Nurses are the largest work force in the healthcare industry. The increasing demands for nurses opt to increase the quality of care given by these nurses. The Institute of Medicine (IOM, 2010) states that patients “deserve the care that centered on their unique needs and not what is most convenient for the health care professionals”. Nursing practice has changed significantly since the beginning of the profession secondary to increased demand for high quality care given and for the safety of the nurses and the patients. In order to overcome these challenges the Institute of Medicine (IOM) created a report that served as a foundation for the future and advancement of nursing. IOM reported that, “Nurses have the opportunity to play a central role in transforming the healthcare system to create a more accessible, high quality, and value-driven environment for patients”. (Institute of Medicine [IOM], 2010, pg. 85) The IOM report, ”The Future of Nursing: Leading Change, Advancing Health”, emphasized on different topics with regards to the future of nursing especially the importance of nursing education, nursing practice and the roles of nurses as a leader in the healthcare system.
The goal of nursing education is for the nurses to be prepared to face the increasing needs of a diverse population of patients and to deliver a safe and quality patient care. In addition, the transformation of nursing education is encouraged to prepare new nurses to work hand in hand with other healthcare professionals in different settings. These changes are needed because of technological advancements, older patient population and increasing complexity of the patient conditions. Care in the acute care setting and outside the hospital has become more complex as well. Nurses have to be trained on flexibility and ability to take in more roles than what is expected when they graduate nursing. With this note, advancement in the education curriculum and changes are needed to compensate for these demands. Nurses should be able to have evidence-based practice care, collaborative skills with other professionals, be proficient with the new technologies and even more skilled on the acute and chronic healthcare settings.
Most hospitals are teaching hospitals and require more BSN graduate nurses in their workforce. The IOM has a view to increase BSN nurses working in hospitals from 50% to 100%. In spite of this view, IOM set a goal of having BSN nursing percentage of 80% by 2020. This is “necessary to move the nursing workforce to an expanded set of competencies, especially in the domains of community and public health, leadership, systems improvement and change, research and health policy”. (IOM, 2010, pg. 173) In addition, having a BSN degree is a good foundation for nurses to advance to a higher education, APRNs and Doctorate levels, that will in turn advance nurses to research, faculty nurses to teach future nurses, ability to participate in creating healthcare policies and leadership roles.
IOM also encourages having bridge programs from RN to BSN and having a residency program that will allow nurses to gain more skills, experience and knowledge and alleviate the stress around new nurses that are being thrown out of the real world without enough exposure and understanding of the profession. There are plenty of barriers in accomplishing these goals but with proper incentives, motivation and encouragement that are given to nurses, it is not impossible to have a better future in nursing education and have more educated and advanced nursing workforce in our society today.
IOM also emphasized the importance of advancing the nursing practice to the community and not just concentrate in the acute care setting due to the increasing needs of the population and changes in the healthcare system. The outdated policies governing nursing scope of practice is a hindrance to the advancement of nursing practice and because of this patients are limited to access a better quality of care. IOM stressed on their report that a necessary alteration in nursing practice is needed
to provide patient-centered care; deliver more primary as opposed to specialty care; deliver more care in the community rather than the acute care setting; provide seamless care; enable all health professionals to practice to the full extent of their education, training, and competencies; and foster inter-professional collaboration. (IOM, 2010, pg. 86-87)
Nurses are encouraged to pursue their education to Advanced Practical
Registered Nurses (APRN) due to a shortage of primary care professionals in the acute and mainly in the community healthcare setting. APRNs are knowledgeable, well trained and proficient enough to provide safe and high quality of care without the supervision of a primary doctor. IOM believes that changes in the regulations and expanding the scope of practice of nurses and of APRNs are necessary so that they can have the ability to practice and make decisions more independently. “The committee believes all health professionals should practice to the full extent of their education and training so that more patients may benefit”. (IOM, 2010, pg. 96) Again having bridge programs and residency programs for new nurses will help with the advancement of nursing practice. Redefining the roles and extending the scope of nursing practice is highly recommended by the IOM for the future of the nursing profession and to keep up with the evolution of the healthcare environment.
Another vision that the IOM has is nurses as leaders in healthcare. It is time for nurses to move forward from bedside roles and start being active as leaders and partners with other healthcare professionals in delivering high quality care to patients. Together with the changes of nursing education and nursing practice, nurses as leaders are required to finally reach the goal of an advanced healthcare system. IOM’s vision “specifically challenges nurses to demonstrate full partnership with physicians and other healthcare professionals in redesigning U.S healthcare.” (Porer-O’Grady, 2011, pg. 33) in addition the IOM “report suggests that the nursing profession must produce leaders at every level of the system and accept key leadership positions in policy, politics, organizations, and practice.” (Porer-O’Grady, 2011, pg. 33)
Today’s advancements in technology, nurses have an important role in research and they assist in developing evidence-based practice care to maintain safety. Nurses are the main caregivers and they understand very well the healthcare process. Nurses also play a vital role in delivering quality patient care through facilitation, coordination and making sure everything is at ease. So it is imperative that nurses be involved in policy making and provide strategies to improve care delivery and ensure quality care. With these expectations put into nurses, it is every nurse’s responsibility to advance in their career, through education, be very well rounded with competencies and be active partners and be future leaders in the healthcare system.
In conclusion, IOM has a very broad insight and goals with regards to the future of nursing. In order to achieve these goals, the importance of advancing nursing education and practice are emphasized as well as having more nursing leaders in the healthcare system. Having more BSN graduate nurses in the acute care settings and having more APRNs extending their services to the community is going to facilitate the advancement that the IOM views. Changing policies and extending the scope of practice for nurses to avoid limiting their abilities to practice and taking advantage of the nurse’s full capabilities is another goal that the IOM envisions. Lastly, nurses are seen more involved as leaders for a successful reform and in turn provide a better quality and safe care to patients.
Porer-O’Grady, T. (2011). Future of Nursing Special:Leadership at All Levels. Nursing Management, 32-37. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1163290 The future of nursing: leading change, advancing health. (2010). Washington, D.C.: The National Academies Press. Retrieved from http://www.nap.edu/catalog.php?record_id=12956