“The job ahead will test our willingness to change, our gumption and our patience—but it’s worth it.”
That was the warning and the encouragement offered by Risa Lavizzo-Mourey, M.D., M.B.A. on October 14 when she spoke to a standing room-only crowd at the University of Pennsylvania. The president and CEO of the Robert Wood Johnson Foundation (RWJF), who was once a professor at the University of Pennsylvania School of Medicine, was back to launch The Future of Nursing: Leading Change, Advancing Health. It is the product of a two-year study conducted by the Institute of Medicine (IOM) Committee on the Robert Wood Johnson Foundation (RWJF) Initiative on the Future of Nursing.
Afaf Meleis, Ph.D., F.A.A.N., Margaret Bond dean of the University of Pennsylvania School of Nursing, introduced Lavizzo-Mourey and noted that the first IOM report on nursing in 1983 led to the creation of the National Institute of Nursing Research. “This report has the potential to make an even bigger impact and to fundamentally change nursing and nursing education,” she said.
“This is a report about fulfilling the missing pieces in health care’s puzzle,” Lavizzo-Mourey agreed. She called the launch a “first step in moving the recommendations forward,” pointing out that the report has the potential to fulfill the vision of General Robert Wood Johnson, the RWJF founder. She said that strengthening nursing as a profession was a personal crusade for the general. When he started the Foundation, he said he wanted to help tear down the silos that then prevented—and often still prevent—nurses from being full partners in ensuring quality of patient care.
Lavizzo-Mourey outlined the four overarching themes of the new report: empowering nurses as leaders in health care; aligning nursing education to transform health care and shape training for the profession; expanding nurses’ scope of practice; and improving workforce data.
“We have to view this as a call to action,” she said. “We must do this and do it now. We’ve already committed $10 million to research, readying the field and the disruptive change that will come.” She urged the group to visit the Initiative’s Web site, www.thefutureofnursing.org, which will be continually updated with action steps, start-up ideas and programs that exemplify the recommendations in the report.
Lavizzo-Mourey’s comments were echoed by other speakers, including Pennsylvania Gov. Ed Rendell, who addressed the crowd via video. He pointed out that many of the report’s recommendations are already in place in Pennsylvania, thanks to the sweeping “Prescription for Pennsylvania.”
Julie Fairman, Ph.D., R.N., F.A.A.N., is a distinguished nurse scholar in residence at the Institute of Medicine who worked with the IOM Committee on the Future of Nursing to help produce the report. She clarified the rigorous standards the report’s authors had to meet. Each of the recommendations is based on evidence and the authors had to respond directly to questions raised by an expert panel of reviewers.
A panel discussion followed Fairman’s review. Julie Sochalski, Ph.D., R.N., F.A.A.N, associate professor of nursing at the University of Pennsylvania School of Nursing, provided the federal perspective on the report and George Thibault, M.D., president of the Josiah Macy Jr. Foundation, provided the foundation perspective.
Sochalski pointed out that even as the IOM committee was developing the report, events were happening in Washington, D.C. that will help advance some of its recommendations. In particular, she cited passage of the Affordable Care Act (ACA) and the American Reinvestment and Recovery Act (ARRA). Together, these laws have provided for significant investments in community health centers—including nurse-managed health centers— and primary care training, which includes $1 billion for the National Health Service Corps. She urged nurses and others who support an expanded role for nursing to take advantage of these advances and to push for more.
Thibault urged the nursing community to remember that all health care professionals are part of a team. “We’re not meeting the health care needs of the public now and we won’t when 32 million new people have access,” he said. “This is not a doctor-nurse issue. This is a health care issue. We must expand scope of practice for all, not just nurses. And even if we do everything, we won’t have enough primary care providers. We need to train people in settings that exemplify patient-centered, collaborative care models. And we must apply the principles… at the highest level to all health care, not just primary care.”