Transformations in the Future of Nursing
The Institute of Medicine's (IOM) report entitled "Future of Nursing: Leading Change, Advancing Health" (2010), details many needs in the medical field and recommends changes in the field of nursing for the decade between 2010 and 2020. It addresses concerns of increased demand for nurses due to societal issues such as the aging baby boomer population and the Affordable Care Act, which allows more people access to medical insurance, which in turn means more visits to medical facilities.
The report makes three strong recommendations that will have an impact on the nursing community. These are that nurses "should practice to the full extent of their education... should achieve higher levels of education and... nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States" (IOM, 2010).
The Future of Nursing
Education is a primary concern for the nursing community moving into the future. Higher levels of education not only open new doors for the nursing profession, but are also correlated with better success rates in facilities employing nurses with more advanced degrees. A 2013 study of 21 university hospitals found that nurses with at least a bachelor's degree had lower rates of mortality when compared to nurses with their associate's degree (Blegen, Goode, Park, Vaughn, & Spetz, 2013). For this reason the IOM's report calls for an increase of nurses with baccalaureate degrees to be 80 percent of the registered nurse workforce by 2020 (IOM, 2010).
Furthering nursing education also has an impact on the graduate level, since the report calls for nurses with post-baccalaureate degrees to be doubled by 2020 (IOM, 2010). Clark, Casey, and Morris in their 2015 article "The Value of Master’s Degrees for Registered Nurses," explain that advanced degree registered nurses can begin to fill in much of the roles that physicians once filled. This is an important step forward for the nursing community in gaining recognition, but also for the medical community at large as it will mean more people capable of providing healthcare for the ever expanding populations served.
This concept of expanding the definitions of nursing practice leads into the commission of the IOM for nurses to "practice to the full extent of their education" (IOM, 2010). This recommendation has strong implications since nurses are often underutilized and thought of as assistants to doctors. Even for nurses with advanced degrees there are still obstacles to overcome in allowing them to practice within the full scope of their abilities (Clark et al, 2015). However, once they are able to do so they will be able to provide additional primary care for patients as opposed to simply specialized care, which is one of the points made by the IOM (2010). As such, nurse practitioners and those in school to become advanced practice registered nurses can alter their practice to accommodate this recommendation. Whereas, before, a nurse with an advanced degree would plan to fulfill a supporting role in a hospital or go into public health, now those nurses can plan on working directly as primary care providers. This will be a great benefit to the community as there is a shortage of primary care providers (IOM, 2010).
One of the greatest areas of impact for the report is the recommendation for nurses to be "equal partners" with other medical administrators. This is something nurses have strived to achieve for years. Nursing is not meant to be an extension of a doctor's work, but rather its own adjacent field with a separate client focused goal. The "Future of Nursing" report reflects these values and acknowledges that this will be a significant change since "the public is not used to viewing nurses as leaders" (IOM, 2010).
This transition will require many nurses to step up into leadership roles in order to work with other healthcare professionals to address various administrative issues such as identifying areas of waste, implementing plans for improvement, and tracking said improvement (IOM, 2010). This also extends to the realm of policy, as nurses will have a future in the shaping of medical policy on a large scale.
In clinical settings, medical professionals are becoming more and more independent in their jobs (IOM, 2010). While teamwork may be less emphasized as jobs become more compartmentalized, the report emphasizes a need for healthcare professionals to work as "full partners" (IOM, 2010). This makes sense as nurses must make decisions for themselves considering that their licensure and code of ethics dictate that their primary obligation it to their patients and not to their coworkers or physicians with whom they work (ANA, 2010). A need exists, however, for healthcare workers to support each other. This need, coupled with the fact that nurses must make decision for themselves, requires a system in which nurses work as partners with other healthcare providers but on equal standing, allowing them the authority they need to be effective in their field.
This new leadership role advocated by the IOM is, in a way, more important than the other two goals listed in this paper, as it will allow nurses to change policy and advocate for themselves. With nurses in administrative and policy making roles, they will be able to set goals such as those outlined in the IOM's report and make the necessary changes to attain those goals.
American Nurses Association, Scope and standards of clinical nursing practice (2010 ed.). Silver Springs, MD: American Nurses Association.
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94.
Clark, L., Casey, D., Morris, S. (2015). The value of master’s degrees for registered nurses. British Journal of Nursing, 24(6), 328-334. Institute of Medicine (2010). The future of nursing: Leading change, advancing health. Retrieved from http://www.nap.edu/read/12956/chapter/1
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