The focus of this years’ International Nurses Day (ICN) is Our Nurses. Our Future. The economic power of care. The International Council of Nurses (ICN) states that:

“Despite being the backbone of health care, nursing often faces financial constraints and societal undervaluation. IND 2024 aims to reshape perceptions, demonstrating how strategic investment in nursing can bring considerable economic and societal benefits.”

This week Editor in Chief, Alison Twycross (a.m.twycross@bham.ac.uk) and Deputy Editor Jane Wray (J.Wray@hull.ac.uk) highlight journal content to demonstrate the difference a well-educated nursing workforce can make to patient care and safety.

On International Nurses’ Day 2024, we call for strategic investment in the nursing workforce, an issue highlighted in their our editorial¹.

Good for patients. Good for our communities.

At a time of increasing patient complexity and demand for care, a highly educated and skilled workforce is crucial. The relationship between nurse education and improved patient outcomes has long been apparent. Hospitals in which 60% of nurses had bachelor’s degrees had lower mortality rates than that those in which 30% of nurses had a degree². Despite more and more evidence emerging to  support this the issue continues to be debated, disputed and sometimes even overlooked. Why is this? Garcia and Qureshi’s³ editorial on nurse identify and the misrepresentation of nursing in the media discusses these issues in greater detail.Those with expertise in what is good for patients and our communities, and what education, training and working conditions they need to deliver this. They are also experts in their own professions’ future and this needs to be centre stage of The NHS England Workforce plan⁴.

We invest. We retain.

Increasing the number of advanced clinical practitioners (ACPs) within the UK healthcare workforce to improve both patient outcomes and service delivery was discussed in a recent commentary by Wood and Hyde⁵.  Allocating resources to the promotion of evidence-based practice improves patient care and also increases nursing engagement and decreases staff turnover⁶.  The reasons staff leave are well known and evidenced; workload, low morale, dissatisfaction, burnout, moral distress, professional discrimination, pay and limited access to continuous professional development and career progression^{7, 8, 9,10} . We need to ensure that the learning environment for students is focused on support¹¹, wellbeing¹⁰  and better collaboration at ‘all levels, in all processes’ between universities and healthcare providers contributes also to a future healthy workforce¹².

Conclusion

The evidence is clear, investing in the development of the nursing workforce leads to high quality safe and effective care and better patient outcomes.  Improving working conditions and environments, high quality education programmes, continued professional development throughout nursing careers will help re-shape perceptions of nurses and nursing. At first glance, this may appear ‘costly’ to those who manage the relevant budgets. However, the cost of not investing is much much higher.

References

1. Twycross A, Wray J NHS England long-term workforce plan: Can this deliver the workforce transformation so urgently needed or is it just more rhetoric?FREE Evidence Based Nursing 2023, 26 (4) 125-127; DOI: 10.1136/ebnurs-2023-103807
2. Aiken LH , Sloane DM , Bruyneel L , et al . Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 2014; 383:1824–30. doi:10.1016/S0140-6736(13)62631-8
3. Garcia R. Qureshi I Nurse identity: the misrepresentation of nursing in the media Nurse identity: the misrepresentation of nursing in the media | Evidence-Based Nursing (bmj.com) Evidence Based Nursing  2023, 26 (4) 125-127; DOI: 10.1136/ebnurs-2023-103807
4. NHS England NHS long term workforce plan. 2023 Available: https://www.england.nhs.uk/publication/nhs-long-term-workforce-plan/
5. Wood AF, Hyde R Advanced Clinical Practitioners (ACPs) have a significant impact on patient outcomes and healthcare services Evidence Based Nursing 2024, 27 (1) 29; DOI: 10.1136/ebnurs-2023-103725
6. Powers J Nursing leaders must make a conscientious effort to invest in practices that support evidence-based practice (EBP) among nurses to improve patient outcomes and decrease nursing turnover Evidence Based Nursing 2023 Apr;20(2):162-171. doi: 10.1111/wvn.12645.
7. Palmer W , Rolewicz L . Nuffield trust Explainer. the long goodbye? Exploring rates of staff leaving the NHS and social care. Nuffield Trust 2022 The long goodbye? Exploring rates of staff leaving the NHS and social care | Nuffield Trust
8. Muir KJ, Porat-Dahlerbruch J, Nikpour J, Leep-Lazar K, Lasater KB. Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021 | Health Policy | JAMA Network Open | JAMA Network JAMA Netw Open.2024;7(4):e244121. doi:10.1001/jamanetworkopen.2024.4121
9. Peirson J Staff burn-out has implications for organisational and patient outcomes: would an open culture of support with structures in place prevent burn-out? Evidence Based Nursing 2022, 25 (3) 99; DOI: 10.1136/ebnurs-2021-103437
10. Finch N Impact of moral distress on early career nurses: an integrative review | Evidence-Based Nursing (bmj.com) Evidence-Based Nursing 2024;27:48-49.
11. Zhang N, Casas B Professional discrimination toward nurses increases nurse silence threatening patient safety outcomesEvidence Based Nursing, 2022, 25 (4) 133; DOI: 10.1136/ebnurs-2021-103474
12. Mills M Collaboration between universities and nursing placement providers is essential to ensure the well-being of the future nursing workforce Evidence Based Nursing Jul 2022, 25 (3) 92; DOI: 10.1136/ebnurs-2021-103444
13. Olasoji M Coping strategies and resilience in students should be supported by nursing curricula Evidence Based Nursing Jul 2022, 25 (3) 90; DOI: 10.1136/ebnurs-2021-103471