uNight Light was invented by nurses for their fellow frontline healthcare workers.
When nursing student Anthony Scarpone-Lambert worked the overnight shift during his clinical rotations, he disliked turning on a patient's overhead lights to check vitals or perform other care and disrupting their sleep.
In talking to other nursing friends and healthcare clinicians, Scarpone-Lambert realized they all shared a problem: Caring for patients in the middle of the night meant either waking them up every few hours with an overhead light or doing their job in the dark.
Scarpone-Lambert, a 2021 graduate of the University of Pennsylvania, contemplated possible solutions with Jennifferre Mancillas, a California neonatal ICU nurse whom he had met at a nursing hackathon about two years earlier.
The pair, who shared a desire to see how technology could help solve problems they and other frontline workers encountered at work, created the uNight Light, a wearable LED light that illuminates workspaces, while decreasing patient sleep disturbances, especially at night.
"As nurses who worked during the pandemic, we frequently felt frustrated by the lack of tools and resources we had access to," said Scarpone-Lambert. "Many solutions address patients directly, but we understood how the value of supporting healthcare workers directly correlates to improving patient experience."
Scarpone-Lambert and Mancillas created a startup company, Lumify Care, to manufacture the uNight Light, as well as other solutions to empower healthcare workers with tools and resources to help them perform their jobs. Medline today announced it has partnered with Lumify Care as the exclusive distributor of the uNight Light, greatly expanding access to the tool.
"Hospitals are disruptive," Mancillas said. "They’re noisy with bright flashing lights in your face, even in the middle of the night, and when our patients can’t get the solid sleep they need, their healing process is delayed and patient satisfaction decreases."
"Just as important as improving the patient experience, healthcare employers now have an opportunity to provide a functional tool to help staff feel more supported in performing their duties with less fumbling and higher rates of efficiency," she said.
There's typically a disconnect between companies that manufacture products for healthcare professionals and the people who actually use them, Mancillas said, but the uNight Light was designed by frontline workers for frontline workers.
Their invention, for example, contains three lighting settings: the white light is dim, yet still effective for reading, preparing medications, inspecting lines, and for careful patient assessment; the red light increases alertness, preserves night vision, and can help signal colleagues when preparing medications to decrease distractions; and the blue light, the brightest setting, was designed to increase cognitive function to minimize human error.
"We know the value that uNight Light has brought to our own experience as frontline healthcare workers," said Scarpone-Lambert, "and we’ll continue to work toward every healthcare worker around the world having a uNight Light."
Nurse leaders indicated they couldn't get enough time with their team because of administrative tasks, so their CNE gave them the gift of a time management course.
When COVID-19 brought chaos to nurse leaders at Allegheny Health Network (AHN)'s 14 hospitals, a time management course designed just for them helped them feel less overwhelmed about their day.
"They were saying, 'We work really hard all day, but we feel like we don't accomplish anything.' And that is a hit on their morale," says Claire Zangerle, DNP, MSN, MBA, RN, FAONL, NEA-BC, chief nurse executive for AHN, based in Pittsburgh. "They live in chaos all day, and the issue for them is, 'How do I control the chaos?' "
Nurse leaders indicated that they couldn't get enough time and engagement with their team because of other tasks such as staffing schedules, disciplinary actions, overseeing budgets, developing their team, and self-care, Zangerle says.
Zangerle had recently taken an effective time management course and thought that might be a solution.
She worked with Carol Perlman, PhD, a cognitive behavioral therapist specializing in time management, who surveyed nurse leaders about their time management strategies and how they felt about how they managed their workday. From those responses, Perlman then created a word cloud chart, which is a clustered list of words mentioned by the nurse leaders, portrayed in different sizes. The bigger, bolder words are those that are mentioned the most.
"The biggest two words were 'busy' and 'chaotic,' " says Zangerle.
Perlman provided a customized time management course for the nurse leaders with the objectives of teaching them to create a daily schedule, helping them attain skills for centralizing a task list and prioritizing daily tasks, encouraging them to incorporate time for self-care, and creating a plan for engaging and developing their staff.
"The goal was to reduce their stress level and to help them feel that they were in more control of their day, which would lead to them being able to spend some time on themselves to eat right, plan their meals, take time for exercise, take time for meditation, or whatever would contribute to their health and well-being while in a chaotic environment," Zangerle says.
