Category Archives: Future of Nursing: Three Years Later
Rita K. Adeniran, DrNP, RN,CMAC, NEA-BC, is director of diversity and inclusion-global nurse ambassador at the Hospital of the University of Pennsylvania, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2012-2015).
It is exciting and humbling to witness and talk about the positive transformation that nursing has been experiencing since the release of the 2010 Institute of Medicine (IOM) report on the future of nursing. The report emphasizes development of leadership programs that harness nurses’ capacity to lead change, and advance health and health care by creating innovative opportunities for education and professional growth. In addition to many other recommendations, the report calls for interdisciplinary collaboration and underscores the imperative for diversity of the nursing workforce to more appropriately reflect the diversity of the United States population.
More than ever before, nurses are recognized as key to leading successful and sustainable health care for the nation. Nurses are at the forefront of health and health care improvements, leading many quality initiatives. Comprehensive, cost-effective patient and family-centered models of care led by nurses are increasingly becoming popular.
With more nurses obtaining advanced degrees and practicing to the fullest extent of their education and skills, they are engaging side by side with members of interdisciplinary care teams to collaborate in clinical practice, and conduct research and enquiry that can provide solutions to some long-standing clinical problems.
Alexia Green, RN, PhD, FAAN, professor and dean emeritus, Texas Tech University Health Sciences Center and co-leader of the Texas Action Coalition. She is an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program.
As a nurse, I have long desired to be a full partner with physicians and other health care leaders in improving health care delivery in our country. The truth is many nurses have this desire, but all too often we are not viewed as key players in the larger policy arena. When the Institute of Medicine Future of Nursing report was issued in 2010, I was very excited to see a major emphasis placed on nurses become full partners in redesigning health care in the United States.
I personally became intrigued with impacting health care policy while a graduate student at the University of Texas Health Sciences Center in Houston—where my professor, Dorothy Otto, encouraged me to become engaged, providing me with a vision that policy was something I could shape and develop rather than passively watch. My engagement with the Texas Nurses Association and the Robert Wood Johnson Foundation Executive Nurse Fellows program helped solidify my leadership skills to be well prepared to actively serve on boards where policy decisions are made in hopes of improving health systems to advance patient care.
Linda Burnes Bolton, DrPH, RN, FAAN, is vice president for nursing, chief nursing officer, and director of nursing research at Cedars-Sinai Medical Center in Los Angeles. She was vice chair of the Institute of Medicine Commission on the Future of Nursing, and is a trustee of the Robert Wood Johnson Foundation. It has been three years since the Institute of Medicine issued Future of Nursing: Leading Change, Advancing Health.
Developing the Institute of Medicine report, Future of Nursing: Leading Change, Advancing Health and working to implement its recommendations has been a magnificent journey. It hasn’t been about nursing, but rather about health and health care. We focus on nursing, because it is one of the keys to improving health and health care. But our success, and the reason people are joining us on this journey, is because the report and its recommendations mean better health for the public and a stronger health care system for the country.
What began as a report has become a groundswell. It is doing exactly what we hoped it would do, bringing people together to strengthen our health care system. Today a large, multidisciplinary, national movement is engaging nurses, consumers, and other health professionals in local and regional efforts to bring this report to life. There are great examples, for instance, of people from diverse fields coming together to remove practice barriers, physicians saying they believe medicine must be a “team sport,” consumers working to improve care in their communities—and much more.
Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation, and director of the Future of Nursing: Campaign for Action. Three years ago, the Institute of Medicine issued Future of Nursing: Leading Change, Advancing Health, which supports “efforts to cultivate and promote leaders within the nursing profession—from the front lines of care to the boardroom.” The goal, the report says, is that nurses be full partners, with physicians and other health professionals, in redesigning health care in the United States.
The only way to achieve a healthier future for everyone in this country is to work collaboratively toward that goal. Leading in a collaborative environment takes very special skills. To find effective leaders, we must consider the skills, talents, and experience of everyone who aspires to leadership, regardless of their profession.
