Nurses Leading Change and the Future of Nursing 2020–2030: Strengthening Nursing Education

As we conclude 2024 and look forward with anticipation to the new year, it is time to reflect on the past year and make resolutions, with optimism, for what we hope to accomplish in 2025. The practice of making New Year’s resolutions has been a tradition for thousands of years, yet we are told that only 9 percent of Americans who make resolutions achieve them. Research shows that 23 percent of people will quit their resolution by the end of the first week, and 43 percent will stop by the end of January (Norcross & Vangarelli, 1988). What is the difference between those who commit to and achieve their resolutions and those who do not? Psychologists have noted several reasons for our failure to keep our New Year’s resolutions. One significant reason is an understanding of why we want to change. Clinical psychologist Terry Bly says, “The pain of not changing must be greater than the pain of changing for us to really…change” (Vinney, 2024). Those who commit to change have determined that change is necessary and more important than not making the change. This past fall, I reread the 2011 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health and its recommendations for advancing the profession. This report explores how our roles, responsibilities, and education must change to advance improvements in the nation’s complex health care system. I thought about the established resolutions and goals and realized that many could have been achieved had nurses across the nation acted collaboratively and spoken with one voice. Did we miss an opportunity for transformational change? Nearly 25 years later, we are now halfway through a second report with broad expectations for the profession. The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity was published by the National Academies of Sciences, Engineering, and Medicine nearly five years ago with ambitious recommendations. It reflects the most recent call to action for the profession and is built upon the fundamental recommendations from the original report. A critical component of the second report emphasizes the importance of nursing in improving health care outcomes and contributing to equitable public health and health care systems. Specifically, the report acknowledges that educators are critical to changing health care outcomes nationwide and globally through strengthening nursing education and preparing graduates to link the complex social, economic, and environmental factors that influence health and well-being while addressing strategies to mitigate them effectively. The value of providing nursing students with substantive, diverse, and sustained community-based experiences, categorically reviewing and revising curricula to accentuate health care systems’ critical issues, and intentionally examining our hiring and admission practices to realize a diverse faculty and student population is emphasized. There are many references to education in the report, but three conclusions stand out for specifically addressing how health equity in health care systems can be achieved. Conclusion 7-1: A curriculum embedded in coursework and experiential learning that effectively prepares students to promote health equity, reduce health disparities, and improve the population’s health and well-being will build the nursing workforce’s capacity. Conclusion 7-3: Learning experiences that develop nursing students’ understanding of health equity, social determinants of health, and population health and prepare them to incorporate that understanding into their professional practice include opportunities to learn cultural humility and recognize one’s own implicit biases; gain experience with interprofessional collaboration and multisector partnerships to enable them to address social needs comprehensively and drive structural improvements; develop such technical competencies as use of telehealth, digital health tools, and data analytics; and gain substantive experience with delivering care in diverse community settings, such as public health departments, schools, libraries, workplaces, and neighborhood clinics. Conclusion 7-4: Successfully diversifying the nursing workforce will depend on holistic efforts to support and mentor/sponsor students and faculty from a wide range of backgrounds, including cultivating an inclusive environment; providing economic, social, professional, and academic support; ensuring access to information on school quality; and minimizing inequities. Building a nursing workforce competent in caring for diverse populations, equipped with advanced knowledge related to equity, social determinants of health, interprofessional collaboration, and use of technology and data analytics, is essential to improving health care outcomes. Holistic approaches to admissions, student retention, and student well-being are key to these initiatives. This is our opportunity to make a difference and use the tools that the National League for Nursing (NLN) has developed to make these recommendations achievable. The 2019 NLN Vision Statement, “A Vision for Integrating the Social Determinants of Health Into Nursing Education Curricula,” provides a structure for educators to provide evidence-based approaches to teaching/learning strategies related to social determinants (NLN, 2019). The 2022 Vision Statement, “Climate Change and Health,” underscores the realization that health consequences of climate change are among the most urgent public health and health equity crises of the 21st century and that climate change is not experienced equally across all communities (NLN, 2022). With the understanding that climate change is another social determinant of health, this NLN Vision Statement provides a framework for educators to bridge the gap in knowledge about climate change and how it can be taught to current and future nurses. The NLN’s most recent Vision Statement (NLN, 2023) is “Integrating Competency-Based Education in the Nursing Curriculum.” Its complementary toolkit (NLN, 2024) was just published in September. Together they provide additional support to educators in the realm of minimizing inequities in nursing programs through teaching/learning strategies and thorough implementation of competency-based education. Additionally, this toolkit provides much-needed support for educators to help bridge the gap between education and the complexity of our health care systems. The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity asserts that our nation will fully thrive only when all people can live their healthiest possible lives. Just as policymakers must look for ways to support, strengthen, and transform nursing as the largest segment of the health care workforce, educators can and must contribute to the effort to reimagine nursing education curricula, clinical experiences, and our understanding of population health. Colleagues, will we collectively resolve to make the changes necessary in our practice to mitigate the gaps in our coursework and experiential learning to promote positive health care outcomes across the continuum? Will we bridge gaps in our knowledge of teaching/learning strategies to encourage professional diversity and thus health equity? Will we resolve to support inclusion efforts that cultivate success in all students? Experts tell us that the new year is a good time for creating a timeline for establishing small milestones that will help us achieve our larger goals over time (Vinney, 2024). Colleagues, will we collectively resolve to make the changes necessary in our practice to mitigate the gaps in our coursework and experiential learning to promote positive health care outcomes across the continuum? As nurse educators, we must resolve to move the recommendations of the Future of Nursing 2020–2030 report forward and make a substantial difference in the health of this nation and across the globe. We are well positioned to support a new paradigm where all people can live their healthiest possible lives. It takes resolve to embrace and commit to realizing the outcomes that the National Academies of Sciences, Engineering, and Medicine believe we can achieve!