The Future of Nursing: Health Equity.

Abstract

In his Notes on Surgical Nursing, published in England in 1874, Dr J. H. Barnes wrote that a surgical nurse needs to “have an eye as well to the future as the immediate present.”1(p71) Although he was referring to the nurse’s need to anticipate what might be required during a surgical procedure, the same could be said about nurses’ need to look to the future and the evolution of the nursing profession. A few years after I graduated with my bachelor’s degree in nursing, the Institute of Medicine (now the National Academy of Medicine) published The Future of Nursing: Leading Change, Advancing Health.2 This report recognized the importance of the role of nurses in improving health care, and provided recommendations to strengthen the nursing workforce through education and enhanced roles in practice and leadership. Ten years later, the National Academies of Sciences, Engineering, and Medicine has released a follow-up report, The Future of Nursing, 2020-2030: Charting a Path to Achieve Health Equity.3 While the former report spoke to strengthening the expertise of the nursing workforce, the 2021 report provides an agenda for using that expertise.3 Although it is not possible to thoroughly summarize this more than 500-page report here, the emphasis of the report is that nurses should be prepared for and engaged in “the complex but essential work of advancing health equity, addressing [social determinants of health], and meeting social needs of individuals and families.”3(pxv) According to the Robert Wood Johnson Foundation, Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. 4 Achieving health equity encompasses working to eliminate differences in health outcomes and access to health care that are based on systemic barriers, such as lower socioeconomic status, racism, and other forms of discrimination.3 The nine major recommendations from the 2021 National Academy of Medicine report are aimed at nursing organizations, government agencies, public health organizations, payers, education programs, employers, and nurse leaders to help prepare nurses for these efforts. The first recommendation reads, in part, “In 2021, all national nursing organizations should initiate work to develop a shared agenda for addressing social determinants of health and achieving health equity.”3(p13) As a nursing organization, AORN is dedicated to improving health care equity through efforts to strengthen diversity, equity, and inclusion (DEI).5 The goals in AORN’s DEI plan are to increase diversity in the workforce, its membership, and its board of directors; to develop and implement programs that support communities of color; and to educate perioperative teams on the effects of health care disparities on outcomes of surgical care.5 The AORN National Committee on Education has been charged with exploring the significance of social determinants on health care of the perioperative patient and evaluation in the preoperative environment. There is a lot of work being done within AORN in regards to diversity, equity, and inclusion. For the most up-to-date look at this important work, please visit the AORN DEI web page at http://www.aorn.org/about-aorn/dei. This web page contains links to blogs, articles, position statements, and continuing education. All patients deserve to receive the highest quality of health care regardless of race, nationality, ethnicity, culture, sexual orientation, gender, gender identity, age, education, and mental or physical ability. As patient advocates who work in many different types of communities, facilities, and roles, nurses are well positioned to collaborate with other medical professionals to improve health equity for all citizens. The resources AORN provides are important tools to help our members move equity initiatives forward. Holly S. Ervine, MSN, RN, NPD-BC, CNOR, is the AORN President and a system learning & development specialist RN, Wellstar Health System, Atlanta, GA. Ms Ervine has no declared affiliation that could be perceived as posing a potential conflict of interest in the publication of this article.