In Johnson Foundation (RWJF) began a two

February 5, 2019 Nursing

In 2008, the Institute of Medicine (IOM) in partnership with the Robert Wood Johnson Foundation (RWJF) began a two year project in response to the need for assessment and change in the profession of nursing. This initiative brought together a diverse group of people who, at the end of the two years, provided a detailed report entitled “The Future of Nursing: Leading Change, Advancing Health”. The goal the committee hoped to address in the formation of this initiative was multi faceted and sought to assess how nurses could be better utilized to “address the increasing demand for safe, high quality, and effective health care services”. (policynet) This report has guidelines for improvement and recommendations for the future of nursing and seeks to clearly define and expand the roles of nurses in the future of healthcare.
The IOM’s position in the report is that nurses of all types should be able to work to the fullest extent of their education and training. The IOM recognized the need for nursing education to “better prepare them to deliver patient-centered, equitable, safe, high-quality health care services; engage with physicians and other health care professionals to deliver efficient and effective care; and assume leadership roles in the redesign of the health care system.” (IOM) In order to do that, the report communicated a need for nurses to be better trained, with higher levels of education. As nursing education progresses, it strengthens the ability of the nurses to provide care for greater acuity patients, in addition to providing education and prevention strategy to the general population. Their conclusion was that “A more educated nursing population would be better able to meet the ever changing demand of the health care system”. (IOM)
In addition to attaining higher level nursing degrees, the nursing force as a whole must seek to continue lifelong learning. As such, the transition from one program and degree field to the next should be as seamless as possible in order to encourage the upward move for knowledge. Achieving a more educated work force can be attained by making it financially possible for a person to further their education and providing more programs that are tailored to people already in the workforce. The continued promotion of RN to BSN programs, additional facilities that offer traditional BSN programs, online programs, and educational collaborations will allow a more automatic and painless continued education movement of the nursing force.
Nursing Practice
In direct partnership with higher levels of education for the nursing workforce, is the understanding that nurses would be able to obtain the higher level degrees that would allow them to serve as primary care providers, nurse researchers and educators. It encourages the utilization of the educational experiences of these nurses to impact the growing populations of the aging and sick and to help fill in the gaps left by the decrease in the number of primary care providers. Our healthcare system is in the midst of a dramatic shift where care providers are attempting to develop new ways to provide more primary instead of specialty care, and to deliver more care to the community. (IOM) Advanced practice nurses such as Nurse Practitioners, Nurse Midwives, and Nurse Anesthetists have the training and ability to directly impact the healthcare profession and provide primary care. In the US, most nursing protocols for continuing education, nursing practice and nursing leadership are spelled out by the state themselves. In some states, it is very detailed, and in other it remains very vague and left open to interpretation. Unfortunately, the frustration caused by the vague terminology and constrained scope of practice for these advanced degree nurses is leading to many nurse practitioners and doctorate level nurses returning to the bedside as RN’s
The final piece to this puzzle is educating nurses to become leaders. The desire of the OEM writers was to prepare and enable nurses to lead, change, and advance health. (OEM) It is a step that is vital in the empowerment of nurses. In order for nurses to fulfill the roles of leadership, there must be changes made to education programs that would allow nurses to be trained in leadership from the very beginning. Nursing leadership begins with nurses being able to take responsibility for professional and personal growth. “Historically, nurses have been viewed by policy makers, administrators, and the public as workers who carry out tasks that have been delegated by physicians – and not as strategic thinkers who make informed decisions and act independently”. (American Sentinel)
In order for nurses to be seen as an important part of the healthcare team and as true partners and leaders, nurses must learn and maintain new practice and skills. These must include ” knowledge of process improvements, patient safety, ethics, cost management, policy making, care delivery models, translating research into practice, etc” (American Sentinel) We must continue to educate ourselves and participate as full partners, capable and ready to provide first rate care.
Nurses are a pivotal and integral part of today’s healthcare system. As nurses, we must continue to demand better of ourselves and realize that we can be a force for positive change. By furthering our education and improving our practice we are showing that we are up to the task.

Institute of Medicine. (2010, October 5). Retrieved from Future-of-Nursing-Leading-Change-Advancing-Health.aspx

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Institute of Medicine Report – The Future of Nursing: Leading Change, Advancing Health – Policy and Medicine. (2011, February). Retrieved from leading-change-advancing-health-.html


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