Category Archives: Future of Nursing
Want to stay on top of the latest news from RWJF? Check out all the ways you can get the latest news delivered to you:
· Sign up for Content Alerts, newsletters, and funding alerts
· Sign up to receive Charting Nursing’s Future policy briefs
· Stay up to date on the Future of Nursing: Campaign for Action
Linda H. Aiken, PhD, RN, FAAN, is the Claire Fagin Professor of Nursing, professor of sociology, director of the Center for Health Outcomes and Policy Research, and senior fellow of the Leonard Davis Institute for Health Economics at the University of Pennsylvania. Olga Yakusheva, PhD, is an associate professor at the University of Michigan School of Nursing.
Four years ago the Institute of Medicine’s (IOM) landmark report on the future of nursing was released. The study was remarkable in multiple respects including the interdisciplinary perspectives of national experts comprising the study committee, the breadth and scope of the study, its actionable recommendations, and the commitment of the Robert Wood Johnson Foundation (RWJF) to provide philanthropic funds to help implement the study’s recommendations—a rarity. One net result of the IOM Report, as viewed on the 4th anniversary of its release, is its notable impact on the commitment of stakeholders to finally make the transition of the nation’s nurse workforce to BSN qualifications, after many decades of limited progress.
Changing trends in nurse employment and education: The IOM recommended that 80 percent of nurses in the United States hold at least a baccalaureate in nursing (BSN) by the year 2020. The recommendation was quite bold considering that two-thirds of new nurses still graduated with less than a BSN, despite numerous previous reports and commissions over decades recommending the BSN as the entry qualification for professional nurses.
While the percentage of nurses with bachelor’s and graduate education had been slowly increasing over time, when the IOM report was issued only about 49 percent of nurses held a BSN. However, the IOM’s recommendation, based upon a growing research base documenting that patient outcomes were better in settings that employed more BSN-qualified nurses, acted as a tipping point to mobilize responses from many stakeholders that together are impacting changes in nurses’ qualifications.
Nurses truly run the front lines of hospitals. Their leadership oversees every hospital quality initiative essential to improving care—from reducing hospital-acquired infections, to cutting unnecessary readmissions, to preventing patient falls.
Poor scores in these quality measures now result in government penalties that can hit hospitals hard.
And as health care evolves and hospitals stretch beyond their own walls, nurses are leading the programs that bring health care into communities. They are critical to the success of health reform as more Americans obtain health insurance and seek primary care.
So tell me something? Why is the highest level of hospital leadership in our nation nearly devoid of nurses?
Surveys find the number of nurses with voting positions on hospital boards is about 4 to 6 percent — an unfathomable statistic for anyone who understands, even a little, how hospitals work.
We need the leadership of nurses on every hospital board.
This week marks the 4th anniversary of the Institute of Medicine’s future of nursing report. Fran Roberts, PhD, RN, FAAN, is owner and executive leader of the Fran Roberts Group, a consulting and contracting practice providing expertise on health care leadership, higher education, governance, regulation and patient safety. The Kate Aurelius Visiting Professor for the University of Arizona College of Medicine–Phoenix, Roberts serves on the boards of directors of several health care organizations, including the Presbyterian Central New Mexico Health System. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive News Fellows program.
“Leadership from nurses is needed at every level and across all settings.” That’s what the Institute of Medicine’s (IOM) Future of Nursing panel wrote in its 2011 report—a message I’ve taken to heart. Here’s why the IOM was exactly right.
I’ve served (and still serve) on several health-related boards, in most cases as the only nurse in a group dominated by physicians, local business leaders, and administrators. My experience on the Presbyterian Central New Mexico Healthcare Services board, which I now chair, is both representative and instructive. I joined the board about eight years ago, recruited by one of my colleagues in the RWJF Executive Nurse Fellows program, Kathy Davis, RN, the senior vice president and chief nursing officer at Presbyterian.
It was an honor to be asked, doubly so because I live and work out of state. But Presbyterian had concluded that it needed a nurse with executive experience on its board, so I got the call.
