But several challenges must be addressed first, says Dr. Ernest Grant, at the School of Nursing’s annual Petzold Lecture.

The coronavirus pandemic exposed a number of inadequacies in healthcare, and how it affected nurses was among the most pressing of problems.

Dr. Ernest J. Grant has some ideas on how to fix that.

“The Covid-19 pandemic lifted the veil on a broad range of challenges that we as nurses face in our efforts to provide expert compassionate care to patients,” said Grant, the immediate past president of the American Nurses Association (ANA), “but it also helped to shape healthcare policy. We have to redouble our efforts to address the challenges because nurses need to be the ones who drive the solutions in our profession, within health systems and public policymaking, and beyond.”

Grant, the Interim Vice Dean for Diversity, Equity and Inclusion at the Duke University School of Nursing and an internationally renowned nursing leader, touched on a number of solutions at the MGH Institute School of Nursing’s annual Natalie Petzold Endowed Lecture.

“This lecture is also a testament to not only Miss Petzold, but the mission of the School of Nursing to promote lifelong learning,” said MGH Institute School of Nursing Dean Dr. Ken White in opening remarks, who noted that the 150th anniversary of the founding of the former Massachusetts General Hospital diploma nursing school occurs next September. “We have a long legacy of innovation and a long legacy of excellence.”

Prior to Grant’s talk, UMass Dartmouth School of Nursing Dean Kimberly Christopher, a 1976 graduate of the hospital’s nursing school, introduced the audience to Petzold, who was the last director of hospital’s diploma nursing school that closed in 1981 and who subsequently served as dean of students at the MGH Institute during the school’s formative years and she remained a supporter until her death in 2012. “I was struck by her long career as a school leader, her capacity to see the necessary transition to the Institute model of collegiate nursing education, despite some significant challenges,” Dr. Christopher said, noting Petzold led the diploma school during its final 33 years.

Addressing the Ongoing Nursing Shortage

During Grant’s keynote address, he touched upon several topics that need to be addressed in the nursing profession. One issue that continues is the growing nursing shortage, a situation he said could result in as many as 450,000 vacancies in the coming years. 

“Prior to the pandemic, the nursing shortage was already a big issue with a complex set of causes that needed a comprehensive approach – and we still don't have that,” he told the audience in the Institute’s 1CW conference space. “We're now talking about a 20% shortfall in the number of nurses it will take to assure quality care and to keep patients safe. Meanwhile, each day brings more stories of hospitals and health systems scrambling to fill the vacancies while nurses on duty continue to face enormous pressures and deteriorating working conditions brought on by understaffing.”

He said nursing schools like the MGH Institute’s can provide a solution. “It doesn't seem right that in times of severe shortage, many nursing schools across the country do not have the capacity to absorb a surging number of qualified applicants. And I know that's not the case here,” he said. “But we've got to fix that. America needs more nursing educators. And I know that Dean White and many of you are focused on the challenge of increasing learning opportunities for nursing students on a wider scale. I also think that we need to impress upon policymakers that nursing itself is a public good and there needs to be enough nurses to ensure patient safety and quality health care.”

Before completing his term in 2022 as ANA president, he led a Covid-19 task force in which nurses were asked for their opinions on what issues should be prioritized. It produced several recommendations, including: creating a healthier work place environment; integrating diversity, equity and inclusion in a broad range of management functions; creating more flexibility and work scheduling in roles to address burnout, moral distress and compassion fatigue; implementing innovative care delivery models; and improving compensation.

He also urged nurses to become better policy advocates at the local, state, and national levels, and called on faculty to incorporate this sense of advocacy in their teaching.

A Call for Better Representation

Grant, who was the first man and third person of color to lead the organization in its 127-year history, discussed at length the importance of having the nursing workforce be representative of the country’s racial and ethnic composition. Noting that fewer than 20% of nurses are from minoritized backgrounds, he said, “A more diverse nursing workforce would also be more effective in helping our society address the growing racial disparities in health care and health outcomes.” He also said that while there are more male nurses than ever, more attention needs to be paid to increase that number.

The ANA’s task force reported the disparate treatment between white nurses and those of color during the pandemic, he said. The survey results revealed that Black and Latinx nurses were more likely than their white colleagues to have provided direct care to infected patients, nurses of color were more than twice as likely to become infected with the virus, and that Black nurses were much more likely than their white colleagues to take emergency financial measures to stay afloat.

In 2021, Grant appointed the National Commission to Address Racism in Nursing which identified rampant racism within the nursing profession, which prompted the ANA to investigate its own history of racial policies that included barring nurses of color from joining the organization between 1917 and 1964.

“The purpose of racial reckoning is to create a space for us to examine our past actions, our behaviors and the policies that contributed to marginalizing and harming nurses based on based on their race and ethnicity, ethnicity,” he said, “and involved acknowledging past harms, apologizing, and seeking forgiveness and establishing accountability so that these behaviors, actions and policies will never occur again.”

Looking ahead, Grant remains optimistic about the role nurses will play. “Nurses must continue to lead nurses. The future of all humanity depends on that,” he said. “This is at the very core of the power to move nursing forward. It was recognized many decades ago by Miss Petzold herself, who said that while nursing schools exist because of the social need, they must strive and excel in helping students develop their personal and professional capabilities to become well qualified practitioners and in doing so, be responsive to the voice of change and the vision of what might be and what ought to be.”