All About Nursing (18)

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Welcome to All About Nursing with your host Dr. Joyce Batcher, executive nurse advisor Dr. Batcher, who will present a significant role in nurses play in providing health care in a multitude of health care settings. Listen to some of today's key nurses who work and practice in academia settings and talk about the challenges they face in today's modern medical world.

So please welcome the host of All About Nursing, Dr. Joyce Batcher. Good evening. I'm your host Dr.

Joyce Batcher on All About Nursing and we're live on the BBM Global Network and tuning radio. I have a very distinguished guest on the show this week and I'm really excited to have her here for all of us to learn more about the incredible work that she's leading. My guest is Dr. Pamela Zipriano, who is the 35th president of the American Nurses Association, which is the largest nurses organization in the United States that represents the interest of the nation's 4 million registered nurses.

Pan was also elected to the board of directors of the International Council of Nurses in 2017 and serves as the first vice president. She currently holds a faculty appointment as a research associate professor at the University of Virginia School of Nursing. As a distinguished nursing leader, Pam has extensive experience as an executive and academic medical centers. In 2018, she was named one of the top 100 most influential people in US healthcare by modern healthcare magazine for the fourth year in a row.

And in 2015, the publication also named her as one of the top 25 women in healthcare. She's known nationally and internationally as a strong advocate for healthcare quality and advancing nursing influence on healthcare policy. Dr. Zipriano's tireless efforts to advance the role in disability nurses is well recognized throughout the profession.

So thank you so much for Pam for being on the show this evening. I would like to start by asking you just to tell us a bit about why you decided to go into leadership role as a nurse. It's a very interesting journey, Joyce, and I make sure that I try to tell new nurses all the time, which is as a student, I became very interested in the National Student Nurses Association when at the time that I was a student, there was mandatory numbers in those associations. And I became very excited about the Breakthrough to Nursing Project, which was to recruit minority nursing students into nursing so that we would begin to have a much more diverse nursing population.

Well, that led to me getting involved locally where I was going to school and then also going to the national convention where I became elected from the floor as a first vice president and then was the following year with elected as president. So I really got hooked on nursing organizations and recognizing that when nurses speak up and have a voice, they really can influence change in nursing as well as in healthcare. So as I entered my career as a registered nurse, I really loved taking care of patients. You know, I think most nurses will say, you know, that really is one of the most exciting and rewarding parts of any nurse's work when you can relate to patients and their family.

But after several years, I did go back to graduate school and was working at the Clinical Nurse Specialist again where it was very rewarding to be able to help the nurses improve their practice and see us be able to deliver much more specialized care to patients. But I also recognized that there were gaps that there were many, many excellent clinicians. But we were sometimes lacking in terms of leadership, having had those experiences as a student and really been mentored and had people take me under their wing. I really recognized pretty early on that I really needed to live in fellowship and that I would do that through volunteer activities as well as, you know, again, sort of flexing my muscle at the time to be willing to speak up to the yesterder and the same.

It's really important for the nurses voice to be heard. So early on, I decided that I wanted to be part of leadership and did that through professional associations but also within the places where I was employed. Which I think was probably a little bit unusual at the time. This was back in the late 1970s.

But again, felt like it was really important for me to continue my leadership career, which actually ended up leading me into an nursing administration. Well, you have so many wonderful accomplishments. I was just curious if you could share an example of an accomplishment that you are just really, really proud of. Probably the most significant one was leading the University of Virginia Medical Center staff to their first magnet designation.

When I came to the University of Virginia in December of 2000, I was in a role called Chief Clinical Officer, which fulfilled the Chief Nursing Officer role as well as being the individual that oversaw all of practice with a medical partner as well. And we started on the magnet journey. But what was important to note there was that the staff had already laid the groundwork. We had amazing staff nurses at every level, in every area who said this is really important for this organization.

But they really needed a dedicated leader to help with those efforts. So it took a couple years, as one would expect, if you understand the magnet designation process, we had programs to put in place. We had to have real buy-in across the organization. And we had to demonstrate that this was an organizational commitment, not just a nursing commitment.

So over several years, we did work toward gaining that first magnet designation. And I was incredibly proud of the work that our nurses did because they were the backbone. They were the ones that really dug in, worked hard, and said, this is important for us because we want to not only amplify the nursing excellence that we have, but we wanted to permeate the entire organization. So they were the ones that provided recognition to other departments.

