About 20 years ago, I was admitted to the hospital with chest pains. The situation turned out to be a non-event; the problem was related to anxiety, not my heart. What was an event, at least for me, was the kind nurse who spent extra time with me that night, talking about anything and nothing to help me calm down and finally get some sleep.
Every vulnerable, frightened hospital patient deserves the kindness and attention I received that night. Today’s nurses, though, are caught up in a triple-bind environment of staffing shortages, burnout and unequal and underpayment. COVID-19 obviously had a huge impact on the profession, but available data shows that the issues facing American nurses persist today. In 2023, for example, about one-fifth of the country’s 4.5 million RNs said they intended to leave the profession by 2027.
Forget the extra TLC my wonderful nurse was able to provide all those years ago — last year, a meta-analysis of studies on nursing burnout found that the condition is associated with adverse patient impacts, including more frequent infections, medication errors and “adverse events or patient safety incidents.” Nursing burnout isn’t just a professional issue. If this situation continues, the nursing shortage will become a public health crisis in a country that’s already facing way too many such calamities.
In New York state, the Mother Cabrini Health Foundation has decided to do something about the nursing shortage and nursing burnout with a $51 million, five-year commitment to help 13 of the state’s “safety net” hospitals — healthcare providers that serve vulnerable communities — reduce burnout, address nursing shortages and improve patient care. Each of the 13 grantees, which include urban and rural hospitals, will receive from $1 million to $5 million over the life of the initial grants to pursue one of two accreditations: either the American Nurses Credentialing Center’s Pathway to Excellence, which recognizes healthcare organizations that “foster a supportive and empowering workplace for nurses,” or ANCC’s Magnet Recognition, “a prestigious designation for healthcare organizations that demonstrate excellence in nursing practice and patient care,” according to the foundation’s May press release announcing the “Nursing Initiative” program.
Mother Cabrini Chief Programs and Grants Officer Daniel Frascella told Inside Philanthropy that the new grant program is the result of “a good amount of work, research and conversations” culminating in the funder commissioning a healthcare workforce report from New York’s Center for Health Workforce Studies focusing on hospitals serving high-need populations; for example, areas with a high percentage of individuals and families receiving Medicaid or who don’t have health insurance.
Frascella said that while the initial program is set to run for five years, the foundation plans to learn from this first group of grantee hospitals. “We want to be open to incorporating what we learn as we go into possible next steps or expansion, whatever the case may be,” she said.
Anupa Fabian, Mother Cabrini’s chief evaluation and learning officer, provided more details. “We will be doing an evaluation to really understand the impact of this initiative on nurse wellbeing, recruitment and retention, and on nurse sensitivity and patient quality of care,” she said. “And we hope that what we learn will be useful for the wider field of healthcare and nursing as to what works and what doesn’t.”
The foundation is also committed to persuading others to support better working environments for nurses. “We certainly engaged in many conversations with peer funders throughout this process,” Frascella said, and, as the work moves forward, Mother Cabrini will “try and engage others to see if there might be interest in either supplementing or adapting it to whatever their [healthcare-related] funding priorities might be.”
Those plans include presenting information about the nursing initiative at this November’s American Public Health Association conference.
Improving workplace conditions for nurses is vital because of the strong link between a “happy and healthy, robust nursing workforce and quality of care,” Fabian said.
The bottom line for Mother Cabrini is that improving nurses’ working conditions is necessary to improve patient outcomes, starting with hospitals serving some of New York’s most vulnerable communities. “The quality of patient care is very much at the front of our minds as we think about this,” Frascella said. “Everyone deserves high-quality healthcare, and people that go to hospitals with less resources deserve the same level and quality of care from nurses that we would all want for ourselves, our friends and our loved ones.”
Nursing, particularly hospital nursing, is one of the most demanding service professions there is. The people in that profession are entitled to safe, supportive and well-paying working environments with reasonable caseloads that allow them to practice their profession free from burnout. If more funders join Mother Cabrini in providing this sort of support for the profession — whether they do so to promote patient health, justice for underserved communities, or an interest in improving working conditions overall — we may be able to create more nursing environments where nurses and patients alike are better served.
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