Setting up the 'classroom'
AHN provided the course for CNOs, nursing directors, and nurse managers at all the health system's hospitals.
Each participant was given an 18-month planner, customized with AHN's colors, along with a workbook. The 21-day course included daily self-paced work that generally took less than five minutes, plus weekly virtual sessions.
For one of those weeks, each individual discipline group—all CNOs, directors, and nurse managers—met with their peers to share information related to their leadership level, Zangerle says.
They also set up a Google classroom where the instructor posted lessons and participants could post their work, ask questions, and offer hacks, she says.
"Now, the nurse managers want their assistant nurse managers and supervisors to take the course," Zangerle says. "They recognized the need to cascade the same valuable information to this group of newer nurse leaders so they could also learn how to prioritize tasks, deal with the unexpected, and block out time appropriately."
For the 300-plus nurse leaders who have completed the time management course, "They feel that they're a lot more in control, and that contributes significantly to their wellness," says Zangerle.
The time management course resulted in collateral benefits as well, Zangerle says.
Allegheny Health Network CNOs pulled together directors from their hospitals and worked on lessons together, learning how to delegate and do succession planning, says Zangerle.
The results
A post-course questionnaire revealed:
62% of nurse leaders rate their current time management strategies as "very good," as compared to 29.61% before the course.
76% felt they got many targeted tasks done by the end of the day, as compared to 35.9% before the course.
46% felt that time management affected their overall job performance "a lot," as compared to 32.45% before the course.
58% use a master list to organize their tasks every day, as compared to 26.2% before the course.
28% felt their ability to create and implement a leadership development plan for their staff was "extremely effective," as compared to 7.3% before the course; 54% felt their ability was "very effective" post-course, as compared to 28.7% before the course.
60% felt they used strategies to manage procrastination that interferes with their productivity "very well," as compared to 30.92% before the course.
78% can use a system to address unexpected demands "very well," as compared to 24.68% before the course.
A second word cloud created by Perlman after the course also revealed changes in how the nurse leaders felt about their day. Instead of "busy" and "chaotic," the biggest, boldest words in the post-course word cloud were "productive" and "good."
"The chaos is still there, but they feel like it's controlled chaos," she says. "We're going to have chaos for a while here, and the value is in de-escalating the chaos to control what you can, so that you can better manage the things you cannot."
Steadfast Medical Staffing 'willfully' misclassified workers and shortchanged their overtime pay, U.S. Department of Labor says.
A Norfolk, Virginia, medical staffing agency that intentionally denied more than 1,000 RNs, licensed practical nurses (LPNs), and certified nursing aides their rightfully earned overtime wages, has been ordered by a federal court to pay more than $7.2 million in back wages and liquidated damages.
The U.S. District Court for the Eastern District of Virginia-Norfolk Division ordered Medical Staffing of America LLC—doing business as Steadfast Medical Staffing—to pay at least $3,619,716 in back wages and at least $3,619,716 in liquidated damages to 1,105 employees, according to a press release from the U.S. Department of Labor.
The court ordered the department’s Solicitor of Labor to update the back wages to the present, which likely will increase the back wages and liquidated damages amounts substantially.
The action follows an investigation by the U.S. Department of Labor’s Wage and Hour Division and litigation by the Solicitor of Labor.
The Department of Labor's Wage and Hour Division investigation determined that since at least August 18, 2015, Steadfast Medical Staffing, a healthcare industry employment agency that provides independent medical personnel nationwide, willfully misclassified the nurses and aides as independent contractors.
By misclassifying the nurses and aides, the medical staffing agency paid them straight-time wages instead of time-and-a-half when they worked more than 40 hours in a workweek, according to the Department of Labor.
Steadfast Medical Staffing also failed to maintain accurate records of total weekly hours worked. Both actions violated the Fair Labor Standards Act.
"When employers misclassify employees as independent contractors and fail to pay workers their hard-earned wages, the U.S. Department of Labor will hold them legally accountable," said U.S. Secretary of Labor Marty Walsh. "The court's judgment means we can finally recover these essential workers' wages."
The court’s decision ends litigation filed in 2018 and in 2019 by the department after Steadfast Medical Staffing refused to pay back wages owed, and come into compliance after the investigation.
"The court sent an unequivocal message to Steadfast and other healthcare industry employers that the Solicitor of Labor and the Wage and Hour Division will work together to recover stolen wages when employers violate the law," said Solicitor of Labor Seema Nanda.
