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National Academies Press: OpenBook

The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (2021)

Chapter: 5 the role of nurses in improving health equity, 5 the role of nurses in improving health equity.

Being a nurse … in 2020 must mean being aware of social injustices and the systemic racism that exist in much of nursing … and having a personal and professional responsibility to challenge and help end them.

—Calvin Moorley, RN, and colleagues, “Dismantling Structural Racism: Nursing Must Not Be Caught on the Wrong Side of History”

When this study was envisioned in 2019, it was clear that the future of nursing would look different by 2030; however, no one could predict how rapidly and dramatically circumstances would shift before the end of 2020. Over the coming decade, the nursing profession will continue to be shaped by the pressing health, social, and ethical challenges facing the nation today. Having illuminated many

of the health and social inequities affecting communities across the nation, the COVID-19 pandemic, along with other health crises, such as the opioid epidemic ( Abellanoza et al., 2018 ), presents an opportunity to take a critical look at the nursing profession, and society at large, and work collaboratively to enable all individuals to have a fair and just opportunity for health and well-being, reflecting the concept of “social mission” described by Mullan (2017, p. 122) as “making health not only better but fairer.” This chapter examines health equity and the role of nursing in its advancement in the United States.

As stated previously, health equity is defined as “the state in which everyone has the opportunity to attain full health potential and no one is disadvantaged from achieving this potential because of social position or any other socially defined circumstance” ( NASEM, 2017a , p. 32). While access to equitable health care, discussed in Chapter 4 , is an important part of achieving health equity, it is not sufficient. Health is affected by a wide range of other factors, including housing, transportation, nutrition, physical activity, education, income, laws and policies, and discrimination. Chapter 2 presents the Social Determinants of Health and Social Needs Model of Castrucci and Auerbach (2019) , in which upstream factors represent the social determinants of health (SDOH) that affect individuals and communities in a broad and, today, inequitable way. Low educational status and opportunity, income disparities, discrimination, and social marginalization are examples of upstream factors that impede good health outcomes. Midstream factors comprise social needs, or the individual factors that may affect a person’s health, such as homelessness, food insecurity, and trauma. Finally, downstream factors include disease treatment and chronic disease management.

Much of the focus on the education and training of nurses and the public perception of their role is on the treatment and management of disease. This chapter shifts that focus to nurses’ role in addressing SDOH and social needs, including their potential future roles and responsibilities in this regard, and describes existing exemplars. First, the chapter provides a brief overview of nurses’ role in addressing health equity. Next, it describes opportunities for nurses to improve health equity through four approaches: addressing social needs in clinical settings, addressing social needs and SDOH in the community, working across disciplines and sectors to meet multiple needs, and advocating for policy change. The chapter then details the opportunities and barriers associated with each of these approaches.


As described in Chapter 1 , the history of nursing is grounded in social justice and community health advocacy ( Donley and Flaherty, 2002 ; Pittman, 2019 ; Rafferty, 2015 ; Tyson et al., 2018 ), and as noted in Chapter 2 , the Code of Ethics for Nurses with Interpretive Statements, reiterated by American Nurses Association (ANA) President Ernest J. Grant in a public statement, “obligates nurses to be allies and to advocate and speak up against racism, discrimination, and injustice” ( ANA, 2020 ).

Addressing social needs across the health system can improve health equity from the individual to the system level. The report Integrating Social Care into the Delivery of Health Care identifies activities in five complementary areas that can facilitate the integration of social care into health care: adjustment, assistance, alignment, advocacy, and awareness ( NASEM, 2019 ) (see Figure 5-1 and Table 5-1 ). In


TABLE 5-1 Definitions of Areas of Activities That Strengthen Integration of Social Care into Health Care


the area of awareness, for example, clinical nurses in a hospital setting can identify the fall risks their patients might face upon discharge and the assets they can incorporate into their lives to improve their health. In the area of adjustment, telehealth and/or home health and home visiting nurses can alter clinical care to reduce the risk of falls by, for example, helping patients to adjust risks in their homes and learn to navigate their environment. And these activities can continue to the high level of system change through advocacy for health policies aimed at altering community infrastructure to help prevent falls.

In short, improving population health entails challenging and changing the factors and institutions that give rise to health inequity through interventions and reforms that influence the institutions, social systems, and public policies that drive health ( Lantz, 2019 ). It is important to note, however, that there are shortcomings in how evaluations of health equity interventions are carried out (see Box 5-1 ).


Although the provision of clinical care is a downstream determinant of health, the clinical setting presents an opportunity for nurses to address midstream determinants, or social needs, as well. Screening for social needs and making referrals to social services is becoming more commonplace in clinical settings as part of efforts to provide holistic care ( Gottlieb et al., 2016 ; Makelarski et al., 2017 ; Thomas-Henkel and Schulman, 2017 ). Nurses may conduct screenings; review their results; create care plans based on social needs as indicated by those results; refer patients to appropriate professionals and social services; and coordinate care by interfacing with social workers, community health workers, and social services providers. Although the importance of screening people for social needs has led more providers to take on this role, it has yet to become a universal practice ( CMS, 2020 ; NASEM, 2016 ), as most physician practices and hospitals do not perform screenings for the five key domains of social need 1 : food insecurity, housing instability, utility needs, transportation needs, and interpersonal violence ( CMS, 2020 ; Fraze et al., 2019 ). As trusted professionals that spend significant time with patients and families, nurses are well equipped to conduct these screenings ( AHA, 2019 ). Federally qualified health centers (FQHCs)—community-based health centers that receive funds from the Health Resources and Services Administration’s (HRSA’s) Health Center Program—often screen for social needs.

In many clinical settings, however, challenges arise with screening for social needs. Individuals may be hesitant to provide information about such issues as housing or food insecurity, and technology is required to collect social needs data and once obtained, to share these data across settings and incorporate them into


1 These five domains of social needs are part of the Centers for Medicare & Medicaid Services’ Accountable Health Communities Model ( Fraze et al., 2019 ).

nursing practice in a meaningful way. While nurses have an educational foundation for building the skills needed to expand their role from assessing health issues to conducting assessments and incorporating findings related to social needs into care plans, this focus needs to be supported by policies where nurses are employed. As the incorporation of social needs into clinical consideration expands, nurses’ education and training will need to ensure knowledge of the impact of social needs and SDOH on individual and population health (see Chapter 7 ). Communicating appropriately with people about social needs can be difficult, and training is required to ensure that people feel comfortable responding to personal questions related to such issues as housing instability, domestic violence, and financial insecurity ( Thomas-Henkel and Schulman, 2017 ). Finally, the utility of social needs screening depends on networks of agencies that offer services and resources in the community. Without the ability to connect with relevant services, screenings and care plans can have little impact. Consequently, it is important for health care organizations to dedicate resources to ensuring that people are connected to appropriate resources, and to follow up by tracking those connections and offering other options as needed ( Thomas-Henkel and Schulman, 2017 ).


While interest in and action to address social needs in the clinical setting is rapidly expanding, nurse engagement in these issues in community settings has been long-standing. Nurses serving in the community often work directly to address social needs at the individual and family levels, and often work as well to address SDOH at the community and population levels. Public health nurses in particular have broad knowledge of health issues and the associated SDOH, as well as needs and resources, at the community level. Embedded within the community, they also are well positioned to build trust and are respected among community leaders. Also playing important roles in addressing social needs within the community are home visiting nurses. At the individual and family levels, home visiting nurses often represent the first line of health care providers with sustained engagement in addressing social needs for many individuals. They recognize and act on the limitations associated with social needs, such as the inability to afford transportation, or may work with an interdisciplinary team at the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to address food issues and other social needs. By connecting with individuals in their neighborhoods and homes, public health and other community-based nurses promote health and well-being for families within communities and engage in this work with partners from across social, health, and other services.

At the population health level, public health nurses work to achieve health equity within communities through both health promotion and disease prevention and control. They often work in municipal and state health departments and apply

nursing, social, epidemiology, and other public health sciences in their contributions to population health ( Bigbee and Issel, 2012 ; IOM, 2011 [see AARP, 2010 ]; Larsen et al., 2018 ). They offer a wide range of services to individuals and community members and are engaged in activities ranging from policy development and coalition building to health teaching and case management ( Minnesota Department of Health, n.d. ). Public health nurses serve populations that include those with complex health and social needs, frail elderly, homeless individuals, teenage mothers, and those at risk for a specific disease ( Kulbok et al., 2012 ). Their interventions may target specific health risks, such as substance use disorder, HIV, and tobacco use, or populations at risk for health problems, such as individuals with complex health and social needs. Specific knowledge and skills they bring to communities include the ability to perform assessments of individual, family, and community health needs; use data and knowledge of environmental factors to plan for and respond to public health issues in their community; provide community and health department input in the development of policies and programs designed to improve the health of the community; implement evidence-based public health programs; and develop and manage program budgets ( Minnesota Department of Health, n.d. ).

Public health nursing roles are characterized by collaboration and partnerships with communities to address SDOH ( Kulbok et al., 2012 ). Core to public health nursing is working across disciplines and sectors to advance the health of populations through community organizing, coalition building, policy analysis, involvement in local city and county meetings, collaboration with state health departments, and social marketing ( Canales et al., 2018 ; Keller et al., 2004 ). Yet, while the work of public health nurses is foundational to the health of communities, their work is rarely visible. Additionally, regarding measurable reductions in health disparities, little research is available that connects directly and explicitly to public health nursing roles ( Davies and Donovan, 2016 ; Schaffer et al., 2015 ; Swider et al., 2017 ).

Recent experiences with H1N1, Ebola, Zika, and COVID-19 underscore the importance of having strong, well-connected, well-resourced social services, public health, and health care systems, matched by an adequate supply of well-educated nurses. A 2017 report from the National Academies of Sciences, Engineering, and Medicine focused on global health notes that when infectious disease outbreaks occur, significant costs are often associated with fear and the worried-well seeking care ( NASEM, 2017b ). In their role as trusted professionals, and given their widespread presence in communities, incorporating public health nurses into community, state, and federal government strategies for health education and dissemination of information can help extend the reach and impact of messaging during infectious disease outbreaks and other public health emergencies. Nurses can serve as expert sources of information (e.g., on preventing infectious disease transmission within their communities) ( Audain and Maher, 2017 ). In the United States, for example, as Zika infections were

identified and spreading, one of the strategies used by the U.S. Department of Health and Human Services (HHS) was to work through nursing associations to reach nurses and through them, help reach the public with factual information and minimize unnecessary resource use ( Minnesota Department of Health, 2019 ). Given their expertise in community engagement and knowledge of local and state government health and social services assets, public health nurses are well positioned to link to and share health-related information with community partners to help reach underresourced populations, including homeless individuals, non-English-speaking families, and others.


