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• W4317506323 abstract "Nursing is at a crossroads. Emerging from the peak of one of the worst pandemics in history, the nursing profession is facing multiple challenges: hospitals and other facilities report a growing nurse shortage, new graduates express uncertainty about their readiness to practice, nursing education is both grappling with a faculty shortage and scrutinizing the best methods for educating students, and violence toward healthcare providers is of major concern along with stress and burnout. But with challenges come opportunities. To provide insight for regulators, nursing leaders, and policymakers on the extraordinary circumstances currently confronting nursing, the National Council of State Boards of Nursing (NCSBN) presents the embodiment of this information and data in its annual Environmental Scan. The Environmental Scan describes the state of the workforce, nursing education, healthcare delivery, technological advancements, and policy and legislation. It also describes social and other issues affecting nursing and summarizes the actions of boards of nursing (BONs) around the country. This report is more important than ever as everyone prepares for a new future that has rapidly arrived and we have yet to completely understand. NCSBN’s National Nursing Database tracks the number of U.S.-licensed nurses from 57 BONs daily (excluding Michigan). There were a total of 4,412,003 registered nurses (RNs) and 903,898 licensed practical nurses/licensed vocational nurses (LPN/LVNs) in the United States as of September 19, 2022 (NCSBN, 2022a). The most recent Occupational Employment Statistics data indicate that 3,047,530 RNs and 641,240 LPN/LVNs were employed in the United States as of May 2021 (U.S. Bureau of Labor Statistics [BLS], 2022f). Figure 1 illustrates a steady rise in RN employment while LPN/LVN employment substantially declined in 2020 and 2021. The number of employed RNs per population in each state varies widely across the country, from more than 700 nurses per 100,000 capita in Utah to more than 1,700 nurses per 100,000 in the District of Columbia (Figure 2) (BLS, 2022fe; United States Census Bureau, 2022aUnited States Census Bureau. (2022a). Annual Population Estimates, Estimated Components of Resident Population Change, and Rates of the Components of Resident Population Change for the United States, States, District of Columbia, and Puerto Rico: April 1, 2020 to July 1, 2021 (NST-EST2021-ALLDATA). Retrieved from, https://www.census.gov/programs-surveys/popest/data/tables.htmlGoogle Scholar). Other states with fewer than 750 RNs per 100,000 people are Georgia and Texas. Conversely, states such as South Dakota (1,579 per 100,000) and North Dakota (1,524 per 100,000) have the highest ratios of employed RNs per population. The ratio of employed LPNs/LVNs is between 30 and 70 per 100,000 capita in Utah, Alaska, and Hawaii and nearly 400 per 100,000 in Louisiana (BLS, 2022f). The maps in Figure 2 provide a quick state-level snapshot of the supply of employed nurses; however, there are regional differences within each state that may not reflect the overall state-level view. Such regional differences within states are often the main concern for researchers and stakeholders studying and monitoring the nursing workforce. For instance, California has one of the lowest employed nurse-to-population ratios; however, within the state, city centers like San Francisco may have very high nurse-to-population ratios, whereas rural areas of the state may very low nurse-to-population ratios. Within-state regional nurse employment numbers are available for download from the BLS (2022e). While we have consistently used the data from the Occupational Employment Statistics (BLS, 2022f) survey to report on the state of the nursing workforce and to analyze trends (data run from May 2020 to May 2021), it is important to note that according to Auerbach et al., 2022Auerbach, D. I., Buerhaus, P. I., Donelan, K., & Staiger, D. O. (2022, April 13. A worrisome drop in the number of young nurses. Health Affairs Forefront. https://www.healthaffairs.org/do/10.1377/forefront.20220412.311784/Google Scholar the 2021 Current Population Survey monthly data (which run from January through December 2021) show a decline in the RN population by more than 100,000 nurses. The investigators attributed this decline to a 4% decline in the number of RNs younger than 35years—nurses who were leaving the profession or taking a break from practice (Auerbach et al., 2022Auerbach, D. I., Buerhaus, P. I., Donelan, K., & Staiger, D. O. (2022, April 13. A worrisome drop