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The project, “Promoting Healthy Work Environments and Confronting Workplace Violence Through Simulation Training,” will aim to decrease workplace violence across the UNC system and equip nurses with the skills needed to address it, including effective de-escalation tools, accurate reporting strategies and post-situation support. The filmed simulation scenarios will be disseminated as educational resources.

“We are immensely grateful to the AARP Health Equity and Nursing Innovation Fund for their support and the Ingram Institute for their generous matching funds,” said Dr. Valerie Howard, dean of the UNC School of Nursing and NC FON AC Co-Chair. “This combined funding enables us to expand our efforts in creating safer work environments for nurses.”

NC FON AC is a driving force transforming health and healthcare through nursing in the state. It is North Carolina’s arm of The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and Robert Wood Johnson Foundation.  

UNC’s TAPP is a new partnership between UNC Hospitals, UNC Health Rex, and the UNC School of Nursing, and it was established to support a partnership between academia and the practice setting to ensure nurses are prepared for nursing practice.

“We are excited to collaborate on this program,” said President Emerita NC AARP, and NC FON AC Co-Chair Catherine Sevier, DrPH, RN.  “Assisting nurses to be more capable and effective in their work environment is an important mission of the nursing school and the NC FON AC. This grant will fund a much-needed tool for that work.”

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The North Carolina Institute of Medicine convened the Task Force on the Future of the Nursing Workforce to develop policy recommendations that ensure nurses feel prepared and supported to practice in our state. This work was supported by The NC Pandemic Recovery Office, The Duke Endowment, and AARP NC. Stephanie McGarrah, Executive Director of The North Carolina Pandemic Recovery Office, said: “The task force has provided a path forward to address a workforce crisis that threatens the health and well being of all North Carolinians. More than ever, we owe it to our nursing professionals to take action using the strategies laid out in this report.”

The task force worked over a 12 month period to develop 8 evidence-based recommendations for Securing a Strong Nursing Workforce for North Carolina. These policy recommendations address the nursing shortage in North Carolina by ensuring nurses are valued and supported in their work. They include developing a strong and diverse nurse workforce; enhancing the educational and career advancement of nurses through all stages of their careers; ensuring a workplace culture that values the well-being of nurses; expanding the role of nurses in leadership; improving the retention of nurses; equipping nurses to be strong advocates for nursing and health care improvement; quantifying the value of nursing care; and optimizing the payment for health care services. NC FON AC Co-Chair Dr. Valerie Howard stated, “serving on the steering committee provided NC FON AC members a powerful opportunity to partner with other leaders across the state who are working to advance our shared vision to improve the health and health outcomes of North Carolinians and ensure we have the nursing workforce needed to achieve this goal.”  NC FON AC Co-Chair Dr. Catherine Sevier added, “The task force worked extremely hard to understand how serious the nursing shortage is in North Carolina. Now, we must address the findings, innovate, and make the changes needed to assure a healthy future for our state.”

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The North Carolina Future of Nursing Action Coalition (NC FONAC) marked their first in-person retreat and planning session since the onset of the COVID-19 pandemic, convening at the AARP North Carolina headquarters in Raleigh, North Carolina, on Saturday, February 4, 2023.

In planning for the meeting, the Coalition prioritized discussion of three recommendations included in the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Retreat participants focused on Recommendation 1: Creating a Shared Agenda; Recommendation 2: Supporting Nurses to Advance Health Equity; and Recommendation 4: Capitalizing on Nurses’ Potential.

Breakout sessions provided participants with the opportunity to discuss each recommendation with a goal of shaping the Coalition’s work to advance these areas for the benefit of residents of North Carolina.

“Our conversation was stimulating and strategic,” said Valerie Howard, EdD, RN, ANEF, FAAN,co-leader of the Coalition and dean of UNC School of Nursing. “We discussed how we might lead and encourage others in our Coalition—and beyond—to take action to advance health equity in North Carolina.”

Howard co-convened the retreat with NC FONAC co-leader Catherine Sevier, State President Emerita of the NC AARP.

