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Trust Science and Inspire Hope: Our Duty of Care

      At the stroke of midnight on December 31, 2020, we ushered in 2021. While the celebratory nature of the calendar change is nothing new, this year, it seems to offer more hope. As scientists, researchers, and leaders in practice and academia, we know that nothing miraculous happened overnight. Yet, the start of a new year brings an opportunity for a new perspective, a new approach, and a renewed effort.
      The nation and many countries around the globe ended 2020 with vaccine distribution. The coronavirus pandemic (COVID-19) placed an immense personal and societal impact on global citizens that will be hard to ever measure completely. The devastation to the mental, economic, physical, and emotional well-being of individuals and industries will warrant time to recover. Bringing hope, however, was the fact that science prevailed—faster than ever before—which was celebrated and cheered.
      In the United States, we watched as Sandra Lindsay, an ICU registered nurse at Long Island Jewish Medical Center in Queens, received the first vaccine on Monday, December 14, 2020. In her interview, Lindsay noted, she trusted science and wanted to “inspire people who look like me” (
      • Otterman S.
      ‘I Trust Science,’ Says Nurse Who Is First to Get Vaccine in U.S..
      ). In just a few short words, this incredible nurse, who has been working throughout the pandemic, summarized the needed message for 2020 and the one to carry into 2021— trust science and inspire hope.

      Trust Science and Inspire Hope

      We know that there is much work to be done in this area as we start the new year. According to a Kaiser Family Foundation poll, 15% of Americans surveyed in December said they would not get the vaccine (
      • Hamel L.
      • Kirzinger A.
      • Munana C.
      • Brodie M.
      KFF COVID-19 Vaccine Monitor: December 2020.
      ). Further, vaccine hesitancy is more prominent in certain populations. Specifically, it is highest among Republicans, rural residents, those 30-49 years of age, and Black adults (
      • Hamel L.
      • Kirzinger A.
      • Munana C.
      • Brodie M.
      KFF COVID-19 Vaccine Monitor: December 2020.
      ). In my last president's message of 2020, I shared insights on the impact of the COVID-19 vaccine and how vital the nursing profession will be to continue the battle into 2021. This will remain a cornerstone of the American Academy of Nursing's (Academy) work from a public communications perspective, and as we look to engage with the 117th Congress and the Biden Administration.
      At the end of the year, I submitted, on behalf of the Academy, a letter to then President-Elect Biden and Vice President-Elect Harris. In this letter, I outlined how our organization, comprised of the most accomplished nursing leaders in health care, can assist the new Administration, and highlighted the Academy's specific policy priorities. I shared that, as a science-based organization, the Academy continues to be concerned with misinformation circulating about the COVID-19 pandemic related to the spread of the virus, and the vaccine. It further stated that as nurses, “Our ethical code and professional obligation is to provide clear, unbiased education and information based on the latest research and science. Ultimately, it is incumbent upon our profession to elevate the nation's health literacy” (). To that end, I reaffirmed that in 2021, the Academy will work diligently to amplify science, trust, and health literacy as the COVID-19 vaccine is rolled out.

      Duty of Care

      In preparing this communication, it was hard not to reflect on President Biden's message “Duty of Care.” The President-Elect shared this message in his speech following the killing of George Floyd where he stated, “For that's what the presidency is: a duty of care – to all of us, not just our voters, not just our donors, but all of us” (). “Duty of Care” could not resonate more strongly with the nursing profession. The Academy's new vision is healthy lives for all people, signifying that as an organization, we too are resolute in our duty of care. Over time, the Academy has had a clear and distinct focus on health equity and uses this lens to advance policies and solutions. To that end, the Academy's letter to the new Administration emphasized pressing issues. Specifically, the organization addressed the preservation of key Affordable Care Act provisions; reuniting children separated at the southern border with their families; the impact of climate change on health; maternal health and infant health, a critical focus for Black mothers; the ongoing impact of COVID-19; addressing gun violence; combating military sexual trauma; and research funding to name a few ().
      Specific to COVID-19 and our mission, I think it is important to highlight that the Academy's letter to the Biden-Harris Administration addressed the mental health of nurses and health care providers as a top priority. As I have noted before in my communications to Fellows, the moral, emotional, ethical, and physical stress health care professionals have experienced during the pandemic will have long-term ramifications. Our organization will be a committed partner to provide support to those health care professionals needing vital mental health resources. Moreover, and central to the Academy's work, the letter spoke to our commitment to protecting vulnerable populations. Efforts to expand access to quality care through novel approaches, aimed at eliminating racism and improving health equity will lead to improved health. In the letter, the organization noted, “There must be a distinct focus on removing disparities and enhancing the care experience, especially for Black and brown mothers, migrant populations, LGBTQ individuals, children, older adults, indigenous communities, and other vulnerable populations” ().
      As you can see, the Academy is unwavering in its effort to bring the voice of our profession to the most critical policy discussions our nation will face over the next four years. To do that, and do it well, the Board of Directors needed to review and consider our organizational policy priorities.

