The Top Five Issues for Nursing in 2015

Dec 3, 2014, 9:00 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Actionwhich is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

In 2013, the Institute of Medicine released a report, U.S. Health in International Perspective: Shorter Lives, Poorer Health, that compared the United States with 16 other affluent nations. The United States ranked last or near last on nine key indicators:  infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. This is despite the fact that we spend significantly more on health care than any other nation.

I believe there are five ways nurses can contribute to improving these conditions in 2015. 

Nurses Can Help Us Build a Culture of Health

In a Culture of Health, the goal is to keep everyone as healthy as possible.  That means promoting health is as important as treating illness. Unless everyone in the country joins this effort, we will remain at the bottom of the list of healthiest nations. “Everyone” means all health care workers, business owners, urban planners, teachers, farmers and others, including consumers themselves.  Nurses especially understand wellness and prevention, and have a special role to play in building a Culture of Health. 

Regardless of our individual jobs, we can all pledge to keep prevention and wellness at the forefront of everything we do. We can work with others in our communities to foster policies that promote wellness, such as healthy eating and walking programs. In her presidential message, Robert Wood Johnson Foundation (RWJF) President and CEO Risa Lavizzo-Mourey, MD, MBA, outlined the Foundation’s pledge to rework its own policies to focus more on keeping individuals and communities healthy. 

Nurses Can Increase Access to Health Care

Because of the Affordable Care Act, more people have health insurance. This does not, however, translate to having access to high quality health care, where and when care is needed. There are not enough primary care practitioners to meet the growing need for care. One solution is to allow all nurses to practice to the top of their education and training. Right now, legal, regulatory, and policy barriers prohibit nurse practitioners from doing this in 31 states. Numerous reports, including the Institute of Medicine’s report, The Future of Nursing: Leading Change, Advancing Health, encourage state policymakers and other decision makers to ease practice barriers in order to improve consumer access to safe, high quality care. These barriers create inefficiencies and higher costs —the kind of increased costs reflected in Shorter Lives, Poorer Health

Nurses Can Lead Change By Getting on Boards

Nurses know what needs to be done to make care safe, accessible and cost effective. They also know how to help consumers stay healthy in the first place. They are uniquely positioned to help build a national Culture of Health. Therefore, nurses can have a great impact on every one of the nine areas where our nation lags. So, what do nurses need to do? Lead! 

I am encouraging all nurses—no matter where they are or at what level they work—to get involved in committees, boards, professional organizations—whatever it takes to “lead change to advance health.” Nurses have to believe they can make a difference and work hard to prepare themselves for leadership positions. The Future of Nursing: Campaign for Action has announced a new initiative, “10,000 Nurses on Boards by 2020,” to bring many more nurses to the table to help guide the transformative decisions they are qualified to make.  

Nurses Can Engage in Interprofessional Collaboration 

It is imperative that health care providers work in interprofessional teams to improve care. Nurses are called to lead, yes, but they are also called to work with others from multiple disciplines and sectors so that care might be as seamless and safe as possible. We know that bad things happen when teams do not work effectively. RWJF is sunsetting ten leadership programs that serve single disciplines and shifting its focus to programs that will bring teams together from multiple sectors to work on the many health and health care challenges our system presents. 

To successfully build a Culture of Health in our nation, we must engage people from diverse fields and with a variety of perspectives.  We need urban planners, school personnel, architects, nutritionists, business people, the faith community and many others to help us develop solutions to the health care problems that have kept us at the bottom of the list when it comes to key indicators of a nation’s health.

Nurses Can Advance Their Education

To be leaders in our health care system, to keep people healthy, to work as part of high-functioning teams, and to advance policies that ensure nurses practice to the top of their education and training requires that nurses be as highly educated as possible. Providing health care is very complex today. Our population is aging and health care increasingly involves technology. We are requiring more of nurses no matter what they do or where they work.  The business case for at least 80 percent of all nurses having bachelor of science in nursing (BSN) degrees by 2020, as the IOM’s future of nursing report recommends, is solid. 

That case is even stronger once other factors are considered: the crushing nurse faculty shortage; the need for many more primary care nurse practitioners; and the growth in community-based care, driven by consumer preferences and the Affordable Care Act. To fill these needs, nurses must have advanced degrees, so first attaining a BSN is imperative to move up the education ladder.

This may be a daunting list, but we can make progress on it. Through the Future of Nursing: Campaign for Action and its Action Coalitions in 50 states and the District of Columbia,  a wide range of health care professionals, consumer advocates, policymakers, and the business, academic, and philanthropic communities are coming together to implement the Institute of Medicine’s evidence-based recommendations on the future of nursing.  Working together, we will build a Culture of Health for all.

Learn more about Hassmiller’s view on HealthLeaders Media.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.