NRS-440VN — IOM Future of Nursing Report and Nursing
NRS-440VN — IOM Future of Nursing Report and Nursing
Introduction
Nurses are the largest group in the healthcare profession, with nearly three million registered nurses in the U.S. They play key roles in health promotion, direct patient care, care coordination, patient education, research, leadership, and health policy reform. With the ongoing changes in the healthcare system, partly driven by the Affordable Care Act (ACA), nurses are positioned to significantly impact the delivery of accessible, patient-centered care at a lower cost. The Institute of Medicine (IOM) report, “The Future of Nursing: Leading Change, Advancing Health,” offers recommendations to better align nursing with the reformed healthcare system. This paper will discuss the influence of the IOM report on nursing education, practice, and workforce development, as well as the role of state-based action coalitions in advancing the recommendations.
The Work of the Robert Wood Johnson Foundation Committee Initiative
In 2008, the Robert Wood Johnson Foundation (RWJF) partnered with the IOM to conduct a two-year study assessing the nursing profession, recognizing the importance of nurses in a transformed healthcare system. The RWJF Committee was tasked with evaluating whether the nursing workforce could meet the demands of the reformed system. According to Altman et al. (2019), the committee developed recommendations focused on nursing care in the evolving healthcare landscape and the education system needed to prepare nurses effectively for the future.
The Four Key Messages of the IOM Report
- Nurses should practice to the full extent of their education and training
The IOM committee found that regulatory, policy, and historical barriers often prevent nurses from practicing to the full extent of their training. Recommendations were made to state legislatures, Congress, and federal entities to remove these barriers. For example, many states have implemented changes allowing nurse practitioners (NPs) to have full practice authority. By 2013, fifteen states had updated laws to grant NPs full authority to practice and prescribe independently (Hansen-Turton, 2015). - Nurses should achieve higher levels of education and training through an improved education system
The IOM report emphasized that more nurses should pursue higher education, aiming for 80% of nurses to hold a baccalaureate degree by 2020 and to double the number of nurses with doctoral degrees. Additionally, the report advocated for lifelong learning and a more diverse nursing workforce. In response, baccalaureate programs have expanded, and more health systems have implemented nurse residency programs, such as the AACN/UHC program, which saw participation grow from 3,579 in 2010 to 9,000 in 2014 (Altman et al., 2016). - Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the U.S.
The IOM committee recommended that nurses take leadership roles and collaborate with other healthcare professionals in transforming healthcare. They also advised healthcare organizations and educators to provide opportunities for nurses to develop leadership skills. Programs such as the American Organization for Nursing Leadership’s Nurse Manager Fellowship exemplify efforts to foster nurse leadership and entrepreneurship (Altman et al., 2016). - Effective workforce planning and policy-making require better data collection and improved information infrastructure
To successfully implement changes in the healthcare system, accurate and detailed data on the healthcare workforce is crucial. The IOM report suggested that the National Health Care Workforce Commission collaborate with the Health Resources and Services Administration (HRSA) to improve data collection and analysis (Altman et al., 2016).
The Role of State-Based Action Coalitions
State-based action coalitions play a crucial role in promoting the implementation of the IOM report recommendations. The Center to Champion Nursing in America (CCNA) and the AARP launched action coalitions in every state and the District of Columbia to drive change at the local level (Friberg, 2019). These coalitions collaborate with stakeholders to support initiatives that align with the report’s goals, such as improving nursing education, increasing leadership opportunities for nurses, and advancing public health.
Initiatives of the California Action Coalition
The California Action Coalition, in partnership with HealthImpact, focuses on executing the IOM report’s recommendations to improve healthcare delivery in California. One initiative aims to enhance leadership development for nurses by providing mentorship programs through organizations like the Association of California Nurse Leaders. These efforts help equip nurses with the skills needed to take on leadership roles in the evolving healthcare environment.
Barriers to Advancement in California
One significant barrier to nursing advancement in California is the lack of full prescriptive and practice authority for nurse practitioners. As Phillips (2020) notes, nurse practitioners must adhere to standardized protocols when prescribing medications or performing certain medical tasks, limiting their autonomy. Additionally, resistance from physicians and a lack of public awareness about nurses’ competencies are other barriers. Nursing advocates are addressing these challenges by lobbying for legislative changes and educating the public and healthcare providers about the vital role of nurse practitioners.
Conclusion
The IOM report has had a profound impact on the nursing profession, driving changes in education, practice, leadership, and workforce development. State-based action coalitions, such as the California Action Coalition, play an essential role in advancing these changes at the local and state levels. Despite ongoing barriers, nursing advocates continue to push for policy reforms and greater recognition of nurses’ contributions to healthcare. The future of nursing is evolving in response to these recommendations, ensuring that nurses remain at the forefront of healthcare transformation.
References
Altman, S., Butler, A., & Shern, L. (2016). Assessing Progress on the Institute of Medicine Report The Future of Nursing. The National Academies Press.
Friberg, E. E. (2020). Conceptual Foundations E-Book: The Bridge to Professional Nursing Practice. Elsevier Health Sciences.
Hansen-Turton, T., Sherman, S., & King, E. S. (2015). Nurse-Led Health Clinics: Operations, Policy, and Opportunities. Springer Publishing Company.
Phillips, S. J. (2020). 32nd Annual APRN Legislative Update: Improving access to high-quality, safe, and effective healthcare. The Nurse Practitioner, 45(1), 28–55.
