This morning, nurses from all over the country gathered for a protest in front of the White House to bring about awareness of the ongoing hazardous conditions nurses are being subjected to due to shortage of personal protective equipment (PPE). The also honored fallen nurses that have passed after contracting COVID-19 while working.
WHO| News Release| Geneva [original release here]
The Covid-19 pandemic underscores the urgent need to strengthen the global health workforce. A new report, The State of the World’s Nursing 2020, provides an in-depth look at the largest component of the health workforce. Findings identify important gaps in the nursing workforce and priority areas for investment in nursing education, jobs, and leadership to strengthen nursing around the world and improve health for all. Nurses account for more than half of all the world’s health workers, providing vital services throughout the health system. Historically, as well as today, nurses are at the forefront of fighting epidemics and pandemics that threaten health across the globe. Around the world they are demonstrating their compassion, bravery and courage as they respond to the COVID-19 pandemic: never before has their value been more clearly demonstrated.
‘Nurses are the backbone of any health system. Today, many nurses find themselves on the frontline in the battle against Covid-19,’ said Dr. Tedros Adhanom Ghebreyesus, WHO Director General. ‘This report is a stark reminder of the unique role they play, and a wakeup call to ensure they get the support they need to keep the world healthy.’
The report, by the World Health Organization (WHO) in partnership with the International Council of Nurses (ICN) and Nursing Now, reveals that today, there are just under 28 million nurses worldwide. Between 2013 and 2018, nursing numbers increased by 4.7 million. But this still leaves a global shortfall of 5.9 million – with the greatest gaps found in countries in Africa, South East Asia and the WHO Eastern Mediterranean region as well as some parts of Latin America.
Revealingly, more than 80 per cent of the world’s nurses work in countries that are home to half of the world’s population. And one in every eight nurses practices in a country other than the one where they were born or trained. Ageing also threatens the nursing workforce: one out of six of the world’s nurses are expected to retire in the next 10 years.
To avert the global shortage, the report estimates that countries experiencing shortages need to increase the total number of nurse graduates by on average 8% per year, along with improved ability to be employed and retained in the health system. This would cost roughly USD 10 per capita (population) per year.
“Politicians understand the cost of educating and maintaining a professional nursing workforce, but only now are many of them recognizing their true value,” said ICN President Annette Kennedy. “Every penny invested in nursing raises the wellbeing of people and families in tangible ways that are clear for everyone to see. This report highlights the nursing contribution and confirms that investment in the nursing profession is a benefit to society, not a cost. The world needs millions more nurses, and we are calling on governments to do the right thing, invest in this wonderful profession and watch their populations benefit from the amazing work that only nurses can do.”
About 90 per cent of all nurses are female, yet few nurses are found in senior health leadership positions– the bulk of those positions are held by men. But when countries enable nurses to take a leadership role, for example by having a government chief nursing officer (or equivalent), and nursing leadership programmes, conditions for nurses improve.
“This report places much-needed data and evidence behind calls to strengthen nursing leadership, advance nursing practice, and educate the nursing workforce for the future,” said Lord Nigel Crisp, Co-Chair of Nursing Now. “The policy options reflect actions we believe all countries can take over the next ten years to ensure there are enough nurses in all countries, and that nurses use of the full extent of their education, training, and professional scope to enhance primary health care delivery and respond to health emergencies such as COVID-19. This must start with broad and intersectoral dialogue which positions the nursing evidence in the context of a country’s health system, health workforce, and health priorities.”
To equip the world with the nursing workforce it needs, WHO and its partners recommend that all countries:
- increase funding to educate and employ more nurses;
- strengthen capacity to collect, analyze and act on data about the health workforce;
- monitor nurse mobility and migration and manage it responsibly and ethically;
- educate and train nurses in the scientific, technological and sociological skills they need to drive progress in primary health care;
- establish leadership positions including a government chief nurse and support leadership development among young nurses;
- ensure that nurses in primary health care teams work to their full potential, for example in preventing and managing noncommunicable diseases;
- improve working conditions including through safe staffing levels, fair salaries, and respecting rights to occupational health and safety;
- implement gender-sensitive nursing workforce policies;
- modernize professional nursing regulation by harmonizing education and practice standards and using systems that can recognize and process nurses’ credentials globally; and
- strengthen the role of nurses in care teams by bringing different sectors (health, education, immigration, finance and labour) together with nursing stakeholders for policy dialogue and workforce planning.