They were the ones that said, yes, we want a clinical research program. They were the ones that said, it's really important that we make sure that our care is person-centered. And it's really important that we emphasize how that we have to have evidence-based practice. So they were living the values and really doing all of the heavy-wistening, if you will, to get us to magnet designation.

But then I was the voice and the leverage working with my executive colleagues in the organization to say, this is an important credential. And that this will elevate our ability to provide excellence in patient care, improve outcomes, and really focus on what's important to keeping nurses at the bedside, retaining them with any organization, raising the level of practice, and really elevating everything that occurred in the medical center. So I was very proud of that. I think almost any chief nurse who works toward magnet designation knows what an amazing effort that is.

And again, you play sometimes a small part, sometimes a big part, but an important role in making sure the staff really know that you're behind them and that you're doing everything you can to support them. So that's certainly one example that I will cherish forever because of the close relationship with the incredible staff that I have the privilege to lead. It's funny that you should use that example because that's one that I use when people ask me a similar question. And we had four hospitals that went at once for a system magnet designation.

And that was quite unusual back then and took a lot of dialogue with the magnet commissioners and others to have them understand that we wanted all four. We didn't want it because we had so many things we were doing across the system that we didn't want it to be divisive, but rather really helped to bring everybody together. And it'd be important for the audience that's listening to understand just how significant that designation is. Maybe you could just say a few words about that.

Yeah, definitely. So magnet designation really does represent excellence across an organization spearheaded and really emphasizing the contribution of nurses, not just what they do on a daily basis, but the overall impact that they have. Again, using a practice that is grounded in research evidence, really recognizing that what's important is to be committed to elevating the level of practice, not just within nursing, but across the organization, making sure that you have mutually supportive communication and that you embrace teamwork and that the recognition and retention is important across the organization. That we respect and honor all of the individuals at work in an organization.

So magnet designation, you know, again, really goes from the scientific to the to the personal in terms of making sure that an organization is truly exemplary from its commitment to staffing, its commitment to safety, its commitment to outcome, its commitment to really helping nurses develop so that they can provide the very best care. That's wonderful. That's wonderful. We're going to need to just stop you there for a second.

This is all about nursing and I'm Dr. Joyce Bachelor, we're live on the BBM Global Network and Tune in Radio. It's time to take a short break. America is out of control.

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Welcome back everyone. You're listening to All About Nursing live with the Bee Bum Global Network and Tune in Radio. I'm Dr. Joyce Batchley, the host of the show.

Before the Break, Pam was telling us about the importance of the manic designation and just wanted to come back to have you kind of finished up a little bit about that, Pam, because it is such an important designation and not everybody that's listening probably understands the significance of it. Just to wrap up, this is an organizational designation and so it is not just about nursing. It again is an organizational commitment to excellence that is exemplified through the leadership of nursing, the inclusion of their voice and decision making, their commitment to practice it is based on the search finding. It is one of the most important programs of the American Nurses Financial Center, which is part of the American Nurses Association.

We're very proud of that. I'm really curious, Pam, and how did you prepare yourself to be positioned to become the president of the American Nurses Association? Can you tell us about that? Yeah, well, it's interesting.

Very early on in my career, I was, again, fortunate to progress from being president of the National Student Nurses Association to being immediately involved with the American Nurses Association as a new graduate. The relationship was a little different back then to the NSA president was very engaged, formally, as a student and then it was a natural progression. So I knew that I wanted to be involved in the AMA and immediately served on the first stage where I was licensed in Utah. I served on the Utah Nurses Association Board of Directors and volunteered in my local association and then ran for election to, at the time, what was called the Congress of Nursing Practice.

That group has existed in different forms. So I was elected to the Congress, it was a great experience, to be able to work side by side by some really great leaders in nursing practice, which then led to my being elected to the AMA Board of Directors, again, as a relatively young nurse, and then I was elected as treasurer. So that was when I was, I had been in a process about 10 years. And then, of course, other life events came into play and I eventually had been married and had two children.

At the time, I moved to my interest in American Academy of Nursing, which is, again, an affiliate of the American Nurses Association. And even though I had set my sights early on in my career saying, gee, I'd really like to be AMA president someday, I kind of put it out of my mind because the timing just was never right. And then about five years ago, I met my colleagues, said, you know, would you be interested in running for election to AMA president? And I said, oh, wow, you know, I'm not sure the timing is right now.