“It’s encouraging to me to see the Coalition’s commitment as we continue to advance the nursing profession by advocating for our patients, the community, and each other,” said Sevier.

NC FONAC, founded over ten years ago, is comprised of nursing and community leaders from public and private organizations including universities in the UNC system, private universities in North Carolina, community colleges, hospital and health care systems, AARP NC, and other organizations committed to the health and well-being of North Carolina residents. The Coalition is committed to improving the health and health outcomes of populations across North Carolina.

AARP generously hosted the retreat.

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Nurses’ efforts to achieve health equity are always stronger when they form partnerships with the community being served. That’s why matching funding and local partnerships were a requirement for every project supported by the Future of Nursing: Campaign for Action’s Nursing Innovations Fund. The connections facilitated by this design were essential for these projects’ impact.

But an Innovation awardee in North Carolina took an especially effective approach to forming partnerships: engaging a “coalition of coalitions.”

This approach was pursued by Project RARE (Reciprocal, Authentic Relationships for Equity), an initiative of the North Carolina Agricultural and Technical University (NC A&T) supported by the North Carolina Action Coalition, a state-based arm of the Campaign. Initially focused on COVID-19 vaccinations in underserved communities, the program has since expanded to focus on an array of health conditions in African-American and rural communities.

According to program leaders, the relationships at the heart of this initiative were actually formed at a meeting about the Campaign’s Health Equity Toolkit. That’s where the Campaign, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation, took care to introduce Action Coalition leaders with representatives of Historically Black Colleges and Universities (HBCUs) from their states. That’s how Valerie Howard, EdD, RN, FAAN, met Lenora Campbell, PhD, RN.

“That was where the relationship began,” said Howard, who was recently named Dean of the College of Nursing at University of North Carolina Chapel Hill. “It’s all about building and maintaining relationships with others, even if you don’t know exactly what opportunity is going to come of that.”

Howard and Campbell, who served as Dean of NC A&T’s College of Health and Human Sciences until 2021, were soon using the toolkit to design a new approach to addressing social determinants of health in North Carolina. Cone Health, their partner and the provider of the matching funds, identified six North Carolina ZIP Codes with the highest number of low-acuity emergency room visits — a classic sign that a community lacks access to health care resources.

Then the team worked with churches in each ZIP Code to identify their most important health needs. Crucial to this partnership was the Congregational Nurse Program established by Cone Health in 1998, which had already identified trusted health professionals in many faith communities.

Congregational nurses are members of churches who serve as health advisers to their co-parishioners. According to Howard, these members of the most trusted profession enjoy an even higher level of trust. “It’s not just that you brought in a nurse to speak to this congregation,” she said. “She is a part of the congregation, a trusted member of the community.”

By the time Howard and Campbell began meeting with the pastors and nurses, it was clear that the COVID-19 pandemic would be the most pressing health need for their communities. So they agreed to work with Cone Health and the Guilford County Health Department to set up church-based sites for testing and vaccinations.

Campbell said that an important strength of the churches, Cone Health, and all the partners involved in the work was that they each already represented strong local coalitions. This helped bring whole communities on board from the start.

“If you can come to the table with people who already understand the importance of forming partnerships and coalitions, and who bring some themselves, then you are going to be ahead of the game,” Campbell said.

“You can already have diversity of thought when you receive an opportunity,” Howard added. “We all bring our own ideas and opinions, and that strengthens any proposal or initiative.”

That’s not to say the program did not face challenges, however. Campbell said that in early conversations, it was unclear what role pastors would play. They were more comfortable serving as spiritual leaders than health leaders, she said.

“They were pretty quiet in those meetings when we started out,” she said. “We let them be quiet if that is what they needed to be. But then we provided expertise that helped them feel like they could engage on these issues.”

One key area where the pastors could lead was building trust. As in underserved communities all over the country, the mostly Black church communities had a higher level of distrust in the health care system due to a history of racial violence and oppression.

The team took care to explicitly address these concerns. For example, presentations by a virologist explicitly contrasted the development of today’s vaccines with traumatic episodes from the past such as the Tuskegee Syphilis Study.