As nurses work in concert with other sectors and disciplines, interventions that address multiple and complex needs of individuals and communities can have far-reaching impacts on health outcomes and health care utilization. Through partnerships, community-based nurses work to address an array of health-related needs ranging from population-level diabetes management to community-based transportation to enable low-income families to access health care services.

Because multiple factors influence individual and population health, a multidisciplinary, multisectoral approach is necessary to improve health and reduce health inequity. While an approach focusing on only one SDOH may improve one dimension of health, such as food insecurity, intersectional approaches that simultaneously address complex, holistic needs of individuals, families, and communities are often required. Commonly found across underresourced communities are layers of intersecting challenges impacting health, ranging from adverse environmental exposures to food deserts. Health care systems, community-based organizations, government entitities, nurses, and others are increasingly working together to design interventions that reflect this complexity ( NASEM, 2017a , 2019 ). Creative alliances are being built with for-profit and not-for-profit organizations, community groups, federal programs, hospitals, lending institutions, technology companies, and others ( NASEM, 2019 ).

Work to prioritize and address health disparities and achieve health equity is predicated on meaningful, often multidimensional, assessments of community characteristics. One key opportunity to inform multisectoral efforts lies in community health needs assessments. The Patient Protection and Affordable Care Act requires nonprofit hospitals to conduct these assessments every 3 years, with input from local public health agencies. These assessments are then used to identify and prioritize significant health needs of the community served by the hospital while also identifying resources and plans for addressing these needs. Conducting a community health needs assessment is itself a multisectoral collaboration as it requires engaging community-based stakeholders ( Heath, 2018 ). The results of the assessment present opportunities for multiple sectors to work

together. For example, a hospital may partner with public health and area food banks to address food insecurity. Or it may partner with a health technology company and a local school board to address digital literacy for underserved youth and their families, and also extend the reach of broadband to support health care access through telehealth technology and strengthen digital literacy. In assessing the community’s health needs, these hospitals are required to obtain and consider community-based input, including input from individuals or organizations with knowledge of or expertise in public health. The reports produced as part of this process are required to be publicly available ( IRS, 2020 ).

These and other community engagement efforts can involve nurses from a variety of clinical and community-based settings in any and all steps of the process, from design to implementation and evaluation of the assessments themselves or the processes and programs established to address identified priorities. For example, the Magnet recognition program of the American Nurses Credentialing Center requires participating hospitals to involve nurses in their community health needs assessments ( ANCC, 2017 ).

A variety of models feature nurses directly addressing health and social needs through multidisciplinary, multisectoral collaboration. Two illustrative programs are described below: the Camden Core Model and Edge Runner.

Camden Core Model

The Camden Coalition, based in Camden, New Jersey, is a multidisciplinary, nonprofit organization that works across sectors to address health and social needs. The Coalition’s formation was based on the recognition that the U.S. health care system far too often fails people with complex health and social needs. These individuals cycle repeatedly through multiple health care, social services, and other systems without realizing lasting improvements in their health or well-being. The Coalition employs multiple approaches that include using faith-based partnerships to deliver health services and encourage healthy choices; sharing data among the criminal justice, health care, and housing sectors to identify points of intervention; and building local and national coalitions to support and educate others interested in implementing this model ( Camden Coalition, n.d. ). One of the Coalition’s best-known programs is the Camden Core Model. This nationally recognized care management intervention is an example of a nurse-led care management program for people with complex medical and social needs. It applies the principles of trauma-informed care and harm reduction with the aim of empowering people with the skills and support they need to avoid preventable hospital use and improve their well-being ( Finkelstein et al., 2020 ; Gawande, 2011 ). The model uses real-time data on hospital admissions to identify “superutilizers,” people with complex health issues who frequently use emergency care. An interprofessional team of registered nurses (RNs) and licensed practical nurses (LPNs), social workers, and community health workers engage in person

with these individuals to help them navigate their care by connecting them with medical care, government benefits, and social services ( Camden Coalition, n.d. ; Finkelstein et al., 2020 ). With federal funding, similar versions of the model have been extended to cities outside of Camden ( AF4Q, 2012 ; Crippen and Isasi, 2013 ; Mann, 2013 ).

Camden Coalition partnerships optimize the use of nurses in the community in several ways. An interprofessional team of nurses, social workers, and community health workers visits program participants, helps reconcile their medications, accompanies them to medical visits, and links them to social and legal services. Critical to the model’s success is recruiting nurses who are from the local community, capitalizing on their cultural and systems-level knowledge to facilitate and improve access to and utilization of local health and social services. The culture of the Camden Coalition model has been key to its success. The uniform commitment of nurses, staff, and leadership to addressing people’s complex needs has created a supportive work environment in which each team member’s role is optimized. Care Team members have accompanied people to their meetings and appointments for primary care, helped with applications for such public benefits as food stamps, provided referrals to social services and housing agencies, arranged for medication delivery in partnership with local pharmacies, and coordinated care among providers.

The Camden Coalition focuses on “authentic healing relationships,” defined as secure, genuine, and continuous partnerships between Care Team members and patients. This emphasis has evolved into a framework for patient engagement known as COACH, which stands for C onnect tasks with vision and priorities, O bserve the normal routine, A ssume a coaching style, C reate a backward plan, and H ighlight progress with data. An interprofessional team of nurses, social workers, and community health workers visits participants in the community. Team members are trained to problem solve with patients to achieve the program goals of helping them manage their chronic health conditions and reducing preventable hospital admissions.

Early evidence of the program’s effect in a small sample showed a 56 percent reduction in monthly hospital charges, a roughly 40 percent reduction in monthly visits to hospitals and emergency departments, and an approximately 52 percent increase in rates of reimbursement to care providers ( Green et al., 2010 ), although later evidence from a randomized controlled trial (RCT) indicated that the Camden Core Model did not reduce hospital readmissions ( Finkelstein et al., 2020 ). Other RCTs, conducted in Philadelphia and Chicago, showed that similar social care programs using case management and community health workers can reduce hospital admissions and save money in addition to improving health and quality of health care. Kangovi and colleagues (2018) conducted an RCT in Philadelphia to assess Individualized Management for Patient-Centered Targets (IMPaCT), a standardized community health worker intervention addressing unmet social needs across three health systems ( Kangovi et al., 2018 ). After 6 months, patients

in the intervention group compared with controls were more likely to report the highest quality of care and spent fewer total days in the hospital (reduced by about two-thirds), saving $2.47 for each dollar invested by Medicaid annually ( Kangovi et al., 2020 ). The RCT in Chicago assessed the effectiveness of a case management and housing program in reducing use of urgent medical services among homeless adults with chronic medical conditions and found a 29 percent reduction in hospitalizations and a 24 percent reduction in emergency department visits ( Sadowski et al., 2009 ).

Edge Runner

The American Academy of Nurses’ Edge Runner initiative identifies and promotes nurse-designed models of care and interventions that can improve health, increase health care access and quality, and/or reduce costs ( AAN, n.d.a ). As of February 2020, 59 such programs had been evaluated against a set of criteria and designated as part of this initiative. Many Edge Runner programs are built around the needs of underserved communities and seek to improve health through holistic care that addresses social needs and SDOH, including a range of upstream, midstream, and downstream determinants. Mason and colleagues (2015) assessed 30 Edge Runner models identified as of 2012, finding four main commonalities that illustrate these programs’ broad and encompassing approach to health.

A holistic definition of health. Across the programs, health was defined broadly to include physical, psychological, social, spiritual, functional, quality-of-life, personal happiness, and well-being aspects. Additionally, the definition of health was based on the values of clients and shaped around their preferences. Typically, programs were grounded in SDOH to inform their design of individual- and community-level interventions.

Individual-, family-, and community-centric design. Most programs prioritized individual, family, and community goals over provider-defined goals through a “participant-led care environment” and “meeting people where they are.” Thus, interventions were tailored to the values and culture present at each of these three levels.

Relationship-based care. The programs reflected the importance of building trusting relationships with individuals, families, and communities to help them engage in ways to create and sustain their own health.

Ongoing group and public health approaches to improving the health of underserved populations. The nurses who designed the programs viewed serving underserved populations as a moral imperative. Through peer-to-peer education, support groups, and public health approaches, they sought to empower clients, give them a sense of control, build self-care agency, and increase resilience.

An in-depth study of three Edge Runner programs (the Centering Pregnancy model, INSIGHTS, and the Family Practice and Counseling Network) revealed particular lessons: the essential role of collaboration and leaders who can col-

laborate with a wide range of stakeholders, the need for plans for scalability and financial sustainability, and the importance of social support and empowerment to help people ( Martsolf et al., 2017 ). In these and other models, the capacity and knowledge associated with building meaningful, sustained partnerships across sectors is a key dimension of nursing practice that impacts health equity. The Edge Runner programs emphasize how, in the pursuit of improving care, lowering costs, and increasing satisfaction for people and families, nurses are actively working to achieve person-centered care that addresses social needs and SDOH and focusing on the needs of underserved populations to promote health equity ( Martsolf et al., 2016 , 2017 ; Mason et al., 2015 ). However, evidence directly linking the programs to decreases in disparities is generally not available. Two examples of Edge Runner programs are described in Box 5-2 .

As models continue to evolve and be disseminated, it is critical to establish an evidence base that can help understand their impact on health and well-being and their contribution to achieving the broader aim of health equity. For care management programs incorporating social care, it is important to consider a broad array of both quantitative and qualitative measures beyond health care utilization ( Noonan, 2020 ). Although RCTs generate the most reliable evidence, this evidence can be limited in scope. For example, the RCTs cited above assessed neither the multidimensional nature of care management/social care models that might be reflected in such outcomes as client self-efficacy, satisfaction, or long-term health outcomes nor their potential social impacts. Also important to note is that care management models incorporating social care are limited by the availability of resources in the community, such as behavioral health services, addiction treatment, housing, and transportation. Programs that connect clients to health and social

services are unlikely to work if relevant services are unavailable ( Noonan, 2020 ). Important to underscore in the context of this report is that multisector engagement, as well as health care teams that may involve social workers, community health workers, physicians, and others engaging alongside nurses, all are oriented to a shared agenda focused on improving health and advancing health equity.


Public policies have a major influence on health care providers, systems, and the populations they serve. Accordingly, nurses can help promote health equity by bringing a health lens to bear on public policies and decision making at the community, state, and federal levels. Informing health-related public policy can involve communicating about health disparities and SDOH with the public, policy makers, and organizational leaders, focusing on both challenges and solutions for addressing health through actions targeted to achieving health equity.

