Nursing Network

Over the last five years, our attention to numerous important issues has often blurred our focus from our primary role as nurses. Although multifaceted, our primary role is centrally focused on delivering high-quality healthcare to individuals and communities. Nurses provide care that encompasses physical, emotional, social, and spiritual well-being, ensuring patients receive holistic and person-centered care.

This focus on people can be achieved and measured using quality improvement frameworks, such as Magnet Recognition, Pathway to Excellence, Regulatory Standards, or Nursing-Sensitive Indicators. Each of these frameworks focuses on standards and metrics directly influenced by nursing practice. Prioritizing these nursing quality outcomes helps improve overall healthcare delivery, reduce costs, and enhance patient and nurse experiences.

Nursing quality outcomes are measurable indicators demonstrating the effectiveness, safety, and quality of nursing care provided to patients. These outcomes are critical for evaluating the impact of nursing interventions, improving care delivery, and ensuring patient safety and satisfaction.

Our focus on patients' health needs and expected outcomes is critical to the role of nurses, setting our role as holistic coordinators of care as unique and essential. Nurses play a pivotal role as caregivers, advocates, and leaders, making a significant impact on individual and community health. Nurses' ability to adapt and meet the needs of diverse populations ensures their essential presence in all areas of healthcare.

We hold a vital role that almost exclusively can be accomplished by a nurse. As we continue to address the many challenges around us, let's not lose sight of our primary responsibility to patients and the people we are pledged to protect and serve.

For most, the joys of nursing outweigh the challenges, reaffirming our passion for care and our unique ability to see people achieve better lives. As we strive for positive outcomes for our patients and the achievement of our teams and organizations, let's stay true to our nursing pledge: to maintain and elevate the standards of our profession and stay focused on improving the outcomes and quality of care for the people and communities we serve.

I joined ANA in 2015 and couldn't be more proud of all the work Idaho Nurses have done to better the lives of Idahoans and care for our patients. In the years I've been serving I've been fortunate enough to have seen so much progress for nursing in Idaho.

We've worked tirelessly to support and push for Medicaid Expansion and have helped prevent subsequent attempts at defunding.
We've championed full practice authority for our NPs in order to ensure Idahoans have access to timely care.
We've championed and supported various Nursing Scholarships within the state to encourage enrollment of Idaho students in Idaho's Nursing Programs and supported RNs practicing in rural areas.
Championed and supported our Student Nurse Associations with assistance to restart their SNA programs and increase engagement/membership
Added an additional state conference to support our nurses in Eastern and North Idaho
Piloted the inclusion of LPNs/LVNs in Idaho's Nurse Association and added two LPN appointed positions to the Board. The purpose of this work is to ensure the Idaho Nurses Association is inclusive of all nurses - LPNs are an invaluable part of the nursing workforce and it is way past time for this inclusion!
Amended our bylaws and added an additional Director-at-Large for a recent graduate to ensure all voices within our nursing generations are heard.
We have a nurse in the Idaho Legislature! Representative Dori Healey from District 15.
Idaho has been THE leader within the state associations for the development of our Idaho Center for Nursing. We've modeled how this can be successful for rural states

I would be remiss if I didn't mention our time in nursing during COVID. There's so much to say, and still so many downstream impacts of the worst of that time. Saying 'thank you' seems too small. I couldn't be more proud of the hard work, exceptional care, and unending levels of compassion you all gave to each other, our patients, and our communities. There really are no great words that can sum up my level of gratitude, so I will leave it as a "thank you" and hope you truly know how amazing you are.

I feel very fortunate to have had the partnership of Erica Yager, our incoming ANA Idaho President over the past two years. Her Presidential tenure begins Jan 1, 2025 and she's absolutely perfect for this role. Erica has been a nurse for 19 years in Med/Surg Acute Care. She's been active at the bedside in so many capacities; committees, shared governance, precepting, charge nursing and eventually moved into leadership roles as a Nursing Supervisor/Assistant Nurse Manager and is currently working as a Department Manager in Northern Idaho. Erica joined ANA Idaho nine years ago, was elected to the board four years ago as Secretary and has served the board as President-Elect for the last two years. She's been a vocal advocate for the unique needs of our state at the National Level in the ANA Leadership Summits and Membership Assemblies.