“He couched what he was saying in terms of historical information for marginalized communities,” Campbell said. “For many of the pastors, this was an a-ha moment. It said ‘We have this history, but we also have this virus that knows no history.’ The virologist himself was African-American, so he understood the full weight of what they were dealing with.” The pastors, in turn, felt comfortable embracing the information shared.”

While the counties targeted by the program had COVID-19 vaccination rates that were lower than average overall, the data show signs of hope in the communities being served by the program, with vaccination rates rising among the targeted communities The team attributes this difference to the work of Project RARE.

Now the project has turned to designing interventions for hypertension, cardiovascular disease, and other chronic diseases exacerbated by social determinants of health. But no matter what health issues are addressed, Campbell said, nurses will still be key to the program’s success.

“Nurses have always been focused on the whole patient,” she said. “That’s our history. They were focused on social determinants before anyone even coined the term.”

If you want to build programs like the one that emerged in North Carolina, learn more by visiting the Nursing Innovations Fund page or by downloading the Campaign’s Health Equity Toolkit.

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When nurses are empowered to create health equity in their communities, they bring together a network like nobody else can.

The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP and the Robert Wood Johnson Foundation, has demonstrated this principle through its Nursing Innovations Fund that supports the Campaign’s state-based Action Coalitions in creating replicable and promising solutions for improving health equity through nursing.

The Nursing Innovations Fund was also designed to spark collaboration with partners outside of nursing. One condition of the award is that applicants must seek matching funds from other organizations. In combination with other tools to engage local stakeholders, the awards have led to an impressive array of new multi-sector relationships, helping nurses discover new allies for creating better access to care and services.

Launched in 2018, the Nursing Innovations Fund has led to new projects in 23 states. The Campaign has awarded more than $850,000 to a wide variety of initiatives, with every dollar being matched by other funders. This blog highlights the collaborations and projects from the 2019 and 2020 cohorts representing 17 states, whom created over a dozen publicly accessible tools to be used for building health equity. All of the resources are available on the Campaign website.

State coalitions secured investment from multiple organizations that understand why it is so important to invest in better access to care and services. They include organizations one might expect, such as hospitals, nursing schools, and regional philanthropies. Action Coalitions also secured funding from unexpected sources:

• In Georgia, funding from the Clayton County Fire and Emergency Services helped create more effective paths for Black men to enter nursing.  
• In Kentucky, the Kentucky Beef Council supported an initiative to prevent suicide in the farming community, and
• In Nebraska, Scoular, an agriculture supply chain company, contributed matching funds to a project aimed at improving health equity.

In addition to funders, Action Coalitions garnered critical support from community partners representing dozens of different organizations. Here are a few of their stories:

• In Pennsylvania, a podcast highlighting nurses in health equity roles featured many local partners, including Sanctuary Farm, a program that converts abandoned areas in Philadelphia to farm plots.
• In Washington, a program to bring culturally appropriate food and essentials to older Filipino community members worked with local and national groups such as the National Alliance for Filipino Concerns.
• In Indiana, nurses from the Indiana Center for Nursing collaborated with the AARP state office to enable nursing schools across the state to implement holistic admissions programs

Crucial to the impact of these projects is the idea that all of them can provide insights that help many other organizations disrupt disparities and improve access to care and services.

Actions Coalitions drew on well-established tools to address health disparities, including the Campaign’s Heath Equity Toolkit and the Centers for Disease Control and Prevention’s (CDC) Healthy People 2030. In turn, many of them developed new resources to help others:

• In Wisconsin, the Action Coalition developed a curriculum to improve nurses’ disaster response capabilities, and it is being shared throughout the state.
• In Massachusetts, nurses developed an anti-vaping resource kit for use in public schools.
• The Pennsylvania initiative centers on a podcast that helps nurses envision new careers in health equity.

Together, these partnerships, resources, and insights add up to a powerful network working to achieve health equity in the U.S. built on strengthened nursing capacity and expertise, as the National Academy of Medicine’s Future of Nursing 2020—2030 report has envisioned.

