How To Avert a Global Nursing Workforce Catastrophe

As the world celebrates International Nurses Day on May 12, 2023, we face a looming nursing workforce crisis that threatens health care delivery and health care systems around the globe.

COVID burnout and retirement have combined to severely deplete the ranks of professional nurses. Here in the United States, the National Council of State Boards of Nursing (NCSBN) reports that 100,000 nurses left the workforce during the pandemic. By 2027, almost 900,000 plan to retire. That’s nearly one-fifth of the nation’s 4.5 million RNs. The NCSBN says we are at an “urgent crossroads” and calls for significant and swift action to avert a catastrophe.

What Can We Do Right Now?

The nursing shortage poses challenges, but it also presents opportunities. The sooner we address these challenges and embrace these opportunities, the greater our chance for success.

One of the most important and impactful areas we can focus on is the future of health professionals education. I had the honor to address this topic at the University of Miami, and later at the NYU Rory Meyers College of Nursing with University of Miami President Dr. Julio Frenk, Dr. Lincoln Chen, President Emeritus of the China Medical Board, the outgoing Dean of NYU Dr. Eileen Sullivan Marx, and the Dean of Nursing at the University of Miami Dr. Cindi Munro.

We spoke of strategies to reform health care education in ways that will address and remediate the workforce shortage moving forward. Drs. Frank and Chen wrote in greater detail about many of these recommendations in an article in The Lancet in 2022. These guiding principles include:

• Focus on education for life
  Learning is not static. It is a process. Learning throughout life is critical to maintain professional competence in a world of near constant scientific, technological, environmental, and social change. Education for life encourages learners to focus on ways to promote and restore health, and improve the lives of individuals, families, and communities. Equally, it promotes greater individual work-life balance, as well as a sense of purpose, service, and mental vitality, thus shoring up resilience and helping to mitigate stress and burnout.
• Expand competency-based education
  
  Competency-based education (CBE) focuses on desired performance characteristics of health care professionals. Whereas traditional learning focuses on what the learner should know, CBE focuses on what the learner should be able to do.

Applying competency-based education in new areas can make a profound, long-term effect on health professional education. These areas include:

–Information technology and big data interpretation
–Artificial intelligence and machine learning in health care decision-making
–Telemedicine
–Social determinants of health and health equity
–Climate change and health
–Social media to increase evidence-based understanding and counter misinformation
–Ethical issues, such as AI and genetic engineering
–Health improvement initiatives
–Interprofessional collaboration across organizations and communities

• Increase the use of learning technology
  Greater use of learning technology can make health professional education more effective, efficient, and inclusive, as well as more resilient to future pandemics. Learning technology such as online education, virtual lectures and exams, patient simulations, and augmented reality create global education networks that reach more learners and prepare them for success in a technology-dependent environment. Technology can also be used to assess educational interventions to improve learning and teaching.

The bottom line: we are at a pivotal moment. The loss of nurses threatens not only health care delivery but also health care excellence and quality, population health, and even environmental health. We must continue to work on implementing recommendations and policy priorities from the World Health Organization’s Global Strategic Directions for Nursing and Midwifery, which include a focus on education, jobs, leadership and service delivery, and the National Academy of Medicine’s Future of Nursing report, which emphasize strengthened nursing capacity and expertise and a roadmap to achieve health equity.