But it was always something that I had had as sort of the pinnacle of my career. What an amazing opportunity it would be if I could be president of AMA. So throughout my career, again, I had served on three board of directors of state nurses association. I was very active in the American Academy of Nursing, was on that board, led some commissions and committees was an active volunteer in many organizations served on other boards, and but have always been very committed to AMA.

So I said, you know, this would be a great opportunity. I also had been taxed by ANA to be the inaugural editor of American Nurse Today, AMA's official journal back in 2008, and felt that I really had a close connection to AMA. So all of those activities together and kind of a lifelong aspiration to continue to give back to AMA and really understanding that the honor to serve as an a president is really unparalleled within most organizations. I said, yes, I would I would be willing to do this.

I think any of you that have ever run for office in a volunteer association know that that can be very stressful. But I knew it would be worth it because this again has been the most amazing opportunity. And yeah, something that I knew would be not only valuable to me, but a great opportunity to be able to give back to the profession. And I hear that you really started a very young age in your career to become involved in the association.

So I just curious, what's your advice for any nurse who aspires to take on a leadership position? That's a great question because it's something that I deal with all the time. And again, there's sort of a bond with current past presidents of the National Student Nurses Association and any of the board members and any nurses that have stepped up to be leaders in their school chapters or their state associations because they are people who have already begun to aspire to be leaders. Similarly, when I look to staff nurses within the organizations that have gotten involved in their shared governance organizations that have been really looking at how they can make a contribution, the first thing that I say is volunteer.

You need to step up because if you want your voice heard, you can't just stand in the way. The second thing is to make sure that you aren't afraid to ask because I want to be an mentor. All they can say is yes or no. And that's really important because there's so many landmines in any job or profession.

And so many ways we want people to connect us to other influential individuals and be able to give some advice. The other thing is that I really encourage people to be somewhat fearless. There are times where it's hard to stick your neck out. It's hard to not have anybody following you.

But if you've got a great idea or you want to do something, what you realize is that there's not really a lot of people lined up to support that. And sometimes that can be a really lonely feeling. So I really do encourage nurses to not give up, to be bold, to be assertive, to put their ideas out there, to make sure that if they have an idea or want to be heard, that they're not afraid to step up. And then also, I very clearly say that if you're getting pushed back, again, that's where you want your mentors to help you.

That's where you want people who can run interference for you. You can help kind of grease the skin, if you will, because nursing still tends to be the type of environment where sometimes the younger person has a harder time breaking in. I think that's changing. And again, that's where I encourage people to not give up, not be discouraged, but to make sure that they are looking for opportunities where they can start, maybe sometimes start small and be successful or find that person who will take them under their wing so that they aren't viewed as trying to go to the top too quickly, but really find that right place to plug in.

Because right now we educate almost all nurses saying, you can be leaders. We need nurses to be leaders. We need them to help. We should know.

Thank you so much for all that. I want them to feel supported. So we are coming to you live from the BBM Global Network in Tune & Radio for all about nursing and Dr. Joyce Matchelor.

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Joyce Bachelor in All About Nursing and we're live on BBM Global Network and Tune in Radio. Before the break, Dr. Sipriana was telling us some great pointers for nurses who are aspiring to take on leadership roles and how to have the courage to do that and to get involved. I often think that when we talk about the future of nursing, we really need to be sure we have our young nurses involved because it really is their future that we're describing and impacting.

So thank you so much for all of those key points. So to kind of shift us a little bit, what are some of the key issues that nurses are facing with the turbulence in healthcare? What are you seeing? One of the things that we're seeing is that there are increasing demands for care.

And it's really prevalent in almost every community, whether it's because of the aging of society and the fact that people are living longer and that they are seeking healthcare because more individuals actually have healthcare insurance coverage now, which is a good thing. So what we see with that is that sometimes our workplaces are really stressed. So workload is really high. At the same time we know that geographically we have a number of areas with shortage of nurses.

And so the combination of more patients, increasing demands, increased workloads, and sometimes an insufficient number of staff and the complexity of care being really high can lead to emotional exhaustion on the part of staff, which we're really concerned about. So as nurses are dealing with these issues on the front lines and other nursing leaders and certainly people like me and other association leaders are trying to address these in the policy arena, these issues are really again affecting nurses at the sharp end of care. So nurses are very concerned with their staffing and that they have enough resources, not just the registered nurses, but the support systems and the people who assist nurses in providing care. Keeping up with the quality measures and expectations so that people transition from hospital settings to home or to be able to recover in their home setting and restore health, whether it's again recognizing that we have a lot of people with chronic conditions that cycle through our healthcare system.