In the coming weeks, this Campaign blog will feature more detailed explorations of how this work brought together local and state coalitions to address health equity. Projects to be featured include:

• Indiana – This project brought together partners including AARP Indiana State office and Orbis Education to help nursing programs implement holistic admissions and peer-to-peer mentoring for the Nursing Education, Engagement, and Diversity Statewide Initiative, or NEEDS.
• Kentucky – The Kentucky Nurses Action Coalition enlisted school nurses to address the state’s disproportionate suicide rate, culminating in a dramatic presentation designed with the Actors Theater of Louisville. Title: School Nurses to BARN Camp for the Mental Health and Wellness of Kentucky Youth.
• Massachusetts – This project addressed vaping in youth in partnership with education and law enforcement groups from across the state, yielding new curricula to aid teachers in elementary and secondary schools. Title: Promoting Health Literacy to Influence Health and Wellness of Students in the Community: Widening the Connections.
• North Carolina – Working with the North Carolina Action Coalition, the North Carolina Agricultural and Technical University developed a new model of coalition-building to help African American and rural communities. Title: Project RARE (Reciprocal, Authentic, Relationships for Equity).
• Wisconsin. The Wisconsin Nurses Center explored gaps in the state’s emergency preparedness plans, then developed a training to help nurses address the problems. Partners included nursing schools as well as the Rural Wisconsin Health Cooperative and the Wisconsin Primary Health Care Association. Title: Preparing Wisconsin Nurses to Address the Needs of Vulnerable Populations in a Public Health Emergency.

Previous blog entries have also explored Nursing Innovations Fund programs in Pennsylvania, West Virginia, and Wyoming.

Are you interested in addressing health equity in ways like the Campaign’s Action Coalitions? Visit the Nursing Innovations Fund page for a complete list of programs as well as the Campaign resources nurses used to create them.

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To nominate yourself or someone else, please visit:
https://app.smartsheet.com/b/form/5e8abe10f5334490abf41a2485e55808.

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Join the NC Organization of Nurse Leaders on Thursday, November 5, 2020, for a virtual conference entitled “Nurses: Powerful. Purposeful. Positioning for the Future!” Topics will include: moral and ethical challenges of nurse leadership during a pandemic; incivility; active bystander training; COVID 19 rapid appraisal of frontline healthcare workers in North Carolina; and newfound professional and personal strength derived from COVID. View the agenda at https://duke.box.com/v/NCONL-2020-conference-agenda for more details and visit https://nconl.memberclicks.net/ for registration information.

Nurses: Powerful. Purposeful. Positioning for the Future!

Thursday, November 5, 2020

9:45 am -10:00 am Welcome -NCONL
Crystal Hayden, DNP, RN, , CNO/COO UNC Nash, NCONL President

Sponsor Recognition

10:00 am -10:50 am CNO Panel: Moral and Ethical Challenges of Nurse Leadership during a Pandemic

Moderator: Kimberly Gordon, MSN, CRNA, Piedmont Triad Novant Health

Cindy Boily, MSN, RN, NEA-BC, SVP, CNO. WakeMed Health and Hospitals

MaryEllen Bonczek, BSN, RN, MPA, System CNE, New Hanover Regional Medical Center

Donna Wimberly, RN, MBA/MHA, SVP and CNO, Wayne UNC Hospital

Rebecca Smith, MBA, BSN, RN, VP, COO, CNO, UNC Caldwell

Deb Harding, DNP, RN, NEA-BC, CNO, Wake Forest Baptist Medical Center

10:50am-11:00 am. Break

11:00 am -11:50am Incivility is Hardly Harmless

Brenda Burk, MSN, RN, CSSM, CNOR, Director of Surgical Services, Lake Norman Regional
Medical Center

11:50am- Noon Break

12:00 pm –1:00 pm Lunch Break and Sponsor Gallery

1:00pm-1:50pm Active Bystander Training
Michele Blakely, DNP, RN, Director of Nursing Professional Practice, Wake Forest Baptist
Medical Center

