Burnout knows no borders. The nursing workforce crisis cares little about country lines or continents. Regardless of their time zone, nurses in all settings are leaving the profession. “Healthcare systems are ailing, and they are in urgent need of healing. [We] call to action health system executives and other leaders to support, promote, and enable bold experiments to avert additional personnel losses and improve patient outcomes,” ONS member Christopher Friese, PhD, RN, AOCN®, and colleagues wrote in a July 2023 NAM Perspectives commentary.

Friese—who has spent considerable time on Capitol Hill in roles such as the National Cancer Advisory Board and Patient-Centered Outcomes Research Institute Board of Governors—progressively takes his already strong activism to greater heights. The current commentary is “aligned with the National Academy of Medicine’s (NAM’s) National Plan for Health Workforce Well-Being and outlines the need for bold changes to address the crisis in nursing care through two historical examples and a current successful innovation from Singapore.”

The authors described Singapore’s novel approach, the Health District at Queesntown, which “harnesses the resources and expertise of the public, social, and private sectors in a real-world, location-based district to codesign effective, scalable, and sustainable programs that increase healthy and purposeful longevity, strengthen intergenerational cohesion, and enable a community for all ages, allowing residents to age in place with long-term care within their homes and communities, among families and friends.” To address the nursing workforce, the Health District embeds interprofessional teams of community nurses and other health and social care professionals in its public housing. When integrated with support from the country’s universities, the innovation “generate a learning cycle to ensure that nurses have the skills to develop person-centered, longitudinal care within the community.”

Friese et al. called for healthcare executive teams throughout the world to implement similar bold actions recognizing that nursing is pivotal to success. They suggested specific examples, including:

  • Flexible scheduling models
  • Shared clinical practice roles between schools of nursing and health systems
  • Dynamic patient assignment systems
  • Delivery of expert advanced practice nursing care regardless of the patient’s physical location
  • Innovation centers for nurse-led developments in care delivery and population health

“Compellingly, after such bold actions, care will likely be less expensive to deliver than the current state due to reduced spending on temporary staffing and ongoing employee recruitment and orientation,” they added.

“The authors issue this call to action for health system executives to join forces with physician and nursing leaders to create this moonshot for transformative change,” Friese et al. concluded. “Executives need to harness the creativity of their expert clinicians to propose and test innovations. Such efforts have the potential to achieve population-level health improvements and a sustainable and vibrant healthcare workforce.”