The report’s message is clear: governments need to invest in a massive acceleration of nursing education, creation of nursing jobs, and leadership. Without nurses, midwives, and other health workers, countries cannot win the battle against outbreaks, or achieve universal health coverage and the Sustainable Development Goals.
In light of this gruesome pandemic, we have chosen to advocate for nurses, doctors and other healthcare workers who have died on the frontline. Our founder is currently serving in a high impact area and most of our ambassadors are working in critical areas alongside hundreds of thousands of other healthcare workers. Countless nurses on the front lines have been infected and several have died in service due to the lack of PPE, below standard working conditions and impossible patient surges. With such conditions, a resounding fear amongst providers has been their own mortality and the financial impact it may have on their families- amid other concerns. This fear has kept some away from the frontline and is definitely a large stressor to those who are working tirelessly.
We charge the federal government with negligence evidenced by the lack emergency stockpile of protective gear and overall unpreparedness for pandemic- despite governmental and private sector warnings. Please read our petition below and click here to sign.
As the COVD -19 pandemic persists- nurses, doctors and other healthcare workers (HCWs) are being infected on the front line and several have already died from complications of the virus. Experts believe that health care workers are at a greater risk for serious illness despite age. Yet hundreds of thousands of professionals continue to report to their shifts amidst severe shortages of personal protective equipment (PPE), ever-changing protocols and the lack of other critical equipment (beds, ventilators, testing kits etc.) necessary to do their jobs – placing their lives directly on the line.  Many are doing so without a clear understanding of the insurance benefits that may or may not be made available to their families should they succumb to the virus.
In a climate of so much uncertainty, nurses, doctors and other HCWs should not have to endure the additional stress of worrying if their families will be taken care of financially should they pass.
What We’re Asking
This petition is a call to action to the federal government to create a death-in-service pandemic fund to be paid out to the families of fallen providers. Said funds would provide compensation to victims’ families when COVID-19 infections lead to death or serious injury and cover but not be limited to: economic loss, virus related medical debt, burial fees, crisis/hazard pay differentials and post-incident response for injured victims- regardless of underlying conditions. Such fund would also set precedent for future crisis.
A federal death-in-service fund would determine specifics around victim compensation packages and explicitly name “death gratuity”-a lump sum, non-taxable gratuitous payment or collective benefit for healthcare providers. This fund would supersede, but fill gaps where state workers’ compensation, employers’ benefits, pension plans and other guarantees fall short. Nurse, doctors and HCWs would qualify by having worked full-time on the frontline areas with evidence of origin of exposure.
A Victim Compensation Fund for Nurses, Healthcare Workers
Although a pandemic death-in-service fund for nurses and other HCWs is unprecedented, the federal government has created funds for servicemen and civilians of the 9/11 terrorist attacks & Oklahoma City bombings- allocating billions of dollars to the families ofÂ servicemen killed on duty. In addition, the US Military provides a death gratuity made to eligible beneficiaries of members who die on duty along with various other entitlements and benefits. For those whose death is as a result of hostile actions or performing a hazardous duty, the payment is $100,000, in addition to any life insurance plans or policies. These funds are also often released immediately to aid survivors in their readjustment and to help address immediate expenses incurred. HCWs on the front line deserve the same parity during this pandemic.
If We Don’t Act
Failing to provide nurses, doctors and other HCWs death-in-service benefits could possibly lead to lack of participation on the front line during the most critical peaks of the pandemic. The UK is currently facing concerns that the loss of death-in-service benefits has made some HCWs less willing to work in high risk areas and is creating untimely tension with the National Health Service, a large publicly funded healthcare system in England. Deaths amongst US HCWs continue to trickle in; however, countries abroad have reported staggering numbers of infected and deceased. To date, more than 3,300 healthcare workers have been infected in China and 46 doctors have died, with an unreported number of nurses and other HCWs. At least 6,420 health care workers in Italy have contracted the virus as of March 27th 2020, which has resulted in the death of some 50 doctors and an unreported number of nurses and other HCWs.  Aftermath liability claims could potentially clog court systems and create further economic harm and mistrust amongst governments and insurance companies, much like in 9/11. In addition claims would be arguably larger due to the prolonged suffering for families of the fallen.
Nurses, doctors & HCWs are our strongest asset and we must provide them reassurance during this time. Give our nurses, doctors and HCWs peace of mind. Please support this petition to help urge our federal government to develop compensatory measures for the families of our fallen healthcare heroes.
What You Can Do- Sign Now!