in the number of young nurses. Health Affairs Forefront. https://www.healthaffairs.org/do/10.1377/forefront.20220412.311784/Google Scholar). It will be important to continue to follow these numbers because a continued decline will not only put a strain on the healthcare system but will also have a significant impact on nurses who must work longer and harder to compensate for a lack of staff. NCSBN’s National Nursing Workforce Study, conducted from March through August 2022, will be released in Spring 2023 and will provide additional data and insight as to the true numbers and status of the U.S. nursing workforce. The possibility of nurses leaving the profession has been a concern for some time, even prior to the pandemic. The 2020 National Nursing Workforce Survey, which was conducted on the verge of the pandemic, reported that 22% of RN respondents were considering retiring or leaving nursing in the next 5years (Smiley et al., 2021Smiley R.A. Ruttinger C. Oliveira C.M. Hudson L.R. Allgeyer R. Reneau K.A. Silvestre J.H. Alexander M. The 2020 national nursing workforce survey.Journal of Nursing Regulation. 2021; 12: S1-S96https://doi.org/10.1016/S2155-8256(21)00027-2Abstract Full Text Full Text PDF Scopus (145) Google Scholar). Another survey conducted immediately prior to the pandemic focused on nurses in New York and Illinois (Lasater et al., 2021Lasater K.B. Aiken L.H. Sloane D.M. French R. Martin B. Reneau K. McHugh M.D. Chronic hospital nurse understaffing meets COVID-19: an observational study.BMJ Quality & Safety. 2021; 30: 639-647Crossref PubMed Scopus (112) Google Scholar) and included 41,000 nurses and 350 hospitals. The results revealed 48% of nurses in U.S. hospitals experienced high burnout; 20% intended to leave their hospital employer; 57% reported not having enough staff to adequately care for patients; and 69% lacked confidence in their employers to resolve problems in care (Lasater et al., 2021Lasater K.B. Aiken L.H. Sloane D.M. French R. Martin B. Reneau K. McHugh M.D. Chronic hospital nurse understaffing meets COVID-19: an observational study.BMJ Quality & Safety. 2021; 30: 639-647Crossref PubMed Scopus (112) Google Scholar). The American Association of Critical-Care Nurses’ 2021 Critical Care Nurse Work Environment Survey (Ulrich et al., 2022Ulrich B. Cassidy L. Barden C. Varn-Davis N. Delgado S.A. National nurse work environments – October 2021: A status report.Critical Care Nurse. 2022; 42: 58-70https://doi.org/10.4037/ccn2022798Crossref PubMed Scopus (19) Google Scholar) reported that 67% of respondents indicated that they planned to leave their current position in the next 3years, up from 55% in 2018. About 38% of those in 2021 who indicated an intent to leave their current position in the next 3years planned to retire, return to school, or leave the profession. The intent and readiness to leave were influenced by individual characteristics (e.g., satisfaction with being an RN and frequency of experiencing moral distress) and work environment characteristics (e.g., appropriate staffing, quality of care, whether the organization values RN health and safety, meaningful recognition) (Ulrich et al., 2022Ulrich B. Cassidy L. Barden C. Varn-Davis N. Delgado S.A. National nurse work environments – October 2021: A status report.Critical Care Nurse. 2022; 42: 58-70https://doi.org/10.4037/ccn2022798Crossref PubMed Scopus (19) Google Scholar). A McKinsey survey conducted in November 2021 found that 32% of RNs indicated a likelihood of “leaving their current position involving direct patient care,” up from 22% in February 2021. Of those indicating a likelihood to leave their current position in November 2021, about 39% planned to retire, return to school, or leave the profession. The main drivers of the intent to leave were identified as insufficient staffing levels, desire for higher pay, not feeling listened to or supported at work, and the emotional toll of the job (Berlin et al., 2022Berlin, G., Lapointe, M., & Murphy, M. (2022, February 17. Surveyed nurses consider leaving direct patient care at elevated rates. McKinsey & Company. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/surveyed-nurses-consider-leaving-direct-patient-care-at-elevated-ratesGoogle Scholar). Throughout 2022, there have been ongoing reports of severe nursing shortages experienced by institutions across the country (Haines, 2022Haines, J. (2022, November 1. The state of the nation’s nursing shortage. U.S. News and World Report. https://www.usnews.com/news/health-news/articles/2022-11-01/the-state-of-the-nations-nursing-shortageGoogle Scholar). In one survey of nurses conducted in August 2022 (n = 500), 99% of respondents stated there was a staffing shortage where they worked and 94% stated they were negatively impacted by the shortage (ShiftMed, 2022ShiftMed. (2022). 