After more than two years of heightening response and awareness in every corner of U.S. society, the COVID-19 pandemic public health emergency (PHE) and national emergency is sticking around a few months longer. Originally set to expire on March 1 and April 11, respectively, both will finally come to an end on May 11, 2023, the Biden-Harris administration announced in January.

To try to get ahead of a feared increase of COVID-19 cases over the winter, the Biden-Harris administration released a COVID-19 winter preparedness plan in December 2022 that focuses on making vaccinations, testing, and other resources easily accessible.

My world changed on December 22, 2021. It is a day I will never forget: the day I tested positive for COVID-19. For nearly two years, all while caring for patients with the virus, I avoided contracting it. I prided myself on mask-wearing, handwashing, and social distancing, but what we know all too well is that COVID-19 does not discriminate.

I found a card from him the other day and my breath hitched. Then I remembered how annoying I thought he was the first time I heard him.

Creating a pathway for policymakers, providers, and the public to understand and recommend a new professional nursing dynamic, the Institute of Medicine’s 2011 Future of Nursing report investigated the current and future state and challenges of the nursing profession.

As I walk into the exam room, isolation mask and eye protection on against the COVID-19 pandemic, my heart feels heavy with the reality of the day, of this moment, of these years.

Created from $226.5 million in American Rescue Plan Funding, the Community Health Worker Training Program will increase the number of community health workers; mental health and substance use disorder prevention, treatment, and recovery services; chronic disease care; and other important health services, according to an April 2022 press release from the U.S. Department of Health and Human Services (HHS).

People from all major racial and ethnic minority population groups in the United States report experiencing more COVID-19–related discrimination than White adults, including being threatened or harassed based on a perception of having COVID-19, according to results from a new study funded by the National Institutes of Health (NIH).

More than $560 million in provider relief fund (PRF) phase four distribution payments reached more than 4,100 healthcare institutions across the United States in February 2022, according to the U.S. Department of Health and Human Services (HHS). The funding will be used to help healthcare institutions prevent, prepare for, and respond to the COVID-19 pandemic, including maintaining operations at facilities and recruiting and retaining healthcare professionals during the workforce shortage.

Cancer is one of the top five most expensive healthcare conditions to treat, costing the United States more than $157 billion annually. The payout from patients’ pockets may be even greater, with the cost of cancer medications alone standing at $895 billion per year. But paying for cancer during a pandemic? Even financially secure patients with healthcare coverage are struggling.

“Cancer doesn’t wait, and neither should you,” the Centers for Disease Control and Prevention (CDC) urged patients in its new cancer screening adherence campaign. The COVID-19 pandemic has created barriers to regular health visits, screenings, and treatment for individuals everywhere, and providers and organizations alike are seeking solutions.

Responses to pandemic-related screening and treatment delays have created new opportunities for oncology advanced practice RNs (APRNs), too. In both their institutions and communities, APRNs are guiding patients and providers to reverse the increases in late cancer diagnoses, morbidity, and mortality—ultimately improving outcomes.

Young nurses are “less emotionally healthy and less optimistic about the future,” even after accounting for age and years of nursing experience, according to findings from a 2022 study conducted by the American Nurses Foundation. High levels of burnout correlate with drones of professionals leaving the nursing field, the foundation said in its Pulse on the Nation’s Nurses Survey Series: COVID-19 Two-Year Impact Assessment Survey.

Ambulatory oncology began to gradually evolve in the mid-2000s to include multiple aspects of the care continuum. Then suddenly, a pandemic skyrocketed that growth as institutions Raced to develop their ambulatory infrastructure to meet new and changing needs.

President Joe Biden released the National COVID-19 Preparedness Plan in March 2022, enabling the United States to move forward with goals to protect against and treat COVID-19, prepare for new variants, prevent economic and educational shutdowns, and expand vaccinations.

Shortly after emergency workplace safety standards were removed and guidance on isolation time following a positive COVID-19 test result was updated, healthcare workers and administrations urged legislators to issue protections for the profession. To ensure their voices were heard, House of Representatives legislators Robert C. “Bobby” Scott (D-VA) and Alma Adams (D-NC) wrote a letter to President Joe Biden and Department of Labor Secretary Marty Walsh to advocate for a reversal.

On March 21, 2022, the U.S. Food and Drug Administration (FDA) announced that the United States is experiencing interruptions in the supply of prefilled 0.9% sodium chloride (saline) IV lock/flush syringes because of an increase in demand during the COVID-19 pandemic and vendor supply chain challenges, including the permanent discontinuance of certain prefilled saline lock/flush syringes.

