Health care providers, including registered nurses (RNs) across all health care settings continue to serve on the frontlines as the nation responds to the COVID-19 pandemic. ANA has served as an independent resource and thought leader to nurses, essential workers, states, the public, media, government agencies, Congress, and the past and current Administrations. As response to the pandemic evolves, so too has the nature of ANA’s work—addressing priority issues from availability of Personal Protective Equipment (PPE) and decontamination to vaccine rollout and distribution guidance. 

Personal Protective Equipment (PPE) and Decontamination

Health care providers continue to report insufficient PPE, including gloves, masks, and N95 respirators. Shortages of raw materials and issues with supply chains have become commonplace due to the global need of PPE. This has presented unprecedented challenges as nurses find themselves operating under emergency standards where they are required to reuse and decontaminate PPE. Gaps in PPE availability and lack of data to substantiate the safety of decontamination processes leave nurses and patients unprotected and potentially at risk for COVID-19 infection and further spread of the virus and other illnesses. ANA is working with Congress and the Biden Administration to address these issues now and to ensure the nation will be prepared for future emergencies.  
ANA strongly encourages the return to single use of PPE. However, as PPE supply challenges continue, the association urges Congress to engage with the U.S. Food and Drug Administration and expeditiously research the effectiveness of various decontamination methods. This research is critical to safeguard nurses and other health care professionals forced to reuse PPE, along with the patients they serve. Further, Congress and the Administration must exhaust all options to fix gaps in the current supply chain to secure adequate amounts of PPE. These are critical steps as the nation continues to respond to the COVID-19 pandemic. 

Public Health Infrastructure

The nation’s public health infrastructure and workforce has been underfunded for decades. Federal funds for state, local, and tribal public health preparedness were cut from $940 million in 2002 to $675 million in 2019. At the same time, health care emergency preparedness was cut by nearly fifty percent, from $515 million in 2004 to $265 million in 2019. This is unacceptable as it is vital that our nation is better equipped with preparedness and response measures, not only during the time of crisis, but also integral to narrowing disparities, improving health outcomes, and reducing disproportionately high morbidity and mortality rates due to preventable illness.
ANA urges Congress to appropriately address the public health infrastructure and workforce by providing $100 million to support community-based care through the development of teaching health centers and mental health centers. Additionally, at least $500 million must be provided to the Centers for Disease Control and Prevention (CDC) to improve the capabilities of the agency and other public health departments to modernize and encourage implementation of information technology and data systems.

Mental Health and Hazard Pay

Prior to the COVID-19 pandemic, nurses already experienced tremendous levels of stress in their day-to-day work. The pandemic has further intensified the feelings of exhaustion, anxiety and being overwhelmed. It is vital the nation prioritizes the mental health of nurses and other health professionals who are caring for our most vulnerable patients. We will actively advocate to reduce stigma around seeking help for mental health and substance use disorders for health professionals as well as their patients. 

Of the more than 12,000 nurses who participated in a December 2020 survey conducted by the American Nurses Foundation (The Foundation), Pulse of the Nation’s Nurses, 72 percent shared they are experiencing a higher likelihood of depression, anxiety, and distress from when they were surveyed in spring 2020. During the spring survey, 50 percent of nurses indicated they were overwhelmed. 

The Foundation also created the Well-Being Initiative, which supports the mental health and resilience of all nurses. Through the initiative, nurses are encouraged to take self-assessments, listen to recommended podcasts, and provides a safe space to discuss shared experiences.

ANA proudly endorsed the Dr. Lorna Breen Health Care Provider Protection Act, which was introduced in the 116th Congress. This legislation would have reduced suicide and mental and behavioral health conditions among health care professionals. It was a good first step as Congress must establish mental and behavioral health resources for nurses and other health care workers serving across all health care settings. 

Health care workers must be treated and compensated appropriately as they provide care under extraordinary circumstances, so that the next generation is encouraged to enter the field and ensure the nation’s readiness for public health emergencies. Legislation is needed that prevents nurses from being forced to use paid time off because of suspected exposure or contraction of the COVID-19 virus. Additionally, ANA continues to call on Congress to provide hazard pay to essential health care providers. 


Vaccines are critical to the control and prevention of infectious disease transmission. As the voice of the nation’s registered nurses, ANA has established key principles to guide nurses and other health care professionals as they examine considerations when immunizing for COVID-19. Nurses play a critical role in educating the public and fellow health care colleagues as well as in the administration of COVID-19 vaccines. ANA sent a December 2020 joint letter with the American Hospital Association (AHA) and the American Medical Association (AMA) urging the public to trust the vaccine process and follow the advice of scientists when it comes to effective and transparent COVID-19 vaccines.

The Centers for Medicare and Medicaid Services (CMS) is interested in developing a clinical quality measure related to COVID-19 vaccination among health care providers. In the future, this data could be used in federal payment programs such as the Merit-based Incentive Payment System, which determines the payment adjustment applied to Medicare Part B claims. The first of the COVID-19 vaccine measures that ANA has seen also appeared in the CMS proposed payment rules for Fiscal Year 2022. For more information on ANA’s responses to CMS click here.

ANA strongly recommended that nurses be prioritized for vaccination according to current recommendations for immunization of health care professionals by the CDC’s Advisory Committee on Immunization Practices (ACIP). Immunization of nurses and other frontline workers is essential for their safety and building public trust in the COVID-19 vaccines. 

As more vaccine doses are made available, it is critical the federal government provide state and local public health agencies and jurisdictions sufficient resources and funding to support mass distribution and administration of the COVID-19 vaccine.

Continued Advocacy

ANA led a very large and successful advocacy campaign, which resulted in the inclusion of several key provisions in the March 2020 Coronavirus Aid, Relief, and Economic Security Act (CARES Act) (H.R. 748). Even with passage of the CARES Act, health care providers are still in need of resources to combat the pandemic. ANA continues to call on Congress and the Administration to act with its first call to action of the 117th Congress where nurses and nurse advocates alike can make their voice heard. ANA stands ready to work with policymakers to identify and enact legislation and regulation that support nurses and other health care workers on the front lines.