Six Things to Know About How a Foundation Involved Nurses in “Reimagining” Their Profession
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It seems like ages ago that ordinary citizens banged pots in the streets to thank the nurses and healthcare heroes working on the front lines of a raging pandemic. The cheers have since died down, but the virus stubbornly remains, leaving nurses tired and burned out, and eager to change the status quo.
In the first year of the pandemic alone, a Mayo Clinic Proceedings report found that two in five nurses expected to leave nursing and COVID behind. National Nurses United cited even higher levels, with 68% of nurses considering an exit. COVID exacerbated a nursing shortage that was already a challenge pre-pandemic, as tens of millions of aging baby boomers strain the nation’s healthcare infrastructure. Today, as registered nurses continue to reach their limits, the Bureau of Labor Statistics projects that the U.S. will need to gain 1.1 million new nurses in the coming five years or face major staff shortages.
Recently, the American Nurses Foundation, the philanthropic arm of the American Nurses Association, found a way to bring $14 million in giving to the bedside, involving nurses in ideas and decision-making toward the goal of “reimagining” nursing.
Here are six things to know about the Reimagining Nursing Initiative and its 10 pilot projects, chosen with key input from nurses, to transform the way the nursing profession uses technology and educates and compensates its members.
1. By nursing, for nursing
The American Nurses Foundation is the philanthropic arm of the Americans Nurses Association, which represents 4 million registered nurses across the country. It’s been around since the mid-1950s, working to apply the collective power of nursing to transform national health. Today, it acts as a catalyst, thought leader and convener to address nursing’s most pressing problems, working with constituencies in and outside the profession.
2. Reimagining the profession
The Reimagining Nursing Initiative is the foundation’s largest grantmaking effort to date, and will award $14 million over three years to projects impacting 20 states. Funding will test ideas developed and led by nurses. It’ll be the basis of what American Nurses Foundation Executive Director Kate Judge called a transformation of “the education, regulation, and practice of nursing.”
The grantmaking initiative seeks to involve the people it serves, harnessing nurses’ “unmatched perspective on prevention, wellness and delivery of healthcare services,” insights that make them a “natural catalytic force for accelerating the evolution of our health system.”
3. The selection process
The Reimagining Nursing Initiative attracted an initial pool of more than 350 nurse-led submissions, including ideas from 48 states, rural and urban areas, educational institutions, entrepreneurs and research partners in clinical and acute care.
Foundation staff did the initial read-throughs, and then sent top ideas on to a diverse panel of reviewers from “lots of walks of life,” as well as healthcare experts in each of three priority areas. From there, the top cohort went to the foundation’s board for a final selection of 10 pilot programs.
Judge said that the winnowing-down process meant asking a number of questions: Is it bold? Is it scalable? And can the grant achieve sustainable change? The team also considered equity and the social determinants of health, seeking a portfolio that would work as well in a rural hospital in Maine as it would in a busy urban medical center.
In the end, the winning pilot projects centered on producing “practice-ready” graduates, tech-enabled nursing and means of direct reimbursement for nursing. Projects are also meant to raise visibility around the complexities and essential nature of care delivery.
4. Ten bold ideas
Selected projects aiming to make nurses “practice ready” include an immersive virtual reality simulation to help nursing students prepare for multiple patients and complex care; an effort to help generalists prepare for specialty nursing like perioperative care; and another that accelerates competency development.
Other projects will help bring nursing to a wider range of settings, like rural areas and patients’ homes. A pilot with Navi Nurses addresses the acute shortage in nursing for patients transitioning from hospital to home by using on-demand technology to hire — and pay — nurses directly. Another creates a payment and care structure for nursing care in underserved rural areas of Oregon’s Tillamook and Columbia counties.
Several of the projects selected involve high-tech solutions. The pilot with ChristianaCare explores engaging collaborative robots, or “cobots,” in daily routine work. Another tech project coming out of Columbia University Irving Medical Center in New York will put “the right tech in the hands of nurses and care” by using artificial intelligence to chart, observe and assess patients, and then convert nurses’ notes to green, red and yellow scorecards showing a patient’s likelihood to deteriorate. Judge likened the process to when “family members know you better than anyone else,” and “can advocate when the care team may not be listening.”
5. A shot in the arm
In the 2018 and 2019 fiscal years, the American Nurses Foundation’s revenues totaled roughly $2 million. In 2020, that jumped to $16 million as donors actively looked for ways to support professionals on the front lines of COVID.
Reflecting that trend, other large gifts to benefit the nursing profession have gone out recently, like a $125 million gift from Leonard Lauder to fund a tuition-free nurse practitioner program at Penn Nursing at the University of Pennsylvania. By 2027, the program hopes to enroll 140 students who are dedicated to working in underserved communities. And last September, the Elaine Nicpon Marieb Charitable Foundation announced a $21.5 million gift to the University of Massachusetts Amherst College of Nursing, the largest cash gift in the school’s history.
6. Prescient funding
Reimagining Nursing, though, was the result of prescient funding that got things off the ground pre-pandemic, in January 2020. The initiative was born from a challenge issued by Greg Adams, CEO of the integrated healthcare provider Kaiser Permanente. Major initial funding came from the Kaiser Permanente National Community Benefit Fund at East Bay Community Foundation, and it drew additional support from AMN Healthcare, Omnicell, and the Salka Impact Fund.
Adams started his career as a nurse, and didn’t need a global epidemic to understand that transformational change was needed in nursing. Still, he feels the pandemic “has reinforced the critical and foundational role nurses play, and has solidified how the healthcare system must change to meet evolving needs.”
There is no better time, he said, to “reimagine the nursing profession to help lead this transformation with innovative ideas and solutions” drawing directly on the perspectives of nurses. And no better way to thank them.
