Switzerland, the US, and many other countries worldwide face the challenge of ensuring care for an aging population. A delegation from the Canton of Vaud*, led by Stéphane Cosandey, Director of the La Source School of Nursing, and Christine Gaulis, Head of International Affairs, Foresight and Innovation at the Directorate General for Higher Education (DGES) of the Canton of Vaud, traveled to the US East and West Coast to learn about new guidelines for nursing and look ahead to trends shaping the next decade. 

*Participants of the delegation: Anne Oulevey Bachmann, Professor at Higher Education School of Nursing “La Source”, Chantal Montandon, Nursing Director of the Clinic of “La Source”, Philippe Thomas, Director of Nursing at Lausanne University Hospital, José Iglesias, Director of Nursing at Riviera-Chablais Hospital, Valérie Klein, Director of Inpatient Care at Hospital de la Cote, and Marina Kreus, Director at Fondation de Nant (psychiatric hospital).

West Coast Learnings

On the West Coast, Swissnex in San Francisco organized a one-week program for the delegation to dive deep into California’s experience around the nurse-to-patient ratio law passed in 1999, which established minimum care ratios, maintaining the standard of how many patients one nurse can be assigned to during their shift. The program also allowed a glimpse into technology developments shaping today’s and tomorrow’s reality in nursing, focusing on AI, wearables, and remote care. This week offered connections with leading Bay Area hospitals and practitioners, such as UCSF Benioff Children’s Hospital, Sutter Health CPMC, Zuckerberg General Hospital, and Kaiser Permanente. Interactions with nursing schools and meetings with UCSF and UC Davis schools of nursing allowed exchanges to provide deep insights into the workforce dynamics of nursing and examine best practices to ensure enough qualified professionals are ready to enter the labor market. One key goal of this one-week program, linked to understanding the California legislative process around the ratio law, was addressed by meeting with legislators and their staff (e.g., the Assembly and Senate Health Committees), as well as lobbyists, advocacy groups (e.g., ANA California), and associations (e.g., the California Hospital Association) involved in the creation of the law.

The week surfaced key differences between the US West Coast and Switzerland, offering learning opportunities from California’s approach. Firstly, nursing is a sought-after career in California with attractive salaries in cities but a strong urban-rural divide; therefore, nursing schools must turn away prospective students due to capacity constraints. The main challenge is to attract and retain faculty and educators to teach the students, along with the general difficulty of adequately staffing rural hospitals. 

While nursing remains an attractive profession today, the nurse ratio law initially exacerbated nursing shortages. This was partly due to nursing schools’ limited capacity to rapidly expand enrollment and programs to meet the increased demand, both financially and logistically. However, over time, these institutions have increased their capacity to train the necessary number of nurses, although in rural areas, the shortage challenge still exists. Going forward, many stressed the need for flexibility for individuals and institutions in new measures to address workforce retention. 

The second key realization relates to AI’s immense speed and broad scope, which already affect nursing practices. The exchange with Hippocratic AI’s Chief Nursing Officer, Amy McCarthy, was eye-opening, even more so when she shared that patients sometimes preferred speaking via phone to the AI nurse instead of a human because in-person interactions were often pressed for time and much shorter. A lesson learned is that Swiss schools and institutions must prioritize experimentation with AI for their professors, students, and practitioners to continue providing the best care with available resources and not fall behind.

East Coast Experiences

A week prior to visiting California, a smaller group consisting of Stéphane Cosandey, Christine Gaulis, and Karen Van der Veken, toured the US East Coast to seek academic collaborations and gather insights about innovations in nursing education and health care delivery. 

On the East Coast, La Source explored current and future collaborations with leading schools and colleges of nursing at Georgetown University in Washington, DC, Columbia University and Rory Meyers College, NYU, in New York, and Boston College in Massachusetts, with which La Source has a longstanding summer school exchange program. In Washington, the team engaged in discussions on nursing education policy with members of the American Association of Colleges of Nursing (AACN) and visited Ambassador Ralf Heckner at the Embassy of Switzerland. They learned about the challenges in attracting and especially retaining nurses in the US, as well as strategies ranging from residencies to post-master programs to nursing ratio laws being deployed to combat the loss of nursing professionals. 

Diving into healthcare innovation in Boston, the delegation saw how AI, nursing-centric innovations, and new biotech and medtech solutions converge in this vibrant ecosystem. At the MIT Jameel Clinic, the delegation saw how AI cancer detection for breast and lung tumors is a promising innovation that may influence care delivery. At Massachusetts General Hospital, the delegation learned about bottom-up innovation projects in which nurses propose real-world solutions to their daily challenges, such as precise algorithms for properly distributing drug dosage. And from two Swiss-led companies with a presence in Boston – Energesis Pharmaceuticals, which is developing advanced treatments for diabetes and obesity, and machineMD, a leader in ophthalmological diagnostics for brain disorders – the group could see how broader advances in treatment and diagnostics may soon change the face of nursing.