When nurses engage with policy change as an upstream determinant of health, they can have a powerful and far-reaching impact on the health of populations. In the National Academy of Medicine’s Vital Directions series, Nancy Adler and colleagues (2016) note that “powerful drivers of health lie outside the conventional medical care delivery system…. Health policies need to expand to address factors outside the medical system that promote or damage health.” Because health inequities and SDOH are based in social structures and policies, efforts to address them upstream as the root of poor health among certain populations and communities need to focus on policy change ( NASEM, 2017a ). Nurses alone cannot solve the problems associated with upstream SDOH that exist outside of health care systems. However, by engaging in efforts aimed at changing local, state, or federal policy with a Health in All Policies approach, 2 they can address SDOH that underlie poor health ( IOM, 2011 ; NASEM, 2017a ; Williams et al., 2018 ). Whether nurses engage in policy making full time or work to inform policy part time as a professional responsibility, their attention to policies that either create or eliminate health inequities can improve the underlying conditions that frame people’s health. Nurses can bring a health and social justice lens to public policies and decision making at the community, state, and federal levels most effectively by serving in public- and private-sector leadership positions. Much of this work is discussed in Chapter 9 on nursing leadership, but it is noted in this chapter given the substantial

2 Health in All Policies (HiAP) is a collaborative approach that integrates health considerations into policy making across sectors. It recognizes that health is created by a multitude of factors beyond health care and in many cases, beyond the scope of traditional public health activities. In accordance with HiAP, for example, decision makers in the health care sector should consider transportation, education, housing, commerce, and other sectors impacting communities. HiAP stresses the need to work across government agencies and with private partners from these different sectors to achieve healthy and safe communities. It also encourages partnerships between the health care sector and community developers, for example ( CDC, 2016 ).

influence that policy decisions have on health equity. Nurses can and should use their expertise to promote policies that support health equity.

For example, a nurse in Delaware was influential in getting the state’s legislature to pass legislation to implement a colorectal cancer screening program that has increased access to care and reduced disparities in morbidity and mortality from colorectal cancer (see Box 5-3 ). While individual nurses, often through their workplace and professional associations, engage in upstream efforts to impact health equity, there have been repeated calls from within the nursing community for more nurses to engage in informing public policy to improve health outcomes for individuals and populations.


In the coming decade, the United States will make substantial progress in achieving health equity only if it devotes resources and attention to addressing the adverse effects of SDOH on the health of underresourced populations. As 2030 approaches, numerous initiatives to address health equity are likely to be launched at the local, state, and national levels. Many of these initiatives will focus on health care equity. Yet, while expanding access to quality care is critical to reducing disparities and improving health outcomes, such efforts need to be accompanied by additional efforts to identify and change the social institutions, dynamics, and systems underlying health inequities from the local to the national level. Nurses can contribute to reshaping the landscape of health equity over the coming decade by serving in expanded roles, working in new settings and new ways, and partnering with communities and other sectors beyond health care. Some nurses are already working in roles and settings that support health equity and are engaged in educating about and advocating for health equity through their professional associations. Nonetheless, broader engagement as a core activity of every nurse will help advance health equity nationwide. To achieve this aim will require

  • support for and the willingness of the nursing workforce to take on new roles in new settings in the community;
  • consistency in nurses’ preparation for engaging in downstream, midstream, and upstream strategies aimed at improving health equity by addressing issues that compromise health, such as geographic disparities, poverty, racism, homelessness, trauma, drug abuse, and behavioral health conditions;
  • more experiential learning and opportunities to work in community settings throughout nursing education to ensure that nurses have skills and competencies to address individuals’ complex needs and promote efforts to improve the well-being of communities;
  • nursing education that goes beyond teaching the principles of diversity, equity, and inclusion to provide sustained student engagement in hands-on community and clinical experiences with these issues;
  • funding to support new models of care and functions that address SDOH, health equity, and population health; and
  • evaluation of models to build the evidence needed to scale programs and the policies and resources necessary to sustain them.

These issues are discussed in the chapters that follow. Programs described in this chapter, such as the Camden Coalition and the Edge Runner initiatives, are exemplars of the kind of multidisciplinary, multisector efforts that will be necessary to address the complex needs of individuals and communities and make a lasting impact by eliminating health disparities, with the goal of achieving health equity. Central to these future efforts, however, are parallel efforts that evaluate

and provide the evidence base on which to determine the effectiveness of models. One of the greatest challenges this committee faced was finding evidence directly linking the efforts of nurses to address social needs and SDOH to reductions in health disparities that would signal improved population health outcomes and health equity. Such evidence is essential to informing payment policy decisions that can ensure the sustainability of and nurse engagement in these models (discussed further in Chapter 6 ). Through evidence, the nursing profession can leverage its own potential, and the public, other professionals, and other sectors can understand the impact and value of such nursing engagement.

Conclusion 5-1: Nurses are in a position to improve outcomes for the underserved and can work to address the structural and institutional factors that produce health disparities in the first place.

Conclusion 5-2: Nurses can use their unique expertise and perspective to help develop and advocate for policies and programs that promote health equity.

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The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions.

A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone.

The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.


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essay nurses roles

How to Write a Nursing Essay with a Quick Guide

essay nurses roles

Ever felt the blank-page panic when assigned a nursing essay? Wondering where to start or if your words will measure up to the weight of your experiences? Fear not, because today, we're here to guide you through this process.

Imagine you're at your favorite coffee spot, armed with a cup of motivation (and maybe a sneaky treat). Got it? Great! Now, let's spill the secrets on how to spin your nursing tales into words that not only get you that A+ but also tug at the heartstrings of anyone reading. We've got your back with nursing essay examples that'll be your inspiration, an outline to keep you on the right path, and more!

What Is a Nursing Essay

Let's start by dissecting the concept. A nursing essay serves as a focused exploration of a specific aspect of nursing, providing an opportunity for students to demonstrate their theoretical knowledge and its practical application in patient care settings.

Picture it as a journey through the challenges and victories of a budding nurse. These essays go beyond the classroom, tackling everything from tricky ethical dilemmas to the impact of healthcare policies on the front lines. It's not just about grades; it's about proving, 'I'm ready for the real deal.'

So, when you read or write a nursing essay, it's not just words on paper. It's like looking into the world of someone who's about to start their nursing career – someone who's really thought about the ins and outs of being a nurse. And before you kick off your nursing career, don't shy away from asking - write my essay for me - we're ready to land a professional helping hand.

How to Start a Nursing Essay

When you start writing a nursing essay, it is like gearing up for a crucial mission. Here's your quick guide from our nursing essay writing service :

How to Start a Nursing Essay

Choosing Your Topic: Select a topic that sparks your interest and relates to real-world nursing challenges. Consider areas like patient care, ethical dilemmas, or the impact of technology on healthcare.

Outline Your Route : Plan your essay's journey. Create a roadmap with key points you want to cover. This keeps you on track and your essay on point.

Craft a Strong Thesis: Assuming you already know how to write a hook , kick off your writing with a surprising fact, a thought-provoking quote, or a brief anecdote. Then, state your main argument or perspective in one sentence. This thesis will serve as the compass for your essay, guiding both you and your reader through the rest of your writing.

How to Structure a Nursing Essay

Every great essay is like a well-orchestrated performance – it needs a script, a narrative that flows seamlessly, capturing the audience's attention from start to finish. In our case, this script takes the form of a well-organized structure. Let's delve into the elements that teach you how to write a nursing essay, from a mere collection of words to a compelling journey of insights.

How to Structure a Nursing Essay

Nursing Essay Introduction

Begin your nursing essay with a spark. Knowing how to write essay introduction effectively means sharing a real-life scenario or a striking fact related to your topic. For instance, if exploring patient care, narrate a personal experience that made a lasting impression. Then, crisply state your thesis – a clear roadmap indicating the direction your essay will take. Think of it as a teaser that leaves the reader eager to explore the insights you're about to unfold.

In the main body, dive into the heart of your essay. Each paragraph should explore a specific aspect of your topic. Back your thoughts with examples – maybe a scenario from your clinical experience, a relevant case study, or findings from credible sources. Imagine it as a puzzle coming together; each paragraph adds a piece, forming a complete picture. Keep it focused and let each idea flow naturally into the next.

Nursing Essay Conclusion

As writing a nursing essay nears the end, resist the urge to introduce new elements. Summarize your main points concisely. Remind the reader of the real-world significance of your thesis – why it matters in the broader context of nursing. Conclude with a thought-provoking statement or a call to reflection, leaving your reader with a lasting impression. It's like the final scene of a movie that leaves you thinking long after the credits roll.

Nursing Essay Outline

Before diving into the essay, craft a roadmap – your outline. This isn't a rigid skeleton but a flexible guide that ensures your ideas flow logically. Consider the following template from our research paper writing service :


  • Opening Hook: Share a brief, impactful patient care scenario.
  • Relevance Statement: Explain why the chosen topic is crucial in nursing.
  • Thesis: Clearly state the main argument or perspective.

Patient-Centered Care:

  • Definition: Clarify what patient-centered care means in nursing.
  • Personal Experience: Share a relevant encounter from clinical practice.
  • Evidence: Integrate findings from reputable nursing literature.

Ethical Dilemmas in Nursing Practice

  • Scenario Presentation: Describe a specific ethical challenge faced by nurses.
  • Decision-Making Process: Outline steps taken to address the dilemma.
  • Ethical Frameworks: Discuss any ethical theories guiding the decision.

Impact of Technology on Nursing

  • Current Trends: Highlight technological advancements in nursing.
  • Case Study: Share an example of technology enhancing patient care.
  • Challenges and Benefits: Discuss the pros and cons of technology in nursing.
  • Summary of Key Points: Recap the main ideas from each section.
  • Real-world Implications: Emphasize the practical significance in nursing practice.
  • Closing Thought: End with a reflective statement or call to action.

A+ in Nursing Essays Await You!

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Nursing Essay Examples

Here are the nursing Essay Examples for you to read.

Writing a Nursing Essay: Essential Tips

When it comes to crafting a stellar nursing essay, a few key strategies can elevate your work from ordinary to exceptional. Here are some valuable tips from our medical school personal statement writer :

Writing a Nursing Essay: Essential Tips

Connect with Personal Experiences:

  • Approach: Weave personal encounters seamlessly into your narrative.
  • Reasoning: This not only adds authenticity to your essay but also serves as a powerful testament to your firsthand understanding of the challenges and triumphs in the nursing field.

Emphasize Critical Thinking:

  • Approach: Go beyond describing situations; delve into their analysis.
  • Reasoning: Nursing essays are the perfect platform to showcase your critical thinking skills – an essential attribute in making informed decisions in real-world healthcare scenarios.

Incorporate Patient Perspectives:

  • Approach: Integrate patient stories or feedback into your discussion.
  • Reasoning: By bringing in the human element, you demonstrate empathy and an understanding of the patient's experience, a core aspect of nursing care.

Integrate Evidence-Based Practice:

  • Approach: Support your arguments with the latest evidence-based literature.
  • Reasoning: Highlighting your commitment to staying informed and applying current research underscores your dedication to evidence-based practice – a cornerstone in modern nursing.

Address Ethical Considerations:

  • Approach: Explicitly discuss the ethical dimensions of your topic.
  • Reasoning: Nursing essays provide a platform to delve into the ethical complexities inherent in healthcare, showcasing your ability to navigate and analyze these challenges.

