Handling Future Crises Requires Bold Action
When the National Academy of Medicine (NAM) began its Future of Nursing 2020-2030 study in 2019, disaster preparedness was not on the agenda, but the events of 2020 brought two realities into stark relief: Our institutions need to better prepare most nurses to deal with public health emergencies, and these events exacerbate existing health inequities.
The COVID-19 pandemic is a case in point. It didn’t create the conditions that put communities of color at greater risk of serious illness and death, but it took advantage of those conditions to do its worst and left nurses reeling. Many nurses put their own health and safety at risk to care for COVID-19 patients, and many will bear the scars of that experience for years to come.
Could the pandemic response have gone better? Absolutely, which is why the study report, The Future of Nursing 2020-2030: Charting a Path to Health Equity, calls for bold action to ensure the nursing profession is ready to respond to future crises and ensure health equity remains squarely in view as emergency response plans are made.
In the past decade, 2.6 billion people around the world have been affected by earthquakes, floods, hurricanes, and other natural disasters. Nurses have been pivotal in safeguarding the public during and after these disasters, and during public health emergencies such as the COVID-19 pandemic. They educate and protect people, engage with and build trust with the community, help people prepare and respond, and help communities recover by fostering resilience. To do these jobs well, nursing students need a solid grounding in emergency preparedness, response, and recovery while they are in school; and practicing nurses need regular opportunities to refresh their knowledge and practice their skills.
The report recommends several actions to achieve these goals.
Create a national center for disaster nursing.
The proposed National Center for Disaster Nursing and Public Health Emergency Response would be a home where nurse experts in preparedness could take a strategic look at what the nursing profession needs and develop a unified plan—one that includes education, training, practice, and certification—for better preparing nurses to respond to future emergencies. The center would also create a pipeline of nurse preparedness experts who could be deployed across the United States to start regional centers and foster excellence in disaster nursing and public health and emergency response.
Articulate a national action plan.
Health is regulated at the state level, which can create immense challenges during an emergency that requires nurses to work across state lines. Planning at the national level can make it easier to meet workforce needs when a crisis arises. Additionally, a national action plan can help everyone stay focused on common goals that are critically important during a disaster: lifting up the nursing workforce, providing more preparedness education and training, furnishing nurses with personal protective equipment, and offering them mental health supports.
Expand nurses’ preparedness knowledge and skills.
Preparedness content is minimal in most nursing courses and in nurse licensure exams. The report calls upon the nation’s nursing education associations to lead the effort to integrate missing preparedness content into the curriculum. Schools of nursing, accreditors, and boards of nursing share a collective responsibility for producing newly licensed nurses equipped with the knowledge and skills they need to feel comfortable rendering care during public health emergencies. Expanding nurse licensing examinations to cover nurses’ responsibilities in a crisis will hold these entities accountable.
Engage employers to protect nurses and the public.
Employers have a responsibility to equip all nurses in their workforce with the information and tools they need when a crisis occurs through relevant education, training, and career development opportunities. Too often, chief nursing officers know what needs to be done, but the information doesn’t trickle down to managers and nurses on the frontlines. Inviting those nurses to the table when plans are made and engaging them in periodic drills will strengthen nurses’ ability to respond during public health emergencies. Employers also need to take steps before disasters strike to protect nurses’ health and well-being.
We live in a time when climate change, social unrest, and emerging infectious diseases mean nurses will regularly be called upon to render clinical care under chaotic and ambiguous circumstances. We can no longer afford to be complacent and assume that nurses are prepared to handle these events. We need to take bold action now to ensure our nation’s nurses have the resources they need so they feel adequately prepared to respond.
Enacting the NAM report’s recommendations can empower and help protect frontline nurses during the next public health crisis. Let’s seize this moment to capture the lessons learned by nurses working in the trenches of the COVID-19 response and equip them with the knowledge and skills they need to protect themselves and all of us.
Veenema is an expert in public health preparedness and a contributing scholar at the Center for Health Security within Johns Hopkins University’s Bloomberg School of Public Health. The NAM commissioned her for its 2030 report to author a chapter on disaster preparedness and public health emergency response (https://www.nap.edu/read/25982/chapter/10).
The Campaign for Action explored the ways nurses can prepare themselves, their institutions, and their communities for future crises in several earlier blog posts. Have a look!