Thank you all for allowing me to serve as your ANA Idaho President over these past two years. It has been an honor and a privilege to represent Idaho's nurses at the ANA National Level and here at the State level. I'm looking forward to all the innovative ways ANA Idaho will advocate and support our nursing profession moving forward.

Two decades ago, the landscape of healthcare began to shift, thanks to the dedication, passion, and relentless advocacy of nurse practitioners who secured full practice authority for NPs in Idaho. Their commitment to patient care, perseverance in overcoming barriers, and unwavering belief in the value of advanced practice nursing have paved the way for countless opportunities---not just for NPs, but for the patients and communities we serve. NP contributions have been instrumental in demonstrating the effectiveness of nurse-led care, and your voices have been vital in shaping policy and legislation that benefits us all. Over the past year, we have made significant strides to enhance the value and support we offer to our members. We are excited to share a few highlights:

Preceptor Incentive Program: We have successfully launched a new program designed to recognize and reward preceptors for their invaluable contributions to training the next generation of nurse practitioners. This initiative underscores our commitment to fostering a supportive and enriching learning environment. The program was very successful, with 71% of new preceptors affirming the incentive motivated them to precept a student. The program successfully targeted rural healthcare access as the majority of the awards were allocated to rural Idaho preceptors.
Executive Director Appointment: We are pleased to welcome Teresa Stanfill, DNP, RN, NEA-BC, RNC-OB as our new Executive Director. With her extensive experience and passion for advancing the role of nurses in her role with the Idaho Center for Nursing, we are confident that she will be a tremendous asset to our organization.
Special Interest Groups: We have introduced special interest groups to provide additional education and networking opportunities tailored to specific areas of practice. These groups are designed to foster deeper connections and enhance professional development within specialized fields.
Annual Fall Conference: We saw record attendance at our annual Fall Conference in beautiful Coeur d'Alene, Idaho. NPs learned from a variety of speakers and had excellent networking opportunities. Save the date for next September 19-20 2025 in Boise!
Improved Membership Communication: We hosted a town hall meeting, which is now available for viewing on our website. This session provides valuable insights into the current state of our organization, our priorities for 2024-2025, and our policy agenda. We have two additional presentations on our website focused on recent policy updates. We encourage you to watch it to stay informed and engaged with our ongoing efforts.

As we look back on these 20 years, let us also look forward with hope and determination. The journey doesn't end here. There are still challenges to face and new heights to reach, but with the same spirit of collaboration and advocacy that has brought us this far, I am confident that we will continue to thrive and transform the healthcare landscape. Thank you for your commitment, your resilience, and your unwavering dedication to our profession and the patients we serve.

Introduction

Between 2022 and 2024, Idaho agencies that employ nurses continued to experience staffing shortages. Since 2016, the Idaho Center for Nursing has supported strategies to increase the number of nurses working in Idaho, to improve their educational levels, to ease credit transferability between schools, to improve their work environments, and to support public policy that positively impacted nurses. On a biennial basis these factors have been evaluated since 2000, and the findings reported publicly.

Nursing workforce reporting was historically a national activity whereby researchers from the Department of Labor looked at the number of licensed nurses and their geographic distribution and arrived at a total number of nurses in the United States. There were issues with this methodology because it could not account for individual nurses who were licensed in more than one state, and thus there was a duplicate count that some researchers reported was as high as 500,000 nurses. Today, the National Council of State Boards of Nursing (NCSBN) reports that there are 5,744,766 RN licenses issued in the U.S., but there are only 4,845,706 RNs (NCSBN, 2024). Thus, the duplicate RN license count is now nearly 900,000.

To help alleviate the problems associated with evaluating the nursing workforce, the Robert Wood Johnson Foundation funded a national effort in 2000 aimed to establish a nursing workforce center in each state. The outcome was the establishment of the National Forum of State Workforce Centers (NFSNWC) that works with each state's individual workforce center and that established the Nursing Workforce Minimum Data Sets (NFSNWC, 2004).