For the past two years, patients and providers have turned their attention to combatting a global health threat. We’ve nearly crumbled amid the chaos, but carried on through acts of comfort and innovation. However, as we pled for an end to this nightmare, for heard immunity through vaccination, another health threat took a backseat. Cancer screening rates plummeted, particularly among communities of color. Oncology nurses can use evidence-based interventions to increase screening rates for all patients with cancer.  

Carole Johnson returned to the U.S. Department of Health and Human Services (HHS) as the new administrator of the U.S. Health Resources Services Administration (HRSA) in December 2021. Johnson, who previously served as testing coordinator for the White House COVID-19 response team before being replaced by HHS’s Tom Inglesby, expanded access to health services in New Jersey as the state’s human services commissioner.

Provider Relief Fund Phase 4 payments distributed approximately $9 billion to more than 69,000 healthcare institutions that have experienced revenue losses and expenses related to the COVID-19 pandemic, the U.S. Department of Health and Human Services (HHS) announced in December 2021.

Rewind. I adjust the strap on my mask and pinch it tightly around my nose and move it just under my lower eyelashes to prevent my goggles from fogging. These days, I am grateful for the face cover as it hides the pallor from six months in and the dark circles from long hours and anxious sleep. I wait at the valet circle for my team. Another SOS text out to them this morning. All hands on deck.

In late December 2021, the Centers for Disease Control and Prevention (CDC) released updated COVID-19 guidance, shortening the recommended time for isolation for those who tested positive for COVID-19 to five days followed by five days of wearing a mask when around others. Organizations that advocate for the well-being of healthcare professionals, such as the American Nurses Association (ANA) voiced their concerns and urged national leaders to prioritize those on the frontlines.

Overall trust of scientists and their research during the COVID-19 pandemic has increased by nine percentage points between 2018 and 2020, according to the results from the November 2021 Wellcome Global Monitor 2020: COVID-19 report.

In December 2015, I titled my ONS Connect column, “I Am Nurse, Hear Me Roar,” and addressed the outcry after a talk show host diminished Ms. Colorado, a nurse who was competing in the Ms. America competition that year. Nursing united its voice to educate the talk show host, the media, and the public.

For better or for worse, the COVID-19 pandemic has affected nearly every aspect of life as we know it. As the virus evolves, so do we—from individuals to health systems, the country, public health policies, and more.

As cancer care delivery changes, oncology nurses step up to the challenge: they adapt and develop solutions to fuel the future of nursing education, certification, and practice. During the November 2021 ONS Hackathon™, launched in partnership with the Oncology Nursing Certification Corporation (ONCC), teams were tasked to identify methods that address issues in the delivery of cancer care and prepare the future nursing workforce to care for patients with cancer anywhere.

Nurses and other healthcare professionals persevered through 2021 and its obstacles, including the COVID-19 pandemic, staff shortages, and increasing rates of burnout, and their selflessness, drive, and honesty have not gone unnoticed by the American public, according to Gallup’s annual Most Honest and Ethical Professions Poll. In results released in January 2022, Americans ranked nurses as the most honest professionals for the 20th consecutive year on a list that also included physicians, grade-school teachers, pharmacists, and other professions.

Driven by evidence-based practice and patient-centered care, nurses have earned the faith of the American public. For two decades, nurses have been ranked the most trusted and ethical profession in the United States. Although trust is critical, what it lacks is support for the profession through federal investment in research, education, and workforce issues for long-term stability.

Employer-sponsored health insurance premiums increased by 4% for families in 2021, bringing the average annual cost to $22,221 per family, according to the results of a benchmark Kaiser Family Foundation (KFF) Employer Health Benefits survey released in November 2021. KFF also assessed the COVID-19 pandemic’s impact on workplace health benefits, including telemedicine and mental health services.

As we turn the calendar to the new year, it feels a bit like the film Groundhog Day. Information about the COVID-19 pandemic—and related topics like masks, vaccination, and protecting ourselves and our patients from infection—still dominates the news and the literature. Many areas are struggling with surges in winter cases, and we all feel the personal loss of friends and family, colleagues, and patients and the toll it has taken on our profession. It is, without doubt, a constant presence in our lives.

The COVID-19 coronavirus pandemic has forced healthcare providers to make unprecedented adjustments to patient care, including the pivot to telehealth. At a series of virtual events from October 2020–March 2021, ONS members shared their challenges, successes, and future needs to permanently adopt virtual cancer care visits.

An investment of nearly $1 billion will help modernize 1,292 Health Resources and Services Administration (HRSA) health center program-funded health centers across the United States, according to an October 2021 announcement from the U.S. Department of Health and Human Services (HHS). The funding will be used to support major healthcare construction and renovation projects and strengthen the country’s healthcare infrastructure.

Patients with cancer are more likely to contract the COVID-19 coronavirus and experience complications from the infection—and the risk is highest for Black patients, study findings show. Researchers published the report in JAMA Oncology.

