Abstract and Introduction
In this dynamic discussion, Nancy Valentine, whose extensive leadership and scholarly work focuses on assessing and developing leadership strategies directed toward healing trauma in the work environment, and Nursing Economic$ Editorial Board Member Therese Fitzpatrick, identify factors involved in framing the business case for transition to a wellness orientation for healthcare organizations and strategies for creating a healthy environment.
The 20 million nurses and midwives worldwide compose 50% of the healthcare workforce. The COVID-19 pandemic stressed this critical professional workforce to unprecedented limits. The World Health Organization designated 2020 as the International Year of the Nurse and the Midwife, well before the pandemic hit, to celebrate these essential healthcare professionals and bring to light the challenges often inherent in the profession. The designation was prophetic.
"As the impact of COVID-19 on patients and healthcare systems began to manifest, nurses found themselves in unprecedented situations, frequently working long hours with limited access to personal protective equipment and evolving guidance on how to care for patients with the virus" (Johnson & Johnson, 2020, para. 9). Nurse deaths related to the pandemic now exceed 2,200 (International Council of Nurses [ICN], 2021a). With high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse, and protests by anti-vaccinators.
There is also the emotional toll. "With COVID-19 patients isolated and without access to visitors, nurses must provide emotional support to patients and their families. In many cases, nurses have had the difficult task of helping families say goodbye to their loved ones by phone and video conference" (Johnson & Johnson, 2020, para. 10).
Jennifer Taubert, Worldwide Chairman of Johnson & Johnson, observed: "Challenging conditions, new ways of working, an unrelenting global pandemic – all of this has created a perfect storm with the potential to seriously impact nurses' emotional and psychological well-being. In fact, in the current pandemic environment, research has shown that nurses are impacted to a greater degree than their physician counterparts by stress, anxiety and depression" (Johnson & Johnson, 2020, para. 11).
"This is due, in part, to the fact that nurses are the care team members who spend the most time with patients. As a result, they may disproportionately experience changes in operating procedures and protocols, shortages of PPE, heavy workloads, extended shifts and fear of exposure to the virus" (Johnson & Johnson, 2020, para. 12).
ICN CEO Howard Catton stated, "This unique mass trauma is having an immediate and profound effect, but it is also highly likely to have a significant long-term impact as it contributes to a wave of post-traumatic stress disorder (PTSD), depression and anxiety, the scale of which we cannot yet determine.
"There can be no doubt there will be a large COVID-19 effect on the size of the nursing workforce, which is already heading for a 10 million deficit. Even if only 10 to 15% of the current nursing population quits because of the COVID-19 Effect, we could have a potential shortfall of 14 million nurses by 2030, which is the equivalent of half the current nursing workforce. Such a shortfall would impact all healthcare services in the post-COVID-19 era to such an extent that I would argue the health of the nursing workforce could be the greatest determinant of the health of the world's population over the next decade" (ICN, 2021b, paras. 6–7).
The burden now resides with our colleagues in leadership, education, research, and clinical practice to assess the impact of these devastating events on the nursing workforce and develop interventions to heal the psychological, emotional, and physical havoc COVID-19 has left in its wake. The task before us is significant; however, nursing leaders around the world are looking to the evidence and marshalling resources and experts in addressing this daunting challenge. I had the privilege of interviewing Nancy Valentine, PhD, DSc (hon), MPH, FAAN, FNAP, whose extensive leadership and scholarly work focuses on assessing and developing leadership strategies directed toward healing trauma in the work environment. Our conversation focuses on identifying factors involved in framing the business case for transition to a wellness orientation for healthcare organizations and strategies for creating a healthy environment.
Dr. Valentine is President, Valentine Group Health, LLC, which focuses on building quality systems, and grooming results-oriented leaders using evidence to improve healthcare in practice and educational settings. With a diverse background in both healthcare delivery and education, Dr. Valentine has experience in many areas of healthcare including top administrative roles in federal government, military, and hospitals and health systems. She has held roles as Vice President (CIGNA Healthcare) and was appointed by the Secretary of the U.S. Department of Veterans Affairs to serve as national Chief Nursing Executive, Washington, DC, where she successfully led the nursing workforce to be recognized leaders in caring for Veterans.
She has served as Interim Chair, School of Nursing, Northern Illinois University, and Associate Dean for Practice, Policy, and Partnerships, UIC College of Nursing. Recently, she worked with senior leadership of DePaul University to develop strategic options and operations improvements for the school of nursing.
She is a founding board member and past president of the American Psychiatric Nurses Association and American Psychiatric Nurses Association Foundation and served as President, Friends of the National Institute of Nursing Research (FNINR), Washington, DC.
Nurs Econ. 2021;39(5):225-238, 250. © 2021 Jannetti Publications, Inc.