In fact, there is no evidence pointing to a single profession as having all requisite leadership skills to get our population to a healthier state. It is truly about the skills, talents, and experience of the whole team, and everyone on the team should be considered a potential leader.
The Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health states that all professions should be equal partners in leading health and health care efforts in this country to assure access, affordability, quality, and a healthier future for all. The IOM committee members who shaped that report made extremely thoughtful recommendations on leadership.
Below, I add my own take, based on experience, about what it takes to lead in a collaborative environment.
Three years ago this week, the Institute of Medicine issued a landmark report, Future of Nursing: Leading Change, Advancing Health. Its recommendations include increasing the proportion of nurses with baccalaureate degrees to 80 percent by 2020. Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program (2005).
Lifelong learning has always been a value in my personal and professional life. I fully support the national goal of increasing the number of RNs holding a minimum of a bachelor’s degree in nursing (BSN).
My personal dilemma is that I once could not gain entrance into a 4-year baccalaureate program. I will never forget my meeting with the dean, who shared that I should “pick another major” since my mid-quarter pre-nursing grade point average was not competitive with more talented constituents!
As I withdrew from that university, I was determined to follow my dream and become a registered nurse. I learned of a program (i.e., “Diploma in Nursing”) that would allow me to become an RN in the state. I am a proud graduate of St. Vincent Hospital School of Nursing, Toledo, Ohio; a once thriving program that has since closed.
Without any regret, I have continued my formal education in nursing, and recently graduated with a doctorate in public health from Ohio State University. No one knows my obsession with life-long learning better than my family!
Executive Nurse Fellows Leading the Way to Implement the Institute of Medicine’s Nursing Recommendations
Victoria Niederhauser, DrPH, RN, PNP-BC, is dean and professor at the University of Tennessee, Knoxville College of Nursing, an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program, and a director of the program’s Alumni Association.
One of the greatest impacts the Institute of Medicine’s (IOM) report on the future of nursing has had is to provide a national actionable platform for RWJF Executive Nurse Fellow (ENF) alumni to put into action their collective leadership skills and attributes to improve health and health care across the nation.
The RWJF Executive Nurse Fellow alumni are 221 individuals strong and together they use skills in strategic agility, leading change, effective communication, creativity, and risk-taking to create sustainable models of Action Coalitions throughout the country. Through these Action Coalitions, the future of nursing is changing!
For example, in one year, the Tennessee Action Coalition was established with a diverse board of directors led, in part, by two RWJF Executive Nurse Fellows: Debra Honey (2008) and Victoria Niederhauser (2008). And we have already seen a significant impact on our community as a result of the Action Coalition. Specifically, from 2011 to 2012, enrollment in RN to BSN programs in Tennessee increased 20 percent (from 1,375 to 1,635) and the number of RN to BSN graduates rose 30 percent (from 499 to 680). One key recommendation from the IOM report is that more nurses get BSN or higher degrees.
Three years ago this week, the Institute of Medicine issued a landmark report, Future of Nursing: Leading Change, Advancing Health. Its recommendations include increasing the proportion of nurses with baccalaureate degrees to 80 percent by 2020. Cole Edmonson, DNP, RN, FACHE, NEA-BC, is chief nursing officer at Texas Health Presbyterian Hospital Dallas, and a Robert Wood Johnson Foundation Executive Nurse Fellow (2012 – 2015). He also serves as practice team co-lead for the Texas Team, the state’s Action Coalition.
Improving the lives of people in the communities we serve is our guiding mission and it is supported by our Magnet Redesignation program and our professional practice model. In 2010, when the Institute of Medicine’s (IOM) Future of Nursing report was released, we were one of the few IOM meeting sites in Texas to bring together people from both practice and academia to hear about the report and begin to discuss how we might fulfill the 2020 vision with the creation of new partnerships.