And while nurses really try to do their best with transitions in care and care coordination, sometimes those are really big challenges. But I think what we see more than anything else again is the fact that in our healthcare system, there are such high demand and the pace of change is really rapid, whether it's technology, whether it's new medications, whether it's really looking at the pressure to get people in and out of our systems as quickly as possible. Whether it's a 15 minute visit in an outpatient area that's so unrealistic, I think nurses are reacting to the stress. As we've studied, we've done some surveys with nurses.

We know that they experience twice the level of anticipated stress in the workplace than the average public. So this turbulence in healthcare is taking its total on nurses, which again is a serious concern for us. So what are nurses and the American Nursing Association doing to try to advocate for improving some of the working things that you're talking about with the turbulence and all? Are there things that you know that are going on to try to address that?

So one of the areas that ANA and certainly other nursing associations have really focused on is having a healthy and ethical work environment. We know how important that is. We, over the last several years, we've addressed everything from reducing violence, incivility, and bullying in the workplace by putting out recommendations that both nurses and their employers can work on together. So looking at making sure that nurses are very aware of the revised code of ethics for nurses with interpretive statements, because one of the key provisions there is that you have a duty to care for yourself.

And nurses always put others first. So we think that's really important part. We also know that it's important that nurses are protected to the degree possible to having injuries on the job. So that includes safe patient handling and mobility where we've supported federal legislation that hasn't passed yet, but that's part of the Quagmire in Washington these days.

But again, really guidance for organizations and nurses to say, we need ways to make sure that nurses are not doing manual lifting and handling of patients. Not good for nurses, it's not good for patients. And we shouldn't be relying on body mechanics or lift teams to do all that work. We need to take advantage of some of the technologies, not just all high-end technologies, but some very simple things that can help.

We also need to make sure nurses are sleeping enough and that they have reasonable work schedule. So we've looked at and revised our policies on on fatigue and nursing. Again, really indicating that nurses have to identify how they can take better care of themselves. So there are a number of things that we believe nurses can do together.

And at the same time, we also know that teamwork and team-based care is making a difference in terms of reducing some of the stress in order to be able to address this turbulence, to be able to address the complexity of care, be able to have good communication and good handoffs and be able to manage these transitions, as well as, again, the quality expectations. You know, when we're looking at things like patients who get re-admitted to the hospital, that's really a combination of the coordination of care that nurses are often overseeing. But it's also the team effort in making sure a patient has a good transition. So we're experiencing a lot of changes in how we deliver care, but also the teamwork that goes into making sure we're doing the very best job that we can.

So what do you see the nurses and the American Nursing Association doing to really advocate for access to very affordable health care? What kind of changes are happening? Well, you know, this is probably one of the key issues that has been percolating around the country because of the political emphasis in being able to afford to have affordable health. We know that our health care system is one of the most expensive in the world, and yet we're concerned that when we look at some of the statistics, you know, like expectancy in the United States has gone down for two years in a row.

And so we're not even at the same level as some of the other advanced countries in the world. So it's been very important as we've looked at the work over the last 10 years or mostly the last eight years to continue to support the Affordable Care Act. Now we know in some areas of the country that's not popular, but that alone has really helped us to be able to expand Medicaid in about half of our states. It's been able to help older people be able to afford the medications that they need, been able to help young people continue to have insurance and have been able to help individuals who didn't have the means to cover the cost of insurance to be able to get that support.

That's great. We've been able to advocate on a regular basis, take advantage of these programs and to make sure that we are protecting the benefits that people need. So we are coming to you live from the BBM Global Network and to an in radio. This is all about nursing.

Dr. Joyce Batch, the host is showing. We will be right back. For over 50 years, Evelyn Stapula has been a loving advocate for people with disabilities throughout the state of Pennsylvania.

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Joyce Bachel, the host of the show. And prior to the break, Dr. Sipriana was telling us what the American Nursing Association and Nurses in general are doing to really address the issue we have on assuring that there is access to affordable health care. So Pam, maybe you could finish up some of your thoughts on what kinds of things are happening out there.