2022 nursing shortage: ShiftMed survey shows nurses aren’t okay. https://www.shiftmed.com/blog/2022-annual-state-of-nursing-report/Google Scholar). Forty percent stated the shortage had negatively impacted their mental health and 65% indicated they are likely to leave the profession within the next 2years (Medshift, 2022). In November 2022, U.S. News & World Report cited burnout, an aging workforce, and a lack of training as contributors to the shortage (Haines, 2022Haines, J. (2022, November 1. The state of the nation’s nursing shortage. U.S. News and World Report. https://www.usnews.com/news/health-news/articles/2022-11-01/the-state-of-the-nations-nursing-shortageGoogle Scholar). McKinsey research also found that the increased tendency toward leaving the workforce is not limited to the United States. Surveys conducted in France, Singapore, Japan, and the United Kingdom all found substantial proportions of nurses indicating they planned to leave direct care. The surveys found that COVID-19 was not the primary reason nurses were leaving; financial considerations and plans to retire or return to school played bigger roles. The surveys indicated that the primary reasons for RNs staying on the job were such factors as doing meaningful work and maintaining good health (Berlin et al., 2022Berlin, G., Essick C., Lapointe, M., & Lyons, F. 2022, May 12 Around the world, nurses say meaningful work keeps them going. McKinsey & Company.https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/around-the-world-nurses-say-meaningful-work-keeps-them-goingGoogle Scholar). As can be expected, shortages of nurses enhance the employment of new graduate nurses. The National Student Nurse Association (NSNA) sends out an annual survey to their membership who are near graduation to determine the state of new graduate nurse employment. The 2021 survey focused not only on employment trends but also on past educational experiences, mentorship, future plans, and their confidence in entering the workplace (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar). As shown in Figure 3, the 2020 employment dip has bounced back to near-record levels of employment of new graduates. Overall employment of all new graduate nurses in 2021 was 92%, compared to 85% in 2020. Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar reported that of those new graduates who had jobs, 85% were hired within 3months of graduation and 97% within 6months. Regionally, the lowest employment rate remains in the West and Northeast, but the difference compared with Central and Southern regions is slight (Table 1). The most gains from 2020 to 2021 were made in the Northeast, reflecting the recovery from areas most affected by COVID-19 surges in 2020 (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar).Table 1Employment Rates of New Graduates by Region, 2009–20212009201020112012201320142015201620172018201920202021Regions South69%64%70%74%84%85%88%92%92%92%91%92%95%Regions West41%41%55%55%64%68%77%85%82%84%78%77%87%Regions Northeast50%50%61%60%71%72%82%88%85%87%84%79%93%Regions Central60%60%72%73%84%84%89%92%92%92%94%93%94%Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar Open table in a new tab Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar While the percentage of employed baccalaureate graduates is slightly higher than that of graduates of associate degree or accelerated baccalaureate programs, that difference in 2021 was much smaller than in previous years (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar). The NSNA survey also queried the participants (n = 2,691) about their perceptions of employment trends during their job search (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar), and their responses included the following:•Hospitals are hiring travel and agency nurses (91%)•Nurses are leaving the profession (88%)•RNs are working harder (80%)•Most acute care facilities are hiring new graduates (79%)•RNs are resigning (79%)•Jobs for new graduates are plentiful (69%)•RNs are retiring (63%)•Hospitals are creating residency programs (59%)•Full-time RNs are also working in other part-time positions (56%). These perceptions of new graduates are eye-opening and worrisome for the nursing profession in maintaining a stable workforce. Other findings from this survey also yield valuable insight for regulators, educators, and practice partners. Among new graduates in 2021, 56% reported that they are adequately prepared for their first nursing