In 2010 the Institute of Medicine (IOM) released a report indicating that nurses are a key component to the improvement of the healthcare transformation in the United States of America. The Future of Nursing: Leading Change, Advancing Health discussed the powerful impact of a highly educated and trained nurse in the medical profession by examining evidenced based research and relative trends. In the following essay we will discuss how these findings influence nursing education, primary care nursing practice, and the leadership roles nurses will inevitably be placed. When addressing how nursing practice will be affected, we will also discuss how the goals of the IOM will be met. Impact on Nursing of the 2010 IOM Report
The Affordable Care Act of 2010 presented an interesting dilemma. According to the IOM panel, America will heavily rely on the expertise and compassionate care of advanced practice nurse’s to bridge the gap between the existing low number of primary care providers and the addition of thirty- two million people to the currently insured group of Americans. To connect this gap, it will be necessary to allow nurses to practice to their full potential by expanding their education and training. Nursing Education
The majority of nurses in the workforce today are educated at a community college level and do not hold a Bachelor’s Degree. However, the report findings indicate the need for these nurses to attain a Bachelor Degree. This push is mainly because studies have shown a ten percent increase in the proportion of nurses holding a bachelor’s degree was associated with a five percent decrease in probability of patient’s demise within thirty days of admission and the odds of failure to rescue (Aiken, 2003). The IOM’s goal is to increase this from fifty percent to an eighty percent by 2020. To meet this goal they call for “seamless academic progression” through integrated transitions between community colleges and universities. The committee also stated the need for more affordable nursing education and training to meet the complex demands that chronic health conditions create. Primary Practice Nursing Care
The IOM committee recommended the necessity of nurses to be able to practice to the full extent of their education and training especially Advanced Practiced Registered Nurses (APRN’s). In the United States of America, there are many legal barriers and inconsistent state regulations that prevent nurses from practicing to their full potential. The IOM report states, “APRN’s scopes of practice are so circumscribed that their competence extends far beyond their authority. At any point in their career, APRN’s can do much more than they may legally do. As APRN’s acquire new skills, they must seek administrative or statutory revision of their defined scopes of practice (a costly and often difficult enterprise).” Once legislation allows APRN’s to practice to their full scope of practice the high quality health care can be delivered.
APRN’s in primary practice can be extended to meet the physicians and patient needs. When nurses and doctors collaborate, quality patient care increases and cost efficiency is created. One way of establishing this collaborative team effort is by hiring more Advanced Practiced Nurses (APN) in primary care practices.
Another way we can transform nursing practice in primary care is by allowing nurse’s to be more involved with data collection. Jack Rowe from the IOM committee stated that science is based on “objective evaluation of evidence”. This evidence can be provided by the nurses who provide care to patients on a daily basis in order to create a more efficient health care system. Nurse’s Role as a Leader
The IOM report indicated the need for nurses to become the leaders of the upcoming reform. Today’s nurse is in a unique position due to the 2013 Gallup Poll’s statement that they are the most “trusted” profession in the United States. Bill Neville from the panel suggested that more nurses be put in boardrooms, legislation panels, and given more opportunities to lead. These qualities combined give nurses more power and force in leading discussions that will ultimately drive the change that needs to take place.
Overall the IOM report is opening the door for huge upcoming opportunities for the nursing profession. Nurses are a vital part in the healthcare reformation by becoming full partners with physicians, creating seamless academic progression for educational advancement, and practicing to their full scope of practice.
Aiken, L. H., et al. (2003). Educational Levels of Hospital Nurses and Surgical Mortality. Journal of the American Medical Association, 290(12), 1617-1623. Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. IOM, Pg. 97. Retrieved from http://books.nap.edu/openbook.php?record_id=12956 Institute of Medicine. (IOM). (2010, October 5). The Future of Nursing: Leading Change, Advancing Health-Report Briefing [Video]. Retrieved from