October 13, 2021

Nurses have been rated the most honest and ethical professionals in America for 19 consecutive years, according to the Gallup Poll, and for good reason: We provide essential care and services in hospitals, clinics, nursing homes, public health departments, schools and other settings in the best and worst of times.

We earn the public’s trust by adhering to the Code of Ethics for Nurses, boiled down to a first principle of centering the needs of patients. Although the pandemic continues to showcase the dedication of nurses who labor to save lives and contain outbreaks, it also spotlights a problem within the profession that manifested quietly for years and is now reaping serious consequences: vaccine hesitancy.

Official data on nurse vaccination rates are not available, but national estimates range from 56% to 88%, with variation by employment setting and geographic location.

An American Nurses Association survey conducted in July 2021 reveals that 83% of the 125 Ohio nurse respondents had either received or planned to receive the COVID-19 vaccine. 

And yet, some Ohio health care systems struggle to enforce mandates as a subset of nurses threaten to quit over vaccine mandates. How did we get here? Lagging uptake of annual influenza vaccine was a warning sign that some nurses would hesitate to take the COVID-19 vaccine. Several studies published the last two decades show that a sizable percentage of nurses decline annual influenza vaccine, in some studies more frequently than pharmacists and physicians. 

May 19, 2021

by Pat Ford-Roegner

Lurking right behind the COVID-19 pandemic is another major killer: the seemingly unstoppable incidences of violence by Americans on one another. Most recently, we witnessed senseless shootings in areas including Atlanta, Austin, Boulder, Chicago, Columbus, Indianapolis, Kenosha, WI and Orange County, CA. Major cities are experiencing a steep rise in gun violence. My hometown of Philadelphia reels daily from violence. Innocent children are frequent victims.

The events themselves are horrific, but only part of the story.

We have learned the stark lesson that no place is immune to this danger: not grade schools, universities, grocery stores, movie theaters, churches, office buildings or even our nation’s Capitol. And if only we could develop a vaccine to prevent acts of racial hatred, personal revenge, delusional rage and outright brutality.

A few weeks ago, Columbus Mayor Andrew Ginther rolled out new anti-violence initiatives as the city is on pace to having another record-breaking year of homicides. “I think we will be working on this for a long time,” the Mayor said during a news conference.

Missing from these initiatives is the critical health component. The Centers for Disease Control and Prevention (CDC) and the American Public Health Association (APHA) seek a national call to action to reduce and prevent violence. A host of healthcare groups – including the American Academy of Nursing, Nurses United and the American Nurses Association – has expressed hearty agreement.

The human and economic costs to our society are enormous. In 2019, the Institute for Economics and Peace (IEP) estimated the cost of violence around the world was over $14 trillion annually, with the United States facing the biggest bill. APHA recently emphasized the increasing body of data showing the profoundly harmful effects of violence on child development, the long-term health of affected populations and the economic development of the entire community, especially communities of color.

APHA went on to say, “The current fragmented approach that leans heavily on the justice system needs to be updated to an integrated one that supports extensive cross-sectoral collaboration with an emphasis on health.”

To that end, the CDC highlights a four-step process rooted in the scientific method. The approach “emphasizes input from diverse sectors including health, education, social services, justice, policy and the private sector.” Critical in defining and understanding the problem involves understanding the “who,” “what,” “when,” “where” and “how” associated with it. Data from many sources can give the full picture and help design prevention strategies.

As we celebrate Nurses’ Month this May, we are reminded that nursing has much at stake in addressing violence as a public health crisis. The American Association of Colleges of Nursing (AACN), in a position statement on Violence as a Public Health Problem, reminds nurses to call upon their assessment skills and nursing intervention to prevent the cycle of violence. After all, nurses care for the victims, the perpetrators, the families and the witnesses of physical and psychological violence. We see it all.

The escalating pace of violent personal or mass attacks is spilling over into the healthcare workplace. According to a study from the Occupational Health and Safety Administration (OHSA), healthcare workers account for approximately 50 percent of all victims of workplace violence. Nurses and nursing assistants bear the brunt since they are on the front lines.

In response to increasing workplace violence, The Ohio State University Wexner Medical Center created BERT – the Behavioral Emergency Response Team – comprised of nurses. During an interview with WBNS 10TV in Columbus, hospital officials said the team responded to 1,500 incidents in 2019.

Year after year, initiatives such as Healthy People* works to reduce the risk of violence and its threat to public health. Nurses can and must take a leadership role to interrupt the transmission of violence based on a system of health approaches just as they are doing in vaccinating our communities against COVID-19. It is imperative for our nation’s health and well-being.

Enough is enough.


*Since 1980, HHS's Office of Disease Prevention and Health Promotion has set measurable objectives and targets to improve the health and well-being of the nation.