position (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar). This is a stark decrease from 67% in 2020 and 68% in 2019. While 2020 nursing graduates were impacted by COVID-19 in their final semester, the 2021 graduates were impacted for a larger portion of their education, likely affecting their attitudes toward being prepared. In a related question, the graduates reported their confidence on a 1-100 analogue scale. The mean score decreased from 63 in 2020 to 61 in 2021 (Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar). The number of new graduates who reported being assigned a mentor has also continued to decrease from over the past 3years (35% in 2019; 31% in 2020; and 29% in 2021) despite the literature supporting the value of mentorship for new graduates (Vance, 2022Vance C. Where have all the mentors gone?.Dean’s Notes. 2022; 43 (https://www.ajj.com/sites/default/files/deansnotes/spring2022.pdf): 1-4Google Scholar). Feeg et al., 2022Feeg V.D. Mancino D.J. Vasquez-Clarfield B. Employment trends and the class of 2021 new graduates’ job search and transition to practice in the post-COVID-19 workplace.Dean’s Notes. 2022; 44 (https://www.ajj.com/sites/default/files/deansnotes/summer2022.pdf): 1-5Google Scholar caution that stakeholders will not stem the tide of nurses leaving the workforce until the workplace culture is transformed. The advanced practice registered nurse (APRN) title consists of four roles: (a) certified nurse practitioners (CNPs), (b) certified nurse midwives (CNMs), (c) clinical nurse specialists (CNSs), and (d) certified registered nurse anesthetists (CRNAs). Due to the variation in state laws related to the recognition and licensure of APRNs, it is difficult to accurately estimate the size of the APRN workforce. However, the BLS does track employment data for three of the APRN roles (CNPs, CNMs, and CNSs), and the data have consistently shown growth. According to the most recent data (through May 2021), APRNs have reached a significant milestone—the three roles tracked by the BLS now employ a combined total of 300,000 nurses, an increase of nearly 30,000 from the previous year (BLS, 2022a). The BLS expects growth in this profession to be much faster than average over the next decade, increasing 40% by 2031 and adding nearly 120,000 more personnel to the APRN workforce by that time (BLS, 2022a). CNPs continue to be the most populous APRN role, with more than 230,000 CNPs now employed in the United States (BLS, 2022b) (Figure 4). Nearly three quarters of growth in the APRN workforce was in the CNP role. The number of CNMs also increased slightly in 2021 to 7,750 individuals, which represents an increase of about 9% from 2020 (BLS, 2022c). After a slight dip in employment at the time of the 2020 BLS reporting (during the early months of the pandemic), CRNA employment is once again on the rise, with a total of 43,950 CRNAs employed by May 2021 (BLS, 2022d). The number of CNSs is not independently tracked by BLS at this time. Overall, studies are showing that the pandemic, the nursing shortage, and other factors are taking a toll on the nursing workforce. In a study conducted but the American Nurses Foundation, 2021American Nurses Foundation. (2021). Mental health and wellness survey 2. https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/mental-health-and-wellness-survey-2/Google Scholar, among the 12,500U.S. nurse respondents, 40% experienced feelings of depression. According to Lasater et al., 2021Lasater K.B. Aiken L.H. Sloane D.M. French R. Martin B. Reneau K. McHugh M.D. Chronic hospital nurse understaffing meets COVID-19: an observational study.BMJ Quality & Safety. 2021; 30: 639-647Crossref PubMed Scopus (112) Google Scholar, 48% of nurses in U.S. hospitals experienced burnout. New data from Trinkoff et al., 2022Trinkoff A.M. Selby V.L. Han K. Baek H. Steele J. Edwin H.S. Storr C.L. The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates From the Nurse Worklife and Wellness Study.Journal of Nursing Regulation. 2022; 12: 35-46Abstract Full Text Full Text PDF Scopus (17) Google Scholar indicate that prescription-type drug misuse is higher in nurses, at 9.9%, compared with 5.9% in the general U.S. population. Overall, 18% of nurses screened positive for substance use disorder (SUD) (Trinkoff et al., 2022Trinkoff A.M. Selby V.L. Han K. Baek H. Steele J. Edwin H.S. Storr C.L. The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates From the Nurse Worklife and Wellness Study.Journal of Nursing Regulation. 