The Institute of Medicine (IOM) has researched how nursing as we know it will and is changing. They have written a report called “The Future of Nursing: Leading Change, Advancing Health” that outlines the impact of these changes on education, nursing practice, and nurses as leaders and made recommendations on the necessary changes.
Regarding the impact of education, practice and the nursing role as leaders, they have developed four key messages: “1) Nurses should practice to the full extent of their education and training, 2) Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression, 3) Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States and 4) Effective workforce planning and policy making require better data collection and information infrastructure” (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). Impact on Education This IOM report strongly encourages our nursing population to obtain higher degrees. Not only does the committee prefer baccalaureate, master and doctorate prepared nurses, but they want to see our nursing population become more diverse. They want the nursing workforce to be leaders, able to meet the needs of all patients and able to deliver care at a higher standard.
Health policy and health care financing competencies need to be included in the curriculum as well as leader ship, quality improvement and systems thinking (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). The committee has set a goal for 80% of nurses to have a minimum of a BSN by the year 2020. In order for this goal to be met, several changes in our education programs need to occur. One change is there will need to be an increase of qualified nursing instructors. In addition to needing more instructors is the need for more classroom space. One way of solving part of this problem is to make more online classes available. However, online classes cannot take the place of clinical sites. It is imperative for students to attend clinical sites that will allow them to experience acute care needs.
Simulation in the classroom is a great supplement, in my opinion, but it cannot replace the educational experience of a hands-on, real-life situation. With an increase in nursing student population to meet the goals of the committee, more hospitals will need to accept nursing students into their facilities. Impact on Practice Nurses now have more opportunities in their career. They can return to school and expand their scope of practice, such as becoming a Nurse Practitioners (NP) or Advanced Practice Registered Nurse (APRN). States vary on their restriction for APRNs and NPs, but there is no evidence the states with higher restriction have better outcomes.
What is seen is higher technology in our hospitals, physicians combining office and hospital practice, shorter hospital stays, shorter hours for physicians resulting in safer patient care, increased primary care capacity, easier access to care for the underprivileged and those living in rural areas, care for the dying, coordinated care for those with chronic illnesses and the geriatric population, and increased access to specialty services (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). One example is guided care. Guided care is designed for the chronically ill population that provides primary care through a Registered Nurse (RN) who has specialized training and works closely with several physicians to ease their patient load.
This RN will be responsible for “assessment, planning care, monitoring, coaching, chronic disease self-management, educating and supporting caregivers, coordinating transitions between providers and sites of care, and facilitating access to community services” (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011). This type of provider care reduces the cost to the patient and can improve the outcomes of patient care. This is so important because our elderly population is rapidly increasing and people have better access to care which means our physicians simply cannot keep up with the high volume of patient needs. Impact on Nursing Role as Leader The future of nursing will be seen as nurses being full partners in the healthcare setting. Nurses need to be ready to step up to the plate and answer the call to be leaders.
Leadership skills can be learned in the classroom setting as well as through mentors. Nurses have been on the “front-line” for many years and have had such close contact with patients and their care that they have so much to offer to committees and boards that are making the decisions. It is a new responsibility for the nurse to accept the challenge of leadership that many may not have considered when they were pursuing their education, but whether leadership is a natural characteristic or the hardest thing for a nurse to do, we must step into this new role for the goals of the IOM report to be met (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, 2011).
Nurses need to develop a level of comfort in their career to be proactive in creating new policies, brainstorming ideas to improve the field, and get involved in committees that are making decisions regarding the changes that are happening in healthcare. Conclusion For the future of nursing, it is imperative to keep up with the changes that are occurring. Continuing education is the key, not only our own education, but the education of our patients. It is critical that we teach our patients. We need to pursue learning how to perform new procedures and further our education whenever there is a need for it. Not every nurse needs to pursue becoming an APRN or NP, but we all have a responsibility to delve deeper into the newest information concerning our career choice at every opportunity.
No matter what your nursing “title” is, we all have the same overall responsibilities: encouraging our patients to be their best advocate with their health needs and teaching our patients proper care for their condition. Instead of waiting for people in our community to become sick, we need to encourage people to focus on prevention. We need to change our focus to caring for patients in less acute settings and “catch” illnesses and disease before it gets to the acute level. In my practice, I plan to focus on teaching the patient and making sure they completely understand the information I have presented to them, promoting prevention and personal wellness, and help plan interventions for patients with chronic conditions while obtaining my BSN.
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, a. t. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, D.C.: THE NATIONAL ACADEMIES PRESS.