In Idaho, the initial grant was managed by Boise State University. After RWJF funding stopped in 2006 it moved to the Idaho Board of Nursing (BON). Because the BON only had access to supply and education data and there were issues associated with job demand data analysis, the BON contracted with the Idaho Department of Labor for data reporting and analysis 2011-2015. The report was transferred to the Idaho Center for Nursing (ICN) in 2016 for comprehensive data assimilation and evaluation. Today the ICN is the umbrella nursing organization that supports the Idaho Nursing Workforce Center.

The ICN's workforce center has been funded by the BON's designated fund balance and supports the research, analysis and dissemination of the report's data. The report uses three nationally vetted data sets so that it is possible to compare state to state information using the same data collection tools and analysis framework. They are supply, education and job demand data. An additional nurse self-reported survey is also offered in Idaho.

States that have in excess of 100,000 licensed nurses use a sample survey. In Idaho, because we have less than 20,000 resident nurses, we can complete a population survey whereby the data from each individual nurse is analyzed and reported. To maintain confidentiality of the individual nurse, all data is reported as aggregate and cannot be linked to individual nurses.

Supply data is based on the June 25, 2024, nurse license database information that was available on the National Council of State Boards of Nursing (NCSBN) Optimal Regulatory Board System (ORBS) report that was accessed by Idaho Board of Nursing staff. Additional information from the newly developed Idaho Department of Professional Licensing OASIS system that was implemented in July 2024 was also used.

Licensed Practical Nurse supply data shows that there are 3,467 LPNs with active licenses and 3,105 are Idaho residents. The other 392 reside in other states or are in the military. This is 72 fewer LPNs than in 2022. Of the 3,105 Idaho LPNs, 283 report that they are not employed and not seeking work. The age of these nurses is an important consideration, with 242 (7.8%) being over the retirement age of 67 years. Only 1,067 (34%) are younger than 40 years.

Registered Nurse supply data shows that there are 22,845 RNs with active licenses and 2,487 of them are APRNs. Because APRNs do not commonly fill RN roles, removing them from the RN count yields 20,358 for the potential RN workforce. This is a 1,708 RN increase from 2022. However, 1,399 (7%) of RNs are older than the retirement age of 67 years, and 46 are older than 80 years. Considering age, an adjusted RN workforce count can be made at 18,959 nurses, which is 309 more working RNs than in 2022.

Geographic distribution is significant. The 2022 workforce report identified a geographic shift from small towns and rural communities to either one large town in a region or to the Boise area. In 2024 there is evidence that this movement has slowed and rural Idaho actually gained 520 more nurses than were rural in 2022. Some of this could be the result of the Idaho Rural Nurse Loan Repayment program that went into effect in 2023. Still, the greatest number of RNs live in the Boise area at 9,071 (44.5%).

An important factor in evaluating nurse employment potential in Idaho is that 90% of all nurses, both RN and LPN, are already employed either full or part time. This is compared to an average of 63% being employed in all other professions. Thus, the pool of nurses who are available to hire is very limited.

Advanced Practice Registered Nurses (APRNs) are divided into the 4 job categories of nurse practitioner, nurse anesthetist, nurse midwife and clinical nurse specialist. There is a significant number of each category who are licensed in Idaho but who do not live in Idaho.

Of 3,730 NPs, only 1,636 are Idaho residents. This is 71 fewer NPs working in Idaho in 2024 than in 2022. Half of the NPs live in the Boise area. Only 42 NPs reported that they practice in communities that do not have providers other than NPs, and 72% work for healthcare systems or physicians. The remainder are educators, government employees or in private practice.

There are 724 licensed CRNAs, representing 493 who live in Idaho. Of this, 201 live in the Boise area with 292 in other Idaho communities and 231 in other states. This is an increase of 43 CRNAs in Idaho.

Nurse Midwives have 97 total licensed, with 76 as Idaho residents. They are primarily in Boise, Nampa, Idaho Falls, and Coeur d'Alene.

Clinical Nurse Specialist have 49 licensed with 30 as Idaho residents, and 20 of those are in Boise. This is an overall decrease by 9 CNSs since 2022.

Ethnicity and age data is presented and is consistent with previous reports.