      Policy Priorities

      As a policy organization, the Board of Directors reviewed and approved the organization's 2021-2022 policy priorities. These did not alter from 2019-2020 and remain:
      • Advance Health Equity and Champion Wellness;
      • Promote Innovation and Sustainability; and
      • Reduce Patient, Provider, and System Burden.
      However, the Academy wanted to take a different approach to be as inclusive as possible in our policy work. Therefore, we did not include specific focus areas as we have done in the past. After a detailed analysis conducted by the Academy staff of the nearly 50 policy products advanced in 2020 to national policy bodies or published in Nursing Outlook, it was noted that the Academy responded to several policy issues that were not directly mentioned in the focus areas. The Board's decision to focus on the three priorities allows the organization to be nimbler in responding to the policy issues that would fall under our three policy themes. I think it is important to see the priorities in full and have included them below.

      Academy's 2021-2022 Policy Priorities

      The vision of the American Academy of Nursing is healthy lives for all people. To actualize this vision, the Academy's mission is to improve health and achieve health equity by impacting policy through nursing leadership, innovation, and science, through four primary goals:
      • 1
        influence policy that achieves health equity, promotes wellness, eliminates racism, and improves health care delivery;
      • 2
        integrate nursing science into health, wellness, and social justice decisions;
      • 3
        disseminate nurse-driven innovation to reduce inequities and improve health; and
      • 4
        position nurse leaders to advance local and global change.
      In conjunction with the Academy's 24 Expert Panels, comprised of Academy Fellows in practice, research, policy, and academia, the 2021-2022 policy priorities further the organization's longstanding commitmentto addressing all of the underlying factors that impact the ability to achieve healthy lives. The Academy has a clear and distinct focus on health equity and uses this lens to advance policies andsolutions within each of our three overarching policy priorities.

       Advance Health Equity & Champion Wellness

      The Academy advances policies that protect and enrich safe and healthy communities. The Academy believes to truly improve health, policies must expand access to quality care across the lifespan through novel approaches, aimed at eliminating racism and improving health equity. This requires a distinct focus on removing disparities and enhancing the care experience, especially for Black and brown mothers, migrant populations, LGBTQ individuals, children, older adults, indigenous communities, and other vulnerable populations. The Academy also remains committed to reducing the impact of gun violence and protecting our communities from climate change and environmental toxins. Moreover, the Academy will continue to safeguard the wellness and safety of every individual in any location during all health stages including women and our nation's military and veterans. In light of the devastating toll coronavirus (COVID-19) has had on the public, the Academy will champion policies that rebuild the nation's public health infrastructure, and target vaccine-preventable diseases, and improve access to mental health care.

       Promote Innovation & Sustainability

      Now more than ever, the Academy believes nursing leadership in policymaking is vitally needed to promote innovation and sustainability while eliminating the systemic racism that contributes to health inequity. The Academy advances policies that adopt modernizations, which are sustainable and effective over time. This includes technologies, treatments, and models of care as well as policies that recognize providers for their expertise, education, and clinical training to amplify patient choice. The Academy believes competition in the healthcare provider market increases access and reduces cost while improving quality. Moreover, innovation in the health care industry, as well as emerging practices, must be tested and advanced for heightened impact and outcomes. This requires necessary investments in research and scientific careers.
      Specifically, the Academy advocates for the policy solutions that will promote positive reforms and advancements in telehealth, payment reform, full practice authority, and other innovative and successful solutions temporarily implemented during the COVID-19 pandemic become permanent.

       Reduce Patient, Provider, & System Burden

      The COVID-19 pandemic has shown the courageous dedication of nurses to ensure high-quality care for all individuals, yet they have experienced great moral, emotional, ethical, and physical distress. It is well known that patient health is linked to the well-being of their clinicians. The Academy advances policies that provide patients, providers, and systems, the ability to give and receive optimal care. This requires efforts to reduce the regulatory burden on daily practice while balancing patient privacy protections
      To achieve the goal of placing the patient at the center of care delivery, policies must equally support providers and systems. Specific to reducing patient, provider, and system burden, the Academy will work to advance policy solutions supportive of the providers within the care team, health literacy, and optimizing work environments so the health care system can take care of its workforce.
      I close by returning to the title of this piece: “Trust Science and Inspire Hope: Our Duty of Care.” The Academy continues to grow and evolve as an organization. I am proud of the work that we have accomplished in 2020 and know that with the addition of 231 new Fellows our potential in 2021 soars even higher. It is my hope for this new year that we all find more time to inspire and be inspired. However you find inspiration, we have the opportunity to create lasting and meaningful change together.

      References

        • American Academy of Nursing
        Letter to President-Elect Biden and Vice President-Elect Harris.
        2020, December 14
        • Hamel L.
        • Kirzinger A.
        • Munana C.
        • Brodie M.
        KFF COVID-19 Vaccine Monitor: December 2020.
        Kaiser Family Foundation, 2020, December 15
        • Otterman S.
        ‘I Trust Science,’ Says Nurse Who Is First to Get Vaccine in U.S..
        The New York Times, 2020, December 14
        • Pager T.
        • Epstein J.
        • Jacobs J.
        Biden Tries to Break Through as Trump Takes Military Footing.
        2020, June 1 (Bloomberg)