Please act now and sign the petition here: https://www.change.org/p/donald-j-trump-death-in-service-compensation-for-us-nurses-doctors-healthcare-workers
From the time I began my nursing career, I knew that I would work in Geriatrics. When expressing this to many of my friends, colleagues and even professors I received the astounding response “Why?”. Many nurses I meet have a goal of working in Pediatrics or OB so that they can be a part of the innocence and beauty associated with childhood, but many view geriatrics as the unglamorous world of bedpans and adult briefs! When I am tasked with answering the questioning of my field choice I immediately begin expressing how I possess a deeply rooted passion for the geriatric population that sometimes can’t be explained by words
As a child, I was raised by my Great Grandmother. The generational gap between us presented many problems and I probably wasn’t participating in some of the same after school and weekend activities as my peers. My great grandmother is a true saint spent most of her time visiting nursing homes to volunteer and visit her family members and friends that were in facilities. During this time I had the opportunity to volunteer as well. Although I was a small child, I connected with the residents in the homes we visited and they took to me and enjoyed my weekly visits. I can truly say that this experience led me to where I am now. As my great grandmother grew older I eventually had to move with my mom and I then found myself visiting my grandmother to take care of her. Just as she had dedicated her life to helping others I found that I became passionate about caring for her. Up until her recent death I vowed to make her golden years her best years.
Today I am proud to say that I have dedicated most of my nursing career to geriatrics. Right out of high school I became a Certified Nursing Assistant and worked in a nursing home as well as a Geriatric Psychiatry Unit. After graduating from nursing school my professors advised me to spend at least one year in the Emergency Department so that I can gain skills to prepare me for my Geriatric career. I literally completed one year and then began working in the Home Health setting where my clients were all 65 and older. I enjoyed educating seniors about chronic conditions and each visit felt like a visit to Grandmas! Recently, I completed my Masters and became an Adult-Gerontology Nurse Practitioner (NP). I currently work in a long term care facility in the specialty of Geriatric Psychiatry. I provide medication management of psychotropic drugs to the residents there. I also educate the staff in the facility on non-pharmacological methods for handling conditions such as dementia. I work tirelessly to ensure that the facility is in compliance with current Medicare Guidelines and prepare them for visits with state agencies. Not a moment goes by that I don’t feel like I am walking in my purpose!
Geriatrics is a field that often is forgotten and I must say I do not see how! I find my job to be very rewarding and I often feel connected to the patients I serve. The benefits of working with this population are vast. There is a true need for those passionate about working with this very vulnerable population. There is always an opportunity to teach these patients, but what is most rewarding is that they often teach you! I find that my patients are at a place in there lives where they may require assistance with care, but their wisdom simply amazes me.
The American Association of Nurse Practitioners reports that, “there are more than 270,000 nurse practitioners (NPs) licensed in the U.S., however, only 1.8% of those providers are certified in Geriatrics (2018 AANP National Nurse Practitioner Sample Survey).
These figures are very alarming considering that, “one in 5 Americans will be eligible for Medicare by 2030, with people 65 and older expected to account for almost 20 percent of the nation’s population by then” (Magaly Olivero, 2015). Equipped with this information, I feel that there is a need to access the reasons that providers do not choose Geriatrics. Wether it is related to a lack of knowledge about the field that is not being addressed in nursing programs or a fear of the field that also needs to be addressed through clinical rotations or patient experience opportunities, we as providers owe it to these individuals to address the need.
As with any field, you have to find the area that most interests you, but I encourage anyone that finds geriatrics the least bit interesting to investigate a career in the field! If you are looking for something that is challenging and structured this is a great fit. The field is mostly preventative and if you are like me and love the aspect of preventing health conditions you will find yourself constantly educating, patients, staff and family members and working to connect your patients with the many resources available to them. Another bonus is that you can work in a variety of settings including hospitals, home health, long term care facilities, assisted living, nonprofit organizations and so on. There is currently a huge demand for geriatric providers and I can guarantee that working in the field will not only be a career reward but also a personal one that will inspire the values of humility and advocacy.
Breonna Leon is a Geriatric Nurse Practitioner in the Atlanta Area who currently serves as a consultant for long term care facilities in the specialty of Geriatric Psychiatry. She holds a M.S. in Adult-Gerontology Primary Care from George Washington University. Breonnabelieves in providing care that is both patient focused and in accordance with the most recent evidence based practice. She works tirelessly to ensure that this vulnerable population is cared for in ways that are holistic in nature. You can find Breonna on Instagram and reach her via email