RNS Keynote: Nurses have ‘profound power’ in achieving health equity

ORLANDO, Fla. — Nurses can play a critical role in providing equal care to all patients regardless of race, ethnicity, age or socioeconomic status, said a presenter at the 2022 Rheumatology Nurses Society Conference.

“Health equity is one of the most urgent and cross-cutting themes in health care today,” Regina Cunningham, PhD, RN, associate professor and assistant dean for clinical practice at the University of Pennsylvania School of Nursing, in Philadelphia, told attendees.

“Health equity is achieved when everyone has a fair and just opportunity to be as healthy as possible,” Cunningham added. “But we know that this does not happen.”

There are several populations that disproportionately do not receive the same quality of health care as others, including people of color, the LGBTQ community, people with disabilities, those with lower income, those in rural areas and the elderly.

Cunningham used the Future of Nursing 2020-2030, a consensus study from the National Academy of Medicine, as a springboard for the discussion. The report was subtitled, “Charting a Path to Achieve Health Equity,” which Cunningham stressed highlights the importance of this topic moving forward.

“I wanted to discuss the profound power each of you have in bringing this report to life,” Cunningham told RNS attendees.

The report was published in 2021 and included field research in the health equity space being conducted in various neighborhoods in Chicago, Philadelphia and Seattle.

“There is a lot of great work going on by nurses,” Cunningham said.

Although the barriers to health equity — poverty, homelessness, food insecurity and structural racism among them — can seem overwhelming, Cunningham believes that every nurse can play a role.

“The first part of you doing something is understanding and learning [about health equity] yourself,” she said. “I want you to be thinking about the roles you can and play in the institutions where you work. Every nurse should see themselves in this report.”

According to Cunningham, nurses are perennially voted the most trusted professionals in the United States. In addition, nurses are accustomed to working in teams, specifically toward the goal of addressing the underlying causes of poor health. Moreover, nurses are able to collaborate with professionals in a number of settings and at multiple levels. Finally, Cunningham called on nurses to continue the “rich history of social justice” that has marked the profession.

Additionally, Cunningham argued that permanently removing barriers around the scope of practice for nurses, valuing the contributions of nurses, preparing nurses to advance health equity as a major cause in the profession, and diversifying the workforce are all ways to help achieve health equity.

Cunningham also noted that the removal of certain restrictions on what duties nurses were able to perform was critical in navigating the COVID-19 pandemic.

“There is no way we could have gotten through the pandemic without nurses being able to have full scope of practice,” she said.

Allowing nurses to continue to use all of their tools will be essential to reaching the goal of health equity, she added.

Regarding the value of what nurses contribute to the health care system, Cunningham noted that the United States spends approximately $3.5 trillion on health care each year, but still lags behind other developed nations in many outcomes. Understanding what nurses can do to improve the value on the dollar for expenditures may help lead to improvements across the health care system, including in terms of health equity, according to Cunningham.

“We really need to understand the contributions of nurses and quantify it,” she said.

In terms of preparing nurses to advance health equity as a cause, Cunningham stressed education. Strengthening curricula surrounding this topic in nursing training is one way to achieve this goal, while spending time working in underserved areas is another, she said. “There are a lot of opportunities in the community to get a real sense of these issues,” she said.

Meanwhile, regarding efforts to diversify the workforce, Cunningham argued there is still much more work to be done.

“Historically, nursing has been predominantly white and female,” she said. “In the last 15 years, we have made strides, but more work needs to be done.”

These strides have come in a number of forms, from early science education to taking a “hard look at racism in nursing,” according to Cunningham.

“We need a workforce that reflects the populations we are treating,” she added.

The ongoing diversification of the workforce was just one reason the National Academy of Medicine chose to highlight health equity as the main topic for nursing to address moving forward.

“The vision of the committee was to bolster nursing capacity and expertise,” Cunningham said. “They really felt nursing could galvanize this issue and rally around it.”