I started my first term on the board determined not to pigeon-hole myself as “the nurse on the board.” I didn’t want my fellow board members to think I had tunnel vision, unable to see beyond the need to advocate for nurses. That’s not to say I didn’t intend to advocate for nurses when that was called for, but I didn’t want to be limited to that, either in my colleagues’ estimation or in reality.
This week marks the 4th anniversary of the Institute of Medicine’s future of nursing report. Sandra McDermott, DNP, RN, NEA-BC, is an assistant professor of nursing and the director of health and service related professions at Tarleton State University in Fort Worth, Texas. A member of the Texas Team Action Coalition, which recently launched the Nurses On Board training program, she is a newly appointed member of the board of directors for the Fort Worth Chamber of Commerce South Area Council.
I have been in my university director position for about six months now, and I knew that before I started teaching classes this fall, I had an opportunity to really get involved in the Fort Worth community. I wanted to get my name out there, because when I do that, I am getting my school’s name out there, too. I started attending Chamber events and enjoyed them, and I realized that the South Area Council is the one that encompasses the hospital district, which is where I want to have a lot of my connections.
If my role is to draw nursing students and build awareness for our nursing programs, then clearly, focusing on the hospital district makes a lot of sense. I had made a strong connection with a South Area Council board member, so I lobbied the Chamber to join the board, and they ultimately added a new spot and appointed me to it, which was very humbling. They did not have a university represented on the Council, and they saw value in having a nurse and an educator join them.
The main campus for my school is about 90 miles away. Everyone knows about our presence there, where there are around 8,600 students. But in Fort Worth, we have around 1,600 students, and the nursing programs are relatively new and very small. I knew I needed to be out in the community as we build up our programs, and what better way to do it than to be at multiple Chamber functions? And as a board member, I knew I could influence a lot more people. In the hospital district, I can go in as not only a nurse and an educator, but a Chamber leader as well. That is a great platform to advocate for my school programs and for wellness and health care as community priorities.
Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Action, which is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.
This week marks the fourth anniversary of The Future of Nursing: Leading Change, Advancing Health, the landmark Institute of Medicine (IOM) report that galvanized the nursing field and partners to participate in health system transformation. Nurses nationwide are heeding the report’s call to prepare for leadership roles at the national, state and community levels. Why? Simply put, nurses coordinate and provide care across every setting, and they can represent the voices of patients, their families and communities. Nurses are the reality check on committees and in boardrooms.
The Future of Nursing: Campaign for Action, a national initiative led by the Robert Wood Johnson Foundation (RWJF) and AARP to implement recommendations from the future of nursing report, is promoting nursing leadership—and I’m thrilled by our progress.
To date, Action Coalitions report that 268 nurses have been appointed to boards. Virginia has implemented an innovative program to recognize outstanding nurse leaders under age 40, and several other states including Arkansas, Nebraska and Tennessee are offering similar programs. New Jersey has set a goal of placing a nurse leader on every hospital board. Texas has partnered with the Texas Healthcare Trustees to provide its nurses with governance and leadership education to prepare them for board leadership. Even better, other states are fostering nursing leadership by adopting these best practices.
RWJF Scholars in the News: Mental health and returning service members, children of incarcerated parents, nurse turnover, more.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:
When reserve service members return to civilian life, such stresses as marriage and health care problems are more likely to trigger drinking problems than traumatic events that occurred during deployment, according to a study reported by Fox News. When it comes to the “long-term mental health for National Guard members, what matters is what happens after they come home,” said lead author Magdalena Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna. “Financial difficulties, re-integrating, difficulties accessing quality health care, all of those seem to matter.” But deployment stress also has an impact. “[T]he more traumatic events they are exposed to during or after combat, the more problems they have in daily life when they come home,” she said. RWJF Investigator Award in Health Policy Research recipient Sandro Galea, MD, MPH, DrPH, co-authored the study. Health Canal also reported on it.