Well, I'm sure it has not escaped any nurses and nurses families and their friends that, again, the issue of access to health care has become a very political one. And so we continue to support efforts that will be sure that people, the active insurance, be able to provide subsidies for those who cannot afford to buy insurance, support states who have or want to expand Medicaid, and certainly, protective benefits that have been put in place by the laws that exist right now, which again is the Affordable Care Act. So that includes the essential health benefits, and also includes coverage of previous conditions. The ANA, because we believe it's important to speak out on policy, has also opposed watering down these kinds of insurance plans, because sometimes it's really unfair the public has a challenge in trying to understand the changes that are proposed.

So we continue to advocate for people to enroll in federal plans if they need to, to protect them from buying insurance that really is not going to provide them the right coverage and keeping the options open. And the Americans above all really want choice. So we have, again, been sort of steadfast in our principles of health care transformation in trying to support the options for individuals to have choices, as well as have choices in their providers. And we know that an adequate workforce is essential to really assuring that we have adequate access.

So what are some of the key issues that we're you now and also for the future? In many cases, when we think about access to care and nurses, we're thinking about advanced practice nurses. So many of the efforts throughout our space have been to really push in our legislatures for full practice authority for advanced practice registered nurses. And that's also a category.

That's nurse practitioners, certified nurse midwife, certified registered nurse and nurse and nurse specialist. So those numbers are increasing. There's great interest on the part of nurses to fill those roles. And in many of our states, one half of our states, we've been able to achieve full practice authority.

That's really good for having people have access to care because most of those individuals are providing care on the front line, primary care, again, really providing a variety of services that perhaps people would not have access to. Now, the other piece though, with an adequate workforce, is that we still have more than half of all nurses work in hospitals. It is in those environments that we know we're experiencing since serious shortages in some of our geographic areas. One of the things that's going to be helpful is that we will be getting a new report from the Health Resources Services Administration pretty soon after the course of the year that's going to tell us a lot more about the workforce.

But we know, not only do we have a shortage of faculty, but we know that we're facing significant retirements of nurses who are aging out of the workforce. So in addition to some of the projections that are already, that we're already aware of from both Health Resources Services Administration and looking at the Department of Labor, that we know that we will be really stressed to be able to provide adequate numbers of nurses to be able to provide care, not just in hospitals, but in our ambulatory care areas, our home care areas, and all the various venues that nurses work. So we're very concerned about a workforce that really provides sufficient number of nurses in all of our communities and in all of our organizations because we know how essential nursing care is. So it's a combination of making sure we have access on the front lines and primary care, but also making sure that we have nurses to provide other care in some of our complex settings of acute care as well as where it's really important at the intersection of health and illness.

You know, it's interesting because people have always tracked the skill mix, meaning the number of license versus unlicensed personnel when they do their staffing and scheduling. And now I hear a lot of Chief Nursing Officers talking about how they have to put in their experience mix in terms of the number of nurses that are new or less than like two years of experience versus those that have more than that. And I think that's to your point, one of the things that's also challenging is you want to be sure you have experts that are able to help the newer nurses really learn more about the profession and gain those competencies and confidence in all those skills. So that's wonderful that you're working on all that.

So one of the recent disturbing issues is the rise of workplace violence. How can nurses influence solutions to prevent violence and ensure support for those who have suffered from violence because we see so much of that today? Yeah, you know, I think it's really disturbing that we are seeing some very severe issues come forward. And you know, I can only hope that it's because we have better reporting that we know nurses are subjected to all levels of violence.

And you know, we tend to minimize the worker's violence, although we need to recognize the success of threat in our work settings. But some of the most outrageous ones have really been perpetrated by patients or visitors. So it's a really stranger to the nurse, if you will. And what's important is that nurses and their employers work together hand in hand to make sure there are prevention measures to make sure we have methods in place to identify any kind of risk that we are already mitigating risk, whether it's the hours that individuals are allowed into an organization, the screening that occurs, you know, making sure people have identified themselves as they're in a visitor situation.

And also having teaching of opportunities to be a polite situation where we think someone might have an increase in anger that could lose their violence. So it's a combination of institutional efforts on the front end to keep individuals who might propose a risk away from a clinical environment. It's also making sure our staff are prepared individually to assess and identify any kind of threat as well as have other support systems such as a robust security force and ability to bring resources to any kind of threatening situation. But the other thing that's important is not to not to dismiss any threat of the nurse raises.

