Policy, Politics, and Nursing Practice最新文献

Recruitment of internationally qualified nurses (IQN) may be an effective way to address acute nursing shortages in New Zealand (NZ). However, the difficulty in retaining IQNs long-term requires serious consideration. We employed a survey design to identify factors that influence IQNs to leave NZ. 1,782 IQNs who graduated from a Competency Assessment Programme over 11 years (2012 to 2023) were invited to participate in the online survey. Participants reported a wide range of factors to migrate including unsupportive workplace culture, lack of professional development opportunities, financial motivators, personal, and social factors including better quality of life. Nearly 50% of IQNs either had left or were planning on leaving NZ soon after obtaining their registration, with an average length of stay for all IQNs of just over 30 months, with nearly 100% of all IQNs leaving NZ within that time. This is the first study that provides policymakers with valuable insights of IQNs recruitment and retention including IQN reasons for migration. There is a need for policymakers and employers to urgently prioritize the development of local nurses instead of depending on IQNs who are difficult to retain long term. Furthermore, as current data indicates a surplus of IQNs in NZ it is crucial for potential IQNs to carefully consider the current oversupply before undertaking the costly, lengthy, and complex process of obtaining registration. Policymakers, employers, educators, and regulators need to work together to develop a robust nursing workforce plan to address the current surplus and include accurate forecasting of future workforce needs.

Effective health workforce analysis requires robust data and information. Quality data facilitate monitoring workforce trends, identifying shortages, forecasting employment needs, and planning educational programs. A wide range of federal agencies collect various forms of data, including administrative data, surveys, and censuses, which can be used for health workforce analysis. However, identifying the most appropriate data sources to address a specific nursing workforce issue can be challenging, particularly for newcomers to the field or those researching unfamiliar topics. In this article, we introduce and review 18 federal data sources pertinent to nursing workforce analysis. We categorize the datasets by their associated federal agency, describe each source, discuss their applicability to nursing workforce studies, present examples of past studies that employed these datasets, and highlight their limitations. Our aim is to help researchers, policymakers, and healthcare administrators efficiently locate and leverage relevant data for their analysis.

Finland is facing a severe shortage of nurses. While uncommon, the deportation of a foreign-born nurse could exacerbate this already critical situation. However, research on the deportation experiences of migrants, particularly healthcare workers such as nurses, remains scarce. This study aimed to provide a descriptive analysis of a deportation case involving a foreign-born intensive care nurse in Finland and examined the implications of this case for nursing education, the healthcare workforce, and government policies. Using a narrative case study approach, publicly available data from various sources, including mainstream and social media platforms, were analyzed. The nurse in this narrative left the country following disappointment with government officials, despite winning the deportation case. The findings of the study also revealed that the deportation decision faced by the foreign-born intensive care nurse has significant implications for nursing education, healthcare management, and government policies, indicating the need for necessary reforms. Intergovernmental collaboration is crucial to expedite the just and equitable processing of residence permits for highly skilled migrant health workers, promoting more effective government policies.

The global nursing workforce shortage poses significant challenges to healthcare delivery, necessitating new policy solutions. This article details a pioneering, nurse-led policy hackathon organized by the American Nurses Association-Ohio Public Policy Committee and Miami University to address the nursing workforce shortage. Held over 3 days, the event brought together 120 participants, including nurses, students, legislators, and healthcare leaders, to develop actionable policy solutions across four critical tracks: acute care, chronic care, public health, and nursing education. Teams utilized a structured framework to generate policy briefs and pitches, focusing on creative and collaborative approaches to root causes of the workforce shortage. Winning proposals included optimizing clinical documentation processes, addressing faculty shortages through state-level initiatives, expanding aging-in-place programs, and enhancing public health nursing recruitment and retention. The hackathon demonstrated the potential of collaborative innovation in crafting data-driven policies that align with healthcare needs. Outcomes from the event have already influenced policy discussions, highlighting the value of nurse-led initiatives in shaping healthcare policy and improving workforce sustainability.

This study provides baseline data for voting patterns and the political affiliation of licensed nurses (licensed practical nurses [LPNs], registered nurses [RNs], and advanced practice registered nurses [APRNs]) in Ohio for the November 2020, 2022, and 2023 general elections. Using two public databases (licensed nurses and registered voters), the findings for 73.7% of all licensed nurses registered to vote are reported, including 18,894 APRNs, 30,731 LPNs, and 137,353 RNs. Compared to the Ohio population eligible to vote, one in 32 persons of the voting-eligible population is a licensed nurse, and one in 51 registered voters in Ohio is an RN. The data show that 11% of the nurses never voted in any of the three general elections, and 47.7% voted in all three. LPNs had the lowest voting (34%) record, while about 48% of RNs and 52% of APRNs voted in all three. Like Ohio's public, nurses' party affiliation (Democrat, Republican, unaffiliated) varied, and most were unaffiliated with any party. Party affiliation was significantly associated with nurse licensure type (e.g., LPNs are less likely to be unaffiliated). Controlling for age and party affiliation, APRNs were more likely than LPNs to vote, and RNs were more likely than LPNs to vote in each election. Unaffiliated voters were less likely than Democrats to vote in all three elections. Across all elections, older voters were more likely to vote. These baseline findings on nurses' actual voting behavior provide the impetus for engaging nurses individually and collectively in voting and policies that increase voter participation of nurses and the public.