"The U.S. Department of Labor will not hesitate to bring legal action, pursuing all available remedies, when it finds that an employer has willfully violated the law."
Racism and those who practice it have 'absolutely no place in the nursing profession,' ANA president says.
Racism in nursing is extensive, say nurses who responded to a new national survey of nurses, with racist acts committed principally by colleagues and those in positions of power.
More than half (63%) of nurses surveyed said they have personally experienced an act of racism in the workplace with the transgressors being either a peer (66%) or a manager or supervisor (60%), according to more than 5,600 nurses surveyed by the National Commission to Address Racism in Nursing.
Of those nurses who report that they have witnessed an act of racism in the workplace, 81% say it was directed toward a peer. Nurses said they have challenged racist treatment in the workplace (57%), but more than half (64%) said their efforts resulted in no change, according to the survey.
"Speaking truth to power takes courage," one nurse respondent said. "I have been ostracized for my advocacy and passed over for promotions."
The commission, comprised of leading nursing organizations, explores the issue of racism within nursing nationwide and details the impact on nurses, patients, communities, and healthcare systems to motivate all nurses to confront systemic racism.
"My colleagues and I braced ourselves for these findings. Still, we are disturbed, triggered, and unsettled by the glaring data and heartbroken by the personal accounts of nurses," said Ernest J. Grant, PhD, RN, FAAN, commission co-lead and president of the American Nurses Association (ANA).
"We are even more motivated and committed to doing this important work justice," he said. "Racism and those individuals who do not commit to changing their ways but continue to commit racist acts have absolutely no place in the nursing profession."
Many respondents across the Asian (73%) and Hispanic (69%) populations as well as other communities of color (74%) reported that they have personally experienced racism in the workplace.
Other findings include:
Black nurses are more likely to both personally experience and confront acts of racism.
72% of Black nurses who responded said there is a lot of racism in nursing, compared to 29% of white nurse respondents.
92% of Black respondents have personally experienced racism in the workplace from their leaders (70%), peers (66%), and the patients in their care (68%).
"I have been called the 'n' word by multiple patients on multiple occasions … I have been called 'colored' by a nurse manager," one respondent commented.
More than three-fourths of Black nurses surveyed expressed that racism in the workplace has negatively impacted their professional well-being.
"I have felt as if there was no way I would advance my career at some facilities due to my race," wrote a survey respondent. "This has caused stress, anxiety, and some depression."
"As cliché as it sounds, it starts at the top," Dawson said. "Leaders must be accountable for their own actions, set an example for their teams, and create safe work environments where there is zero-tolerance for racists attitudes, actions, behaviors, and processes."
"Civil rights and social movements throughout history offer the blueprint, which demonstrates that diligent allyship is key to progress," Toney said. "To the nurses that challenge racism in the workplace, do not get dismayed by inaction, but continue to raise your voice and be a change agent for good."
Hospitals with better nurse work environments appear to be more effective in providing surgical patient care in a lower acuity setting, analysis reveals.
Surgical patients in hospitals that offer better nurse work environments were less likely to end up in the intensive care unit (ICU) and less likely to die, according to a new study published in AACN Advanced Critical Care.
Its findings suggest that efforts to improve the work environment for nurses may reduce ICU utilization and avoid risks associated with ICU admissions.
Researchers examined Medicare beneficiaries undergoing general, orthopedic, or vascular surgical procedures between January 2006 and October 2007 and found that surgical patients in hospitals with good nurse work environments had:
16% lower odds of ICU admission
12% lower odds of in-hospital mortality
11% lower odds of dying within 30 days of hospital admission than patients in hospitals with mixed or poor nurse work environments.
"Hospitals with better nurse work environments may be better equipped to provide complex patient care in a lower acuity setting without compromising a patient’s odds of mortality," said co-author Anna Krupp, PhD, MSHP, RN, an assistant professor, University of Iowa College of Nursing.
"A key difference between ICUs and lower acuity units is the staffing ratio of patients to nurses. In the context of the COVID-19 pandemic, our findings suggest that a limiting factor in a hospital’s capacity to respond to the COVID-19 surges of critically ill patients is likely related to the quality of the nurse work environments prior to the pandemic," Krupp said. "Fewer additional ICU beds may have been needed if hospitals had good nurse work environments prior to the pandemic, with enough nurses to safely care for patients in lower acuity settings."