1:50pm-2:00pm Break

2:00pm-3:00pm Covid 19 Rapid Appraisal of Frontline Healthcare Workers in North Carolina
Andrea Freidus, PhD, MPH, Assistant Professor Anrthropology, UNC Charlotte

2:50pm-3:00pm. Break

3:00 pm – 3:50pm Newfound Professional and Personal Strength Derived from Covid
Emily Sickbert-Bennett, PhD, MS, CIC, Director, Infection Prevention, UNC Hospitals
Administrative Director, Carolina Antimicrobial Stewardship Program, UNC Hospitals
Associate Professor of Medicine-Infectious Diseases, UNC School of Medicine
Associate Professor of Epidemiology, UNC Gillings School of Global Public Health

3:50pm –4:00pm Closing Remarks
Marie Marks, MSN, RN, President-Elect NCONL, CNO Lake Norman Regional Medical Center

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The Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation (RWJF), is pleased to announce that 10 projects proposed by its state-based Action Coalitions, or in a few cases, organizations designated by an Action Coalition, have been selected to receive awards up to $25,000 each for new or ongoing work that strengthens nursing’s role in building a Culture of Health and promoting health equity. All 2020  Nursing Innovations Fund secured dollar to dollar matching funds from a variety of partners, including local county fire and emergency services, a state beef council, United Way, local foundations, health and hospital systems, universities and individual donors, to name a few.

The winning projects from nearly every region of the country range from developing nurse leaders to serve on local boards to a mentoring program for Black men that promotes educational attainment and employment opportunities in nursing. All are designed to address policies that impact the many different social, economic and environmental factors that shape our health, and that will lead to greater health equity for all.

RWJF defines health equity as, “everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments and health care.”

“As a co-chair of the Campaign’s Equity, Diversity and Inclusion Steering Committee (EDISC),

I am proud that these 2020 Nursing Innovation Fund projects are committed to advancing health equity, particularly at a moment when our nation is finally paying increased attention to addressing systemic racism,” said Carmen Alvarez, PhD, CRNP, FAAN, assistant professor, Department of Community-Public Health, Johns Hopkins University.

“A pathway to equity is to help build better health through nursing,” said Eric J. Williams, DNP,  RN, FAAN, assistant director and faculty chair and professor of nursing at Santa Monica College, and fellow co-chair of the EDISC. “These efforts are a step in that direction and I applaud the Action Coalitions for their work.”

The Campaign’s Nursing Innovations Fund was created in 2018 to support work of its Action Coalitions and allies that inform and influence policy, produce replicable strategies that place nurses in positions as essential partners in providing care, and strategically involve a diversity of stakeholders. This competition was limited to the Action Coalitions or organizations designated by Action Coalitions and required applicants to raise funds to match the award dollars. To date, 23 Action Coalitions and allies have received Nursing Innovation Fund awards to build healthier communities through nursing.

“As our nation continues to face the devastation wrought by COVID-19, nurses remain on the frontlines as trusted providers of care. Now, more than ever, our country is relying on nurses to apply their unique knowledge and understanding of community needs for better health. These states demonstrate how nurses use that critical perspective to implement innovative programs to improve health and well-being,” said Susan B. Hassmiller, PhD, RN, FAAN, senior adviser for nursing at RWJF and director of the Campaign for Action and Susan C. Reinhard, PhD, RN, FAAN, senior vice president and director of the AARP Public Policy Institute, and chief strategist at the Center to Champion Nursing in America, an initiative of AARP Foundation, AARP, and RWJF, which coordinates the Campaign for Action.

The winners and an overview of their proposals are listed below:

Arkansas and Tennessee

The Arkansas Center for Nursing and the Tennessee Action Coalition aims to develop nurse leadership and places nurses on local housing and planning boards throughout the Arkansas Tennessee Delta region, to help create healthier communities through the project, “Nurses Building a Culture of Health in the Arkansas-Tennessee Delta”. This geographic area has a history of inequities, poverty and poor health outcomes. Matching funds were provided by the Arkansas State Board of Nursing, the Tennessee Department of Health and the Tennessee Housing Development Agency.