2022; 12: 35-46Abstract Full Text Full Text PDF Scopus (17) Google Scholar). Staff, charge nurses/coordinators/nurse managers, and other administrators had 9 to 12 times the odds of having a SUD compared with educators and researchers (Trinkoff et al., 2022Trinkoff A.M. Selby V.L. Han K. Baek H. Steele J. Edwin H.S. Storr C.L. The Prevalence of Substance Use and Substance Use Problems in Registered Nurses: Estimates From the Nurse Worklife and Wellness Study.Journal of Nursing Regulation. 2022; 12: 35-46Abstract Full Text Full Text PDF Scopus (17) Google Scholar). Even more alarming are data that indicate nurses are at a higher risk for suicide than any other profession. According to a recent study (n = 5,198), the 3 subscales of burnout (emotional exhaustion, depersonalization, and a low sense of personal accomplishment) may be contributing factors to suicidal ideation among nurses (Kelsey et al., 2022). In a study that investigated 203 nurse suicide deaths, job-related problems “focused on substance use, mental health problems, chronic pain, or job loss due to investigations for substance use or diversion of medication” (Davidson et al., 2021Davidson J.E. Ye G. Parra M.C. Choflet A. Lee K. Barnes A. Harkavy-Friedman J. Zisook S. Job-related problems prior to nurse suicide, 2003–2017: A mixed methods analysis using natural language processing and thematic analysis.Journal of Nursing Regulation. 2021; 12: 28-39https://doi.org/10.1016/S2155-8256(21)00017-XAbstract Full Text Full Text PDF Scopus (19) Google Scholar, p. 28). Stigma may play a role in accessing help, and the authors of the study propose that “barriers to accessing mental health assistance include a fear of impacting one’s career, doubt about confidentiality, difficulties in obtaining time off work for treatment, and difficulties scheduling appointment.” Some licensure applications require nurses to answer questions about mental health history, contributing to the fear of seeking help (Kelsey et al., 2022). States and their BONs have already recognized the grave implications of stress and burnout and have acted. The Oregon Wellness Project, hosted by the Oregon BON, allows nurses of all levels access to a licensed mental health professional for eight 1-hour sessions at no cost (Oregon Wellness Program, 2022Oregon Wellness Program. (2022). For patients. Retrieved December 13, 2022 from https://oregonwellnessprogram.org/for-patients/Google Scholar). The Maine Medical Professionals Health Program offers a behavioral health component that addresses burnout. The program is open to health professionals, including students (Medical Professionals Health Program, 2022Medical Professionals Health Program. (2022). Medical professionals health program. Retrieved December 13, 2022 from https://www.mainemphp.org/Google Scholar). The Delaware BON, in collaboration with the Delaware Nurses Association, and Delaware Nurses Coalition, has built a statewide connected community for peer support called the HealthyNurse/HealthyDelaware Program (Delaware Nurses Association and Delaware Action Coalition, 2022Delaware Nurses Association and Delaware Action Coalition. (2022, May 16). Delaware Nurses Association receives $500,000 in Delaware ARPA funds to support nurse mental health and wellbeing. https://campaignforaction.org/delaware-support-nurse-mental-health-and-wellbeing/Google Scholar). They share resources and address stigma in the profession to help nurses with SUDs and mental health, including stress and burnout. According to the BLS, nurse employment is projected to grow 6% between 2021 and 2031, with approximately 203,200 job openings for RNs projected each year over the decade (BLS, 2022e). According to the 2020 National Nursing Workforce Survey, the RN median age is 52years, which presents the country with the stark reality that it is not possible to fully replace retiring RNs with new graduate nurses due to the increase in job openings (Smiley et al, 2021 Buerhaus, 2021Buerhaus P.I. Current nursing shortages could have long-lasting consqeuences: Time to change our present course.Nursing Economic$. 