Hospitals were then categorized as good (top 25%), poor (bottom 25%) or mixed, which were the 50% between the high and low scales.
Patients in the best nurse work environments had the lowest occurrence of ICU admission or 30-day mortality, while patients in hospitals with poor nurse work environments had the highest occurrence, according to the study.
Surgical patients in hospitals with good versus poor nurse work environments had:
29% lower odds of being admitted to an ICU
23% lower odds of in-hospital mortality
21% lower odds of 30-day mortality
28% lower odds of being admitted to an ICU or experience 30-day mortality.
Admission to an ICU varied significantly by surgical group, with vascular surgical patients having the highest use of ICUs (47.4%), followed by general (18.2%) and orthopedic (5.9%), the study said.
While hospital characteristics—number of beds, teaching status, and technology capabilities—varied significantly, the analysis revealed that those with the best nurse work environments were nonteaching hospitals with more than 250 beds.
Authors of a new Journal of Professional Nursing article provide strategic steps to build an infrastructure that supports innovation.
For nurses to lead in health and healthcare innovation, nursing education must think strategically about the skills and knowledge required by the next generation of nurses and then embrace those innovation needs at all levels of research, education, and practice, says an article recently published in the Journal of Professional Nursing, authored by three nurse leaders at the University of Pennsylvania School of Nursing (Penn Nursing).
The article, Creating an Innovation Infrastructure in Academic Nursing, shares actionable steps to position nurses as leaders in this space and provides insight into how Penn Nursing has infused innovation into its mission and curriculum.
Nurses are natural healthcare innovators, and their understanding of patients, families, and communities provides a unique perspective to the use of technology and other innovative processes to promote health and well-being, prevent disease, and manage acute and chronic conditions, the article says.
Still, it adds, nurses are absent or often silent partners in health and healthcare innovation initiatives.
Many schools of nursing are integrating innovation into their curriculums and creating spaces for students and faculty to engage in the innovation process, but innovation must be a central driver of the nursing education provided across the country, according to the article.
"We must promote nurse-led innovation initiatives internally and externally, to amplify the work being done by nurses in education, research, policy, and practice," says the article’s lead author, Marion Leary, RN, MSN, MPH, FAHA, director of innovation at Penn Nursing.
"If we do this, we will achieve a clear, coherent, and unified message around nurse-innovation and further solidify the innovation ecosystem within the profession,” Leary says.
Making Innovation Part of the Mission
Because innovation means different things to different disciplines, the key to integrating innovation into a school of nursing is to develop a shared meaning of innovation within the university and healthcare community, the article says.
"Developing a disciplinary-specific perspective of innovation is a first step to guiding curricular changes and enhancements," says article coauthor Antonia M. Villarruel, PhD, RN, FAAN, professor and Margaret Bond Simon Dean of Nursing.
"This perspective will communicate to interdisciplinary colleagues and the public nursing’s role and focus in innovation, and can be used for forging partnerships to address specific issues and problems," Villarruel says.
Once the definition of innovation is adapted, the authors outline strategic steps to build an infrastructure that supports innovation. Those steps include:
Establish strategic goals to prioritize activities, align resources, communicate innovation, and serve as a progress benchmark.
Build an innovation infrastructure to systematize and embed a culture of innovation within the school.
Develop faculty and faculty champions of innovation.
Integrate innovation into administrative functions.
Build relationships across schools.
Marketing innovation expertise externally.
Transform research discoveries into practice.
Positions students to develop and lead innovations.
Enhance innovation education through active learning.
Position nurses to drive and inform innovations in health systems.
Penn Nursing as a Case Study
The authors share how Penn Nursing took the recommended steps to successfully define and infuse innovation into the school’s program. The first step was aligning with the University of Pennsylvania’s core values, one of which is innovation.
Infrastructure and cross-campus relationship-building soon followed, including engagement with other schools to build and support faculty and student innovation skills and projects.
Penn Nursing then created initiatives to inform the broader community about nursing innovation. Transforming research discoveries into practice remains an ongoing initiative.
The article further describes Penn Nursing’s focus on active learning to enhance innovation education and how the school of nursing leverages its practice partners to position nurses to drive and inform innovations in healthcare.
"The Future of Nursing 2020–2030 report highlights nurses as innovators and advocates for nurses to see themselves as such, while calling for leaders in health and healthcare to support nursing’s innovative aptitude," says article coauthor Therese S. Richmond, PhD, RN, FAAN, Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation.