Georgia

The Georgia Nursing Leadership Coalition plans to implement a mentoring program for Black men that promotes educational attainment and employment opportunities in nursing through the “High School to Higher Education: Increasing Black Male Representation in Nursing” project. The efforts will engage community partners as stakeholders and employ a holistic approach to providing professional and personal development opportunities to assist mentors and mentees build the skills needed for educational attainment and employment success.

Kentucky

The Kentucky Nurses Action Coalition’s project, “Kentucky Partners to the BARN (Bringing Awareness Right Now) Program for a Farmer Dinner Theater Addressing Mental Health & Wellness” is a three-part intervention program designed to help address farmer mental health issues and prevent suicide. Fifty high school students with an agricultural career interest will receive tailored training sessions to raise self-awareness about mental health and wellness, learn suicide prevention skills and theater skills to produce a dinner theater addressing mental health and wellness for approximately 100 Kentucky farmers and their families.

Nebraska

The Nebraska Action Coalition’s project, “Striving for Health Equity in Nebraska,” works to address social determinants through a multipronged approach.

1. Build professional students’ knowledge of population health by having them design and disseminate health information at school health fairs.
2. Develop community-based partnerships via an advanced practice registered nurse led clinic which provides integrated behavioral health care for rural and underserved populations.
3. Promote awareness and build partnerships through an annual Leadership/Culture of Health conference. The conference will address topics such as advocacy, policy, mental health/self-care, implicit bias, and it will also include a “COVID-19 Lessons Learned” panel.

North Carolina

North Carolina Agricultural and Technical State University’s project, “On the Ground: Access to Care through Building Faith, Health, and Community Partnerships,” supported by the North Carolina Action Coalition, seeks to develop a faith, health, and community engagement model utilizing the Campaign’s Health Equity Toolkit. The program aims to enhance the health equity advocacy and partnership/coalition building skills of nurses, nursing students, pastors and church members to promote the health and well-being of communities through congregations. It will also create a regional steering committee to engage stakeholders to prioritize and address social determinants of health that adversely affect the health and well-being of African American and rural communities, and promote health-related congregational activities focused on the needs of the community.

Pennsylvania

Through its “At the Core of Care” podcast, the Pennsylvania Action Coalition will showcase stories of nurses and their partners driving change by addressing social determinants of health. The series will be incorporated into nursing school classrooms to inspire public health leadership and advocacy.

Washington

The National Alliance for Filipino Concerns launched the “Bayanihan Response to COVID-19″ to respond to the immediate and long-term health and wellness needs of Filipino communities in the United States and the Philippines. Via a telephone weekly check in and screening with elders identified as high need, callers assess for COVID-19 symptoms, food, prescription, utilities, housing needs and pre-paid phone minutes. They also offer a grocery and meal delivery program to ensure clients have access to nutritious and culturally appropriate food.  Lastly, they will conduct a community wellness survey. Focus group results will be disseminated to community members, stakeholders, and the public. In collaboration with Seattle University College of Nursing, and support of the Washington Action Coalition, they will use survey data to create interventions and initiatives to address community needs.

West Virginia

The West Virginia Action Coalition project, “RN Entrepreneur Project Continuation,” will create five sustainable nurse businesses and teach the entrepreneur course to 20 additional nurses. The training curriculum and program will expand across the state.

Wisconsin

The Wisconsin Action Coalition’s project, “Preparing Wisconsin Nurses to Address the Needs of Vulnerable Populations in a Public Health Emergency”, will design and develop trainings for Wisconsin nurses in response to the specific educational needs created by COVID-19. Trainings will address disparities impacting Wisconsin’s most vulnerable populations. Components include: launching educational programs for Milwaukee nurses who care for diverse and vulnerable populations, evaluating and improving learning content and methodologies and expanding the program statewide.

Wyoming

The aim of the Wyoming Institute for Disabilities, University of Wyoming, in support with the Wyoming Action Coalition project, “Facilitating Seniors’ Use of Technology to Decrease Social Isolation,” is for nursing students to help older adults use technology in their homes to access health care, purchase groceries and household goods, and communicate with their friends and family.

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