Balance Theory and Practice:

  • Approach: Connect theoretical concepts to real-world applications.
  • Reasoning: By bridging the gap between theory and practice, you illustrate your capacity to apply academic knowledge effectively in the dynamic realm of nursing.

Highlight Interdisciplinary Collaboration:

  • Approach: Discuss collaborative efforts with other healthcare professionals.
  • Reasoning: Acknowledging the interdisciplinary nature of healthcare underscores your understanding of the importance of teamwork – a vital aspect of successful nursing practice.

Reflect on Lessons Learned:

  • Approach: Conclude with a thoughtful reflection on personal growth or lessons from your exploration.
  • Reasoning: This not only provides a satisfying conclusion but also demonstrates your self-awareness and commitment to continuous improvement as a nursing professional.

As we wrap up, think of your essay as a story about your journey into nursing. It's not just about getting a grade; it's a way to share what you've been through and why you want to be a nurse.

Imagine the person reading it – maybe a teacher, a future coworker, or someone starting their nursing journey. They're trying to understand your passion and why you care about nursing.

So, when you write, remember it's more than just an assignment. It's your chance to show why nursing matters to you. And if you ever need help – there's always support from our essay writer online .

Ready to Excel in Your Nursing School Essay?

Order now and experience the expertise of our professional writers!

How to Write a Nursing Essay?

How can a nursing essay effectively address ethical considerations, what are some examples of evidence-based practices in nursing essays.

Daniel Parker

Daniel Parker

is a seasoned educational writer focusing on scholarship guidance, research papers, and various forms of academic essays including reflective and narrative essays. His expertise also extends to detailed case studies. A scholar with a background in English Literature and Education, Daniel’s work on EssayPro blog aims to support students in achieving academic excellence and securing scholarships. His hobbies include reading classic literature and participating in academic forums.

essay nurses roles

is an expert in nursing and healthcare, with a strong background in history, law, and literature. Holding advanced degrees in nursing and public health, his analytical approach and comprehensive knowledge help students navigate complex topics. On EssayPro blog, Adam provides insightful articles on everything from historical analysis to the intricacies of healthcare policies. In his downtime, he enjoys historical documentaries and volunteering at local clinics.

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Writing Tips for Nursing School Students

NurseJournal Staff

  • Nursing School Writing Types
  • Writing a Nursing Essay
  • Citations Guide
  • Common Writing Mistakes
  • Writing Resources

Are you ready to earn your online nursing degree?

Young African-American female sitting and working on her laptop in a coffee shop during the day.

Writing is an essential skill nurses should achieve proficiency in early in their career. It is a crucial part of the profession, as nurses need to be able to effectively communicate with patients, families, and other healthcare professionals.

While verbal communication also plays a vital role in nursing, being able to write well builds the nurse’s ability to provide better care.

Being able to accurately detail a patient’s personal history, symptoms, and diagnosis allows for the execution of a precise treatment plan that is clearly communicated to all parties involved, both professional and personal.

From registered nurses to clinical nurses and beyond, being able to communicate effectively and efficiently is a critical soft skill that will help nurses in any role increase their ability to treat their patients.

This guide provides an overview of the types of writing nurses will experience throughout their educational training. Utilize the following tips and tricks to help strengthen your writing skills, which will ultimately help in the development of transferable career skills .

Types of Writing Nurses Will Do in School

Personal statements for nursing school.

Nursing schools want candidates who meet academic and professional requirements. They also want a candidate who demonstrates a sincere passion for patient care and individual connections. You should always craft a personal statement, even when the application doesn’t explicitly require one. Personal statements allow you to describe your goals, characteristics, credentials, volunteer work, and meaningful life experiences. A well-crafted essay can help you stand out among other qualified applicants. And, as with any piece of writing, you must take the time to revise.

In your personal statement, you should portray yourself as determined and empathetic, with characteristics, goals, work ethic, and healthcare philosophy that align with a program’s values. Some nursing schools ask for a general personal statement, while others require a specific prompt. Colleges commonly ask students to describe a hardship they overcame, a difficult task they accomplished, or a professional goal they hope to achieve through the program. Many schools also ask students to detail previous experiences in healthcare. You may decide to write about how you connect with patients or how you provide practical and emotional support to loved ones.

You will also encounter writing prompts during examinations, including standardized tests like the GRE or MCAT, nursing school entrance exams , and course-specific evaluations. You may also take exams to get state licensure or professional certification. In most of these instances, you will need to write one or several long-form essays. Proper planning is key. Though you won’t know what specific prompt the test will require, you can expect certain common topics. You can search online or use study guides to determine which prompts usually appear on each test.

On test day, you should begin by creating an outline that lists three main points in response to the prompt. Using these points, work backwards to write a central thesis to guide the essay’s structure. Review what you’ve written to ensure that the essay actually responds to the prompt at hand. Be sure to leave time to correct spelling, grammar, and stylistic errors.

Research Papers

Like essays, research papers follow a long-form structure. Unlike an essay, which heavily relies on the writer’s point of view, a research paper presents an in-depth investigation of a topic using data, expert opinions, and insights. While an essay evaluates general critical thinking and writing skills, a research paper tests your knowledge, research skills, and original contributions. Research papers also allow you to prove you understand what has been argued and discovered about a topic. Research papers, especially at the graduate and doctoral levels, require independent research and analyses. These papers sometimes take months or years to complete.

To write a successful research paper, you should pick a topic relevant to your interests and the nursing field. Possibilities include elderly care challenges, patient safety and ethics, mental health treatment and regulations in the U.S., and nursing shortages and possible solutions. Whatever your choice, you must plan accordingly. Advanced papers such as dissertations may require funding or help from professors. Research papers often consist of the following sections: abstract, introduction, literature review, methods, results, discussion, conclusion, and references. You should keep this general structure in mind as you prepare notes and outlines.

How Do You Write a Nursing Essay?

In nursing school, essay writing includes academic papers, personal narratives, and professional compositions. You should become familiar with each of the five major forms below. There are many similarities between these essay types, such as an overarching thesis and a supportive, logical structure. You should support claims with factual, statistical, anecdotal, and rhetorical evidence. However, each form requires distinct skills to achieve specific results.


Cause and effect, citations guide for nursing students.

Citations allow readers to know where information came from. By citing sources, you avoid plagiarizing or stealing another person’s ideas, research, language, and analyses. Whether intentional or unintentional, plagiarism is one of the most egregious errors one can make. Consequences for plagiarism include automatic course failure, disciplinary actions from the university, and even legal repercussions. You should take special care to ensure you properly cite sources.

American Psychological Association (APA) Style

APA is the most commonly used style among natural scientists, social scientists, educators, and nurses. Like other citation styles, APA emphasizes clarity of font style, font size, spacing, and paragraph structure. APA citations focus on publication date, and in most cases, the date comes right after the author’s name. This order makes the style particularly useful for scientists, who value new research and updates on current findings. For more information on APA style, visit this official website .

(Author and year of publication, page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault, 1977, p. 9).

Chicago Manual of Style (CMS)

CMS (also known as CMOS or, simply, Chicago) features two citation systems, the notes and bibliography, and the author and date. This style is used primarily by historians, who place high importance on a text’s origin. The notes and bibliography include a superscript number with a corresponding footnote or endnote. Scientific professionals use the author and date citation, a generic parenthetical system with similarities to other citation styles. The CMS official website provides additional information, including changes to citation systems in the current edition.

“Punishment, then, will tend to become the most hidden part of the penal process”. 1 1. Michel Foucault, trans. Alan Sheridan, Discipline and Punish: The Birth of the Prison (New York: Pantheon Books, 1977), 9.

(Author and year of publication, page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault 1977, 9).

Modern Language Association (MLA) Format

MLA format traces its history to 1951 when it was first published as a thin booklet. Today, MLA is the primary format used by academics and professionals in humanities, English, literature, media studies, and cultural studies. To adapt to the rapid growth of new mediums over the past few decades, MLA updates its citation system. Visit the MLA Style Center for in-depth information on new guidelines and ongoing changes. In general, in text citations consist of author and page number, or just page number if the author’s name appears in the text.

(Author and page number) “Punishment, then, will tend to become the most hidden part of the penal process” (Foucault 9).

Associated Press (AP) Style

Published in 1952, the original AP Stylebook was marketed to journalists and other professionals related to the Associated Press. AP now stands as the go-to style for professionals in business, public relations, media, mass communications, and journalism. AP style prioritizes brevity and accuracy. The style includes specific guidelines regarding technological terms, titles, locations, and abbreviations and acronyms. Unlike the previous styles, AP does not use parenthetical or in-text citations. Rather, writers cite sources directly in the prose. For more information, including style-checking tools and quizzes, visit the Associated Press Stylebook .

In the book, “Discipline and Punish: The Birth of the Prison,” first published in English in 1977, philosopher Michel Foucault argues that “Punishment, then, will tend to become the most hidden part of the penal process”.

Which Style Should Nursing Students Use?

Because nurses rely on scientific terms and information, professionals in the field usually use APA style. Regardless of the purpose and specific genre of your text, you should always strive for concise, objective, and evidenced-based writing. You can expect to learn APA style as soon as you enroll in a major course. However, you should also prepare to learn other styles as part of your academic training. For example, freshman composition classes tend to focus on MLA guidelines.

Common Writing Mistakes Students Make

Active vs. passive voice.

Active and passive voice represent two different ways to present the same piece of information. Active voice focuses on the subject performing an action. For example, the dog bites the boy. This format creates clear, concise, and engaging writing. Using active voice, nurses might write, I administered patient care at 11:00. Passive voice, on the other hand, focuses on the object of the sentence or the action being performed. For example, the boy was bitten by the dog. A passive sentence is usually one that contains the verb “to be.” Using passive voice, you might write, patient care was administered at 11:00.

Professionals in the sciences often use passive voice in their writing to create an objective tone and authorial distance. Passive voice can prioritize specific terms, actions, evidence, or research over the writer’s presence. Additionally, nurses use passive voice because it is usually clear that the reported thoughts, actions, and opinions come from them. However, you must also learn how to use active voice.


There are 14 punctuation marks in the English language, each with multiple and sometimes overlapping uses. Additionally, certain punctuation marks only make sense in highly specific and nuanced grammatical instances. To master punctuation, you must learn through practice, particularly by revising your own writing.

For example, colons and semicolons are often used interchangeably, when they actually serve distinct purposes. Generally used before itemized lists, colons stand in for the phrases “here is what I mean” or “that is to say.” For example, I am bringing three things to the picnic: applesauce, napkins, and lemonade. Semicolons separate two independent clauses connected through topic or meaning. For example, It was below zero; Ricardo wondered if he would freeze to death. Comma splices, which create run on sentences, are another common mistake. You can identify a comma splice by learning the differences between an independent and dependent clause.