In an effort to protect patients and control the COVID-19 coronavirus pandemic, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) have issued an interim final rule requiring all staff at certain Medicare- and Medicaid-certified healthcare facilities to be vaccinated against COVID-19.

Out-of-state RNs can now practice in Maryland and certain qualified nursing students are fast tracking graduation, according to Maryland Governor Larry Hogan’s (R-MD) September 2021 announcements. The Old Line State’s steps will help increase the workforce and curtail the nursing shortage.

On October 20, 2021, the U.S. Food and Drug Administration (FDA) amended the emergency use authorizations (EUAs) for the Moderna and Janssen (Johnson and Johnson) COVID-19 vaccines to allow for the use of a single booster dose for certain populations.

Many patients are delaying their recommended cancer screenings because of fear of death from COVID-19 coronavirus infection, according to the Centers for Disease Control and Prevention (CDC). However, those fears may not align with real-world outcomes, the agency said, when it reported July 2021 study findings from Arkansas and North Carolina.

On September 22, 2021, the U.S. Food and Drug Administration (FDA) granted emergency use authorization for the Pfizer-BioNTech COVID-19 vaccine for use as a single booster dose administered at least six months after completion of the primary series in individuals aged 65 and older, individuals aged 18–64 at high risk for severe COVID-19, and individuals aged 18–64 whose frequent institutional or occupational exposure to SARS-CoV-2 puts them at high risk for serious complications of COVID-19 or severe COVID-19.

Despite its now-widespread use, telehealth still poses barriers for many patients, such as limited access in rural areas and privacy concerns. In August 2021, the Biden-Harris administration announced the investment of billions of dollars to meet immediate COVID-19 needs and help improve hospital care to rural communities. The funding includes more than $19 million in telehealth to improve the initiative in rural and underserved communities.

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra celebrated the Children’s Health Insurance Program’s (CHIP’s) 24th anniversary on August 4, 2021, a program that “for more than two decades, has been a lifeline for millions of children and families across America,” with an incredible announcement: in 2020 and 2021, CHIP provided more than 6.8 million enrolled individuals with coverage during the COVID-19 coronavirus pandemic.

The nursing shortage has reached dire proportions and more needs to be done to ensure the United States has the nurses we need to care for the public, particularly during the COVID-19 pandemic, the American Nurses Association (ANA) said in a September 2021 letter to the U.S. Department of Health and Human Services (HHS) urging the agency to declare the shortage a national crisis and to take action against it.

One of the many lessons we’ve learned since early 2020 is to hope for the best but prepare for the worst. When COVID-19 vaccination rates climbed and infection rates declined in spring 2021, we all confidently looked to September for a return to prepandemic activities. However, the Delta variant’s rapid transmission in July and resulting surge in infection rates paused our plans as the United States reevaluated the safety of a full return without restrictions.

To achieve value-based, person-centered care, the U.S. healthcare system must promote sustainability and readiness to prepare for future public health emergencies such as the COVID-19 coronavirus pandemic, the Centers for Medicare and Medicaid Service (CMS) said. In August 2021, CMS announced that the Hospital Inpatient Prospective Payment System and Long Term Care Hospital Prospective Payment System final rule will take effect on October 1, 2021, in support of that work.

On August 23, 2021, the U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 vaccine, now marketed as Comirnaty, for the prevention of COVID-19 coronavirus infection in individuals aged 16 years and older. The vaccine is still under emergency use authorization (EUA) for individuals aged 12–15 years and as a third dose in certain immunocompromised individuals.

The COVID-19 coronavirus pandemic has shed light on the U.S. healthcare system’s wide range of issues, from accessibility to barriers and social determinants of health. The country must respond with strategies to address future public health emergencies, the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee said in an April 2021 letter.

Nursing has long been associated with healing hands. Laying hands on patients’ bodies is personal and intimate, providing comfort, soothing reassurance, strength, and hope. It builds a sacred trust that engenders care. When that foundational element of nursing was removed to follow social distancing protocols during the COVID-19 coronavirus pandemic, nurses found a new avenue to connect with their patients—through the use of telehealth.

In today’s digital age of news, the public often struggles to decipher real science from misleading or incorrect information—and the COVID-19 coronavirus pandemic has only magnified the situation. Seeing a detrimental impact to the health of the nation, U.S. Surgeon General Dr. Vivek Murthy, MD, MBA, issued his first advisory report of the Biden administration on the topic of misinformation in public health.

The COVID-19 coronavirus pandemic was a wake-up call for preparedness: it caught society unaware and highlighted gaps in virtually every modern-day system. With those lessons learned, when the United States started removing pandemic-related public health restrictions and we began a return to “normal,” experts from all corners of society started looking to what the future will bring.