1. Hassmiller, Susan B. PhD, RN, FAAN


Charting a path to achieve health equity.


Article Content

The World Health Organization designated 2020 as the Year of the Nurse and the Midwife to increase our visibility, but COVID-19 thrust us into the spotlight for the wrong reasons. The nation watched as nurses cared for critically ill patients-often without the adequate personal protective equipment needed to keep them, their families, and their patients safe. According to Lost on the Frontline, a partnership between Kaiser Health News and the Guardian, more than 3,500 health workers have died from the virus, the majority of them nurses. A disproportionate number of those are people of color. Health inequities laid bare by COVID-19, coupled with the brutal police killing of George Floyd, sparked a racial reckoning and renewed calls for justice, including within nursing. Shuttered schools and skyrocketing unemployment contributed to a burgeoning behavioral health crisis.

Figure. Susan B. Has... - Click to enlarge in new windowFigure. Susan B. Hassmiller

While we are interdependent, we have not experienced the pandemic equally. Black, Latino, Indigenous, Pacific Islander, and lower-income populations have fared significantly worse than higher-income White populations because they are less likely to have access to health care and the ability to work from home, and are more likely to live in communities where social distancing is impossible. Nursing home residents have also been disproportionately affected. Our collective failure to protect these groups harms them and increases the risk of the virus's spread, leading to detrimental health and economic consequences for everyone.


Nurses came into 2021 battered and exhausted. Frontline health workers face trauma amounting to what National Academy of Medicine (NAM) president Victor Dzau and colleagues called a "parallel pandemic" in a New England Journal of Medicine editorial. Nursing also arrives at an inflection point. We face a choice: to maintain the status quo or commit to a more just future. This month's release of the NAM report The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity will give nurses and our partners in health care systems and communities the tools and support to make our country more just and healthy.


This second report, like its predecessor, arrives at a pivotal moment for the U.S. health care system. Released following the passage of the Affordable Care Act, The Future of Nursing: Leading Change, Advancing Health reconceptualized the role of nurses in transforming the health care system. The Robert Wood Johnson Foundation (RWJF) and AARP formed the Future of Nursing: Campaign for Action to advance the report recommendations. The nursing field mobilized to strengthen nursing education, advance practice, promote nursing leadership, and increase workforce diversity. Together, we built the capacity of the nursing workforce to expand high-quality care to more Americans.


The second report will require everyone to work together to make its recommendations a reality. Our nation's health inequities are built on 400 years of slavery, segregation, and systemic racism-and have been exacerbated by the pandemic. Because we are the most trusted profession and the first point of contact for most people seeking health care, nurses are perfectly positioned to advance health equity. Nursing organizations established the National Commission to Address Racism in Nursing, an excellent first step.


Our focus must be broad. We will need to form multisector partnerships with groups who have long been engaged in advancing health equity, including social justice, consumer, and faith-based organizations, and community and advocacy groups. Health systems and broader community partners must join us. We must also right injustices within our own profession and recommit ourselves to prioritizing nurse well-being.


The Future of Nursing 2020-2030 is a consensus report based on the best available evidence. It is also a starting point: readers can take it and make it their own, including furthering the research, conclusions, and recommendations. I invite you to read the report and reflect on what we have learned over the past year. How can we work together across systems and communities to translate these recommendations to ensure a healthier, more just future for all?