Grammar refers to the rules of a particular language system. Grammar determines how users can structure words and form sentences with coherent meaning. Aspects include syntax (the arrangement of words to convey their mutual relations in a sentence) and semantics (how individual words and word groups are understood). Unless you major in writing, literature, etymology, or another related field, you generally won’t examine English grammar deeply. Through years of cognitive development and practice, native users implicitly understand how to effectively employ the language.

Distinct grammatical systems exist for each language and, sometimes, even within a single language. For example, African American Vernacular English uses different syntactic rules than General American English. You should learn grammatical terms and definitions. Common errors include subject/verb agreement, sentence fragments, dangling modifiers, and vague or incorrect pronoun usage. Hasty writers can also misuse phonetically similar words (your/you’re, its/it’s, and there/their/they’re).

Writing Resources for Nursing Students

Apa style central, reviewed by:.

Portrait of Shrilekha Deshaies, MSN, RN

Shrilekha Deshaies, MSN, RN

Shri Deshaies is a nurse educator with over 20 years of experience teaching in hospital, nursing school, and community settings. Deshaies’ clinical area of expertise is critical care nursing and she is a certified critical care nurse. She has worked in various surgical ICUs throughout her career, including cardiovascular, trauma, and neurosurgery.

Shri Deshaies is a paid member of our Healthcare Review Partner Network. Learn more about our review partners here .

Page last reviewed November 30, 2021

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  • The Importance of Community Health Nurses

A community health nurse examines a young patient

The Importance of Community Health Nursing

Community health nurses are a vital link in the health and welfare of neighborhoods. These registered nurses focus on improving the lives of diverse communities of infants, children, adolescents, and adults through education, prevention, and treatment.

“They assist with equalizing health care in diverse populations, so that care is more equitable, affordable, and well-coordinated,” says Sheila Rucki , faculty member in the Purdue Global School of Nursing.

“Community health nurses look at the broader needs of a population, not just an individual,” says Jessica Gordon , associate dean. “The agenda is health promotion, disease prevention, and recognizing the needs of the community.”

Learn more about the role of community health nurses, what their future looks like, and how to become one.

What Is a Community Health Nurse?

Community health nurses start by building trust and relationships with individuals and local leaders. They also develop a strong understanding of people’s backgrounds, experiences, and the social factors that influence health, with the goal of practicing cultural humility with empathetic care.

Many members of the community who take advantage of these services might not otherwise have access to private physicians or testing services, among other medical necessities.

“Ethnically diverse and culturally diverse populations are the most underserved,” Rucki says. “Those are the individual groups that benefit most from this kind of health care."

Community health nurses often participate in mobile clinics to help underserved populations, she says.

“The homeless are hard to reach because they are mobile,” Rucki says. “They benefit greatly from the care provided by community-focused providers, particularly nurses.”

What Do Community Health Nurses Do and Where Do They Work?

Community health nurses work in a variety of settings from community-based centers to government agencies to shelters to vaccine distribution sites. They build coalitions, craft policies, educate the public, manage public health programs, and more.

Services Provided by Community Health Nurses

The American Public Health Association lists 10 essential public health services provided by community nurses and other front-line professionals:

  • Assess and monitor population health
  • Investigate, diagnose, and address health hazards and root causes
  • Communicate effectively to inform and educate
  • Strengthen, support, and mobilize communities and partnerships
  • Create, champion, and implement policies, plans, and laws
  • Utilize legal and regulatory actions
  • Enable equitable access
  • Build a diverse and skilled workforce
  • Improve and innovate through evaluation, research, and quality improvement
  • Build and maintain a strong organizational infrastructure for public health

“Community health nurses are this incredible file cabinet of resources. They can point people in the right direction for what they need at that time,” Gordon says. “They're dealing with the community, but they provide education on where the community can get the help they need for individualized attention.”

For example, if a community has a high diabetes rate, one of the focuses for that area might be diabetes prevention education.

“Every single community health nurse works based on the population and the needs of that population specifically,” Gordon says.

Other health issues that could affect a community include:

  • Substance abuse
  • Teen pregnancy

Where Community Health Nurses Are Needed

Community health nurses, like other registered nurses, often work in local hospitals, trauma centers, and clinics. Many work in locations more focused on underserved communities, such as:

  • Aid organizations, such as Doctors Without Borders or the Red Cross, providing disaster relief along with other daily local needs
  • Community health centers, treating and educating around such topics as family planning, sexual health, and other preventative care
  • Correctional facilities, working to limit the spread of communicable disease, along with running educational programs for inmates and staff
  • Government agencies, helping with health policy development and implementation to create change on a large scale
  • Homeless shelters, focusing on preventative care through screenings and assessments, and helping people find social service assistance
  • Schools, providing education about illness prevention and good health habits, along with managing existing health problems and intervening in cases of abuse or neglect

“A lot of the community-based care centers are in parts of town or areas of the country or state where access to care might be limited or not affordable,” Rucki says. “Being based directly in the community provides access opportunities that might otherwise not be available to diverse populations.”

What Does the Future Look Like for Community Health Nurses?

Community health nurses have a bright future, but some serious challenges remain ahead.

“We’re seeing an increased need because what we thought was the traditional way of delivering care is really no longer applicable,” Rucki says. “Community-based care is becoming the primary way for many people today.”

What Job Growth Looks Like

The national nursing shortage, which has been exacerbated by the pandemic, will continue to fuel a 9% job growth rate through 2030, according to the U.S. Bureau of Labor Statistics . The agency projects employers to add 276,800 RN positions from 2020–2030.*

Because of these growing needs, becoming a community health nurse has some advantages:

  • Creating strong partnerships between nurses and clients and/or community population
  • Enjoying collaborative nursing care working with clients in a nonhospital setting
  • Having a variety of work settings
  • Helping vulnerable communities
  • Providing holistic and more individualized care
  • Working a convenient schedule with little to no holiday or weekend hours

According to the U.S. Centers for Disease Control and Prevention, community health worker programs particularly need nurses trained in preventing and controlling infectious diseases, to deliver home-based care to low-income people.

What Challenges Remain Ahead

The National Institutes of Health indicate that public nurses face many challenges aside from the day-to-day demands of practice, including:

  • Concerns for personal safety
  • Frequent overtime
  • Inadequate staffing levels
  • Limited management support and supervision
  • On-call duties
  • Professional isolation
  • Restricted opportunities for career development

However, Gordon says a greater challenge facing community nurses is resistance.

“This can happen whether you're in acute care or community health, but you often see a population as a whole resisting care,” she says. “It can be incredibly frustrating when you've provided quality education and care. But you persevere. The challenge is not being rejected, it's how you overcome it.”

“It may take time to build trust in populations,” Rucki says. “Once you build trust and build that ongoing relationship, you're more likely to see change, behavior changes in people’s health care practices.”

Who Would Make a Good Community Health Nurse?

You need certain qualities and qualifications if you’re interested in becoming an effective community health nurse.

The Qualifications You Need

At a minimum, you must earn an associate or bachelor’s degree in nursing and pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN). † Some may wish to complete a two-year master's degree program in nursing. Employers often prefer community health nurses who have one to two years of nursing experience.

“Because this is such an education-heavy job, there's a strong preference toward those with a bachelor's degree,” Gordon says.

Community health nurses also are strongly encouraged to have ties to the areas in which they wish to work. Participating in volunteer programs both before and after becoming a community health nurse is highly recommended.

Community health nurses should also consider certification. One exam, the Advanced Public Health Nurse certification exam, is being phased out.

“However, there are opportunities in interprofessional groups to demonstrate excellence and receive certifications,” Rucki says.

Currently, there is no certification specific to public health nursing at the generalist level. However, nurses with a bachelor’s degree and at least five years of public health experience can obtain the Certification in Public Health (CPH). Visit the National Board of Public Health Examiners for more information on the CPH.

The Qualities You Need

A panel convened by the National Institutes of Health agreed that a successful nurse needs such qualities as being analytical, communicative, cooperative, coordinating, disseminating knowledge, empathic, evidence driven, innovative, and introspective.

Community health nurses should also be connected to their community, open-minded to those different from them, sensitive to different opinions, and objective in their view of the communities they serve.

“An essential component to these roles is a passion for serving the communities that are around them,” Gordon says. “These nurses have a connection and they understand the populations. They want to see them thrive and do better.”

“What's really so rewarding for nurses is this long-term engagement with a population,” Rucki says. “In an acute care setting, you're engaged with the patient and family for a short period of time. But in the community, they're your patients for life. You see families grow and care for them over a number of years.

“That ability to connect and learn and know about the individuals that make up your community is so rewarding for nurses.”

How Purdue Global Can Help You Become a Community Health Nurse

“Community-based nurses are very strong force for change in a community,” Rucki says. Gordon says this theme is woven throughout all programs at Purdue Global.

Purdue Global’s online nursing programs can help you start on the road to becoming a community health nurse. ‡ Reach out for more information today .

About the Author

Purdue Global

Earn a degree you're proud of and employers respect at Purdue Global, Purdue's online university for working adults. Accredited and online, Purdue Global gives you the flexibility and support you need to come back and move your career forward. Choose from 175+ programs, all backed by the power of Purdue.

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Your Path to Success Begins Here

Learn more about online programs at Purdue Global and download our program guide.

Connect with an Advisor to explore program requirements, curriculum, credit for prior learning process, and financial aid options.

* Job Growth Projections: National long-term projections may not reflect local and/or short-term economic or job conditions, and do not guarantee actual growth.

† NCLEX Exam : Graduates must meet state licensing and certification requirements and pass the NCLEX-RN exam to become a registered nurse or the NCLEX-PN to become a licensed practical nurse. The University cannot guarantee students will be eligible to sit for or pass exams. NCLEX is a registered trademark of the National Council of State Boards of Nursing, Inc. Licensure-track programs may limit enrollment to students in certain states. Refer to Purdue Global’s State Licensure and Certifications page for state-specific licensure.

‡ Employment and Career Advancement: Purdue Global does not guarantee employment placement or career advancement. Actual outcomes vary by geographic area, previous work experience and opportunities for employment.

Nursing Essay Examples

Cathy A.

Nursing Essay Examples That Will Help You Write a Stellar Paper

Published on: May 6, 2023

Last updated on: Jan 29, 2024

nursing essay examples

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Many nursing students struggle with writing effective nursing essays, which are an essential part of their education and professional development.

Poor essay writing skills can lead to low grades and an inability to effectively communicate important information.

This blog provides a comprehensive guide to writing nursing essays with examples and tips for effective writing. Whether you are a nursing student or a professional looking to improve your writing skills, this blog has something for you. 

By following the tips and examples provided, you can write compelling nursing essays that showcase your dedication to the field.

Let’s get started.

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What is a Nursing Essay?

