The ever-changing landscape of nursing — from the role of artificial intelligence (AI) in the future of health care to an updated model for community health — was the focus of this year’s Maryland Action Coalition (MDAC) Virtual Leadership Summit on May 20, titled “Revolution vs. Rearrangement: How to Realistically Reimage Nursing Education and Practice.” The University of Maryland School of Nursing (UMSON) hosted the summit.

MDAC is part of the Future of Nursing: Campaign for Action, a nationwide movement to improve health care through nursing that is an initiative of AARP and the Robert Wood Johnson Foundation. The campaign includes action coalitions in 50 states and the District of Columbia working to implement the National Academy of Medicine’s Future of Nursing 2020-2030 recommendations.

Innovations in Practice: Future of Community Health

“A lot of times when you’re a leader, you say let’s start with the low-hanging fruit. And let’s get some things done that are easy to do. And I really believe in the opposite,” said Sarah L. Szanton, PhD, MSN ’98, RN, ANP, APRN, FAAN, dean and Patricia M. Davidson Professor for Health Equity and Social Justice at the Johns Hopkins School of Nursing. “Obviously, we need to be able to do the low-hanging fruit and be able to get things done, but it’s the high-hanging fruit that creates new ways of thinking, new collaborations, and new tools.”

Szanton was one of the panelists who led the summit’s “Innovations in Practice: Future of Community Health” session, along with Erin Denholm, MSN, RN, chief nursing officer at DispatchHealth.

Setting a high goal and working toward it can create different innovations, Szanton added. In looking at the American health care system, it’s clear it works as a reactive system, she said. And despite spending a higher percentage of the economy on health care than do peer countries — almost twice as much — the United States still has the worst health outcomes, she said.

For decades, professionals have been discussing how to improve health care in our country, including trying to get everyone insured, Szanton said. That’s a good step — but it doesn’t solve the problem fully, she added.

“It turns out that insurance access is not enough. And, for example, in Baltimore City, 94 percent of people are insured. And yet, we still have the same health inequities,” she said, later adding that health care professionals now understand how many additional factors in someone’s life — segregated schools, toxic environments, lack of housing, for example — also impact well-being. 

Innovations in Practice: Using AI to Drive New Models of Care

In another session, “Innovations in Practice: Using AI to Drive New Models of Care,” Tracie Risling, PhD, RN, associate professor at the University of Calgary Nursing, vice president of the Canadian Nurses Association, and past president of the Canadian Nursing Informatics Association, discussed the complexities of artificial intelligence in health care, emphasizing the importance of understanding AI’s applications while acknowledging potential risks and misinformation. 

“Where have you used AI today?” Risling asked. “A lot of times when I have these conversations with folks about artificial intelligence, and I ask everyone, where have you used AI today, people struggle. Or they say, ‘Oh, no, I don’t really use artificial intelligence,’ in which case I have to break the very sad news to you that if you think you’re not using artificial intelligence, artificial intelligence is absolutely using you.” 

Unlocking a smartphone with one’s face, directing Alexa to turn off the lights, and providing a weather update are all ways that AI seeps into daily living. AI represents a huge opportunity for nursing and for models of care, but it is only part of the bigger picture. The main lesson: Proceed with caution.

“There are all kinds of generative AI tools out there. But the use of these tools in health care is also a danger,” Risling said. “It’s a danger because of misinformation, warned by the World Health Organization, and because these tools, while they can also be used to help us, to persuade, to educate, to learn, they can also be used to generate misinformation.”

AI can be a benefit to nursing and those they serve, but it has to be done in a really thoughtful way, she said. 

Participants also heard from Sophia Walker Henry, MSN ’13, RN, clinical consultant at Beckham Coulter Diagnostics, who discussed the integration of AI in nursing education and practice, highlighting the need for practical experience and clinical judgment alongside technological advancements.

