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Precision Vision: Empowering Innovation and Well-being

May/June 2020


Elizabeth CardElizabeth Card, MSN, APRN, FNP-BC, CPAN, CCRP, FASPAN
ASPAN President 2020-2021

While we regret ASPAN’s 39th national conference in Denver has been canceled, consideration for the health and safety of our members left ASPAN no other choice. And, although the Covid-19 pandemic is unchartered territory for all of us, let us, as nurses, respond with the same courage, empathy, and integrity that first called us into our profession. I would like to share some thoughts with you about my hopes and focus for our organization in the coming months.

Year of the Nurse and Midwife
The World Health Organization (WHO) has declared 2020 the International year of the nurse and the midwife. Dr. Tedros Adhanom Ghebreyesus, the WHO Director-General, stated: “Nurses and midwives are the backbone of every health system: in 2020 we’re calling on all countries to invest in nurses and midwives as part of their commitment to health for all.”1 These two roles are crucial in their ability to impact and improve global health, often the first and maybe the only health point of contact in their communities. This decision to name 2020 the International year of the nurse and the midwife was unanimously approved by the World Health Assembly. The WHO is partnering with the International Council of Nurses, the United Nations Population Fund, and the International Confederation of Midwives to celebrate and, also, to take action on the challenges faced by nurses and midwives. Elizabeth Iro, WHO Chief Nursing Officer, expressed gratitude: "I’m thankful that nurses and midwives are helping make progress towards health for all throughout the world."1

There are many of us to celebrate. Nursing is the nation's largest healthcare profession, with approximately four million registered nurses (RNs) in the United States. Of all licensed RNs, 84.5% are employed in nursing.2 Nurses comprise 50% of the global healthcare workforce in most countries. In 2018, the WHO launched its three-year global campaign aimed to improve communities’ health by improving the status of nursing.1 This work will culminate at the end of 2020, the same year nurses celebrate the 200th birthday of the founder of modern nursing, Florence Nightingale.  

Letter from the Duchess of Cambridge
Her Royal Highness, The Duchess of Cambridge, penned an open letter to nurses and midwives stating “….No matter the setting, I was continually struck by the compassion that those of you I spent time with showed, and the incredible work ethic you demonstrated on behalf of your entire profession - not only performing your rounds but working tirelessly through the night to support people who were at their most vulnerable.”3 

World Health Organization Goals
Worldwide, approximately 70% of the health and social workforce are females, many of which are also nurses and midwives. The WHO recognizes nurses often work under challenging circumstances, being undervalued, without needed resources and often overworked. It is projected by the WHO the world needs nine million more nurses and midwives to achieve universal healthcare coverage by the year 2030.1 This year, the WHO is focused on:

  • Strengthening nursing to work at the highest extent of their licensure to address healthcare for all
  • Increasing nursing leadership and influence
  • Increasing investment in nursing and midwifery

To learn more, or join their campaign, visit their website:

There are many nurses who hear the call for volunteers to address global health inequity. The need is great, but only a few nurses respond to those needs. ASPAN is launching a Humanitarian Global Outreach Strategic Work Team to educate, mentor, and collect narratives from nurses who have volunteered. Author Emily Dickinson wrote “Hope is a thing with feathers that perches in the soul.”4 We can bring hope when we volunteer for this very special type of work, and share the stories of those who answered this call both locally and abroad. 

American Nurses Association Data and Strategies 
The American Nurses Association (ANA) regularly surveys nurses across the United States to appraise health risks. They then share their findings in their executive summary. Their data, which focused on a healthy work environment, had some startling findings. Approximately half of their respondents reported having experienced workplace incivility, the average BMI was 27.6, which is in the “overweight” category and 82% reported they are under “significant levels of risk for work-place stress.”5 In response to this data, the ANA has launched the Healthy Nurse, Healthy Nation Grand Challenge. This initiative engages nurses to improve health in five areas: nutrition, physical activity, quality of life, rest and safety.5,6 

If you have not joined yet, please go to their website: in creating your profile. Associate yourself with ASPAN. As an organization, we can challenge other nursing organizations through the Healthy Nurse Healthy Nation (HNHN) grand challenge!6 ASPAN will be launching a Well-being Strategic Work Team to address some of these issues (nurse civility, wellness initiatives, etc.) and others specific to our practice (waste anesthesia gases, etc.). There are many things we can do as an organization and as individuals to impact the wellness of our work environment; some only take a moment. Mother Teresa stated this so well: “Every time you smile at someone, it is an action of love, a gift to that person, a beautiful thing.”7 

Nurses are Innovators
Nurses are natural innovators. According to Rebecca Love, the director of Nurse Innovation and Entrepreneurship at Northeastern University’s School of Nursing, nurses on average perform 27 workarounds per shift.8 Deborah Debono’s scoping review of the literature on nurses’ workarounds in acute care settings identified three large categories for workarounds: technology (ex-amples may include barcode medication administration features, electronic health record, or pharmacy dispensing), operational failures and work restraint (time pressures, workflow), and policies, rules and regulations (expectations, guidelines or regulations). 

Many times, the nurse is creating a workaround on an issue because that same issue did not include nurses at the decision table. Those who created the policy or electronic health record may not have understood the nursing perspective because the nurses were not represented. So, to meet the demands of their jobs and provide the best care, nurses are innovating solutions, up to 27 times per shift. Rawsi Williams, a nurse and attorney, sums up nurse innovation: “To do what nobody else will do, a way that nobody else can do, in spite of all we go through; that is to be a nurse."10 ASPAN will be launching an Innovation Strategic Work Team.

We are standing on the shoulders of visionary giants. I am truly honored and humbled to begin my journey as president leading our organization and building upon our strengths that Immediate Past President Amy Dooley and other ASPAN past presidents have helped us discover. ASPAN, in the next year, will strive to have precision vision, empowering innovation and well-being!


  1. World Health Organization. Year of the nurse and midwife 2020. Accessed April 30, 2020.
  2. Smiley RA, Lauer P, Bienemy C, Berg JG, Shireman E, Reneau KA, & Alexander M. The 2017 national nursing workforce survey. J Nurs Regul. 2018;9(3):supplement (S1-S54).
  3. Royal UK. An open letter from the Duchess of Cambridge to midwives. Accessed May 2, 2020.
  4. Dickinson E. Enotes. Hope is the thing with feathers. Accessed May 2, 2020.
  5. American Nurses Association Executive Summary, Health Risk Assessment. American Nurses Association, Silver Springs, Maryland. 2018.
  6. ANA Enterprise. Healthy nurse healthy nation. Accessed May 2, 2020.
  7. Mother Teresa. Pass It On. Inspirational quotes. Accessed May 2, 2020.
  8. Love R. Nursing innovations allow RNs to spread their wings.  Accessed May 2, 2020.
  9. Debono D. BMC Health Services Research. Nurses’ workarounds in acute healthcare set-tings: a scoping review. Accessed May 2, 2020.
  10. Williams R. AANAC The Care Connection Accessed May 2, 2020. 

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