At the halfway mark of Future of Nursing 2020-2030, we can determine the progress made since the National Academies of Sciences, Engineering, and Medicine outlined their vision for the decade. Their report made clear that nurse leaders are critical to meeting the evolving demands of healthcare.
The past five years have tested the resilience of nurses like never before in our lifetimes. The COVID-19 pandemic placed extreme stress on healthcare systems, leading to workforce shortages, increased patient complexity, and evolving care models. At the same time, nurses stepped into new leadership roles, influenced policy decisions, and expanded access to care in innovative ways.
One of the strongest themes in the report was the need for stronger nurse leadership at every level — within healthcare organizations, public health, policymaking, and education. While progress has been made, there is still much work to do. But it is certain that nurse leaders will continue to play a pivotal role in shaping the next five years and beyond.
In this article, we’ll explore how well we are positioning our nurse leaders to tackle healthcare’s challenges, and what healthcare leaders still need to do to ensure that nurses can help shape the future.
The major impact of nurse leaders
Nurse leaders have a profound impact on both patient care and the nursing profession. Their influence extends beyond hospital walls, reaching into public health, education, policy, and the future of healthcare.
How nurse leaders are transforming patient care
Since 2020, nurses have taken the lead in transforming how and where care is delivered. The shift toward value-based care, community health initiatives, and holistic treatment models has provided new opportunities for nurses to step into leadership roles.
- Expanding access to care: Nurse-led clinics, mobile health units, and telehealth services have increased access to healthcare for underserved communities. Advanced practice registered nurses (APRNs) are leading primary care initiatives, particularly in rural and low-income urban areas where physician shortages are severe.
- Care coordination and patient-centered models: As chronic conditions become more prevalent, nurses are playing a central role in care coordination and chronic disease management. The development of nurse-led care models, such as the Transitional Care Model, has improved patient outcomes and reduced hospital readmissions.
- Leveraging technology and telehealth: Nurse leaders have embraced telehealth and digital health solutions, allowing patients to receive care from their homes. The pandemic accelerated the adoption of these tools, and nurses are now at the forefront of digital health transformation.
Despite these advancements, barriers still limit nurses’ ability to lead in clinical care. Workforce shortages, administrative burdens, and restrictive scope-of-practice laws continue to challenge the full realization of nurse-led care models.
How nurse leaders are strengthening the profession
Beyond patient care, nurse leaders shape the future of the profession itself. With rising rates of nurse burnout and more nurses retiring, strong leadership is essential to retaining and growing the workforce.
- Mentorship and workforce retention: Nurse leaders play a crucial role in mentorship, professional development, and career advancement opportunities for new nurses. However, staffing shortages and high turnover rates have made it difficult for many organizations to prioritize these efforts.
- Educational reform and training: The Future of Nursing report emphasized the importance of education reform to better prepare nurses for leadership and community-based care. Some progress has been made, but access to leadership training programs and executive education remains limited.
- Advocacy and policy influence: Nurse leaders are pushing for policies that support workplace safety, better staffing ratios, and mental health resources for nurses. The pandemic highlighted the urgent need for stronger nurse representation in policymaking, but gaps in leadership opportunities persist.
While the past five years have seen nurses take on greater leadership responsibilities, many barriers remain. The next five years will be critical in determining whether nurses have the support they need to lead the profession forward.
Comparing the report to today’s realities
The Future of Nursing 2020-2030 report set ambitious goals for the profession, particularly in the area of leadership. At the decade’s midpoint, it’s clear that while some progress has been made, the realities still fall short of where we want to be.
Expanding nurses’ influence
- Report: Nurses should take on executive roles, serve on hospital boards, and lead interdisciplinary health initiatives.
- Reality: While some hospitals and health systems have made progress in placing nurses in executive leadership and governance roles, nurses remain underrepresented in high-level decision-making. The need for nurse-led policy leadership remains stronger than ever.
Building leadership pipelines
- Report: More mentorship and executive education programs can prepare the next generation of nurse leaders.