2024 Nurse demographic data for Idaho residents

Hospitals across Idaho are still using travel agency nurse staffing services, but less than during the COVID years. Long Term Care and Assisted Living facilities across Idaho are using travel LPN and CNA staffing on a regular basis. The phenomena of solving staffing needs with travel nursing is not new, but it received increased national attention during the COVID staffing crisis. Much research on this is available. Essentially, there are fewer nurses doing travel nursing today than a few years ago and most are seeking placements in high salary states with good weather and good recreation. The novelty seems to have peaked and is now slowing. Additionally, study outcomes have failed to identify the relationships between quality of care impact and use of travel nurses (Aiken, Vander Weerdt).

Conclusion

The 2024 report discusses existing and future mitigation strategies that can impact the Idaho nursing workforce. Many of these have existed for the past several years and some have been implemented with measurable outcomes. Three things are certain. (1) Idaho will not stop the migration of adults into the state. It cannot control that many of these families will relocate their elderly parents to Idaho to be closer to family, and they will also need long term care or assisted living arrangements. (2) It will also be difficult to prevent the instate migration of nurses from rural towns to bigger towns or the Ada and Canyon counties because lifestyle opportunities, clinical experiences and other opportunities are greater, even if salaries are comparable. (3) Lastly, Idaho will not be able to meet its nurse staffing needs by relying on recruitment of nurses from other states to move to Idaho. There is no historical evidence that this has worked and competition in surrounding states continues to be attractive to Idaho nurses.

Using non-adjusted RN supply numbers that include retirement aged, licensed nurses, Idaho has a shortage of 468 RNs to meet baseline needs. Using adjusted numbers, excluding retirees, Idaho has a shortage of 1,867 RNs.

The best solution for Idaho to meet its nursing needs is to focus on the education of Idaho high school graduates to enter the nursing profession. To accomplish this, Idaho needs to focus on supporting the education programs to sustain workforce numbers.

Licensed Practical Nurses (LPNs) are a vital part of the healthcare team, bringing unique skills and perspectives to patient care across a variety of settings. In acute care environments, LPNs contribute by providing hands-on care such as monitoring vital signs, administering medications, and assisting with daily patient needs. Their role extends into ambulatory and post-acute care settings, where they co-manage patient health through education, wound care, and coordination of services. In long-term care facilities, LPNs often work collaboratively with RNs and other professionals to address increasingly acute patient conditions, and they are frequently the cornerstone of direct patient interaction, building trusting relationships with residents and their families while ensuring that care plans are followed to improve quality of life.

Beyond their clinical contributions, LPNs demonstrate leadership by mentoring new staff, delegating tasks appropriately, and fostering collaborative environments. Their ability to work closely with registered nurses (RNs), advanced practice nurses (APRNs), providers, and other healthcare professionals ensures that patients receive comprehensive care. Licensed Practical Nurses often take on supervisory roles in long-term care and rehabilitation settings, guiding certified nursing assistants (CNAs) and supporting the development of a cohesive care team. This leadership is critical in maintaining high standards of care and addressing the diverse needs of patients in an ever-evolving healthcare landscape.

Education is another area where LPNs make an indelible impact. Through their own knowledge and experience, and in partnership with other care team members, LPNs provide patient education on medication adherence and preventive health practices. They serve as accessible and approachable resources for patients and families, helping them navigate the complexities of healthcare. Moreover, many LPNs take on the role of preceptor, guiding LPN nursing students or newly hired LPN and CNA staff through hands-on training that bridges the gap between theory and practice.

Recognizing LPNs as integral members of the nursing profession is essential for building unity and strength within healthcare. All nurses, regardless of their title, share a common commitment to patient advocacy, safety, and well-being. Speaking with a united voice that includes LPNs ensures that the nursing profession is more effective in advocating for better resources, policies, and professional opportunities. By embracing the contributions of LPNs alongside their RN and advanced practice colleagues, the nursing community can achieve its shared mission of providing compassionate, high-quality care to all.

