The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity focuses on achieving health equity in the United States through nursing expertise. Two recommendations from the report that specifically impact education departments are as follows:
Recommendation 3: By 2021, nursing education programs, employers, nursing leaders, licensing boards and nursing organizations should initiate the implementation of structures, systems, and evidence-based interventions to promote nurses' health and well-being, especially as they take on new roles to advance health equity. (National Academies of Sciences, Engineering, and Medicine, 2021, p. 13)
Recommendation 7: Nursing education programs including continuing education, and accreditors and the National Council of State Boards of Nursing should ensure that nurses are prepared to address social determinants of health and achieve health equity. (National Academies of Sciences, Engineering, and Medicine, 2021, pp. 13-14)
Recommendation 3 is timely, considering that research has shown that nurses are comparatively less healthy than the rest of the population (American Nurses Association, 2022). This finding seems egregious, seeing that nurses spend their careers working to improve the health of their patients. Recommendation 7 is not surprising, considering the holistic nature of nursing. However, as health care and the world have become more complex, it has become more challenging to understand the factors that impact the everyday life of our patients. The circumstances that led to these recommendations are issues that education departments must navigate to help learners understand the importance of meeting The Future of Nursing 2020-2030's charges.
Sue Johnson thoroughly summarized the Future of Nursing report's implications for nursing professional development (NPD) practitioners in the 2022 article, Nursing Professional Development and the Future of Nursing 2020-2030: A Winning Combination. Johnson notes that NPD practitioners establish safe learning environments that support well-being, and through their advocacy and their role as learning facilitators, they help to promote health equity. There is further opportunity for NPD practitioners to bolster The Future of Nursing 2020-2030's agenda through the professional development of preceptors.
With the mass exodus of the baby boomer workforce, they take their vast knowledge and skill set with them. Therefore, the future of nursing rests in the hands of new graduate registered nurses (RNs). New RNs must be further developed through continuing education to meet the recommendations outlined in The Future of Nursing 2020-2030 report. Preceptors are integral in setting the foundation for the new RN's career. Performing within the seven preceptor roles of leader/influencer, facilitator, evaluator, protector, teacher/coach, role model, and socialization agent (Ulrich, 2019), preceptors can help new RNs practice in ways that work toward achieving health equity while maintaining their well-being.
Hence, NPD practitioners need to consider how to leverage and prepare preceptors to develop new RNs who understand the needs associated with social determinants of health and diversity, equity, and inclusion (DEI). NPD practitioners can support preceptors in this endeavor by creating preceptor development courses and resources that provide preceptors with information regarding DEI, wellness, and evidence-based practice strategies for integrating these topics into the new RN's clinical orientation. This additional preparation may be challenging for education departments that lack the resources to deliver even fundamental preceptor education. Thus, NPD practitioners must be creative in integrating this material into their existing preceptor curriculum. Academic partnerships may be one approach to ensuring preceptors receive the content they need to understand healthcare disparities, methods for achieving health equity, DEI, and wellness. Another approach may be through mentorship programs for preceptors that focus on addressing health disparities and well-being with new RNs.
Preceptor development should examine the preceptor's biases toward other groups (Johnson, 2022). The NPD practitioner must establish a learning environment where preceptors will feel safe having difficult conversations regarding DEI. Preceptors should also understand how to establish trust and create a safe space, as new RNs need to feel comfortable discussing situations where they encounter health inequity and bias (Sumpter et al., 2022). In addition, the program must include actionable strategies that preceptors can employ when having DEI conversations in the new RN's orientation. These strategies may include centering conflict management scenarios around situations where another staff member is not practicing DEI. Preceptors can practice using appropriate language for addressing these situations in a professional way and nonconfrontationally. Another strategy is teaching preceptors to role model advocacy and inclusivity with patients, their families, and staff (Johnson, 2022).
The Future of Nursing 2020-2030 report calls for nursing to assume a health equity lens through academic preparation and continuing education (Virginia Nurses Today, 2022). Preceptor development courses can help preceptors recognize situations where healthcare disparities exist. The preceptor must understand how to facilitate turning these into learning opportunities by setting aside time to discuss possible interventions for addressing these disparities. These discussions should include how to care for diverse patients with competence and empathy (Hassmiller & Wakefield, 2022). However, because of the numerous disparities in health care, teaching preceptors to take a positive approach through methodology such as appreciative inquiry (AI) may be beneficial. Instead of an intense focus on what is broken, AI focuses on the "best of what is," "what might be," "what should be," and "what can be" (Hartsough, 2022, p. 144). The AI approach can foster engagement and help keep the new RN from feeling overwhelmed by what may feel like insurmountable issues.
Burnout is prevalent in the healthcare setting, especially for preceptors orienting new RNs in addition to their primary staff responsibilities. In addition, the complexities of the fast-paced learning environment also lend to stress and burnout for new RNs (National Academies of Sciences, Engineering, and Medicine, 2019). NPD practitioners must be cognizant of the factors that lend to stress for the preceptor and the preceptee and address them in preceptor development courses. Resources must be readily available to support preceptors and new RNs navigating the intense healthcare climate. NPD practitioners also need to teach preceptors to promote and prioritize well-being, which aligns with The Future of Nursing 2020-2030 report's Recommendation 3 (Hassmiller & Wakefield, 2022). The preceptor curriculum should include strategies for building resilience, addressing moral distress, and supporting and role modeling work-life balance. NPD practitioners should advocate against normalizing the "putting everyone else first" mentality that nursing professionals tend to embrace and encourage, eliminating the stigma surrounding mental health. A wellness mindset should be the basis of all preceptor development courses, with the intent for the preceptor to set an example of this mindset for new RNs.
The future of nursing lies with the new graduate nurses assuming their place within the nursing workforce. Achieving health equity will be their legacy as they employ the tenets of DEI learned in their academic preparation. However, healthcare equity is an ongoing pursuit that must be supported through continuing professional development. Preceptors are crucial to setting the stage for an inclusive healthcare environment. Just as Johnson (2022) called on NPD practitioners to use their seven roles to support The Future of Nursing 2020-2030, NPD practitioners must prepare preceptors to use their seven roles to align with the recommendations found within The Future of Nursing 2020-2030 report.
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