The Nurse Training Act (NTA) was passed by the United States Congress in 1964 in response to growing national concerns about a shortage of nurses. The legislation provided substantial funding for nursing education to increase the supply of nurses and improve the quality of nursing services. However, contemporary investigations into the causes of the shortage focused on the professional lives and experiences of white women, who were the main target of nurse recruitment and retention efforts. This research shifts the focus to Black women nurses, examining both the causes of the shortage and the impact of the NTA on the nursing workforce from their perspective. It argues that a key achievement of the NTA-alongside the Civil Rights Act of 1964-was the dismantling of legalized racial segregation in professional nursing schools, a major barrier to the development of the Black professional nursing class. Yet, this federal intervention was not simply bestowed; it was the result of decades of sustained advocacy by Black nurses from the 1890s to the 1960s to secure equal educational opportunity and federal support for their civil liberties. Viewing this landmark legislation through the eyes of Black nurses underscores the federal government's pivotal role in both promoting and obstructing racial and healthcare equality. As the nation faces yet another nursing shortage, coupled with the eradication of affirmative action and diversity, equity, and inclusion initiatives, this perspective is especially timely and important for informing current and future issues pertaining to health equity.

Since the 1960s, nurses have worked to improve access to health care services among underserved communities through the establishment of community-based nurse-led clinics (NLCs). Evidence demonstrates NLCs' effectiveness in delivering high quality and cost-effective primary care services to underserved communities. However, few studies have analyzed the role and meaning of community within NLCs. This article uses historical research to analyze and evaluate the roles played by communities in three community-based NLCs established between the 1960s and 1990s. This research shows that how nurses entered the communities they intended to provide care, the degree to which they collaborated with community members to conceptualize, operationalize, and maintain NLCs, and how they balanced community needs with academic imperatives are critical to understanding and addressing the difficulties NLCs have encountered delivering sustained, community-centered care. This research also addresses the impact on communities when NLCs fail, making clear the need for policy interventions that address the financial and political factors undermining NLCs' sustainability, particularly limitations on nurse practitioners' practice authority and credentialing as Medicaid providers, and reduced reimbursement rates for nurse practitioners. Ultimately, it argues that NLCs' engagement with underserved communities should be historically informed and integrate community expertise, robust community engagement, and community-centered definitions of quality care.

The nursing profession is currently grappling with an ongoing nursing shortage illuminated during the COVID-19 pandemic. While this burgeoning health and environmental crisis exacerbated this workforce issue, it did not create it. This study seeks to expand the idea of "who is a nurse" by arguing for the use of Licensed Practical Nurses (LPNs) as safe, credentialed persons in the nursing workforce. Archival research using primary and secondary sources highlights the history of the LPN movement. Historical case studies of LPN schools show how LPNs enhanced not only the quantity but also the quality of nursing practice. Case studies also reveal successful collaborations between nurses, communities, and hospitals to enhance the nursing workforce and community well-being. Aspects of this study were either approved by or deemed not human subjects research by institutional review boards. The increased emphasis on the registered nurse in the mid-20th century led to the marginalization of LPNs. Yet, history has revealed that collaborations that enhance diversity in the workforce and improve health-care access for patients, without compromising quality of care, can be formed by engaging LPNs. LPNs must be respected as consistent contributors to the country's health-care workforce. As the AACN commits to diversifying nursing, it is significant that LPNs have added to a more diverse, inclusive nursing labor force. For LPNs who wish to advance their nursing education, pathway programs must be supported-thus increasing diversity in the professional and advanced practice workforce.

This article presents a historical analysis of the Sentosa nurses, a group of nurses recruited from the Philippines in 2005 and 2006 to work in a health-care facility on Long Island, New York. The international nurse recruitment company that hired them underpaid them, assigned them to work in unsafe conditions with low nurse-to-patient ratios, and breached other parts of their contracts with the nurses. When the nurses decided to resign and break from their contracts early, the recruitment company retaliated, initiating civil, administrative, and criminal charges against the nurses. The Sentosa nurses' story reflects that by the end of the first decade of the 2000s, the international nurse recruitment industry grew not only in size, but also in power, leaving internationally-educated nurses vulnerable to exploitation. More recent reports from 2019 of the labor trafficking of internationally-educated nurses are not new. Instead, a historical perspective reveals an ongoing pattern of deceptive practices and informs recommendations for stricter policies that ban recruiters from using liquidated damages provisions or breach-of-contract fees to trap nurses in exploitative work environments.