Pat Ford-Roegner, RN, MSW, FAAN has previously served as Region IV director at the U.S. Department of Health and Human Services, chief executive officer at the American Academy of Nursing and health policy expert for Amplify Public Affairs.


Public policy responses
  • On April 9, President Joe Biden declared, “This is an epidemic, for God’s sake, and it has to stop.” Standing with Vice President Kamala Harris and Attorney General Merrick Garland in the Rose Garden, the President outlined six measures he will pursue to try and curb gun violence – although enactment of legislation is unlikely this year given the politics of the issue. Mr. Biden attacked what he sees as disingenuous arguments against common sense laws, saying, “Nothing I am recommending would in any way impinge on the Second Amendment right.”
  • On February 22, 2021, a bipartisan group of U.S. House lawmakers reintroduced the Workplace Violence for Health Care and Social Service Workers Act. H.R. 1195 was passed by the House on April 19 and received in the Senate. Awaiting action in the U.S. Senate, the bill would direct OSHA to issue a standard requiring employers in the health industry to develop plans to protect workers.
  • In 2012, Ohio Nurses Association members helped pass Ohio’s law on workplace violence against healthcare professionals. Violence against nurses now is a punishable offense, a 5th-degree felony charge punishment by a fine up to $5,000.

Photo by cottonbro from Pexels

September 16, 2020

Clinician burnout was a public health epidemic before COVID-19. Now, there is a clinician mental health pandemic within the pandemic. Burnout involves a sense of ineffectiveness, presenteeism, overwhelming emotional exhaustion and depersonalization,1 and is associated with rising rates of anxiety, depression and suicide.2 The Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health notes that, while nurses and physicians overall have higher proportionate mortality rates from suicide than the general population, Black nurses and physicians experience higher rates than their White counterparts. Findings from a recent rapid systematic review and meta-analysis indicated that viral epidemics result in an almost 30% prevalence of acute stress disorder, anxiety, burnout and depression.3 As of June 2020, the prevalence of anxiety disorders in the U.S. had risen as high as three times those observed in Quarter 2 of 2019, while depression had risen fourfold. Essential workers experienced worse mental health outcomes than the general population.4

Burnout among clinicians not only adversely impacts their own health and well-being, but also threatens the quality and safety of healthcare. A recent national study of nearly 1,800 nurses from 19 healthcare systems across the U.S. showed that nurses in poor mental and physical health reported making more medical errors, with depression being their strongest predictor. Nurses who perceived that their organizations supported their well-being had better mental and physical health outcomes.5 Burnout also results in declines in patient satisfaction, absenteeism, presenteeism and turnover, which are very costly to the healthcare system.6

Healthcare system issues, including long shifts, inadequate patient-staffing ratios, problems with the electronic health record, high acuity patients and personal protective equipment shortages contribute to burnout. To improve clinician health and well-being outcomes, organizations must address system failures, invest in building and sustaining a wellness culture led by a chief wellness officer, and implement evidence-based interventions known to promote the mental health and well-being of their clinicians.

Although clinicians strive to take great care of others, they often do not prioritize their own self-care. As one out of two Americans have a chronic disease and 80% of chronic disease is preventable with healthy lifestyle behaviors,7 clinicians need to engage in regular physical activity, eat healthy, not smoke, limit alcohol if they drink, sleep at least seven hours a night and practice regular stress reduction strategies so that they can be in optimal health and well-being. These self-care behaviors and wellness cultures also need to be established in health sciences colleges to ensure a healthier generation of clinicians.

The Ohio State University is recognized as a national leader in this movement, promoting a sustained wellness culture through a comprehensive, multi-component approach that targets leaders, managers/supervisors, the grassroots and the system, led by a chief wellness officer. The University regularly tracks health and well-being outcomes of clinicians, faculty, staff and students that informs strategies to accomplish its wellness strategic plan. Evidence-based interventions such as Mindfulness in Motion, Health Athlete and MINDSTRONG™ are regularly offered to clinicians, and special partnerships promote health and well-being in areas including staying calm and well in the pandemic, wellness support for front-line nurses and aiding clinicians who experience or survive trauma. In fact, the University’s Safe Campus and Scientific Advisory group formed in response to the COVID-19 pandemic has prioritized the mental health and well-being of its population and, next month, Ohio State will host its second National Summit on Promoting Well-Being and Resilience in Healthcare Professionals with national leaders and practitioners sharing evidence and best practices to battle clinician burnout.

Other stakeholders listed below are sharing leadership to demand changes in practice, public policy and academic institutions that prioritize clinician and student well-being. We have been a sick care and crisis-oriented healthcare system for way too long; a paradigm shift must occur that emphasizes prevention and early intervention. With an emphasis on prevention, not only would the health and well-being of clinicians be enhanced, patient outcomes would improve and healthcare costs would decline.

