Nurses are a powerful voice in healthcare, yet they are sometimes the last to be heard. Especially when discussing crucial issues and developing ways to enhance treatment. With many obtaining advanced degrees and the unfortunate shift away from bedside nursing, nurses should have their voices heard and be part of crucial solutions for systemic healthcare change.

Politicians, CEOs, and other top executives are making poor decisions when they should be listening to those on the front lines. They should be listening to those who are delivering care and managing the realities of a failing healthcare system.

The healthcare system has evolved tremendously over the last several decades. After two years of a global pandemic, many controversial problems have surfaced in terms of healthcare access. These include healthcare and nursing policy, and a range of health-related injustices.

These issues combine to fuel the need for systemic healthcare change. “Healthcare redesign involves making systematic changes to primary care practices and health systems to improve the quality, efficiency, and effectiveness of patient care.” (Potter, Ph.D., RN, FAAN, FNAP, et al., 2021)

During the Covid-19 pandemic, the world has experienced amplified gaps in healthcare. Nurses produced inventive ideas and designed process adjustments. They did this while dealing with a double crisis of a global epidemic and a falling healthcare system.

As we watched our world become a battleground, nurses along with other members of the healthcare delivery system were the soldiers coming up with real-time solutions to PPE shortages, staffing shortages, improved infection control strategies for an invisible enemy, conducting real-time research in the ways we provided care for our patients, and creative ways for our patients to communicate while isolated and critically ill.

Despite our clear resourcefulness and flexibility, nurses still largely remain out of the conversation for policy changes and healthcare reform.

Nurses have the power, skills, and knowledge to transform healthcare. We are the leaders in fact-based practice research and should be the loudest voice that drives healthcare initiatives. Nurses should become leaders in the fight for healthcare change. They should be among the most powerful voices in the fight for healthcare change.

A survey of over 4000 nurses found that nurse-led initiatives were most impactful in managing the Covid-19 pandemic. This should provide a clear road map to empower nurses to lead healthcare change. The summary of this survey makes the following recommendations for transforming the U.S. healthcare system:

• Identify gaps and appoint nurse leaders today.

• Grow the pipeline of new nurses.

• Embrace nurse-led experimentation within health systems.

• Rethink systems and policies that hinder community access to care.

Nurses must also elevate their voices on policy changes to be part of the fight for systemic healthcare change. The following are strategies to accelerate change and fight for improved healthcare for all:

• Nurses must advocate for policy changes that prioritize patient engagement and healthcare for all.

• Nurses must insist on healthcare equity.

• Nurse practitioners (NPs) should be allowed to practice to the full extent of their education, advanced clinical training, and national certification.

• Nurse-led community care models and healthcare technology need further investment and support.

• Nursing curriculums must be redesigned to give attention to primary prevention and social determinants of health.

Nurses are both the backbone and heart of healthcare. As the scope of practice for nurses continues to expand with additional roles, diverse responsibilities, and advanced practice providers transforming the delivery of healthcare, we must take the driver's seat in the fight for healthcare change.

We must capture the momentum gained in the last two years and use it to propel us forward. As the strongest advocates for both our patients and their families, the time to lead must-needed change is now.