A nursing essay is a type of academic writing that aims to explore a particular topic related to nursing. It also presents a clear and concise argument or viewpoint supported by evidence. 

Nursing essays can take many forms, including:

  • Descriptive essays
  • Reflective essays
  • Analytical essays
  • Persuasive essays

What is the Importance of the Nursing Essay?

Nursing essays are important for several reasons. First, they help nursing students develop critical thinking skills by requiring them to analyze and evaluate information.

Second, they help students develop research skills by requiring them to locate and use credible sources to support their arguments. 

Third, nursing essays help students develop communication skills by requiring them to present their ideas clearly and concisely in writing. Finally, nursing essays are important for nursing education because they prepare students for the types of writing.

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To help students better understand how to write nursing essays, it can be helpful to review examples.

Below are some examples of nursing essays.

Nursing School Essay Examples

College Nursing Essay Examples

Graduate Nursing Essay Examples

Nursing Scholarship Essay Examples

Nursing Essay Conclusion Examples

Nursing Essay Examples of Different Fields

Nursing is a diverse field with many different specialties and areas of focus. As a result, nursing essays can take many different forms and cover a wide range of topics. 

Given below are some examples of different types of nursing essays:

Personal Philosophy Of Nursing - Essay Examples

Cal State Fullerton Nursing Essay Examples

Evidence Based Practice Nursing In Medical Field - Essay Examples

Leadership In Nursing And Healthcare Professionals - Essay Examples

Principles Of Professional Practice Of Nursing Professionals And Pharmacists

If you're seeking additional examples of nursing essays, you're in luck! 

Below are some more examples that can help you gain a better understanding of nursing essays:

Health Care And Reflective Models For Nursing - Essay Examples

History Of Nursing Essay Examples

Ethical Dilemma In Nurses Work - Essay Examples

Mental Health Nursing Essay Examples

Why I Want To Be A Nurse Essay

Working In A Team And Collaboration In Nursing

How to Write a Nursing Essay

Writing a nursing essay can seem daunting, but with the right approach, it can be a rewarding experience.

Here are the key steps involved in writing a nursing essay:

Understanding the Topic and Question

The first step in writing a nursing essay is to carefully read and understand the topic and question. 

This will help you determine what information you need to research and include in your essay. Make sure you understand any key terms or concepts related to the topic. Consider different perspectives or viewpoints that may be relevant.

Researching the Topic

Once you have a clear understanding of the topic and question, it's time to research. 

Start by gathering information from credible sources such as academic journals, textbooks, and government websites. 

Consider both primary and secondary sources, and make sure to take detailed notes as you read.

Organizing and Outlining the Essay

Once you have completed your research, it's time to organize your ideas and create an outline for your essay. 

Start by identifying the main points or arguments you want to make, and then organize them into a logical order that flows well. 

Your outline should include an introduction, body paragraphs, and a conclusion.

Writing the Essay

With your outline in place, it's time to start writing your essay. Make sure to follow your outline closely, and use clear and concise language that effectively communicates your ideas. 

Use evidence from your research to support your arguments, and cite your sources appropriately.

Editing and Revising the Essay

Once you have completed a first draft of your essay, take some time to edit and revise it. Look for any errors in grammar, spelling, or punctuation, and make sure your essay is well-organized and flows well. 

Consider asking a peer or instructor to review your essay and provide feedback.

What To Include In Your Nursing Essay

When writing a nursing essay, there are several key elements that you should include. Here are some important things to keep in mind:

  • Introduction

Your introduction should provide a brief overview of the topic and purpose of your essay. It should also include a clear thesis statement that presents your main argument or point of view.

  • Background Information

Provide some background information on the topic to help the reader better understand the context of your essay. This can include relevant statistics, historical information, or other contextual details.

  • Evidence and Examples

Use evidence and examples from your research to support your arguments and demonstrate your knowledge of the topic. Make sure to cite your sources appropriately and use a variety of sources to strengthen your argument.

  • Analysis and Evaluation

Provide analysis and evaluation of the evidence and examples you've presented. This can include discussing strengths and weaknesses, comparing and contrasting different viewpoints, or offering your own perspective on the topic.

Your conclusion should summarize the main points of your essay and restate your thesis statement. It should also offer some final thoughts or suggestions for further research or action.

Nursing Essay Topic Ideas

Choosing a topic for your nursing essay can be challenging, but there are many areas in the field that you can explore. Here are some nursing essay topic ideas to consider:

  • The role of technology in nursing practice
  • The impact of cultural diversity on healthcare delivery
  • Nursing leadership and management in healthcare organizations
  • Ethical issues in nursing practice
  • The importance of patient-centered care in nursing practice
  • The impact of evidence-based practice on nursing care
  • The role of nursing in promoting public health
  • Nursing education and the importance of lifelong learning
  • The impact of nursing shortages on healthcare delivery
  • The importance of communication in nursing practice

These are just a few ideas to get you started. You can also explore other topics related to nursing that interest you or align with your academic or professional goals. 

Remember to choose a topic that is relevant, interesting, and feasible to research and write about.

Tips for Writing an Effective Nursing Essay

Writing a successful nursing essay requires careful planning, research, and attention to detail. Here are some tips to help you write an effective nursing essay:

  • Writing Concisely and Clearly

Nursing essays should be written in clear and concise language, avoiding unnecessary jargon or technical terms. Use simple language and short sentences to help ensure that your ideas are communicated clearly and effectively.

  • Stating a Clear Thesis Statement

Your thesis statement should clearly state your main argument and provide a roadmap for the rest of your essay. It should be clear, concise, and located at the end of your introduction.

  • Using Proper Citation and Referencing

Citing and referencing your sources is crucial in any academic writing, including nursing essays. Make sure to use proper citation and referencing styles, such as APA or MLA. Include a reference list or bibliography at the end of your essay.

  • Seeking Feedback and Revising

Before submitting your nursing essay, seek feedback from peers, professors, or writing tutors. Use their feedback to revise and improve your essay. Make sure that it is well-structured, coherent, and effectively communicates your point of view.

By following these tips, you can write a nursing essay that demonstrates your knowledge and skills in the field.

In conclusion, writing a successful nursing essay requires careful planning, research, and attention to detail. 

To showcase your knowledge in the field of nursing, it is important to have a clear understanding of the topic at hand. When writing your nursing essay, be sure to include relevant examples, incorporate current research, and use proper citation and referencing. 

And remember , seeking feedback and revising your essay is key to ensuring that it effectively communicates your ideas and arguments.

If you need help with your nursing essay or any other type of academic writing, consider using our AI essay writer . 

Our nursing essay writing service can provide personalized support to help you succeed in your academic goals.

So, why wait? Contact us to get college essay writing help today! 

Cathy A. (Literature)

For more than five years now, Cathy has been one of our most hardworking authors on the platform. With a Masters degree in mass communication, she knows the ins and outs of professional writing. Clients often leave her glowing reviews for being an amazing writer who takes her work very seriously.

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essay nurses roles

Nursing leaders playing bigger role on global health stage

Bembeke radio station sensitization on diabetes prevention

May 16, 2024—One small cohort at a time, graduates of the Harvard Global Nursing Leadership Program (HGNLP) are beginning to move the needle on improving health systems in their countries.

“We want to see our graduates reforming policies and legislation to move us closer to achieving global health mandates,” said Stephanie Ferguson , professor of the practice of health policy and management at Harvard T.H. Chan School of Public Health and director of HGNLP, a certificate program that will welcome its third cohort this fall.

The world requires better health systems management, and a robust nursing and midwifery workforce is critical, said Ferguson. Placing nursing leaders in positions of power where they can influence regional, national, and international policies can help countries make advances in areas such as global health security, universal health coverage, and the United Nations Sustainable Development Goals.

That’s why she is pleased the incoming cohort of students will again include nurses with a focus on making bolder, broader impact. It will also be more global, as the program, which originally only accepted students from Africa, now accepts them from everywhere.

“We’ve opened the program up globally because the world is facing challenges, including in our own country,” said Ferguson. Here in the United States, the National Council of State Boards of Nursing reports that 100,000 nurses left the workforce during the COVID-19 pandemic. By 2027, almost 900,000 nurses plan to retire. That’s nearly one-fifth of the nation’s 4.5 million registered nurses, said Ferguson.

“We need nursing leaders to help change the legislative rules, the laws, and the regulatory processes to make sure we have the right policies in place to address this looming shortage.”

Increasing the influence of nurses

HGNLP is an innovative public health program that focuses on expanding the role of nurses in shaping global health. It combines leadership education and in-field training with networking and international collaboration to enable nurses to secure more influential leadership roles within the health systems in their home countries.

“Our graduates have accomplished a tremendous amount,” said Ferguson. She noted that some of the participants head nursing schools and have since transformed curricula and created initiatives to enhance the supply of nurses and midwives in their countries.

Ferguson said that graduates have used their certificate to gain entry into global health research degree programs and to secure promotions in their workplaces. The certificate has also enabled them to join organizations that focus on population health, including bilateral organizations such as the World Health Organization and the World Bank.

Making a public health impact

Graduates from the past two cohorts spoke of how they learned to step back and recognize how health systems work, identify gaps in their own systems, and work with public and private leaders and stakeholders to form solutions.

Chancy Banda , who serves as district nursing and midwifery officer for a local government and rural development ministry in Malawi, is developing an awareness campaign to address a sharp uptick in diabetes, which is worsening the nation’s strained health system.

“I learned to analyze a health system and apply that to the context in Malawi. Then I assessed the capacity we have as a district, mapped out stakeholders and potential partners, and went through all the steps to make clear the problem with precise communications,” said Banda, whose three-tier approach to reduce diabetes will include messaging via radio and texts.

Benjamin Yamusah

Benjamin Yamusah, chief nursing officer of the Chereponi Government Hospital in Ghana, said HGNLP helped him develop a heightened sense of advocacy.

“We learned we must make our own plans to address gaps in our health systems,” said Yamusah, who successfully brought his project plan through layers of government in Ghana and developed a highly collaborative and community-informed project that reassigned urban midwives to rural regions of Ghana to address high maternal death rates. “We developed crucial knowledge about how to interact with people in higher authority—how to impart our message in a way that is both brief and clear,” he said.

Gertrude Mwambu

“The HGNLP was life-changing because it taught us to view the world from a different perspective and handle global health challenges in our own local context and then develop tailored solutions,” said Getrude Mwambui, a senior nursing officer in Kenya.

A ‘stronger voice for nurses’

Orientation for the program’s new cohort of 10 students kicks off in August 2024. Lindsey Harris, a family nurse practitioner, assistant professor at the University of Alabama at Birmingham, and legislative fellow in the office of Rep. Lauren Underwood of Illinois, is one of three U.S. students. She is eager to begin.

Lindsey Harris

“I am going to focus on maternal mortality—with increasing maternal mortality rates in the country, I am very concerned about women’s access to safe reproductive health care,” said Harris. “I want a global perspective around what is and is not working in this space and how we can improve.”

