring isn’t an option.

We’re also piloting the virtual remote nursing (VRN) model on one of our acute care units. The VRN team handles all non-hands-on care and workflows, such as admission documentation, discharge education, medication reconciliation, chart reviews, and audits. These nurses have their own office in the hospital and communicate with patients via iPads located in their rooms. They’re available in real-time to answer patient questions and provide education and support. While the bedside team responds to immediate physical patient needs, the VRN team maintains the regular schedule of rounds and patient monitoring.

Nurses and patients on the VRN unit have shared positive feedback, and we plan to implement the model on the other acute care units. In addition, we re-introduced the licensed practical nurse (LPN) role in the inpatient acute care environment, creating a team-based model (RN, LPN, CNA).

CNOs across the country, along with other executives and nursing leaders, continue to pursue solutions to the nursing shortage. But will this be enough? Or will these actions just be short-lived attempts at remodeling care without making necessary healthcare policy changes? I say nothing will change until healthcare policy identifies the economic value of nurses in a way that truly affects change to healthcare reimbursement.

Healthcare policy changes must include full practice authority for advanced practice RNs in all 50 states, regulatory modifications to nursing education, and increased educational loan forgiveness for those pursuing nursing as well as those pursuing higher education to increase nursing faculty capacity. Most importantly, healthcare reimbursement must include the economic value of nursing care, which is inextricably linked with patient safety, quality outcomes, and the patient experience.

Evelyn M. Olenick is the senior vice president and chief nursing officer at Phoebe Putney Memorial Hospital in Albany, Georgia.

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  • As a critical nurse of 35 years and as a relative of a number of people hospitalized and then DC with significant care needs, let me tell you how messed up the healthcare system is. Virtual monitoring actually harms patients. Patients need more positive human contact to get better. Corporations cut all support resources,, thereby increasing workloads on bedside/clinical people. It’s not Covid! This was pre Covid. It is corporate business people running everything for profit rather than for patient health. It is direct clinical people being ran like hamsters on a wheel and t gf en treated as if a nurse is a nurse us a nurse. This is why they have medical assistants with a few months of training taking RN jobs in clinics. Why is our society is so sick…. because every industry has been taken over by MBAs who have made financial profit its goal, rather than health care or education or justice. Get the corporations and misguided MBAs out of people focused industries and get people, not technology back in people focused industries.

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  • Spring of this year I graduated with my degree of MSN in Education. I can attest that there are more reasons than student loan repayment that is keeping me from teaching. Might be valuable to dig a bit deeper in this vein..

    Reply

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