Dear Nurse Leaders,
May is our annual edition of JONA focused on research in administration and leadership. Recently I had the privilege of hosting our annual Editorial Board meeting for JONA. The participants on our Editorial Board represent many years of leadership expertise from all sectors of healthcare and many years of working with JONA authors. I asked the Board to expand on areas they feel would be opportunities for research in the current and coming years. Here are a few of the thoughts in case you are exploring ideas for research with your team or working towards an advanced degree and want an idea of a topic that is an emerging issue.
In the area of workforce, the Board felt we had many challenges. For one, it is obvious we are facing waves of retirements of both experienced clinical providers and experienced leaders. The Baby Boomers are in the midst of their retirement plans as predicted and the pandemic has influenced some to advance their timeframes. How can nursing leaders and organizations assure smooth transitions for these key roles and what models including mentorship and residency programs will be effective at all levels? The data are well substantiated that residency models are effective for new graduates. What about applying the models to other levels including leaders? Are non-acute care agencies including home care open to residency models and the incorporation of new graduates into their ranks?
Another area of workforce discussed was the effect of the large numbers of nurses who left jobs to travel. How are organizations handling the enculturation of these temporary staff and what interventions were put in place to assure safety? When the nurses seek permanent employment, how is the nursing culture of an organization affected? Are there implications for wages and benefits that must be addressed?
Why did these nurses leave to travel in the first place? Was it just salary incentives or were there other factors that caused this movement?
The pandemic disrupted clinical placements for many students, both nursing and non-nursing. In the nursing workforce, how will the changes in models of education moving to more on-line as well as expedited clinical experiences affect new graduate transitions and onboarding, the competence of the new graduates, the orientation of these new graduates and the NCLEX rates? What interventions are employers putting in place to negate the negative effects and capitalize on the opportunities to ensure these new graduates are well prepared and looked at as valuable peers to others? Many schools or organizations did not allow nursing students to participate in the care of COVID patients for both infection control and liability concerns. Will these new graduate nurses be prepared if there is another surge without these valuable experiences and what was the effect of these limitations on the pipeline of new graduates to units and specialties such as critical care, with less student rotations?
Studying the effects of burnout and PTSD from clinical staff and leaders who were heavily involved in the pandemic will need to be ongoing. As with other traumatic events, the experiences that these nurses wittnessed and the ethical dilemmas they were confronted with need to be discussed and addressed. In addition, systems and processes such as nurse to patient ratios were modified. Acuities increased in almost every area of practice. What are the appropriate ratios we should put in place and what are the measures we should recommend to evaluate our most valuable resources, our clincal staff?
Based on emerging clinical needs, various waivers were passed including changes to the scope of practice in many states for APRNs and approval of reimbursement for models of telehealth. What was the effects of these changes and what changes should nursing lobby to preserve? As the economy evolves, monitoring the effects of new programs and modifications of reimbursement models on nursing care must be reported. Modifications introduce the opportunity for research of new ways of delivering cost effective care that must be evaluated.
Two further emerging issues were discussed. First, what will nursing do to address issues related to racism and disparities? JONA has recently published articles describing projects focused on leadership and mentorship models for diverse populations. There are many opportunities to further research workforce disparities as well as ways to care for vulnerable and under-represented populations. Finally the effect of virtual education on both students and patients must be considered. Evaluating new models of patient education incorporating technology is needed as well as evaluation of the cost of these interventions.
As you can see, we have much work to do in the future to keep nursing relevant as a leader in these areas. The pandemic created challenges but also opportunities. As with the articles in this edition, creating structures to support nurse-led research is an imperative. JONA is open to reviewing manuscripts supporting these topics and more as we use publication as one of the most effective vehicles to disseminate our work internationally.
Please email me if you have a question or potential topic of interest to our readers at [email protected] Our Guidelines for Authors are available on our website.
Melora Ferren, MSN, RN-BC, the Social Media Coordinator for JONA, continues to post weekly on Twitter highlighting a topic from the journal. The Twitter address for JONA is #JONANurseLeader.