"Therefore, as we move into the future," Richmond says, "it will be essential that we create a foundation of innovation for the next generation of nurse leaders."
Nursing schools must 'turn performance into possibility' and look beyond test scores before turning away minority applicants, CNO says.
Growing a diverse nursing workforce is crucial to improving healthcare for everyone, but the educational and professional journeys of many nurses of color can leave invisible wounds and aftereffects that may linger throughout their career, says one chief nursing officer who has experienced racial negativity first-hand.
Beginning with nursing school admissions processes that exclude potential students of color and extending to micro-aggressions in both nursing education and careers, the barriers that minority nurses face serve to inhibit their career trajectory, says Stephanie Wroten, BSN, MSN, LNC, chief nursing officer for Roanoke Chowan Community Health Center, which serves rural eastern North Carolina.
"We've made some progress, but the problem is definitely still alive," Wroten says.
But a nursing workforce that reflects its patient demographic makes healthcare more comfortable for every patient, several studies, including a Joint Commission report on cultural diversity, have shown.
Wroten spoke with HealthLeaders about the challenges that minority nurses face, beginning with efforts to get into nursing school and extending throughout their career.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders:What are some of the challenges that students of color experience as they begin to seek a career in nursing?
Stephanie Wroten: The inequities faced by students of color really start at the admission process in the whiteness of nursing and not having nurses of color at the table to better understand and help facilitate the admissions process.
By not including African-American and other nurses of color in the admissions process, we start out with inequity in selection and so most classrooms in nursing programs have less students of color.
HL:How, specifically, would having faculty nurses of color in the admissions process help boost those numbers?
Wroten: It would make a difference in that those who are making admission decisions would dive deeper and understand more the educational inequities that students of color sometimes face and that the playing field is not level.
I'll use the TEAS test as one example. [The Test of Essential Academic Skills is a standardized, multiple-choice exam for students applying for nursing school in the United States.] Oftentimes, students of color may not perform well on those standardized tests for a myriad of reasons, so they're not selected based on those poor scores.
Having minority admissions faculty would provide a layer of support to turn performance into possibility; whereas, a student may have underperformed on a standardized test, maybe their coursework from their prerequisite courses is strong enough to make the case that we can place them in support programs to ensure their success, once admitted.
HL: Once minority students are admitted to nursing school, what are some adversities they face?
Wroten: Minority students are not taught about the first individual who was a nurse from their cultural standpoint. We were taught about Florence Nightingale. She is a very important part of nursing history but she's not the only person who is important from the ethnic standpoint.
Mary Eliza Mahoney, the first Black nurse, is part of my history and I feel it's important to increase knowledge and access and education around understanding how she fought against discrimination in the profession early on and throughout her career. [Nursing schools must] support the narrative that nursing history isn't narrow around just having stories and lectures about Florence Nightingale. We have Hispanic nurses, we have nurses of Asian descent, and they also have very strong stories that need to be told and threaded throughout nursing curriculum.
What I've also seen is poor retention of the minority student. I've seen failure to matriculate due to academic failure, and oftentimes the academic big failures aren't so much associated with lack of ability but [rather] with life circumstances and an inability to manage life when it hits you.
I'll frame it as social determinants. Oftentimes, we're dealing now with adult students who have children or are caring for parents, and no one's taught them how to manage those things that come up—"I don't have a babysitter; I don't have a backup babysitter; I don't have money; I'm having to work; no time to study." All of those things can impact negatively academic success and progression.
I'm not saying that these experiences are only those of students of color. I'm not saying that white people cannot have these experiences, but more often it involves students of color.
HL: What effects can those experiences produce, as students graduate and begin their career?
Wroten: The micro-aggressions from nursing education can leave long-standing scars that interfere with confidence and mental fortitude to progress. And they also lead to internal silences that are infused by fear because you don't want to draw attention to yourself, so you may not speak to that white professor about the experiences you're having or difficulties, and especially if you're in a class where you're the only [minority].
And so, "only syndrome" can lead to long-standing inability to engage in a way where Black nurses and other nurses of color don't have trust that they are understood in a way that makes them successful.
HL: What form do micro-aggressions take for nursing students and nurses?
Wroten: They're covert. There are just implicit biases that students of color sometimes face in that there's not an understanding of who we are, and so we're treated differently because there is this lack of professionalism around race. There are assumptions from explicit bias where individuals, teachers, and colleagues have these mindsets about who we are.