The IOM report was a call to action, to which we responded. Texas Health Presbyterian Hospital Dallas, a part of Texas Health Resources, began the journey by exposing leadership and direct care staff to the report, the research (compelling reasons) behind it, its recommendations, and the gap analysis of the organization in the eight areas of recommendations.
The nursing leadership, with the direct care nurses and the system leadership, integrated the Future of Nursing report into our nursing strategic plan in 2011. The strategies and tactic with metrics of success set in motion a series of actions to meet the 80 percent bachelor of science in nursing (BSN) goal by 2020, doubling the nurses with doctorates, Advanced Practice Registered Nurse (APRN) practice scope, and positioning nurses in strategic positions including the Board of Trustees.
Three years ago this week, the Institute of Medicine issued a landmark report, Future of Nursing: Leading Change, Advancing Health. Its recommendations include increasing the proportion of nurses with baccalaureate degrees to 80 percent by 2020. Charleen Tachibana, MN, RN, FAAN, is senior vice president, hospital administrator, and chief nursing officer at Virginia Mason Medical Center in Seattle, Washington. Tachibana is a Robert Wood Johnson Foundation Executive Nurse Fellow (2009 – 2012).
Virginia Mason Medical Center began a bachelor of science in nursing (BSN)-only hiring guideline in the summer of 2012. The change in hiring guidelines for our staff followed a decade of having educational guidelines in place for our nurse leaders. This was a critical step in our success, as our leaders were able to support and understand the need for this change. It’s important for leaders to model lifelong learning, including advancement with formal education. So, last August I also began my Doctor of Nursing Practice (DNP) program.
The publication of the Institute of Medicine (IOM) report on the Future of Nursing really provided the momentum to move to another level. The prominence of this report has made this a relatively easy transition and provided the clarity on why this is critical for our patients and for our profession at this point in time.
Although we have focused this requirement on new hires, it’s been impressive to see the wave of staff RNs returning to school, many for their master’s or doctorate degrees.
Susan Reinhard, PhD, RN, FAAN, is senior vice president of the AARP Public Policy Institute and chief strategist at the Center to Champion Nursing in America, which coordinates the Future of Nursing: Campaign for Action. Here, Reinhard reflects on the impact of the Institute of Medicine’s Future of Nursing report during its third anniversary week.
The Center to Champion Nursing in America was founded six years ago as an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation (RWJF). Ever since, we have devoted considerable energies and resources to transforming the nursing profession to better serve consumers.
Why is AARP so invested in this work? One simple reason: Nurses, the largest segment of the health care workforce, provide critical care to our members, many of whom are aging and managing multiple chronic health conditions. Our work is not as much about improving conditions for nurses as it is about making life better for consumers and their families. A larger, more highly skilled nursing workforce will improve access to higher-quality, more patient-centered, and more affordable care. That is especially important now, with demand for nursing care growing as the population ages and as millions more people enter the health care system under the Affordable Care Act.
That is why we, at AARP, have made it our mission to ensure that all people have access to a highly skilled nurse when and where they need one.
Linda H. Aiken, PhD, FAAN, FRCN, RN, is the Claire M. Fagin Leadership Professor in Nursing, a professor of sociology, and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. Aiken is a research manager supporting the Future of Nursing: Campaign for Action and a National Advisory Committee member for the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative. This is cross-posted on the Leonard Davis Institute Voices blog.
All too often, the debate about expanding the role of nurse practitioners (NPs) and physician’s assistants (PAs) takes place in a vacuum, as though these practitioners do not already deliver significant amounts of primary care. But they do, and existing evidence indicates that quality of care and patient satisfaction are good as a result.
Even before the passage of the Affordable Care Act, the nation had a shortage of primary care providers. The shortage is likely to intensify when the demand for primary care increases as millions become insured. The numbers of and roles assumed by NPs and PAs have been growing steadily, and allowing these providers to take on an even greater role could address the increased demand for primary care.