What Nurses Want for the Future of Healthcare
PerfectServe’s Nurses of Note awards program began in 2021, and since the launch, we’ve been able to highlight the incredible work, determination, and selflessness of hundreds of nurses. This year, we asked many of these nurses what they long for in their careers—the changes they believe are needed to strengthen the nursing profession. These nurses shared their thoughts and experiences with us, opening up about what they want for the future of healthcare and the nursing field. We’ve broken their feedback down into some of the major areas where nurses want to see growth, adaptation, and overall change.
A Seat at The Table
Since the dawn of the pandemic, the vital role that nurses play in healthcare has only become more evident. From facing extensive burnout to working double shifts to sacrificing their own health by healing others with little to no personal protective equipment (PPE), nurses have had their fair share of challenges in the past nearly three years. But these challenges seemingly brought on by the pandemic were actually just magnified by its presence—complications and problems like these existed well before COVID-19 did.
Finding solutions to the above problems is a big conversation, and unfortunately, decisions about policies and procedures seem to be made far too often without nurses in the room. Commitments and recommendations related to things like scheduling, case numbers, PPE, staffing issues, and even some broader healthcare policies are not informed often enough by nurses’ experience and opinions. Rather, these important decisions are frequently made by other parties and nurses are told after the fact, meaning the people who they often affect most have little to no say in the decision-making process.
This is why many nurses we spoke to said they want their profession to be given a bigger seat at the table. Of the 13 nurses we’ve profiled as part of the 2022 Nurses of Note program, almost all of them said they’d like to be more involved in the decision-making process. Dina Bressler, a nurse at Mount Sinai Health System in New York City, started this conversation.
“I would love to see nurses having a larger role in the executive decisions in healthcare. While the healthcare system and nursing field is constantly evolving, and we’ve come a long way, there is still a lot of positive change that can happen, and I believe that nurses can and should be a part of that.”
Nurses are passionate about caring for their patients—it’s a unifying drive that steers the course of care in every nurse’s job. But not all nurses get to share their opinions on care delivery, and that’s something Tracy Zeigler, Nurse Informaticist at Mecklenburg County Public Health, wants to change.
“I would like to see nurses more empowered to develop plans of care for their patients that align with nursing science and the art of healing.”
Julie Moreton, Nurse Navigator and Staff Educator at Prisma Health’s Children’s Cancer and Blood Disorder department, agreed. The professional decision-making process for patient care initiatives and best practices should include those who are directly involved with care.
“I would also love for nurses to eventually have the energy and motivation again to engage in professional development and quality initiatives when they aren’t so burned out from the pandemic.”
Quality initiatives aren’t just important for the patients that nurses treat. Meghan Walter, Senior Manager of Clinical Professional Development at Northern Westchester Hospital, wants nurses’ voices to be heard when it comes to policies that touch everyone impacted by the care process, including the families of loved ones, administrative staff, and others.
Because care is at the heart of every nurse’s role, it makes sense that nurses want to lead the charge in establishing equitable care for all. Toby Bressler, Senior Director of Nursing for Oncology at Mount Sinai Health System, elaborated.
“In the near future, I would like to see the development of a nursing agenda that will advance and close the gaps of health equity and social justice. In particular, I would like to see full practice authority for advanced practice nurses in every state across the United States. We aren’t doing ourselves or our patients any favors with restrictive practice barriers.”
Beverly Felton, Public Health Director at Little Axe Health Clinic in Norman, OK, is also passionate about equity and representation for nurses themselves. Policies and procedures improve when more voices are heard and respected, including those of minorities and other underrepresented nursing populations. Beverly had a lot to say about this topic in her profile, so be sure to read more here.
“Another thing I see is the difference in the way we’re treated as minorities. In nursing school, I was treated differently than the other students because I was Native, and my other fellow students were white. We need to treat all students with respect, no matter their culture or heritage or ethnicity.”
Along with having a seat at the table, nurses want to be properly supported with adequate resources. This means they want to have adequate staffing numbers to support high-quality care regardless of patient load. They also want better access to updated technology that enhances and streamlines clinical workflows. These resources make a difference in both the quality of care nurses give and the experience they have coming to work every day.
Leigh Barnhill, Nurse Informaticist at Mecklenburg County Public Health, spoke to the topic of staffing. She wants more nurses who are passionate about care to fill open nursing positions. Robert Mangold, Chief Operations Officer at Logan County Health Services, also spoke to this point. Both mentioned adequate nurse-to-patient ratios, which have been hard to come by since the beginning of the pandemic. According to a study done by the National Library of Medicine, the number of patients per ICU nurse increased by 30% during the months April and May in 2020 compared to the same two-month period in 2019.1 The same study found that, in April of 2020, some ICU nurses took care of up to five patients per shift, which is “more than double the maximum of two patients per nurse as stated by the Dutch Guidelines for Intensive Care.”2
Robin Gadd-Lane, Manager of Digital Health and Transformation Systems at Prisma Health, wants to see nurses more involved with technology and the decisions surrounding what technology is used. As someone who works to enhance nursing staff workflows through IT connections, Robin sees great value in nurses having more autonomy over the technology they use.