The racism can be more subtle than overt because there's no awareness from our white counterparts around our education, around our ability. Even being an educated person standing in front of someone, whether it's a patient or colleague, we're often looked at as not being the most educated, prepared person in the room.
I'll give you an example. I'll be in my white coat as the nursing instructor and I'll walk into a room with white students and patients may say, "Would you get your instructor?" or "Could you get the nurse?" The assumption is the white person is the nurse.
HL: How do such experiences affect a nurse's career?
Wroten: It feels like a never-ending fight to practice, a never-ending fight to prove yourself, a never-ending fight to measure up; but I'm asking, to measure up to what? I've passed the test; I've done the work. It feels like ongoing slights, and they hit you in a way where you have to decompress from that, but not allow it to get in your way to meet your own professional goals.
HL: How does that hinder practicing nurses from pursuing leadership roles?
Wroten: The whiteness of nursing sometimes interferes with providing and making accessible leadership opportunities for African-American nurses and nurses of color because they're not represented at the table, so they have a fair chance for their professional goals and trajectories to be realized. Their white counterparts are given those opportunities instead of looking at each candidate or applicant who has applied, equally, so those inequities come through.
Our white counterparts [seem to] have more opportunities to be at those important tables or to get mentorship in those critical exposures that would serve as the catalyst to help nurses of color understand leadership and to be groomed to become our next leaders.
I had a conversation just last week with an African-American nurse who said, "You know, it doesn't feel possible for me to explore or have a position in leadership. How are we considered?" Well, No. 1, you have to apply.
But if there is doubt that there will be no opportunity or chances given, how can we have a movement if there's still resistance? So, I make it a point, and I made it a point my first year here, to ensure that I'm at the table for interviews because we must address the equity around hiring practices.
With their position on the frontlines of healthcare, nurses are perfectly positioned to identify patients who may be victims of intimate partner violence.
The Joint Commission has released a new Quick Safety advisory to address intimate partner violence (IPV), which has increased during the COVID-19 pandemic, according to healthcare providers.
IPV refers to "behavior by an intimate partner or ex-partner that causes physical, sexual, or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behaviors," according to the World Health Organization (WHO).
With their position on the frontlines of healthcare, nurses are perfectly positioned to identify patients who may be victims of IPV.
In 2004, The Joint Commission issued Standard PC 01.02.09 that requires organizations to use written criteria to identify those patients who may be victims of physical assault, sexual assault, sexual molestation, domestic abuse, or elder or child abuse and neglect. It also requires providers to report cases of possible abuse and neglect to external agencies in accordance with laws and regulations.
However, with the rise in telehealth, healthcare providers may need to rethink how to address IPV during telehealth visits, according to the Quick Safety advisory.
"While there are disadvantages associated with telehealth, one advantage is that it may provide the opportunity for survivors to receive evidence-based safety information and psychotherapy via Zoom or telephone calls," it reads.
"Also, the ability to connect via telehealth may reduce IPV-associated barriers like isolation as well as lack of transportation which leads to delayed medical care," the advisory says.
"The pandemic has increased stressors at home as many have had to isolate," says Ana Pujols McKee, MD, executive vice president, chief medical officer, and chief diversity, equity and inclusion officer, The Joint Commission. "It is important that clinicians conducting telehealth visits be alert to signs of intimate partner violence and inquire about this after ensuring the patient is in a safe space to talk."
The Quick Safety advisory also provides safety actions for healthcare organizations to consider, such as:
Partnering with a local domestic violence provider to engage in training or training resources.
Providing training on the basics of how to identify IPV to all employees who interact with patients, not just to licensed healthcare providers.
Examining whether current screening questions are specific enough and providers are asking questions as indicated within their organization’s written policies.
Relying on interpreters rather than family members or escorts when evaluating non-English speaking patients.
FAONL designation is the 'preeminent honor' for nurse leaders, AONL CEO says.
Eight nurse leaders who make healthcare better have been named in the American Organization for Nursing Leadership's (AONL) 2022 Class of Fellows.
The AONL fellow designation (FAONL) recognizes a nurse leader’s significant and sustained contributions to the specialty of nursing leadership, commitment to service, and influence in shaping healthcare, according to a press release from AONL.
Nurse leaders who attain this prestigious honor are committed to shaping the future of nursing leadership through expert leadership, mentoring developing leaders, and contributing to AONL at the regional and national levels, according to AONL.
