Two years ago, when I assumed the role of chair of the National League for Nursing (NLN), it was the beginning of the postpandemic era. We were emerging from the crisis of the pandemic, vaccines were now readily available, and nurses were being recognized for their invaluable contributions to the health of our global society. We were hopeful. Despite the unthinkable, unanticipated tragedies that had occurred, we were ready for our "new normal" and anxious to regain some predictability in our lives.
The pandemic opened doors to the harsh realities surrounding the failings of our health care system. The inequities that existed in care delivery and access could no longer be ignored and demanded immediate action to address longstanding issues interwoven into the fabric of our society. We also recognized the critical importance of nurse well-being, which forced us to look inward on our own systems and rethink respect, recognition, valuing, and workload expectations for nurses. Our failure to recognize and address these issues earlier continues to threaten overall health outcomes and contributes to one of the most significant nursing shortages in our history.
However, we are nurses, we are resilient, and we were passionate about moving forward. We rolled up our sleeves, and together we worked to enact system changes to support nurse well-being and tackle health care inequities. We revised our educational policies and practices, including expansion of holistic admissions; enhanced recruitment of diverse faculty; and implemented support systems to increase success and retention. Workload policies continue to be examined, along with improved compensation, access to wellness resources, and destigmatizing mental health care to support the needs of our own profession and students. We are prioritizing the creation of diverse, equitable, inclusive, and just environments, examining our own implicit biases and taking action to dismantle organizational processes that work to sustain systemic and social racism. Although we are in the early stages of our journey, we have a shared vision that illuminates our path toward a shared destination.
Alongside the tremendous strides we are making, I am troubled by the growing challenges we face that threaten our health and well-being in ways I had not experienced or imagined. I am talking about environmental equity, issues with immigration and health, and fear of international unrest and outbreaks of war. I see threats to the very core of our democracy: growing concerns with racism, antisemitism, reproductive health, threats to the LBGTQ+ community, and the suppression of education, questioning what we can and cannot teach as part of our health care programs. Threats to cut federal funding to programs that include forbidden topics jeopardize the very core of our freedom to conduct programs of research in similar areas of scholarship. Although these issues are broadly viewed as political, nurses must examine the implications of these actions through the lens of equitable health care.
Health care delivery is compromised by social determinants of health that significantly limit access to care for those identified as medically underserved and marginalized populations. The nursing workforce represents the largest population of health care professionals, over 3 million strong, and we have a long history of providing care for all populations across a broad range of environments. The Code of Ethics for Nurses With Interpretive Statements (American Nurses Association, 2015) states: "The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person" (p. 1). The interpretative statements reinforce the belief that health care is a universal right that transcends individual differences and political beliefs where all individuals are treated with respect and dignity (p. 1). Nurses have the greatest potential to reduce actions that promote disparate access to quality health care, while promoting respect and dignity for those persons impacted by environmental inequities and social racism.
To address gaps in access to care, the future nursing workforce will require greater diversity and specialized education and preparation to help improve health outcomes for marginalized and underserved populations. As outlined in the Future of Nursing 2020-2030 report, strengthening the nursing workforce is a key initiative to enhance nursing's role in advancing equitable health care and promoting environmental justice (National Academies of Sciences, Engineering, and Medicine, 2021). We need to move beyond providing care for specialized populations to educate ourselves and our students on strategies to achieve justice by eradicating the root causes of social racism and inequitable access and serve as allies and advocates.
By strengthening and building a nursing workforce prepared with the competencies required to care for the populations we serve, nurse educators and leaders are essential to enhancing nursing's role in reducing health care inequities and improving access to quality health care. Achieving this goal will require a combined effort and a sustained commitment to action and advocacy, interdisciplinary health care collaboration, and shared educational opportunities to meet the diverse needs of our nation and global society.
By strengthening and building a nursing workforce prepared with the competencies required to care for the populations we serve, nurse educators and leaders are essential to enhancing nursing's role in reducing health care inequities and improving access to quality health care. Achieving this goal will require a combined effort and a sustained commitment to action and advocacy, interdisciplinary health care collaboration, and shared educational opportunities to meet the diverse needs of our nation and global society.
Lessons I have learned throughout my career and my time as NLN chair, continuously reinforced by the dedicated efforts of the NLN, include the importance of nurses everywhere to serve as leaders in health care. Strong leaders recognize the importance and value of relationships, and individuals can make strides in achieving good outcomes. Moreover, by working together, organizations can achieve great outcomes and initiate movements that alter the course of history.
A second lesson learned is the importance of authenticity. A key to being an effective leader is for others to view you as trusting, caring, and sincere. Lead with transparency, develop a shared vision, communicate clearly, listen with an open mind, and hear the voices of those you lead and serve. Value the power of mentorship - as mentor and mentee. A great leader recognizes the value of a strong mentor and prioritizes the advancement of others while working to promote the greater good of the organization. Be true to yourself, know your values, and lead with integrity and conviction.
Finally, there is the lesson of the power of networking. The NLN, guided by the core values of caring, integrity, diversity and inclusion, and excellence and dedicated to our mission to "promote excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community," is your door to network with a vast, diverse group of professionals. Seek out opportunities to become involved and take an active role in advancing our profession.
It has been an honor and a privilege to serve as your chair over the past two years. I am pleased to hand over the leadership to my successor, Dr. Patricia Sharpnack, who is an endeared colleague, outstanding leader, mentor, and visionary.
As I write my final note as the chair, I would like to leave you with some inspirational words I read from someone I greatly respect, Suzanne Miyamoto, PhD, RN, FAAN, chief executive officer of the American Academy of Nursing: "A nurse's voice does not need to be the loudest or most dominant in a room. We must be more concerned with the way our voice resonates - with intelligence, integrity, grace, and passion. As advocates for health equity, a nurse's voice speaks for more than the individual, it speaks for those who depend on our message to enact change, and that is a power we must be emboldened to use" (Hassmiller & Daniel, 2023).
Together we are the future of nursing - we are the agents of change - and we will continue to promote environmental justice; dismantle systemic racism; create a diverse, equitable, and inclusive workforce; and continuously strive to advance the health of our nation and global community. Thank you for allowing me to serve as your chair of the NLN.
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