That's really a very important point. This is all about nursing. I'm your host, Dr. Joyce Bachelor and we're live on the B.E.B.

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I'm Dr. Joyce Batch with the host of the show. Before the break, Pam had started to share with us some of the things that the American Nursing Association is working on to help really influence solutions to preventing violence and supporting those who have suffered violence. Pam, why don't you continue that dialogue with us?

Yeah, thanks. I think as we did start a little campaign which is growing, about 15,000 people have signed our end nurse abuse pledge. In part, it's really raising awareness on two levels, which is we want everyone in the country to understand that nurses should not be subject to any kind of abuse in the workplace. This includes making a commitment to identify and report abuse if it's happening and do everything you can to prevent it.

But the other important part of it is in terms of having all of our nurses be able to say that violence and abuse is never part of the job. Nurses are awfully forgiving and they're willing to recognize that sometimes they're put in a situation with someone who's feeling very vulnerable, but really at no time should a nurse be willing to accept being abused or being a subject of violence. So that's a really important part of our messaging now. The other piece is to make sure that nurses are supported if they in fact have been evicted.

And we have a number of examples where sometimes nurses have long standing issues with post-traumatic stress disorder. We need to make sure we are supporting them. We need to make sure that everything that can be done to help them reenter the workplace to be able to make sure that they are being taken care of. Because, again, we wouldn't have wanted them to be evicted to begin with, but we really want them to be able to recover.

The other thing that's important to recognize is that, again, this is a team effort in terms of making sure that we're being everything we can in our organizations to prevent violence from happening, but also making sure that there are solutions in place to prevent it going forward. I think that's really wonderful and really happy to hear all that. And I look forward to being able to sign that pledge as well. I think that's great.

So wanting to keep nurses safe at all times, what other actions are important to ensure a healthy and ethical work environment? One of the primary things that we have identified is that the leadership commitment is absolutely critical. It's one thing to say, oh, yes, we believe in safe environments. But if the leadership doesn't really believe that and demonstrate that on a regular basis, then things are not going to happen.

Because any time where you don't really live the values, what you see is that they erode. So leadership really has to step up and say, it's really important that our staff are safe. Because when our staff are safe, they can take better care of patients. And that's everything from ensuring we have the resources for staffing to make sure that we have other types of resources, such as security force in place, that we have zero tolerance of violence and that we are willing to step up and deal with whether it's visitors or employees or patients who are not behaving in a way that keeps our patients safe, but we're willing to commit to deal with that.

So leadership is absolutely one of the key things that we need to do. And that is a blind, too. Did you want to jump in with something, really? No, I was going to see if you were going to go on to talk about the National Academy of Medicine's action collaboration, because I think that the physicians are also experiencing the same sorts of stressors out there.

Yeah, so let me just say a word about ethical work environment. You know, we talk about safe and healthy work environment, and part of that for nurses in particular is recognizing that all of the work that we do is really what we call emotional labor. And so there is always a component that can be very stressful and that even though nurses embrace that, it can really lead to emotional exhaustion. And when we think about how nurses are dealing with ethical dilemmas today, we want to know that they do have a support in their environment when they don't, when they believe that they either can't provide the care that they need or that patients wishes are not being honored, that can lead to moral distress.

So in the healthy work environment, there is also a requirement for an ethical work environment. Now, where we're seeing this in a bigger picture is that across the board, health care workers of all professions and support roles are really recognizing that this is very stressful work. This is the hard work today. Our health care systems have become political, they have become high workload, they have become subject to many, many regulatory requirements, some really well intended, but some having unintended consequences.

And all of these concerns have led to a sense at times of losing control over your practice, as well as feeling like what you signed up for when you became a professional nurse, or you became a physician, or a pharmacist, or a therapist, or an assistant, that the work has fundamentally changed. And it could be much more dissatisfying because of the stressors in the environment. So the National Academy of Medicine created an action collaborative on clinician well-being and resilience. Almost two years ago now, an American nurses association is one of the key members of the steering committee.

And the goal is really to look at how can we prevent burnout and how can we encourage resilience among the members. Now, A&A has done a lot of work in moral resilience because we know how critical that is in order for nurses to be able to provide care in a way that does not provide ethical challenges. And so we've been able to contribute to the literature and the toolkit and things to really enhance moral resilience. But the overall collaborative has looked at what are the root causes, what are the contributing factors.

