Who Will Speak for You

Gandhi is responsible for this well-known quote, "Be the change in the world you want to see."

Nurses are known for their advocacy skills. We advocate for patients and the community. It is part of the fabric of what it means to be a nurse.

But why does it stop there? Why do nurses allow the healthcare system to do business as usual, operating in 'crisis mode' and plugging staffing holes with less skilled staff and travel nurses? We know that baccalaureate-prepared nurses have a significant impact on patient outcomes.

Harrison et al. (2019) documented that each 10-percentage-point increase in hospital share of BSN nurses was associated with 24 percent greater odds of surviving to discharge. This study and others prompted the Institute of Medicine to recommend BSN for 80 percent of the nurse workforce by 2020. We have made great strides in reaching that goal. Today, 71.7% of registered nurses are entering practice with a baccalaureate degree, and many have pursued an even higher level of nursing education. Here we are in 2025, and the American Association of Colleges of Nursing reports approximately 60-70% of registered nurses in the U.S. hold a baccalaureate, master's, and doctorate (DNP or PhD).

Additionally, the past several years have shown us that there are four times as many RNs as physicians. Often, the nurse is the first point of contact for patients, and why it is essential for a baccalaureate degree in practice settings is necessary for patient safety and outcomes. However,
are we moving backward and destined to repeat history?

Current State

Nurses often describe their work environment as increasingly challenging due to administrative constraints, limited autonomy, and the rise of automated processes. Some common themes in their descriptions include:
A. Reduced Autonomy—Many nurses feel their clinical judgment is restricted by rigid protocols, electronic health record (EHR) documentation requirements, and administrator-driven decisions prioritizing efficiency over patient-centered care.
B. Increased Workload—Automation and standardized workflows, while intended to improve efficiency, often add to nurses' workloads by requiring extensive data entry, mandatory checklists, and frequent system updates, leaving less time for direct patient care.
C. Moral Distress – When administrative policies prioritize cost-cutting and efficiency over patient care, nurses may feel conflicted between following institutional rules and advocating for their patients' best interests.
D. Decreased Job Satisfaction – Many nurses report burnout due to understaffing, rigid scheduling, and the feeling that they are cogs in a system rather than skilled professionals. The lack of input in decision-making contributes to frustration.
E. Improved Safety but Loss of Personalized Care—While automation can reduce errors (e.g., barcode medication scanning, clinical decision support systems), it can depersonalize nursing. Some nurses feel they spend more time interacting with computers than with patients.
F. Limited Professional Growth – Decision-making is often centralized among administrators, leaving nurses with little say in policy changes, workflow improvements, or staffing models. Limited opportunities can hinder professional development and leadership prospects.
G. Resistance to Change—Nurses sometimes experience technology and automation as disruptions rather than enhancements, primarily if new systems are implemented without input or adequate training or input from frontline staff. Conversely, technology often creates systems issues that prevent nurses from " doing the right thing, " leading to moral injury and feelings of frustration and helplessness. Many nurses state that the new technology slows their workflow, though it is excellent in theory.

STOP THE MADNESS!

Nurses must advocate for change and improve working conditions to retain a competent, skilled workforce capable of managing the complexities of health conditions emerging in the 2020s.

Where do we start?

Get involved at the healthcare system level. Be prepared to present a logical and informed position on staff issues. Typically, we offer the problem without potential solutions. Therefore, they are overlooked or even disagreed with. Let's face it: nursing retention is a huge issue facing all healthcare systems. We must resist the urge to go after low-hanging fruit because this only fixes things in the short term.

What strategies can we implement today that have the potential for improving tomorrow?

We can't wait for someone else to save the profession. Our ability to survive and thrive is up to us. Nurses must stand united and advocate for themselves and the profession.

For more information about getting involved, reach out to the Georgia Alliance of Professional Nursing at deniselearyschmitt@gmail.com

#nursingcareers #urses #hospital #nursingeducation #healthcarereform