- Reality: Some hospitals and universities have expanded leadership training and developed clinical ladder programs, but participation is often limited due to workforce shortages and heavy workloads. Many nurses are unable to take advantage of leadership development opportunities because of demanding schedules. Health systems should consider new approaches to encourage opportunities while allowing nurses time to participate.
Innovation in care models
- Report: Nurse-led models in primary care, community health, and chronic disease management should expand.
- Reality: Some success stories have emerged, particularly with nurse-led clinics and home-based care models. However, regulatory restrictions on scope of practice still limit nurses’ ability to provide care independently in many states. Further legislative action is needed to fully utilize the nursing workforce.
Crisis preparedness
- Report: Nurses should play a central role in public health and emergency response planning.
- Reality: The COVID-19 pandemic elevated nurses’ role in disaster response and crisis management, but nurses still face challenges in having a formal seat at the table in national emergency planning. Encouraging nurse leaders to have a more proactive role in emergency response preparedness and public health crises should be an essential priority for healthcare systems.
Adoption of new technologies
- Report: Greater adoption of technology in nursing would enhance patient care, streamline workflows, and improve health outcomes.
- Reality: The adoption of technology has advanced in the areas of virtual nursing and precepting, but progress remains fragmented across healthcare settings. Infrastructure and integration challenges can impede interoperability, resulting in a lack of standardization and slowing change. Training gaps and hesitations related to workflow disruptions, the use of AI, and data security are some of the current barriers to technology adoption in healthcare.
Retention is key to the growth of nursing
While not the main topic of Future of Nursing, we know that retention is a major underlying reason — and beneficial result — of focusing on strengthening nurse leadership. Many of the report’s topics, including leadership development, career pathways, mentorship training, cultivating nursing leadership pipelines, and supporting frontline nurse managers, all lead to better nurse retention by preventing the attrition that occurs when these qualities are absent or lacking.
Focus on nurse well-being
The report highlights workplace emotional health as a key factor in retention. As nurse leaders, we understand that nurse well-being impacts patient care and team resilience. In extreme cases, burnout, stress, and workplace violence can drive nurses to leave the profession altogether.
Strategic workforce planning
Staffing and workforce planning are also areas needing strong leaders who are connected to the needs of their workforce and the organization’s strategic workforce plan. Managing staffing ratios and workloads in a challenging labor market requires a high level of acumen from experienced leaders. In a time when nurses want flexible scheduling and career mobility, nurse leaders must accommodate multiple priorities while promoting quality and safe care on the journey to clinical excellence.
More benefits and supports
More generally, the report advocates fair compensation, professional growth opportunities, and recognition of nurses’ contributions as key factors for retention. These themes collectively promote long-term workforce sustainability by ensuring that nurses remain engaged, supported, and empowered throughout their careers. By retaining high quality nurses while effectively transitioning new nurses into safe clinical practice, we may finally begin to realize an end to the nursing shortage.
What will the next five years bring to nursing?
In terms of the Future of Nursing 2020-2030 report’s predictions, nurse leaders have made significant progress, but challenges remain. While nurses are taking on more leadership roles than ever before, workforce conditions, regulatory barriers, and gaps in leadership development continue to hinder progress.
For nursing to truly shape the future of healthcare, investments must continue in leadership development, workforce empowerment, and policy influence. Healthcare organizations, policymakers, and educators must work together to empower nurse leaders at all levels.
The next five years will determine whether healthcare organizations have set a viable path forward for their nursing leaders to support a stronger, more resilient workforce.
The Critical Role of Nurse Managers in Nurse Retention
Nurse managers play a critical role in nurse retention and job satisfaction. Their ability to lead, communicate, and create a supportive environment fosters high levels of engagement within the workforce. Join industry expert Felicia Sadler, Vice President of Quality at Relias, in this on-demand webinar as she shares insights on building strong leaders and integrating professional development opportunities within your health care organization.
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