Nurses provide nearly 80% of hands-on direct care worldwide, positioning them as crucial in bolstering health system resilience. Although their roles during health emergencies are significant, they often lack representation in leadership positions that determine vital resilience strategies.

A recent investigation from the University of Michigan underscores the significance of health system resilience, which is defined as the capacity of health systems to efficiently respond to systemic shocks or disasters while ensuring the continuity of essential services and safeguarding population health.

“What astonished me most was the limited number of publications that addressed both the nursing workforce and their roles in health system resilience,” stated lead author Katherine Kruger, a doctoral candidate at the U-M School of Nursing.

The study highlights both the obstacles and prospects for better incorporating nurses into these essential processes. The outcomes align with the World Health Organization’s directive to reinforce health system resilience by empowering nurses, a pivotal component of the global healthcare workforce.

Nurses encounter challenges such as insufficient staffing, inadequate training, and restrictive policies. These hurdles limit their participation in strategic planning and governance, exacerbated by traditional hierarchies and gender-related power dynamics in medicine.

“This is the first research that asserts we are talking about the issue, but we are not taking the necessary actions to integrate nurses on a global scale actively in the development of resilient health systems,” Kruger mentioned.

A robust nursing presence enhances overall health system performance and improves population health outcomes, including lower mortality rates. Increasing nurse involvement in system-level roles can further elevate resilience and equity in healthcare delivery, amplifying their current impact in these capacities.

The study advocates for policy reforms that focus on nurse recruitment and retention while also broadening leadership opportunities.

“My aspiration is for larger organizations, at both the top and bottom levels, to amplify nursing voices, while also encouraging grassroots engagement to remind nurses that in times of disaster, they are the ones responding and adapting,” Kruger expressed.

Co-authors include: Sue Anne Bell, U-M associate professor and senior author of the research; Jody Lori, U-M professor of nursing; and Petra Brysiewicz, professor of nursing at the University of KwaZulu-Natal.