An estimated 17.5 percent of newly licensed RNs leave their first nursing job within the first year, and one in three leave within two years, according to research conducted by RWJF’s RN Work Project. Advance for Nurses quotes co-directors Christine T. Kovner, PhD, RN, FAAN, and Carol Brewer, PhD, RN, FAAN. “One of the biggest problems we face in trying to assess the impact of nurse turnover on our health care system as a whole is that there’s not a single, agreed-upon definition of turnover,” Kovner said. “A high rate of turnover at a hospital, if it's voluntary, could be problematic,” Brewer added, “but if it’s involuntary or if nurses are moving within the hospital to another unit or position, that tells a very different story.” Nurse.com also covered the study.
Having incarcerated parents is associated with significant health problems and behavioral issues, and may be more harmful to children’s health than divorce or the death of a parent, USA Today reports. “These kids are saddled with disadvantages,” said Kristin Turney, PhD, author of the study that reached those conclusions. She is an RWJF Health & Society Scholars program alumna. “They’re not only dealing with parental incarceration, but also mental health issues.” The study found that having a parent in prison was associated with such conditions as attention deficit hyperactivity disorder, learning disabilities, speech or language problems, and developmental delays. Turney’s study was also covered by US News and World Report, Salon, Psych Central, Healthline and Mother Jones, among other outlets.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the August issue.
More Nursing Schools Preparing Students to Provide Team-Based Care
Several of the nation’s top nursing schools now require students to participate in at least one interprofessional education course or activity, reports the Future of Nursing: Campaign for Action. Experts have called for interprofessional education for decades, but more health professions schools are responding now because requirements are being written into health professions accreditation standards, says Barbara Brandt, PhD, head of the National Center for Interprofessional Practice and Education, a public-private partnership supported by RWJF, the U.S. Health Resources and Services Administration, and other organizations.
Physical Work Environment in Hospitals Affects Nurses’ Job Satisfaction, With Implications for Patient Outcomes, Health Care Costs
A study conducted by RWJF’s RN Work Project finds that a physical work environment that facilitates registered nurses’ efficiency, teamwork and interprofessional communication relates to higher job satisfaction. The study revealed that physical environment affected whether nurses could complete tasks without interruptions, communicate easily with other nurses and physicians, and/or do their jobs efficiently.
The Robert Wood Johnson Foundation (RWJF) has announced the nine state “Action Coalitions” that will share $2.7 million to advance strategies aimed at creating a more highly educated, diverse nursing workforce. The nine states that are receiving two-year, $300,000 grants through RWJF’s Academic Progression in Nursing (APIN) program are California, Hawaii, Massachusetts, Montana, New Mexico, New York, North Carolina, Texas, and Washington state. For each, this is the second two-year APIN grant and it will be used to continue encouraging strong partnerships between community colleges and universities to make it easier for nurses to transition to higher degrees.
In its groundbreaking 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recommended that 80 percent of the nursing workforce be prepared at the baccalaureate level or higher by the year 2020. Right now, about half the nurses in the United States have baccalaureate or higher degrees.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends related to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the June 2014 issue.
Campaign for Action Is Chalking Up Successes that Will Improve Patient Care
Three years after it launched, the Future of Nursing: Campaign for Action is making steady progress on nurse education, practice, interprofessional collaboration, data collection, and diversity, according to a series of indicators released last month. Led by RWJF and AARP, the Campaign has created Action Coalitions in all 50 states and the District of Columbia that are working to implement recommendations from the Institute of Medicine. “Because of the Campaign, there’s more awareness about the importance of preparing the nursing workforce to address our nation’s most pressing health care challenges: access, quality, and cost,” says RWJF Senior Program Officer Nancy Fishman, MPH.
Pioneering Nurse Scientist Addresses Asthma-Related Disparities
Kamal Eldeirawi, PhD, RN, a pioneering scientist with expertise in immigrant health, was born in the Gaza Strip in Palestine, where he saw the profound impact of poverty and disadvantage on health in his own community. A career in nursing, the RWJF Nurse Faculty Scholar believed, would allow him to make a difference at both the individual and population-wide levels. Today, Eldeirawi, is researching risk factors that contribute to asthma in Mexican American children living in the United States, and the effects of immigration and acculturation on children’s health.