“Is AI a revolutionary moment for nursing education and practice? I can answer with a resounding yes,” Henry said. “I believe that nursing education needs to teach our scholars how technology can impact what they do on a daily basis, and how it can impact patient outcomes. It’s a daunting task, but our students will need to learn that technology works. But our nursing skills and our clinical judgment cannot be replaced by technology. Both things need to work together for the good of our patients.”

As a nurse working in an emergency department, Walker said she dealt with issues of overcrowding for nearly 22 years with small successes. A group of biomedical engineers and data scientists developed an AI machine-learning program called TriageGo, a clinical decision support tool that supports the triage nurse by applying AI to recommend an acuity level.

“All those things are great. But in the end, the nurse gets to make the final decision about what acuity the patient is being given,” Henry said. “The tool isn’t able to look at the patient, the tool isn’t able to get collateral from the patient or from the family member. And so, we still have that human in the loop, that nurse with her clinical skills, being able to make that final decision about where that patient will land.”

The integration of AI and machine learning also must be guided by the nursing profession’s core values of patient-centered care, empathy, and professional excellence. 

“Engaging in this process will help safeguard the integrity of nursing practice while leveraging the power of technologies to improve patient outcomes,” Henry said.

The day’s panels focused on what is needed for the future of nursing and nurse well-being, including challenges with burnout. 

A Focus on Well-Being

Tad Worku, MS, RN, FNP-BC, a mission coach, speaker, and musician, gave the keynote presentation, “The Courage to See Hope.” The hourlong presentation combined original music from Worku alongside his keynote, which focused on his time as a nurse and his experience with burnout.

“My first job out of school was emergency trauma nursing at a Level One emergency department. Something you should know about me is that I’m a hopeless optimist, a glass-half-full kind of person,” Worku said. “I remember early on in my training, someone said to me, ‘Give it three years. And we’ll see if you’re not jaded.’ It wasn’t meant with malice. But that statement stuck with me and shook me. Had I just stepped away from the possibility of a lucrative career in search of purpose, just to end up jaded? Was that the story? Did everyone who stepped foot in the emergency department leave jaded and hardened?

“It’s safe to say that nursing and health care have experienced a collective trauma over the past four years that is ongoing. And yet, it’s also safe to say that hope remains within this reality.” 

Advancing Nursing Leadership

Also during the summit, Lisa Rowen, DNSc, MS ’86, RN, BCC, CENP, FAONL, FAAN, senior vice president and chief nurse executive of the University of Maryland Medical Center, was recognized with the Dr. Peggy Daw Exemplary Leadership Award for her outstanding contributions to nursing education and practice in Maryland. Rowen has established academic-practice partnerships to advance nursing leadership, supported nursing students, and expanded the nursing workforce through innovative care delivery models, Mary Etta Mills, ScD, MS ’73, BSN ’71, RN, NEA-BC, FAAN, professor emerita and MDAC planning committee member, said in announcing the award. 

The MDAC Exemplary Leadership Award was created in 2022 to recognize and celebrate the leadership and accomplishments exhibited beyond one’s day-to-day role. In 2023, the award was renamed in memory of Daw, DNP, RN-BC, CNE, FAAN.

Patricia Travis, PhD ’99, MS ’76, BSN ’69, RN, CCRP, senior associate director of clinical trials at the Johns Hopkins University School of Medicine and co-chair of MDAC, provided closing remarks, thanking attendees for their commitment to learning.

“Health care today is confronted with a challenge amplified post-pandemic with the continued demand for more nurses,” she said. “We hope that as participants in this daylong summit, besides having a better understanding of the well-being of a diverse nursing workforce, you now have new ideas for collaboration to partnerships and academic practice approaches to prepare faculty and students to address the current nursing crisis that can meet Maryland’s future health care needs.”

Attendees received free registration through support by UMSON’s Maryland Nursing Workforce Center and its Nurse Leadership Institute. Both are funded by the Nurse Support Program II, which was funded by the Health Services Cost Review Commission and administered by the Maryland Higher Education Commission.