The next cohort also includes nursing leaders from Belize , Liberia , the Philippines , Tanzania , and Vietnam, including Tran Thuy Khan Linh, leader of the nursing faculty at the University of Medicine and Pharmacy in Ho Chi Minh City, where she has made many academic and research-based improvements for nurses and forged links with international organizations. She is a strong advocate for nursing research led by nurses—a major change for Vietnam, where most research is led by medical doctors.

Tran Thuy Khan Linh

“I am excited to have an opportunity to network with nursing leaders from other countries and learn how they overcome challenges in global health,” she said. “I plan to become an even stronger voice for nurses so that government policymakers invest more in nursing education and create a much better and healthier environment for nurses.”

— Meg Murphy

Photos courtesy Chancy Banda, Benjamin Yamusah, Getrude Mwambu, Lindsey Harris, Tran Thuy Khan Linh

Nurses’ Roles as Health Educators Essay

When making a life-changing decision to become a professional nurse, many undergraduates do not understand the scope of responsibility they accept in terms of this choice. Thus, according to the researchers, an impressive number of young specialists perceive nursing solely as a process of providing care and overlook the requirement to be educators and health promoters (Darch, Baillie, & Gillsion, 2017). However, despite the confusion, the nursing profession indeed encompasses the duty to educate the community, patients, and pre-registered nurses on the matter of healthcare tendencies and approaches. When speaking of the nurse’s role and responsibility as a health educator, the duties may be divided into the categories of nurse education, patient education, and community advocacy.

In terms of patient education, there exists a variety of strategies to enhance the overall efficiency of the individual care plans, including:

  • Using patient’s and family’s story to develop a tailored care pattern. This strategy presupposes communication with the patient and their surroundings to outline valuable information for a further treatment plan.
  • Using case scenarios to showcase the peculiarities of treatment planning. Evidence-based strategies are, by all means, the most beneficial in terms of education, as they help nurses compare information to the current state of events and outline some valuable lessons from the case studies (Darch et al., 2017).

Similar approaches may be addressed in terms of creating a health promotion program, as it is necessary to dwell on the current peculiarities in the field as well as the diachronic patterns of healthcare promotion. Moreover, when identifying the frameworks of personal care and overall health promotion, it is necessary to consider the notion of behavioral objectives, which stand for the measurable goals outlined in the process of treatment and education. These objectives may be utilized as milestones throughout the care plan or program to ensure efficiency in the long-term perspective.

Darch, J., Baillie, L., & Gillison, F. (2017). Nurses as role models in health promotion: a concept analysis . British Journal of Nursing , 26 (17), 982-988.

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Nurses’ and nursing students’ reasons for entering the profession: content analysis of open-ended questions

Lisa mckenna.

1 La Trobe University, Melbourne, Australia

Ian Ruddy Mambu

2 Universitas Pelita Harapan, Tangerang, Indonesia

Christine L. Sommers

Sonia reisenhofer.

3 Bairnsdale Regional Health Service, Bairnsdale, Australia

Julie McCaughan

4 Siloam Hospitals, Tangerang, Indonesia

Associated Data

The datasets generated and/or analysed during the current study are not publicly available due to ethical approval conditions but are available from the corresponding author on reasonable request.

Global nursing shortages require effective recruitment strategies and understanding of individuals’ motivations to enter the profession. These can be complex and bound by numerous factors such as gender and culture. While much research around this has been conducted, little has been undertaken in non-Western cultures where motivations could be different.

To explore Indonesian nurses’ and nursing students’ motivations for entering the nursing profession.

Online survey with closed and open-ended questions drawn from two different studies. This paper reports findings from one similar open-ended question.

As part of two larger surveys, nurses from 13 hospitals across one private health care group and nursing students with clinical experienced enrolled in a baccalaureate nursing program in Indonesia were asked the question, Why do you want to be a nurse? Responses were translated into English and back-translated into Indonesian prior to being subjected to summative content analysis.

In total, 1351 nurses and 400 students provided responses to the question, representing 98.72% and 99.70% respectively of those completing the survey. Both groups were primarily influenced by desire to serve others and God, personal calling and influence of family members and others. Nurses identified a desire to work in the health field and with the sick, in a noble and caring profession.


Nurses and nursing students were motivated by traditional perspectives on nursing. These should be considered in future recruitment activities. However, more research is needed to understand how these factors influence career choice.

Nurses have been identified as crucial to global achievement of Sustainable Development Goals (SDGs) and play a strong role in health policy, achievement of health targets [ 1 ]. However, global workforce shortages, along with an ageing nursing population [ 1 ] and COVID-19 related burnout further impacting retention [ 2 ], mean that strategies for recruitment into the nursing profession are paramount to meet community health care needs. While more than sufficient numbers of graduate nurses are being produced in Indonesia, 54.1% of nurses are located in urban areas, mostly in Java Island, while the other 45.9% are in rural areas with reported chronic shortages in some areas of the country, especially among communities in Eastern Indonesia [ 3 ]. The need for public education to improve the professional image of nursing has been advocated as one means for promoting recruitment of new nurses into the profession [ 4 ].

Understanding why individuals seek a career in nursing is important in facilitating the targeting of recruitment strategies. Some studies have reported on individual motivations to enter nursing courses, largely from western countries. In Italy, Messineo et al. [ 5 ] found that first year nursing students entered their courses with high levels of empathy and altruistic and prosocial motivations. However, there is also evidence that this declines over the duration of nursing studies [ 6 ]. Crick et al. [ 7 ] found that new nursing students in the United Kingdom were motivated to enter the course due to a desire to care for others. In a study of graduate entry nursing students in Australia, McKenna et al. [ 8 ] identified that previous exposure to nurses, either personally or family, played an important role in their decisions to enter the course, along with desire to care for others.

In a systematic review of 29 papers, Wu et al. [ 9 ] examined motivations of healthcare students influencing career choice, identifying a range of both intrinsic and extrinsic factors. They found that altruism through a desire to help others was strong among nursing students, particularly for those who were sick and in need of care. Job security and social status of nursing were considered important, while financial remuneration was not considered as important as for other health professions. Influence of family was mixed in nursing, with some families seeing nursing as having low pay and status, while having family members in the profession was positively influential.

The introduction of the Indonesian Nursing Act in 2014 saw rapid development in the nurse education system and nursing practice with introduction of curriculum standards and accreditation, national competency examination, and nurse registration across the country [ 10 ]. Four-year bachelor or three-year diploma courses can be undertaken to become professional or vocational nurses respectively. Furthermore, there has been recent growth in postgraduate and doctoral programs across the country [ 11 ]. Few previous studies could be sourced exploring why individuals are motivated (seek) to enter the nursing profession in Indonesia. In one study, 20 nursing diploma students participated in focus groups exploring their reasons for choosing to study nursing. Findings identified wanting to help family and others, being inspired by nurses, wanting to improve the image of nursing, influence of family and parents, and work opportunities all influenced choices [ 12 ]. In another study of 57 students in a bachelor degree nursing program, the majority entered the program because they were interested in the nursing profession or wanted to become nurses [ 13 ]. Around a third of students were motivated by their parents to enter the program. Previous studies regarding motivation among existing qualified nurses could not be sourced. Hence, this study sought to explore why Indonesian nurses and nursing students pursued nursing careers.

Data were drawn from two concurrent studies involving online questionnaires, the first focusing on Indonesian registered nurses’ training needs [ 14 ] and the second, on Indonesian nursing students’ experiences of their clinical learning environment [ 15 ]. In each study, participants were asked the same open-ended question: Why do you want to be a nurse? The responses to that question comprise the focus of this paper. Prior to commencement of data collection, approvals were obtained from ethics committees at La Trobe University (ID: S17-155) and Universitas Pelita Harapan (No.005/MRIN-EC/ECL/III/2018). In the original studies, inclusion criteria for the nurses were currently working at the private hospital with a 3-year nursing diploma level qualification or above. Inclusion criteria for nursing students were those who had completed a clinical placement in the private hospital, were enrolled as a nursing student in the university, and were 18 years of age or older. There were no specific exclusion criteria.

Links to the online Qualtrics surveys were provided in participant information materials. These were circulated via internal email and WhatsApp groups to a convenience sample of 2093 eligible registered nurses from 13 sites of an Indonesian private health care group across Jakarta, Sumatra, Sulawesi and Bali and Nusa Tenggara Timur and 796 students from one nursing degree program. Participants provided informed consent using a survey link in the study information provided and participation was voluntary and anonymous. In total, 406 s- and third-year students and 1355 nurses completed the open-ended question forming the basis of this paper.

Responses to the question from both datasets were translated from Indonesian into English and back-translated by two researchers to ensure original meanings were retained [ 16 ]. Data were then subjected to summative content analysis [ 17 ]. Key words were initially identified and coded within Microsoft Excel by two members of the research team. Codes were then manually collated into categories of like terms, quantified utilising frequency counts. Overarching themes were then identified from categories.

In total, 400 students and 1351 nurses provided responses to the question, representing response rates of 98.52% and 99.70% respectively. Among the student group, the average age was 20 years and 84% were female. In the registered nurse group, 80.8% were female and years of experience were relatively evenly distributed from less than one to more than 10 years. Of these, 39% had been in the profession for longer than five years, that is, before introduction of the Indonesian Nursing Act. From the analysis, seven categories and five themes emerged from the student data (Table  1 ) and eight categories and four themes from the nurse data (Table  2 ). Substantial overlap was evident across the two groups and rankings.

Student data (n = 400)

Nurse data (n = 1351)

Overwhelmingly, having an impact on others’ lives was key to both groups through helping or serving others or own family ranked highest for both groups, reported by 50.00% of students and 44.93% of nurses. Students also wanted to be a blessing to others , while nurses valued the interaction with people that is a fundamental part of nursing practice.

For both groups, factors around decision to enter nursing ranked second. Many described having a calling to nursing, while others described this in terms of a ‘childhood dream’, or for ‘personal reward or satisfaction’. Influence of family, others or circumstances played an important part for students and nurses, while a number of nurses described having no reason or choice around entering nursing. Service to God/religious response was also noted to have been the motivation for some students (9.50%); however, it is important to note that these students were enrolled in a faith-based university, so this could be expected. Attraction to the Profession of nursing was also identified as an important factor for both groups. Students expressed a desire to be a part of, or improve, the profession, while many nurses identified a desire to work in the health field or with the sick. For nurses, the status of the profession as noble and caring was a strong factor.

Finally, financial reasons were identified by a small number of participants in both groups who identified commencing their nursing education as they received an offer of a scholarship.

With a predicted continued global nursing shortage, targeted successful strategies need to be introduced to recruit into the profession. Understanding motivations for entering nursing courses can assist with the development of appropriate recruitment strategies and may also inform future retention strategies to keep nurses within the profession. Hence, this study sought to understand why nurses and nursing students in Indonesia chose to enter the profession. Prior to this study, little was known about such motivations in Indonesia, and outside of western countries.