2021; 39: 247-250Google Scholar). Similarly, Berlin, Lapointe, Murphy, & Wexler (2022) estimated that by 2025, the United States may have a gap of 200,000 to 450,000 nurses. They attributed this possible gap to three challenges to effectively meet patient needs: (a) a decreased supply of the absolute RN workforce, (b) an increased in-patient demand from or related to COVID-19, and (c) continued work setting shifts and increased demand due to a growing and aging population (Berlin, Lapointe, Murphy, & Wexler, 2022). The current and predicted nursing shortages have garnered attention at the state and federal level. Nursing programs in Minnesota have built a coalition that is focused on recruitment of nursing students and bringing more diversity to the workforce. The University of Hawaii hopes to double the number of students they can accept into their nursing program by using $1.75 million from state funding to support hiring 36 new faculty positions. Additionally, the White House has designated $80 million through the Department of Labor’s Nursing Expansion Grant Program to assist with addressing the “bottlenecks in training the U.S. nursing workforce” (Haines, 2022Haines, J. (2022, November 1. The state of the nation’s nursing shortage. U.S. News and World Report. https://www.usnews.com/news/health-news/articles/2022-11-01/the-state-of-the-nations-nursing-shortageGoogle Scholar). Furthermore, related to the health and wellness of nurses, future research needs to focus on the outcomes of BON wellness programs so they can be replicated in other states. The first and foremost implication of these data is the need for accurate statistics concerning the nursing workforce. Differing data from differing periods presents a quandary as to the actual numbers of nurses. As previously mentioned, NCSBN is due to release its most recent National Nursing Workforce Survey in Spring 2023. These data provide a consistent measure of the workforce and will be invaluable to regulators, nursing leaders, and policymakers as they move forward and determine how best to address workforce demands. Regulators and other nursing leaders can also encourage enrollment in E-Notify, NCSBN’s ongoing data collection tool, which will provide an even more accurate measure of the workforce when all nurses participate. The departure of experienced nurses has led to the employment of new graduate nurses, many of whom were educated during the pandemic, had varying clinical experiences, and stated they felt unprepared to enter practice. Regulators can encourage nursing leaders to provide comprehensive transition to practice programs, mentorship, and support to these new graduates, who are the future of the profession. Burnout and stress, in addition to being of concern for the overall well-being of nurses, also pose a threat to public protection. In a study by Montgomery et al., (2020) all types of burnout (personal, work-related, and client-related) were significant predictors of self-reported medication administration errors. Programs that were developed at the state level and led by BONs are integral to a healthy and safe workforce. Other BONs are encouraged to adopt these and other types of programs that prevent or address stress and burnout in nursing. BONs should review their licensure applications for stigmatizing language related to a nurse’s health, well-being, or SUDs and replace such language with wording that is compliant with the Americans with Disabilities Act (ADA). NCSBN is embarking upon a project to assist BONs with this issue in 2023. It is also recommended that BONs take advantage of educational opportunities to teach staff about the prevalence of behavioral health disorders, how to identify nurses at risk, and how to speak with non-biased, non-judgmental, and non-stigmatizing terms. Finally, medication-assisted treatment for SUDs is as important for nurses as it is for others. The efficacy and safety of this treatment indicates that nurses who are monitored by a healthcare provider should be able to safely work (Ghanem et al., 2022Ghanem N. Dromgoole D. Hussein A. Jermyn R.T. Review of medication-assisted treatment for opioid use disorder.Journal of Osteopathic Medicine. 2022; Crossref PubMed Scopus (5) Google Scholar). This has been a banner year for nursing education as educators learned many valuable lessons from the pandemic. Educators are continuing to study what happened during the pandemic to shine a light on shine a light on success learn from what did not work. For example, educators learned that clinical experiences, whether simulation or in-person, are critical for students; when such experiences are limited, as they were during the pandemic, students’ practice readiness plummets. The value of practice-academic partnerships stood out during the pandemic, and we are now seeing their growth in all areas, such as primary care pediatric clinics and justice systems. Yet, it has been a challenging year, too. The faculty shortage" @default.
• W4317506323 created "2023-01-20" @default.
• W4317506323 creator A5065590973 @default.
• W4317506323 date "2023-01-01" @default.
• W4317506323 modified "2023-10-18" @default.
• W4317506323 title "The NCSBN 2023 Environmental Scan: Nursing at a Crossroads—An Opportunity for Action" @default.
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