The COVID-19 pandemic is changing the nursing profession. Pre-COVID problems will likely escalate, while others now have workable solutions. Before the pandemic, nursing organizations and employers braced for the widespread nursing retirement trend as the Baby Boomer population ages. By 2022, more than 500,000 nurses are expected to retire, and this number does not include exits due to pandemic stress. Experts anticipate the highest demand for telehealth, home health, critical care and public health nursing.
Before COVID-19, both professionals and patients expressed hesitancy about telemedicine services, citing concerns about online quality care. However, this pandemic advanced the use of telemedicine "by a decade," and it continues to expand. Telehealth is transforming how patients receive some of their care, replacing traditional in-person visits with video or phone visits and patient wearables or apps that monitor health. Nurses use telehealth for almost all aspects of care — education, disease prevention, triage, clinical trial enrollment, symptom management, counseling and chronic disease management.
Although telehealth minimizes physical barriers, it is challenging if patients do not have a device, internet or knowledge of technology. Nurses must coach some patients or practice appointments and demonstrate how to use online portals. The growth in telehealth usage will necessitate an increase in skilled nurses and creative solutions to improve patient access.
Home Health Nursing
The pandemic made it clear that retirement and nursing homes can become hotbeds for the COVID-19, and nursing home residents accounted for 34% of deaths from the virus during the peak of the pandemic. Consequently, families are more hesitant to put their loved ones in long-term care facilities. Instead, they are choosing home health services. This shift in care is creating opportunities for new roles in nursing.
Additionally, many organizations are adopting a care module to shift hospital-level care to home. The Hospital at Home model enables patients who need acute-level care to receive care in their home, thereby also creating demand for home health nurses with acute-care skills post-pandemic. Nurses totally run some programs with medical oversight.
Critical Care and Acute Care Nursing
In an interview of several healthcare executives across the U.S. during the middle of the pandemic, multiple interviewees mentioned the demand for critical care nurses over the next five years. Healthcare executive Jacalyn Liebowitz, DNP, RN, predicts that there will also be a greater need for acute care in hospitals along with a home-based care surge. As home health nurses manage low-acuity cases, high-acuity cases will fill hospitals, accounting for a more significant percentage of the patient population.
Carol Koeppel-Olsen, MSN, RN, stated that she expects to see a significant turnover of critical care nurses after the pandemic. In addition to their planned retirement, pandemic-related burnout is a genuine concern. She predicts seasoned nurses will shift from patient-oriented roles to mentor-oriented positions to support new nurses.
Public Health Nursing
COVID-19 has exposed the weakness of our public health infrastructure, the most crucial system of protection to stop the spread of disease. While multiple studies over the past decade show "chronically underfunded" public health systems, the pandemic sparked a renewed discussion on public health spending. Recently proposed legislation calls for a 23.1% increase in funding for the Department of Health and Human Services to create positions for public health nurses.
Public health nurses have been on the front lines of the pandemic since the beginning. However, like critical care nurses, experts worry about turnover post-pandemic and expect they will need to call upon new nurses "to come into the fold of the public health response."
The immediate healthcare focus is on post-pandemic nurse retention and recruitment strategies and ways to advance the nursing profession. The full effects of COVID-19 on the nursing profession will continue to evolve over the next several months. However, one trend is certain: there will be an increased demand for well-trained nurses over the next decade, with a bachelor of science in nursing (BSN) required for many roles.
Duke Margolis Center for Health Policy:
Pandemic Response is a Defense Game, the U.S. is Playing Offense
COVID-19 and the Nursing Profession: Where Must We Go From Here?
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