And it's everything from the implementation of technologies, such as our electronic health records, to feeling like the system, if you will, is controlling our practice. And so really looking at how do we return that decision making, how do we return the autonomy and do that through teamwork to have our healthcare providers, team members, support systems really help the clinician be able to take the best care of patients and believe they are in the driver's seat. So we need that with some literature calling it a safe cockpit so that you can provide the care you want, make the decisions, be respected for your professional roles and begin to mitigate these causes of burnout. That's wonderful.

And I think your descriptor about being like the cockpit, we have learned a lot by watching and learning from the aviation industry of the incredible work that they've worked on to really assure safety. So I really am glad to hear that they're looking at that because I think that's going to be really vital as we go forward. I was just curious, too, if you wanted to just begin by telling us a little bit about the work you're leading, when it comes to having our nursing workforce also take on healthier habits. And it seems like we might need to just pause on that for a moment.

This is all about nursing. I'm your host, Dr. Joyce Bachelor, relied on the Beeping Global Network and Tune in Radio. And we'll continue this conversation when we come back.

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Now is your time. I'm your host, Dr. Joyce Bachelor in All About Nursing. We're live on the BDM Global Network and Tune in Radio.

And before the break, I had started to ask Pam if she could tell us about what the American Nursing Association's Healthy Nurse, Healthy Nation Grand Challenges, which I think is pretty exciting. So Pam? I am really excited to be able to share with our listeners about Healthy Nurse Healthy Nations. If for some reason they have not heard about it yet.

So last year we officially launched this Grand Challenge and a Grand Challenge actually has its roots in looking at major sociologic change. So in fact, it is setting a very big, abacious goal and figuring out how do we get every level of our communities and our governments and our individuals to really support this change. So then the Grand Challenge is focused on saying if we could raise the health of nurses, we can change the health of the nation. What we know is that nurses are not as healthy as the average public.

We have higher BMI, we're not even the right numbers of roots and vegetables, we're not getting enough sleep. We often talk about not having the same safety factors at work. So as we've looked at the factors affecting nurses, we know that nurses can be healthier. We believe that's an important commitment for us to every nurse in the country.

So we developed the Healthy Nurse Healthy Nation with five domains in mind, activity, rest, nutrition, safety and quality of life. And so we have over 350 partner organizations. We have had thousands of nurses take our health risk appraisal. We have many, many groups that have plugged in and said yes, we want to help our nurses get more healthy.

And we have thousands of nurses that are individually signing up for challenges and being able to look at how can they take on their eating habits or again better sleep, better activity levels, making sure that they are addressing any kind of concerns with fatigue or those kinds of issues. So we embrace almost any activity that will help us really improve health. We also have some great partners. So Decto has stepped up with a stage in striker, again, really focused on safety in other groups that really care about nurses in this country.

So we are encouraging all kinds of behaviors that will influence health and influence the ability of nurses to be at their best. Because we know when nurses are healthy, they can take better care of patients. They're better role models and they can better influence other individuals to be interested in their health and make good choices and decisions. So this is a project that will be long term, not just a one and done.

So we're actually into our second year and we're beginning to be able to record out results. Over time, we hope to be able to demonstrate that we've actually seen some major movement in some of these big metrics for large portions of the nursing workforce. It's about one in every 105 people as a nurse and our nurses in this country. So we know we touch so many family members, friends, community members, our neighbors and other people.

So our goal is, while it's lofty, we think it's important to make sure that we're doing everything we can to help people be more healthy. That's wonderful. I think that you've really given us a lot of great insights on a lot of very important topics here this evening. And I keep thinking to myself that the four million nurses being the most trusted, most influential and most healthy individuals, that would be really a big deal if we could really accomplish those kinds of objectives.

I want to make sure that before we end our show that I also recognize the fact that you've just done a phenomenal job helping to lead the nursing American nursing association. And I believe your term is coming to an end soon. And I wanted to be sure that I got to say out loud to everybody that's listening, that your dedication has certainly been amazing. And we would never have made a lot of improvements we have made in nursing if you have not been at the helm.

So I really appreciate all you've done. So thank you so much for all of that. You are listening to all about nursing live from the BBM Global Network and TuneIn Radio. I'm Dr.

Joyce Batchler, host of the show. And bye for now.