Title 34, Subtitle B, Chapter VI, Part 668, Subpart B §668.14:

32) In each State in which: the institution is located; students enrolled by the institution in distance education or correspondence courses are located, as determined at the time of initial enrollment in accordance with 34 CFR 600.9(c)(2); or for the purposes of paragraphs (b)(32)(i) and (ii) of this section, each student who enrolls in a program on or after July 1, 2024, and attests that they intend to seek employment, the institution must determine that each program eligible for title IV, HEA program funds---

(i) Is programmatically accredited if the State or a Federal agency requires such accreditation, including as a condition for employment in the occupation for which the program prepares the student, or is programmatically pre-accredited when programmatic pre-accreditation is sufficient according to the State or Federal agency;

(ii) Satisfies the applicable educational requirements for professional licensure or certification requirements in the State so that a student who enrolls in the program, and seeks employment in that State after completing the program, qualifies to take any licensure or certification exam that is needed for the student to practice or find employment in an occupation that the program prepares students to enter; and

(iii) Complies with all State laws related to closure, including record retention, teach-out plans or agreements, and tuition recovery funds or surety bonds.

The new regulations place the onus on the institution rather than the student alone. The rules went into effect on July 1, 2024. We encourage all programs to confirm that they are in compliance with this federal law. Also, students who started school prior to July 1, 2024, should verify with the school and licensing state that they meet the state's requirements for licensure. For students who intend to become licensed in Idaho the Idaho Board of Nursing can be reached by email at : HP-Licensing@dopl.idaho.gov or by phone at: (208) 577-2476). A list of schools participating in the Title IV federal student aid programs for 2024-2025 can be found here.

New Well-Being Attestation for Licensing

Mental Health is a concern for a large portion of the population, including health care professionals. The Dr. Lorna Breen Heroes' Foundation's mission is " ...to reduce burnout of health care professionals and safeguard their well-being and job satisfaction" (Dr. Lorna Breen Heroes Foundation, 2024). The foundation has challenged licensing boards to remove intrusive mental health questions from their applications. The Division of Occupational and Professional Licenses Health Profession's Boards have met the challenge by replacing questions regarding mental health with a general attestation of well-being which reads as follows:

The Board recognizes the critical importance of physical and mental health and advocates proactive management of all health conditions to support the well-being of professional licensees and their patients. Our professionals experience trauma, whether directly or vicariously, which may lead to grief, depression, or other conditions. Ethical healthcare professionals will monitor their own personal well-being and attend to their own needs by seeking appropriate care to optimize their ability to care for others. Counseling and treatment provide important support for mental health and personal well-being. Therefore, nothing in the following attestation is intended to discourage those who might benefit from treatment or counseling from seeking it. Voluntarily seeking or receiving mental health treatment and counseling remains confidential and will not negatively impact your eligibility to obtain or retain a professional license.

As a healthcare professional, I commit to monitoring my personal health and well-being and, if I ever need treatment or counseling to support my health, I will attend to those needs by obtaining that treatment and counseling.

The attestation is part of all current licensure applications.

Position and Philosophy Statements

The Idaho Board of Nursing has established Philosophy and Position Statements for nurses to provide guidance and clarification in areas such as discipline, education regulation, and peer review. The Board of Nursing is the only health professions board to provide this type of information to its licensees. The statements are being updated and will soon be posted to the website. If you are interested in accessing the philosophy and position statements, go to the Idaho Board of Nursing website, select Resources/Forms, and then, select Link and Other Information.

State Level Initiatives to Promote Maternal Health

Two state level initiatives that serve to promote maternal health are maternal mortality review committees (MMRC) and perinatal quality collaboratives (PQC). MMRCs are multidisciplinary committees that meet to review pregnancy-associated deaths and make recommendations that could prevent future deaths. Perinatal quality collaboratives are networks within a state or across multiple states that work to identify ways to quickly implement change and improve quality of care for mothers and infants. Washington, Oregon, and Montana have multidisciplinary MMRCs that review maternal pregnancy-associated deaths and release reports with recommendations. In July 2023, the Idaho MMRC, which operated under the oversight of the Department of Welfare, was dissolved. This dissolution left Idaho as the only state in the PNW without a multidisciplinary MMRC. However, recent legislation successfully reestablished the MMRC, now overseen by the Idaho Board of Medicine. Washington, Oregon, Montana, and Idaho all currently have PQCs.

Conclusions

The United States faces a maternal health crisis characterized by regional disparities in paid family policies and perinatal care, which significantly affect maternal and infant health outcomes. As a nursing professional, you have a multifaceted role that is central to enhancing perinatal care in both rural and urban settings. You provide continuous prenatal and postnatal care and support to ensure that pregnant and postpartum individuals are receiving consistent, personalized medical care. Serving as community health educators, you elevate public understanding of health practices, such as nutrition, breastfeeding, and infant care.

