With the nation facing a severe nursing shortage whose causes are more deeply rooted than those of any previous shortage, The Robert Wood Johnson Foundation responded, in 2002, by designating nursing as one of its eight targeted areas and by making a decade-long commitment to strengthening the nursing profession. While this is the first time the Foundation has singled out nursing as an explicit grantmaking priority, it is not the Foundation's first venture into nursing. In fact, since its inception as a national philanthropy, The Robert Wood Johnson Foundation has invested more than $140 million in nursing programs.
The nation's 2.7 million registered nurses make up the single largest part of the health care workforce and are, in many ways, the backbone of the health care system. Strengthening nursing at all levels allows the Foundation to advance two of its long-standing interests: increasing access to high-quality care and improving the health care workforce.
Previous volumes of The Robert Wood Johnson Foundation Anthology series have featured chapters on specific nursing programs. In this chapter, Carolyn Newbergh, a freelance journalist and frequent contributor to the series, reviews the entire range of the Foundation's nursing programs, beginning with early initiatives to build the new profession of nurse practitioner, continuing with its programs to improve academic nursing and strengthen hospital nursing, and concluding with its current programs to develop the leadership skills of high-level nurses and to transform the working conditions of hospital nurses.
Newbergh finds that the Foundation's relatively consistent commitment to nursing has helped strengthen the profession, but also that the erratic nature of the Foundation's entry into and exit from specific programs in the past led to missed opportunities and tarnishing of its image within academic nursing. Nonetheless, the wide range of approaches adopted by the Foundation to advance nursing—fellowships, bolstering of academic departments, demonstration projects, research, publicity, support of professional organizations—provides a good illustration of how philanthropy can, over many years, help build a field.