The year 2021seemed to pass in the blink of an eye. Now that 2022 has arrived and efforts at recovery proceed, the need to rebuild a diverse, qualified, and appropriate general workforce is evident to most employers. Although the unemployment rate is at a historical low, there are still large gaps in all work sectors, including healthcare. The COVID-19 pandemic further exposed a broken US healthcare system, highlighting deficiencies and the effects of structural racism on healthcare access, delivery, and outcomes. But what does this new surge in employment opportunities mean for nursing, the largest segment of the healthcare workforce? Data from the US Bureau of Labor Statistics' Occupational Outlook Handbook-representing only the advanced practice registered nurse (APRN) roles of nurse anesthetist, nurse midwife, and NP-places APRNs as one of the top 20 occupations with the highest projected percent change in employment between 2020 and 2030 with a growth rate of 52.2%, much faster than the average rate of 8% for all occupations. APRNs are also the only healthcare professional listed in the top 10.

The report projects annual job openings of 29,400 APRNs on average over the decade to 2030. Many of these positions will be replacements for workers who leave the profession through transfer to a different occupation or exit from the workforce, such as retirements.1

Full-practice authority

Consider that fewer than 50% of states and the District of Columbia have full-practice authority for NPs. Continuing restrictive legislative and regulatory rules in many states prevent APRNs from universal full-practice authority. The anticipated 34^thAnnual APRN Legislative Update, meticulously produced by Dr. Susanne J. Phillips, DNP, APRN, FNP-BC, FAANP, FAAN, is now available and offers a lot of information about the current APRN practice environment. Will more progress be made in 2022? When will the education and training for advanced practice be the determining factor in an NP's ability to practice autonomously after graduating from an accredited program and attaining national certification? Members of state NP associations work tirelessly not only to change practice in their individual states but also to impact restrictive laws in other states. Federal initiatives by national organizations also address critical issues related to education, licensure, access to care, patient safety, healthcare reform and new models of care, reimbursement, and other concerns.

The 4 P's

I recount thoughts I voiced in my January 2006 editorial, which was titled Purpose, position, passion, and perseverance.2 Purpose: NPs seek to increase access to care; provide high-quality care; and improve health outcomes for individuals, families, communities, and populations. Position: NPs are educated and trained to practice autonomously within a collaborative environment without the burden of unnecessary barriers to practice. Passion: NPs are caring and committed to their role as healthcare providers. Perseverance: NPs never give up; the vision of full-practice authority for every NP motivates them to continue to fight for what should be a human right-equitable access to quality healthcare. Reverend Dr. Martin Luther King, Jr., is noted with saying, "Of all the forms of inequality, injustice in health is the most shocking and inhuman."

Moving forward

One strategy for creating an effective healthcare workforce is to place the right health workers in the right places and to expand the roles of health workers to meet patient needs. Governors' executive orders temporarily removed some barriers to NP practice, but permanent changes provide one solution to workforce needs. The only change in NP practice has been a stronger commitment to meet the needs of patients.

Jamesetta A. Newland, PhD, FNP-BC, FAANP, DPNAP, FAAN

Figure. No caption available.

EDITOR-IN-CHIEF [email protected]

REFERENCES