As the maternal health crisis persists in the PNW and across the United States, you, as nursing professionals, can extend your impact through advocacy and research. You can advocate for paid family leave by educating patients and communities about its health benefits and by participating in public campaigns and social media efforts to raise awareness and support. Additionally, engaging in and sharing research and evidence-based practice related to paid family leave and equitable perinatal care access allows you to contribute to the field of perinatal care.

Although your role as a nursing professional is integral, addressing the disparities in paid family leave and perinatal care requires a coordinated approach across nursing professionals, providers, health systems, community partners, and policy makers to promote research, advocacy, and action. Integration of funding, community programs, and equitable policies are vital to meet the challenges that we face and ensure that all mothers and children receive equitable, high-quality care.

Article references

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Author Note

The author has no known conflict of interest or commercial affiliation to disclose.

Correspondence concerning this article should be addressed to Angela D. Phillips, Boise State University School of Nursing, 1529 Belmont St, Boise ID, 83702. Email: angelaphillips@boisestate.edu

This article addresses the challenges nursing students with disabilities face and discuss a policy update aimed at improving inclusivity in nursing programs.

The Problem

It has been reported that 11% of students are functioning with a disability (Horkey, 2019), and this number has been rising over the last decade (Philion et al, 2021). Because there are more students with disabilities than in the past, working to establish ways to offer support and embrace these differences, is an important part of the future of nursing education. When assessing the adult working population, reports share that 1 in 10 have a disability (Tanner et al., 2021). Within the nursing industry, many nurses and nursing students may not report their disability as they fear repercussions or discrimination.

Nursing programs that embrace the use of the Functional Abilities Domains of 1996 to establish admission and progression, may continue to promote discrimination of students with disabilities (Marks & Sisirak, 2022). By continuing to utilize these functional requirements exclusion of up to 15% of the nursing population, may result. Furthermore, including nurses with a variety of abilities may promote unique and emotional connections with patients experiencing similar disabilities, and encourage an improved patient experience (Tanner et al., 2021).

Policy Updates

The recommended policy update requested that the nursing program standards be changed from Core Performance Standards, which focus on physical requirements, to Core Clinical Judgment Standards, emphasizing performance evaluation with reasonable accommodations (Gonzalez & Hsiao, 2020). The Core Clinical Judgment Standards would be utilized during the admission process and progression within the program.

Barriers

Key barriers included safety concerns, faculty inexperience, and misconceptions about the capabilities of students with disabilities (Elting et al., 2021). Addressing these barriers involved collaboration with health partners to provide alternative clinical experiences, updated teaching methods to better support reasonable accommodations, and promoting Universal Design for Instruction (Levey, 2018).

Benefits of the Proposed Change

The changes were expected to enhance patient experiences and reflect the goals of The Future of Nursing 2020-2030 report (Tanner et al., 2021). The increased concordance between nurses and patients with disabilities and the potential adoption of similar supportive practices by healthcare partners, may result in a more equitable working environment. The implementation of Universal Design for Instruction could be of benefit to help mold a classroom environment that supports students of all abilities (Levey, 2018).

Clinical and Educational Relevance

The School of Nursing implemented the policy change in the spring 2023. This change has promoted a more just and equitable program which better aligns with The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (Tanner et al., 2021). Educational institutions that prioritize supporting students with disabilities should strive to collaborate with healthcare partners to better plan supportive experiences and implementation of accommodations which could lead to more student success (Horkey, 2019).

Updating admission and progression policies is an important step in supporting nursing students with disabilities. By embracing these changes, we create a more inclusive and equitable nursing workforce that reflects the diversity of the population it serves.

