Nursing Workforce Reauthorization Act and Political Activism

Introduction

I am a master’s student, and I will be glad to expand your horizons about issues with financing nursing education while paying vehement attention to the Nursing Workforce Reauthorization Act of 2017 and its revision. Nowadays, being a nurse implies not only providing high-quality care but also being a social example, role model, and political leader (Salmond & Echevarria, 2017; Sun et al., 2015). Thus, education in this sphere continues changing its focus and pays more attention to the social side of the profession, but the government does not devote enough financial resources to resolve this problem, and I would like to address this problem from a perspective of a nurse.

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Overview, History, and Importance

To establish a foundation for discussion, this problem was under strong debate since the development of the nursing profession. The growing number of hospitalized patients led to the rising demands for nurses while the shortage of workforce in the healthcare industry along with high maintenance costs continued to be the major problems of the industry (NACNEP, 2010). To fill these gaps, the management started paying more attention to the professional characteristics of a nurse and his/her education and knowledge. Consequently, education became of paramount importance, and in 2007-2008, The National Advisory Council on Nurse Education and Practice (NACNEP) reviewed educational requirements and suggested highly valuable recommendations that continue to be regularly revised today (NACNEP, 2010).

Thus, another challenge linked to nursing education was highly connected to the fact that not all individuals were able to afford it. To address this matter, in 1980, the Independence Foundation (IF) provided $1 million to support nursing students while during the same year, the program was extended up to $9 million (Hansen-Turton, Sherman, & King, 2015). In 1993-2013, the funding was expanded to nurse-managed health centers while in 1998, funding was limited due to changes in healthcare legislation and the budget deficit (Hansen-Turton et al., 2015). Similar problems tend to exist today and are highly dependent on the national economy strongly worsens this situation. Recently, the Nursing Workforce Reauthorization Act of 2017 was introduced to prolong funding of nursing education until 2022, but it still did not fill all the existent gaps (US Senate Committee on Health, Education, Labor, and Pensions, 2017). Overall, this problem is of paramount importance since advancing nursing education can have a beneficial impact on the quality of the provided services, minimize the shortage of nurses, and make nurses more patient-orientated.

Key Points of the Issue

Earlier I provided only a general overview of the lack of financing for nursing education. Nonetheless, one of the major consequences of this matter is the shortage of nurses. It incurs due to the growing number of individuals over 65 years old, and it implies that more medical assistance will be required (American Nurses Association, 2016). Meanwhile, the Affordable Care Act also had a dramatic impact on this segment, as it strongly decreased the percentage of uninsured individuals from 18.2% in 2010 to 10.5% in 2015 (see Figure 1) (Kaiser Family Foundation, 2016). As a consequence, a combination of these changes in the healthcare industry along with rising accessibility of medical assistance required to have more medical professionals in this area while driving the nursing shortage. For example, currently, the industry does not have enough young professionals since the average age of nurses increased from 42 (2000) to 44 (2010) (American Nurses Association, 2016).

Uninsured rate: statistics.
Figure 1. Uninsured rate: statistics (Kaiser Family Foundation, 2016).

Another factor is the high prices of nursing education since not all individuals can afford it. Subsequently, the percentage of nurses with the appropriate education is still low (below 80%) (Sheffield, 2016). Figure 2 displays that the number of nurses with bachelor’s degree experiences positive dynamics from 41% in 2000 to 80% in 2020 (Sheffield, 2016). This trend takes place due to the development of different legislation such as the Nursing Workforce Reauthorization Act of 2017. Speaking of this act specifically, it mostly focuses on providing grants for advanced nursing education such as doctorate and master programs (US Senate Committee on Health, Education, Labor, and Pensions, 2017). It also offers financial support to the education of authorized clinical nurse specialists, but it is not enough due to the constantly rising demands for nurses. However, it is truly the first step in the right direction.

Nurses with bachelor degrees.
Figure 2. Nurses with bachelor degrees (Sheffield, 2016).

Lastly, this issue is of paramount importance to resolve to diminish shortage. Currently, the existent situation hurts the patient-to-nurse ratio (from 4:1 to 8:1) (Sheffield, 2016). Meanwhile, it results in higher mortality rates due to the lower quality of provided services, as is shown in Figure 3. Consequently, finding a solution will improve the overall quality of care in the country and increase levels of satisfaction among patients and nurses.

Correlation between shortage and quality.
Figure 3. Correlation between shortage and quality (Sheffield, 2016).

Potential Implications

As you have probably noticed, the lack of funding has a direct impact on the quality of the provided services, as a patient-to-nurse ratio tends to be unfavorable (4:1) (Sheffield, 2016). As a consequence, it increases mortality rates while 1/5 of them tend to be preventable (Sheffield, 2016). A combination of these factors hurts the well-being and health of the nation. As for nurses, this issue requires working extra hours, and, as a consequence, it shifts levels of stress and burnout rates. At the same time, on behalf of nursing professionals, I would like to state that this matter limits their possibilities for professional development. For example, the lack of funding prevents nurses from continuing education to become more qualified while prospective students do not have enough finances to become specialists. Overall, devoting more funding will assist in enhancing the quality of the provided services and help nurses reach their professional and individual goals.

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Conclusion

As a future advanced nurse practitioner and social leader, I highly hope that this presentation helped you discover profound insights into the subject. It displayed that the lack of financing of nursing education (grants) not only affected the professional development of nurses and the level of education in the country but also had a vehement effect on the quality of the provided services, mortality rates, and nurse-to-patient ratio. Consequently, expanding the Nursing Workforce Reauthorization Act of 2017 by paying more attention to bachelor education and grants for talented students will have to be discussed profoundly during subsequent meetings. It can help reduce nurse shortage, minimize stress levels, comply with rising demands for qualified professionals, and change the perception of the United States in the global healthcare arena.

Reflective Paragraph

I selected this issue since its consequences not only influenced the working environment and professional development of nurses but also had a substantial influence on mortality rates and quality of healthcare. As a nurse with an active social position, I believe that this issue has to be resolved. Expanding funding under the Nursing Workforce Reauthorization Act of 2017 will help satisfy the needs of nurses and students while simultaneously addressing the aspects that pertain to its global consequences such as shortage of workforce and low quality of healthcare.

References

American Nurses Association. (2016). Nursing shortage. Web.

Hansen-Turton, T., Sherman, S., & King, E. (2015). Nurse-led health clinics: Operations, policy, and opportunities. New York, NY: Springer Publishing Company.

Kaiser Family Foundation. (2016). Key facts about uninsured population. Web.

NACNEP. (2010). Addressing new challenges facing nursing education: Solutions for transforming healthcare environment. Web.

Salmond, S., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36(1), 12-25.

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Sheffield, L. (2016). Nursing shortage statistics. Web.

Sun, V., Olausson, J., Fujinami, R., Chong, C., Dunham, R., Tittlefitz, T., … Grant, M. (2015). The role of the advanced practice nurse in survivorship care planning. Journal of Advanced Practitioner in Oncology, 6(1), 64-70.

US Senate Committee on Health, Education, Labor, and Pensions. (2017). Nursing workforce reauthorization act of 2017 (S. 1109): Hearing before the Senate of the United States and the Committee on Health, Education, Labor, and Pensions, One Hundred Fifteenth Congress, first session,  2017. Washington, DC: Author.

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