How many more clinicians have to die from suicide because of rising depression associated with burnout? How many more medical errors, the third leading cause of death in America,8 will be made by outstanding, well-meaning clinicians suffering from burnout? How many more clinicians will the American healthcare system lose, which will continue to jeopardize the quality and safety of care because it does not invest in supporting their health and well-being? It is time to stop just describing and talking about the problem. Urgent action is needed!

June 27, 2013

Technology Combined with Expert Faculty, Innovation, and Evidence-based Practice

The American Nurses Association (ANA) signed agreements with The Ohio State University College of Nursing and Capella University to develop programs and offerings for the ANA Leadership Institute to advance the preparation and education of nurse leaders.

“With these two partner organizations, we are able to build on ANA’s rich tradition of excellence, the faculty reputation and evidence-based instruction of Ohio State College of Nursing and the competency-based approach combined with the technology and online learning platform of Capella University to enrich the learning experience of programs offered through our ANA Leadership Institute,” stated ANA Chief Executive Officer Marla Weston, PhD, RN, FAAN.

The ANA Leadership Institute selected the organizations from a competitive application process incorporating experience from a piloted series of live webinars to determine the program needs and technology requirements to reach nurses at various levels of their career. The ANA Leadership Institute has designed programs to reach the emerging, developing and advanced nurse leader regardless of past experience or training to help advance their career and leadership opportunity to improve the healthcare system and healthcare delivery and influence the overall health of society.

“Nurses have inherent leadership qualities that with additional preparation, education and skills-building experiences can enhance the overall impact of the profession on the healthcare system,” added Weston.

Advanced leadership programs will be provided in partnership with The Ohio State University College of Nursing and its Leadership Academy for Peak Performance.

“Our partnership with ANA will prepare advanced innovation leaders equipped to transform healthcare and educational systems for their highest levels of performance,” stated Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, dean of the College of Nursing and university chief wellness officer.

“Our faculty is regarded as experts in innovation and leadership development as well as evidence-based practice. We are honored to work with the ANA to reach this extremely important segment of the nursing profession to advance the leadership impact in health care systems, health care improvement and overall delivery of health,” added Melnyk.

In addition to in-person advanced instruction provided by a nationally recognized leadership faculty that includes Tim Porter O’Grady, DM, EdD, ScD(h), APRN, FAAN, GCNS-BC, NEA-BC, CWCN, CFCN; Kathy Malloch, PhD, MBA, RN, FAAN; Scott Graham, PhD, USAF Lt. Col. (ret.); Melnyk; and ANA leaders, the ANA Leadership Institute will offer a large portfolio of online coaching and educational experiences for the emerging and developing leaders.

“We are incredibly excited that Capella University has been chosen to create, host and maintain a learning ecosystem to support selected ANA Leadership Institute offerings.  Outside of Capella’s online nursing degree offerings, the ANA Leadership Institute is another way Capella can bring our online learning expertise to nurses across the country in order to support career development and leadership advancement within the nursing profession,” stated Scott Kinney, Capella University president.

“The technological sophistication combined with the experienced faculty will take us light years ahead as an organization and a profession in the current and evolving health care environment,” Weston said.

New program offerings for emerging, developing and advanced leaders will be available live and online in September.

Media Contacts:

Adam Sachs—American Nurses Association, 301-628-5034, adam.sachs@ana.org

Michael Walsh—Capella University, 612-977-5661, michael.walsh@capella.edu

Kathryn Kelley—The Ohio State University College of Nursing, 614-688-1062, kelley.81@osu.edu

 

About the American Nurses Association: 

ANA is the only full-service professional organization representing the interests of the nation's 3.1 million registered nurses through its constituent and state nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing and lobbying Congress and regulatory agencies on healthcare issues affecting nurses and the public. For more information, visit nursingworld.org.

 

About The Ohio State University College of Nursing:

The Ohio State University College of Nursing is the world’s preeminent college known for transforming health and transforming lives through innovative academic programs and research that improves outcomes and evidence-based clinical practice. The College of Nursing exists to revolutionize healthcare and promote the highest levels of wellness in diverse individuals and communities throughout the nation and globe. The College of Nursing is part of the largest health science campus in the nation that comprises seven health sciences colleges, including dentistry, medicine, nursing, pharmacy, optometry, public health and veterinary medicine. Please visit us at nursing.osu.edu.

 

About Capella University:  

Capella University (capella.eduis an accredited online university* that has built its reputation by providing quality online degree programs for working adults. As of March 31, 2013, more than 36,000 students were pursuing an online degree at Capella.

 

*Capella University is accredited by The Higher Learning Commission and is a member of the North Central Association of Colleges and Schools (NCA), ncahlc.org. Capella University, Capella Tower, 225 South Sixth Street, Ninth Floor, Minneapolis, MN 55402, 1-888-CAPELLA (227-3552), capella.edu.