During the pandemic, nurses were stressed to our limits by high workloads, short staffing, and inability to take time off. If we thought we would catch a break post-pandemic, many have been disappointed. With the aging baby boomer population needing greater and greater care, we simply do not have the medical personnel to provide care to all those who need it. According to the National Council of State Boards of Nursing (NCSBN), 100,000 RNs have left the profession due to stress, burnout, and retirements during the pandemic. Another 799,350 reported an intent to leave by 2027 for the same reasons, with 188,962 of those under age 40 (NCSBN, 2023). Nursing has always been a difficult profession, but do not let it be a detriment to your health. We are the backbone of the medical community and self-care is crucial. Presented here are strategies for any nurse wishing to better prioritize their health with restorative sleep, consistently exercising, anticipating the good things, and eating well.

Restorative Sleep

Prioritizing proper sleep cannot be stressed enough. This is one simple, albeit time-consuming, portion of physical health has domino effects on both mental and emotional health. You cannot expect your mind and body to perform at the peak levels needed in order to do your job as a nurse safely and live a happy, productive life while not giving it enough recovery and rest time (ANA, 2024). Achieving better sleep can feel impossible, especially for our night nurse warriors. It is ok to start with small changes and gradually attain better sleep as you achieve better sleep hygiene. Here are some strategies that can help improve sleep quality and efficiency:

Create a good sleep environment- cool, dark, and quiet. If you are sleeping during the day, try a white-noise maker or earplugs, blackout curtains, or an eye mask.
Create a bedtime routine with a 30-minute wind-down- we can train our bodies that it is time for bed and sleep when it recognizes the bedtime routine. Perhaps enjoy a warm bath or shower, read a book in dimmer lighting, or listen to soft music.
Get sunlight in the morning, or if your morning is dark, bright light, in general, can help drive your circadian rhythms and help establish consistency.
If you have obstructive sleep apnea or another sleep condition, sleep hygiene may help, but your condition will probably need treatment in addition to your lifestyle modification in order to attain the best results (Suni, 2024).

Consistent Exercise

Exercise is also an important factor in physical health that significantly affects mental and emotional health as well (ANA, 2024). If exercise is not your favorite thing, it is important to find ways to exercise that are enjoyable to you, and ways you can fit it into your normal schedule. If you can find something enjoyable, you can find something sustainable. Something as simple as walking with friends or family consistently can make a significant difference over time.

The first key is to establish consistency, and you can work your way up to greater intensity and duration later and as needed and tolerated. Do not push yourself to go too hard, too soon, and give up when your body feels the consequences. You are here for long-term fitness, not the get-thin-quick motivation that burns out early. Take the stairs rather than the elevator a few times per day, until that becomes easy and routine. If you work at a desk a lot, consider a sit-to-stand desk, a walk pad and start walking, even if only for a few minutes at a time, and gradually work the time up. Find what you can do in and around what you are already doing. Get creative.

Anticipating the Good Things

Always have something to look forward to. As humans, we can better slog through the difficult times when we have something to look forward to. Marriage and family therapist Kimberly Diggles stated (as cited in Volpe, 2024), "We know anticipating something positive actually helps to maintain dopamine levels in your brain," she said. "So just the very idea of anticipating something good can physically change your brain chemistry so you feel happy" (pg. 1). These little things we love may take the form of dancing, painting, reading, watching kids sporting activities, camping, spa day, et cetera. We can look forward to little pleasures on a daily/weekly basis, while big things like vacations we can look forward to for months. Those little joyful things help us push through bad days and still enjoy our lives despite difficult circumstances.

Eat Well

How we fuel our body matters (ANA, 2024). Making healthy, nutrient-dense choices in meal-prepping and eating out can be a great solution. However, producing healthy meals can be difficult when we all seem to be short on time. If you fall into this category, maybe it is time to invest in a service that mails you the ingredients and recipes for meals to allow making fresh, healthy and delicious food easier for a busy nurse. Or search for some make-ahead meals prepared on a day off to make for an easy weeknight warmup. Find whatever way works for you and be consistent. When your body is properly fueled, it is better able to handle the stress that is put upon it with greater grace.

We have a difficult and crucial role to perform, and it is imperative we take care of ourselves, so we are up to the tasks we have opted to perform. None of this is really new information. We are nurses, we know these things are important to health. However, we are used to putting our patients, our families, everyone, and everything before ourselves, and we are suffering for it. While the sentiment is admirable, it is not sustainable. Please give your body and mind the care that it deserves so you can continue to offer the great service that you perform for the people you interact with every day.

The 2025 Board of Directors are: