By Nancy Tannler

As cases of COVID-19 continue to rise, we have all become aware of the important duty front line workers are taking on in this crisis. It has become evident that as a nation, we were ill-prepared for this type of catastrophe.

At a recent Oregon Health Forum presentation titled Nurses Out Front: The Future of Nurse Driven Health Reform, professionals in the field presented unique health reform priorities formed by their front line experiences.

The moderator, Travis Nelson, BSN, RN, RNBC, has first-hand experience of where the system is weak and what needs fixing. Originally from rural Louisiana before moving to the Tri-Cities in WA, in 2000 Nelson was the first Black man to graduate from the Tri-Cities area with a nursing degree.

He says it is very hard for a person of color to get the necessary education and funding to become a healthcare professional in this society. Opening this door of opportunity to people of color is the first step to building better care and trust with group of people who are being inordinately affected by COVID-19, he said.

Casey Shillam, PhD, Dean and Professor at the University of Portland School of Nursing, explained why this nurse-driven health reform is a necessary next step to better address the needs of all patients in the future.

Shillam described the basic duties a nurse performs to help patients. They deal with chronic disease care, complex acute care, palliative and hospice care and, most importantly, health promotion and disease prevention. Today’s priorities requires nurses to be knowledgeable in telehealth, allowing long-distance patient and clinician contact.

In the past, Shillam admits the bias in nursing education has made it easier for certain people to gain admittance to the program. The U of P nursing education program now addresses the need for “diversity, equity and inclusion.” 

The nursing program has changed both the admittance standards and educational structure. This step better meets the nursing needs of Hispanic, Black and Native American communities who are currently under-served. It brings more understanding to the chronic health complaints these communities experience, such as Type 2 Diabetes.

Violet Larry, RN, Clinical Nursing Supervisor of the Multnomah County Health Department, Healthy Birth Initiative spoke about the reasons infant and maternal mortality in the African American community is so high. 

She said in Multnomah county, African American babies are more likely to have lower birth rates, be born prematurely, have more complications and are twice as likely to die before their first birthday than white babies and mothers. Larry believes that having more nurses of color on their team would be reassuring and build more patient/medic confidence.

Larry continued, saying having more in-home nurses would be a great service to the people in Multnomah County. For many people, it is to difficult to get to a clinic to see a medical professional. Choosing not to go often makes the matter worse.

Stacey Cohen BSN, RN, PCCN, at Legacy Emanuel Hospital, was clear about procedures that are going well in nursing – diagnosing and treating patients is top of the list.

Cohen further explained that the inpatient nursing staff is spread really thin. Because of this, nurses spend a lot of time with task oriented, check-the-box duties and not usually enough time for a wholistic approach. The ailment patients are being treated for is not always the root cause of an illness. Knowing more about a patient’s history and lifestyle helps nurses teach them about preventative medicine. 

Summarizing the The future of Nurse Driven Health Reform, Deborah Riddick, RN, JD, Director of Public Policy and Government Affairs of the Oregon Nurses Association, gave the final presentation. She stressed that what is needed the most is more nurses. The only way this can be achieved is by making college more accessible for those who want to become a nurse.

Riddick said currently there aren’t enough schools or teachers to accommodate those wanting to apply. One of the reasons for this is the money. Academic nurses don’t get paid the same as nurses working in hospitals do. This is one reason there is a shortage of rural nurses too.

Riddick went on to say this maldistribution of pay makes it difficult to incentivize anyone to want to teach or work outside the Metro area. This needs to change, and hopefully soon. Riddick knows firsthand that, after the pandemic, there will be a lot of tired nurses ready to retire or at least take a break.

It was the consensus of all the panelists that Universal Single Payer Healthcare would ensure that everyone would receive the best treatment. 

This would remove the barriers and challenges under-insured or uninsured people find when trying to seek medical attention. 

The panelists felt hopeful about the future of nurses driving healthcare reform and they believe their common desire for better patient care and engagement will be the end result.