The primary cause of the nursing shortage?

A lack of educators. Despite nursing being an inherently tough career, there is by no means a lack of interest in the profession. In 2019 alone, nearly 80,000 prospective nursing students were denied BSN and graduate school entry into nursing programs due to a lack of funding and availability. Two-thirds of the nursing schools that were applied to stated they had to turn away applicants due to a lack of "faculty, funding, clinical sites or facilities." A large cause of these issues? Demographic shifts. As Baby Boomers age, so do the nursing staff taking care of them (including the nursing educators instructing this staff). There's less and less pipeline feeding into education positions, and with a bottleneck on educators already, this doesn't help matters. Short-term solutions include an increase in travel nurse compensation and supply as well as subsidies toward advanced nursing degrees from employers to nursing staff. Long term solutions may include expanding the scope of both APRNs as well as LPNs to cover growing needs in a variety of situations.

DNRs. Who decides? —

The patient. Legally and ethically, this falls into the hands of the patient or their next of kin. Recently, following a heart transplant, Mr. Jurtschenko suffered brain damage and was left in a vegetative state following the surgery. Prior to the surgery, he told his children that he did not want to me resuscitated if in an "incapacitated form." After a few days, his children said they wanted to begin talking about a DNR in the case that he stops breathing. The supervising doctor said it was too early to tell, and rejected the request for a DNR. Nearly a month later, the request was finally accepted. The American Medical Association states that the "ethical obligation to respect patient autonomy and self-determination requires that the physician respect decisions to refuse care.” So, should the medical team have conceited to the request earlier?

What's uniting doctors and nurses? —

Electronic health records. As you surely know already, the current system punishes both doctors and nurses. As workloads become heavier, it's clear that a main reason for this is the arrival of and increased attention being paid to EHRs. What was originally intended as a time and effort-saving tool has gone the other way, reportedly consuming up to 50% of clinicians' days, taking valuable time away from patients "in the name of electronic box-checking." This is where doctors and nurses can work together to acknowledge and make clear the harm done by the increasing documentation requirements. Physicians have the resources, while nurses have the experience and national organizations to be heard; it's time to work together to turn this universally disliked reality into a unifying challenge that will benefit everyone, clinicians and patients alike.

Who's helping to lower the number of ambulance rides? —

Nurses. A Florida County 911 program has been launched to help reduce the unnecessary amount of non-emergency ambulance rides. How? The program transfers less threatening emergencies (i.e. accidentally cutting a finger while cooking or experiencing flu-like symptoms) to nurses for immediate tele-support and advice. What prompted this change? In 2018-19, 44% of ambulance rides did not result in transport to an emergency room given the low-risk nature of the calls. Accordingly, these rides were unnecessary costs and burdens on emergency workers, potentially distracting from real life-threatening emergencies.

A surprising way to support healing? —

Origami. Vanessa Tran, a nurse-turned-volunteer has tapped into the therapeutic benefits of origami to help promote healing in patients. She states that making origami, requiring focus and a diversion of attention from ailments, allows patients to take a pause from dealing with whatever life has thrown at them: “Origami became a way for me to give patients a pause — a moment when they can shift their perspective and tap into their emotions and what they need to feel better."