“I would like to see nursing take a bigger role in technology. Healthcare lags behind other industries when it comes to technology, and this creates increased challenges to bring about change to the complex workflows in healthcare. Nursing is typically a central part of those workflows, and they are key to that change. The nurse’s perspective is needed to help bridge that gap between technology and healthcare.”
It’s often said that nurses work on the “front lines” of healthcare, an endearing reference that really picked up steam during the height of the pandemic. But despite the critical nature of their role, a survey by Nurse.com found that 46% of nurses are only somewhat satisfied with their salaries.5 Taleba Morrison, Nurse Informaticist at Mecklenburg County Public Health, alluded to nurses deserving higher pay when she was asked what she wanted for the future of healthcare. Though she didn’t mention pay specifically, she references that the nurse shortage is taxing for those currently in the field. She thinks higher salaries would encourage more nurses to continue doing what they love.
“I believe nurses would be happier with a more balanced workload. I also want to see a decrease in the levels of nursing shortages and for the profession to be respected and more highly regarded overall.”
Adding to this need, Amanda Harvan, Lead Advanced Practice Provider at Summa Health System, expressed an opinion similar to Taleba’s.
“We need a lot of things, but the main three are better staffing, higher pay, and a greater level of respect for nurses and nurses’ aides and assistants. They are just as much a part of the care team as nurses are.”
Julie Moreton also spoke on staffing and pay and believes better pay and staffing will give the healthcare industry the boost it needs to help job retention levels. According to the 2022 NSI National Health Care Retention & RN Staffing Report, hospitals are experiencing far too many RN vacancies. The vacancy rate of 17.1% in 2022 is up 7.1% from last year, and over 80% of hospitals in the survey reported a vacancy rate of over 10%.3 What’s more, the turnover rate of staff RNs increased by 8.4% and currently stands at 27.1%. Because the average cost of turnover for a bedside RN is $46,100, this issue costs the average hospital anywhere from $5.2 million to $9.0 million per year.4
“I would love to see nurses receive fair wages and staffing across the country to help with retention. Some organizations really have nurse retention as a focus and you can tell by how they treat their nursing staff,” Moreton said.
Opportunity and Education
Nurses also want more opportunities for growth and education in the future. Though there are varying levels of education and certifications available to nurses, many want to see greater opportunities inside of their current career paths. Others want to see educational opportunities at the beginning of the nursing journey. Chris Morgan, QAQI/Risk Management Director at Community Health and Emergency Services in Southern Illinois, believes there should even be a compassion or empathy exam before entering nursing school.
“For future generations, I think there needs to be some sort of compassion and/or empathy entry exam for nursing school. Some people get into this field simply as a career choice, but it is so much more. If you don’t care about people, you should not be a nurse.”
Ana Tyrkala, Clinical Practice Specialist at Nicklaus Children’s Hospital, envisions education and career growth opportunities intertwined with technology. Ana’s job is to put improvement methodologies in place to enhance processes and make best practice changes, so she deeply values the opportunity for others to get further education to grow their careers.
On a slightly different side of the education coin is Beverly Felton, who wants to change the mindset of educational levels in nursing to increase respect and inclusivity. Her wisdom leans more toward valuing nurses for the work they do and the way they change patients’ lives rather than focusing exclusively on credentials.
“We need to get away from the mindset of who we think we need to be or who need to become. I have worked with some nurses who think they are not good enough because they were ‘only’ an LPN, or they were better than everyone else because they had a master’s degree in nursing when the rest of us were ‘only’ ADN nurses. We are all nurses and should treat each other with respect. It should not matter what initials are at the back of your name—as long as you pass your exams, you are still a nurse.”
The incredible—and demanding—services that nurses provide across the healthcare industry are always expanding. As we learned from the nurses we spoke to, their first-hand experiences give them unique insight into improvements that can be made to build better standards and processes for the healthcare system of the future.
Because nurses play such a heavy role in the healthcare ecosystem, most want to see changes in their profession that will lead to more representation and higher satisfaction levels in their careers. Nurses want a seat at the table for policy and decision-making, better resources for themselves and for their patients, pay that more accurately reflects the workload they handle, and greater opportunity to grow in their careers. Listening to the voices of nurses is the next and most important step to creating a better, more equitable field for nurses everywhere.
To these Nurses of Note, thank you for sharing your passions and thoughts with us. We’re honored to highlight the work you do, and we look forward to another round of the Nurses of Note program in 2023!
Make sure to follow our Nurse of Note blogs as we publish in-depth profiles about more of our deserving Nurses of Note honorees throughout the year. For more about Nurses of Note 2022, check out the full list of winners.
1,2 The impact of COVID-19 on nursing workload and planning of nursing staff on the Intensive Care: A prospective descriptive multicenter study, National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215878/
3,4 2022 NSI National Health Care Retention & RN Staffing Report, NSI Nursing Solutions: https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf