The Affordable Care Act was passed on March 23rd, 2010 and is part of the health reform which increases benefits provided by insurance companies. In Wisconsin insurance companies are now required to cover all preventative care, they are prohibited from dropping coverage of those who are diagnosed with costly diseases, they are unable to make an annual or lifetime limit, and soon they will be unable to “discriminate against anyone with a pre-existing condition” (Health care law, n.d., para. 1-2). “ The new law also makes a significant investment in State and community-based efforts that promote public health, prevent disease and protect against public health emergencies” (Health care law, n.d., para. 2).
This is just a portion of the new benefits and more will come during the health care reform. This increase in accessibility and increase in preventative treatment and education, in addition to the aging population, is going to call for a major increase in health care workers. In order to meet the near future demands, changes must occur in the way health care is provided. The Institution of Medicine of the National Academics wrote a report, The Future of Nursing: Leading Change, Advancing Health (IOM report). This report is already, or is going to be impacting nursing practice in general but specifically in primary care, nurse’s role as a leader, nursing education, and on my goals for my future professional practice during the health reform.
The IOM report “examines how enabling nurses to practice to the full extent of their education and training can be a major step forward in meeting these challenges” (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine [IOM], 2011, p. 86). The IOM report also describes how health care needs to change its focus from acute care settings to primary care and preventative care. By expanding the role of nurses to use their full range of skills, nurses can contribute to the solution of a shortage of primary care providers by completing education, assessments and follow up home visits. An example of this is that a nurse can specialize in educating patients on how to manage their chronic conditions such as diabetes and hypertension.
The same nurse can educate the community on wellness and preventative measures for diabetes and hypertension. Nurses can coordinate the patient’s care and carry out many of the duties required for their care. This decreases the amount of time required for the main provider, allowing them to see more patients. This will help increase patient satisfaction, and allow the main provider to see more patients or see those who are more critical (IOM, 2011).
“If the United States is to achieve this necessary transformation of its health care system, the evidence points to the importance of relying on nurses in enhanced and reconceptualized roles” (IOM, 2011, p. 95) There are many way in which nurses could contribute leadership to improve the health care system to provide advance patient care. IOM states that, “serving as strong patient advocates, nurses must be involved in decision making about how to improve the delivery of care” (IOM, 2011, p. 222). In order to have a voice in the health care reform, nurses need to take opportunities to be involve in committees or board meetings and participate in making policies. The IOM “committee believes there will be numerous opportunities for nurses to help develop and implement care innovations and assume leadership roles in accountable care organizations and medical homes as a way of providing access to care for more Americans” (IOM, 2011, p. 95).
Other ways nurses can step up in leadership roles would include involvement in researching evidenced based practice, engaging in the political process, and returning to school for higher education to take on other roles like a professor at a four year nursing school. The IOM report states, “one study found that new BSN graduates reported significantly higher levels of preparation in evidenced-based practice, research skills, and assessment of gaps in areas such as teamwork, collaboration, and practice” (IOM, 2011, p. 170).
This is step number one in preparing a nursing work force required to allow a true transformation of health care to occur. “An increase in the percentage of nurses with a BSN is imperative as the scope of what the public needs from nurses grows, expectations surrounding quality heighten and the settings where nurses are needed proliferate and become more complex” (IOM, 2011, p. 172). Places of employment need to encourage their staff to seek out higher education. Tuition reimbursement should be provided as an incentive and as assistance to pay for the education. IOM even goes to say that the government needs to provide scholarships as an aid to help the process along.
Not only do many associate degree level nurses need to return for a higher education but some education standards need to be altered. IOM points out that the curriculum needs to include more about geriatrics due to our aging population and on diverse cultures as health care becomes available to more of those who had not had access previously. After reading portions of The Future of Nursing: Leading Change, Advancing Health and other sources that explain what is going to change in the near future as more laws are passed, I know that change must occur. My first step of change to meet the goals of the IOM report is to finish my baccalaureate degree in nursing.
Even after I finish my baccalaureate program I know it is important to continue educating myself on new procedures, technology, and the diverse cultures in the area. I also am very interested in participating in committee meetings related to my immediate area of work and on patient safety. Also, as nursing students have their clinicals on my unit I can discuss the importance of returning for the baccalaureate degrees. The IOM report is going to have a great influence on the future of nursing practice in general and in primary care, on the nurse’s role as a leader, and on nursing education. “Nurses are so well poised to address these needs by virtue of their numbers, scientific knowledge, and adaptive capacity that the health care system should take advantage of the contributions they can make by assuming enhanced and reconceptualized roles” (IOM, 2011, p. 87). Nurses need to have an open mind and have a desire for improvement. By taking the initiative to join a committee, they are giving themselves and other nurses a voice in the change that will occur.
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine; Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. [The National Academies Press]. Retrieved from http://books.nap.edu/openbook.php?record_id=12956&page=R1 How the health care law is making a difference for the people of wisconsin [Fact Sheet]. (n.d.). Retrieved from HealthCare.gov Website: http://www.healthcare.gov/law/resources/wi.html