The inductees will be honored at AONL's annual conference April 11-14 in San Antonio, Texas.
"The FAONL is the preeminent honor for nurse leaders who personally and professionally make healthcare better through innovative, influential, and inspiring nursing leadership,” AONL CEO Robyn Begley said.
In most cases, expect a bit of competition and a lengthy wait, immigration attorney says.
As U.S. hospitals labor to keep nurse staffing at safe levels amidst a nursing shortage intensified by the COVID-19 pandemic, many are seeking a solution beyond American borders.
Henry Ford Health in Michigan, for example, is working to hire hundreds of nurses from the Philippines, according to its CEO, and New York Gov. Cathy Hochul said the state is recruiting qualified foreign nurses to boost its staffing.
"I'm definitely seeing an increase, and not just an increase in hiring right now but also anticipating the future shortage," says Yova A. Borovska, an attorney with Pittsburgh-based Buchanan Ingersoll & Rooney PC who specializes in immigration and nationality.
"Some of my clients are already planning to ramp up recruitment of international nurses in the near future, and that really emphasizes the need for all healthcare organizations that anticipate such needs to start thinking about that as well, because it can get quite competitive," she says.
More than 500,000 seasoned RNs are anticipated to retire by the end of 2022 and the U.S. Bureau of Labor Statistics is projecting the need for 1.1 million new RNs for expansion and replacement of retirees, according to the American Nurses Association.
Nurse leaders should consider hiring internationally if recruitment isn't resulting in enough applicants, as well as for long-term nurse staffing strategy, Borovska says.
The hiring process is a bit more complicated, however, she says, so nurse leaders interested in hiring international nurses should be aware of the challenges involved.
Some countries, for example, are easier to hire from than others.
"The country of citizenship matters … so [nurse leaders] should think about targeting a certain geographic area," Borovska says.
Citizens of Canada and Mexico, for example, have the TN Visa, which offers expedited work authorization under the United States-Mexico-Canada Agreement (formerly the North American Free Trade Agreement).
Canadian nurses who have their VisaScreen—a credentials assessment from the Commission on Graduates of Foreign Nursing Schools (CGFNS) that proves a nurse has the necessary education, licenses, exam scores, and English language proficiency—can go to work in the U.S. nearly instantly, Borovska says.
For Mexican citizens, the process may take two or more months because they need to apply for a visa stamp, and the backlog of visa applicants can delay the process, she says.
"It makes it much easier for employers that recruit citizens of those countries to recruit international applicants because of the visa options that are available to them," Borovska says.
Many U.S. hospitals hire nurses trained in India, but "but their visa options are a bit more limited, so it gets a little more challenging with them," she says.
The Philippines is the major source country, accounting for more than 30% of U.S. foreign-educated nurses, but acquiring Filipino nurses typically takes between six to 12 months, and perhaps longer, depending on the backlog at the consulate, Borovska says.
Indeed, the demand for nurses is so great that it’s created a backlog of more than 5,000 international nurses who are awaiting final visa clearance to work in the United States, according to the American Association of International Healthcare Recruitment.
The snag causing that backlog is that, after jobs are offered and accepted, foreign-born nurses require a final interview to obtain a visa from the U.S. State Department, according to Kaiser Health News (KHN).
Those interviews are piling up because of the pandemic, as many of the U.S. embassies where those interviews take place remain closed or are operating on fewer hours, KHN reports.
Agencies can help
If a hospital doesn't already have a team to handle immigration work, specialized hiring agencies can complete the legwork, Borovska says.
"Some agencies will do the recruitment, and some also offer immigration services," she says.
"It depends on what options are available to the particular candidates," she says. "But there certainly are agencies that provide kind of a full service in that respect, because they do the recruitment, and they also ensure the fact that candidates are qualified with all their certificates and then they perhaps either will handle the visa process or refer it to somebody to handle."
Looking ahead
While international nurses can help stabilize staffing challenges in the short term, they also can be a solution for long-term planning, particularly for a nursing shortage that isn't going away anytime soon.
"[Nurse leaders] should start thinking about the big picture—what are their recruitment needs in the next five years—and come up with a strategy have a steady supply of international talent in the next five years," Borovska says.
"Some (international hiring) options can take a long time, sometimes even over a year," she says, "so it's important to have a strategy in place for recruitment of international nurses."