A desire to impact others’ lives was the strongest reported influence for both nurses and nursing students in this study. This was seen as wanting to serve others, and desire to work with the sick. Altruism has long been identified as a reason why individuals choose nursing careers. However, Carter [ 18 ] cautions against simplifying such motivations just to this aspect, where “gender, culture and class and individual dispositions” (p.703) play an important role in the complex make-up of a nursing professional. These views may also change as students progress in their courses. A longitudinal study of nursing students in The Netherlands found that even though many students entered their courses with altruistic and empathic predispositions, their perceptions towards nursing changed to being more professional and focused on their role, knowledge and skills [ 6 ]. Conversely, this was not reflected in the current study where nurses still displayed strong altruistic characteristics beyond graduation from their nursing courses. This suggests that the caring aspect of nursing and ability to make a difference to people’s lives should be emphasised in recruitment to the profession. Additional research in the Indonesian context is needed to better understand the influences on nurses’ personal dispositions and whether these change over time.

Nurses and nursing students in this study both described a personal calling into nursing. Calling, itself, has been described as complex in nursing, and having changed from a traditional perspective based in religion and femininity, to a more contemporary conceptualisation focused on care provision, the profession and self-fulfilment [ 19 ]. In this study, a more traditional focus emerged with both focus on serving community and service to God. This may be, in part, related to the fact that the study was undertaken in a faith-based university and health care group. Being a strong faith-based country, this may be a particularly important consideration in Indonesia and would benefit from further research with other groups across the country. The importance of inclusion of this concept in recruitment into nursing in the country could be further explored. In a recent study in Indonesia, the concept of calling and reason for entering nursing played a role in student success in a nursing program [ 20 ]. The importance of understanding values is particularly pertinent in nursing recruitment strategies with a recent mandate in the United Kingdom for values-based recruitment of healthcare students aligning with those of the National Health Service [ 21 ].

The influence of families and others was a factor in this study for pursuing a nursing career. In Indonesia, families have been shown to play an important role in career pathways, particularly in family businesses [ 22 ]. However, the literature is mixed on whether this is an important factor for nursing. In their review, Wu et al. [ 9 ] identified that some studies identified parents as not being supportive of their children entering the nursing profession because of low pay and status, a view reflected elsewhere [ 23 ]. Despite this, families have been found to be a strong influencing factor influencing choice of nursing career in some studies [ 8 , 24 , 25 ]. Having family members or friends who are nurses or had experienced time in hospitals were identified as influencing factors in one study [ 8 ]. In a study conducted in the United States, Woods-Giscombe et al. [ 25 ] recommended including family members into recruitment processes into nursing, particularly for recruitment of students from underrepresented groups. This suggests that recruitment strategies should not only be directed towards potential students, but their families as well.

While career stability and vocational reasons have been identified by other researchers as guiding factors in pursuing nursing careers [ 8 , 18 ], these aspects were not identified by nurses and nursing students in this study. It is possible that cultural aspects may play a role. In a Norwegian study, nursing students from immigrant backgrounds were found to be more motivated by salary, status, and work flexibility than non-immigrants [ 26 ]. Findings from the current study suggest that such considerations might not be primary considerations for Indonesian nurses and students and that more research is needed to explore this aspect further.

Media representations have been identified in a number of studies as influencing decisions to pursue nursing careers. In one Australian study, hospital dramas on television as well as print and television news played a role in influencing graduate entry students to pursue nursing education [ 8 ]. In another Australian study focused on television representation of the nursing profession, nursing students perceived nurses to be negatively represented in comparison to doctors who were positively portrayed. They recognised that medical programs could provide some recruitment value [ 27 ]. However, a role of media influencing career choice was not identified in this study. Whether or not this plays some role in assisting career decisions for Indonesian students could also be examined further.

There are some acknowledged limitations to this study. The sample was drawn from one faith-based university and hospital group. While the study population was large and drawn from a number of locations, findings may be different in other Indonesian nurse populations across the diverse cultural groups in the country. Furthermore, data were only collected using one open-ended survey question. Further research that explores these concepts in greater depth would be highly valuable.

With global nursing shortages, there is an ongoing need for effective recruitment strategies into the profession. This makes it vital to understand motivations of those entering the profession to facilitate recruitment approaches. However, motivations may vary according to a wide range of intrinsic and extrinsic factors. This study identified that Indonesian nurses and nursing students were largely motivated by a need to serve others and God, personal calling, and the influence of family. As a strong faith-based country, this is likely to be an important consideration in future nursing recruitment. However, further research is needed across more communities to ensure that other motivating factors can be identified and incorporated into successful recruitment strategies. Further research is also needed to understand if these concepts play a role in nursing students successfully completing a program and entering the nursing profession.


The authors are grateful to all the nurses and nursing students for their contributions to the study.

Author Contribution

All authors have agreed on the final version and meet at least one of the following criteria (recommended by the ICMJE): (1) substantial contributions to conception and design (LM, CS, SR, IM, JC), acquisition of data, or analysis (LM, CS, IM) and interpretation (LM, CS, IM) of data; (2) drafting the article or revising it critically for important intellectual content (LM, CS).

This study was supported by a La Trobe Asia Research Grant Program grant and the Universitas Pelita Harapan Research and Community Service Grant Program.

Data Availability


The study was approved by Human Research Ethics Committees at La Trobe University (ID: S17-155) and Universitas Pelita Harapan (No.005/MRIN-EC/ECL/III/2018). All data collection was in accordance with relevant guidelines and regulations. Participants provided informed consent for this study using the survey link in study information provided.

Not applicable.

The authors have no competing interests to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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  • CDC Continuing Education Accreditation
  • Types of CE for Health Professionals
  • Roles & Responsibilities

Roles and Responsibilities

  • The CE Developer is the primary point of contact for CDC during the accreditation process.
  • The CE Developer must form a planning committee.
  • CDC will assign a nurse planner to review the proposal and provide feedback.
  • If CPE or CHES will be offered, a pharmacy planner and/or CHES planner is needed to ensure the proposal meets requirements for pharmacy and health education.

Man working on laptop

Role of the CE Developer

The CE Developer is usually the education developer within a CDC center, institute, or office (CIO) or a CDC-funded organization who serves as the primary point of contact between the organization requesting CE and CDC.

The Education Developer will also:

  • Review and sign the "Responsibility Agreement and Continuing Education Timeline" which outlines deadlines for the educational activity.
  • Attend an orientation with the assigned CDC CE Consultant
  • Establish a planning committee.
  • Provide completed CE proposal documents by the agreed upon deadlines.
  • Maintain contact with all confirmed planners and presenters to get required documents from each of them.
  • Defer to the CDC CE Consultant to clarify issues or uncertainties with the CE proposal documents.
  • Notify the CDC CE Consultant of any changes in the CE process or educational activity title, date, or time.
  • Ensure CE activity is accurately listed in CDC TRAIN.

The CE Developer should have knowledge of:

  • The educational activity purpose and content
  • Adult learning principles
  • Assessing training needs
  • Analyzing gaps in knowledge, skills, or practice
  • Writing SMART learning objectives
  • Writing goal statements
  • Planning and implementing learning activities
  • Evaluating outcomes

Forming a Planning Committee

The Education Developer must identify a group of experts that represent the activity's intended audience. This group must include a representative for each of continuing education (CE). This committee will help design and implement the educational activity. CDC can help determine which roles to include on the planning committee.

Role of Nurse Planner

CDC assigns a Nurse Planner from CDC's CE Accreditation Team to the program requesting CE for a specific educational activity. The assigned nurse planner will provide feedback during the proposal process to help ensure the proposal meets accreditation requirements. The nurse planner is a registered nurse with an active license.

Programs seeking Continuing Nursing Education (CNE) are encouraged to identify an additional nurse with an active license to serve as a planning committee member, a presenter, or subject matter expert on the content.

Primary Responsibilities

  • Provide relevant insight on educational needs, intended audience, and learning assessments for each CNE activity.
  • Identifying and addressing a professional practice gap.
  • Identifying one or more learning outcomes.
  • Using strategies to engage the learners in the educational activity.
  • Ensuring content is based on the most current evidence (may include, but is not limited to evidence-based practice, literature review, clinical guidelines, best practices).
  • Confirming that learning outcomes are evaluated appropriately.
  • Planning independently, without influence of commercial interest organizations.

The nurse planner is familiar with:

  • Adult learning principles.
  • ANCC and Joint Accreditation continuing education requirements.

Role of Pharmacy Planner

The pharmacy planner is a necessary member of the planning committee for Continuing Pharmacy Education (CPE) requests. They should be a registered pharmacist with an active license.

  • Serve as the pharmacy subject matter expert on the planning committee, providing relevant insight on educational needs, intended audience, and learning assessments for each CPE activity.
  • Review content and objectives to ensure compliance with Accreditation Council for Pharmacy Education (ACPE) continuing education requirements.
  • Assure educational activities are planned according to current ACPE criteria, policies, and procedures.
  • Assure the learning material being presented is appropriate for pharmacists.

The Pharmacy Planner should be familiar with:

  • The Center for the Advancement of Pharmacy Education (CAPE) objectives and educational outcomes.
  • ACPE continuing education requirements.

Role of the CHES/MCHES Planner

The Certified Health Education Specialist (CHES®) /Master Certified Health Education Specialist (MCHES®) Planner is a necessary part of the planning committee when requesting CHES®/MCHES® continuing education.

  • Assess training needs.
  • Analyze gaps in knowledge, skill, or practice.
  • Plan and implement learning activities.
  • Evaluate outcomes.
  • Assign the appropriate competencies and/or sub-competencies from the NCHEC eight areas of responsibility.
  • Serve as a liaison between the NCHEC and the planning committee.
  • Review the educational activity, assess objectives and content, and assign competencies/sub-competencies.
  • Assure educational activities are planned according to current NCHEC criteria, policies, and procedures.
  • Assure the learning material being presented is appropriate for the target audience identified.
  • Assure adult learning principles are considered in the educational activity planning process.

CDC Continuing Education (CE)

Learn how CDC accredits educational activities to support the agency's role of developing leaders and training the health workforce.


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    Background. Nurses have been identified as crucial to global achievement of Sustainable Development Goals (SDGs) and play a strong role in health policy, achievement of health targets [].However, global workforce shortages, along with an ageing nursing population [] and COVID-19 related burnout further impacting retention [], mean that strategies for recruitment into the nursing profession are ...

  30. Roles and Responsibilities

    Role of Nurse Planner. CDC assigns a Nurse Planner from CDC's CE Accreditation Team to the program requesting CE for a specific educational activity. The assigned nurse planner will provide feedback during the proposal process to help ensure the proposal meets accreditation requirements. The nurse planner is a registered nurse with an active ...