Robert Wood Johnson Foundation (RWJF) came up with a way that would reshape the future of the nursing profession by identifying the solutions that have been confronting the nursing profession which will consequently improve the provision of healthcare to the American citizens. RWJF had to include a team of experts from different fields to determine ways how the nursing solutions and the use of nursing leaders can be employed can reduce the cost of healthcare, increase accessibility of health services and improve the quality of healthcare (Sheetz, 2012). The experts were supposed to provide a transformational report on the nursing profession that will take a look at nursing education models and nursing care models that are meant to provide the highest standard of healthcare to the patients while at the same time containing the costs.
The CEO of RWJF, Risa Lavizzo-Mourey, believed that the nursing profession is at the heart of the healthcare, and therefore the challenges faced in this profession must be identified and addressed to achieve improved healthcare for the patients. The committee of experts was constituted in mid-2009 and was expected to meet frequently for ten months to discuss the nursing profession by identifying the problems facing the profession and recommending actions to overcome the challenges. The primary objective of the committee was to determine how the nursing can improve patient healthcare while controlling the costs. The chair of the committee was the former U.S. Department of Health and Human Services Secretary, Donna E. Shalala. The vice-chair of the committee was director of nursing research at Cedars-Sinai Medical Center, Linda Burnes Bolton. The committee was constituted by members from different areas such as NGO’s, education, the nursing profession, and renowned researchers. The study was carried out by IOM but sponsored by RWJF.
The vice-chair of the committee noted that the nurses in the profession are in a better position to identify the challenges they are facing then provide what they think would be a solution to those challenges. The United States has more than 2 million nurses, and this is the biggest workforce in the healthcare fraternity. More so, nurses spend the most amount of time than any other profession in the healthcare field; therefore, they are ideally more qualified in assisting in providing the solutions. The committee worked towards empowering and preparing the nurses to meet the current and future healthcare needs through improving the nursing education and increasing the capacity of nursing schools. The committee designed to increase the nursing retention rates in different areas such as community and public health, long-term care, primary care and ambulatory services. The committee had to redesign the role and responsibilities of the nurses within the setting of the entire workforce.
IOM “future of nursing” report was critical in nursing education, nursing practice and nursing workforce development in various ways. The IOM reports concentrate on nursing leadership, education, and practice. The Affordable Care Act mirrored a movement from Treatment Model to Prevention Model, which requires accomplished nurses with more logical comprehension and in the care continuum. Since the healthcare field is experiencing a dynamic change, there is an expanded requirement for profoundly qualified and skillful nurses to give effective and efficient patient care in the new framework. As the healthcare services framework has experienced incredible changes in the course of the last numerous years, nurses currently need to be highly qualified to give better services in response to the dynamic shifts in the health sector (Kershaw, 2011). An important aspect envisioned by the IOM report is the need to work as a team between the nurses and between the nurses and other physicians to provide maximum patient care. The Affordable Care Act additionally covers prior conditions, which were once dismissed by insurance covers. Such consideration of the previous conditions requires the nurses to build their knowledge and insight bases to adapt to these new circumstances. There is likewise need to enlighten patients since there is an increase in the quantity of patients who convey more confusion.
The review of the scope of practice in different states will enhance the nurses to practice to the full extent of their training and education. The report ensures that nurses are given more responsibilities such as administering drugs to patients without supervision, these increased responsibilities are important because the nurses need to be autonomous and able to react to a situation more promptly when physicians are not available to save a situation. The report also ensures that the nurses are placed in areas they practiced in to maximize their potential, skill and increase their satisfaction. The turnover rates for new nursing professionals can be improved by introducing residency programs to all nursing practices; this will provide the new nurses with the necessary skills to provide quality and safe patient services. The curriculum for nursing needs to be updated to ensure that individual with high competencies is produced to the market. The requirements for entry into the nursing workforce should be raised; this will provide better standards of primary care. There should be a seamless transition from low-level nursing programs to high-level programs; this will motivate individuals in the nursing profession to pursue higher levels of education which consequently translated to better healthcare services.
There is a lack of leadership in the nursing profession from the executives to the licensed practical nurses. Lubans (2010) outlined that one can lead from where they are, and they do not need a position to do so but the behavior/attitude to lead. Typically, the nurses are taught to be subordinates instead of being partners with other healthcare professionals. Leadership is crucial in the nursing profession as this provides a platform for nurses not only to be followers of policies but implementers. Nurses can only achieve their goals through identifying problems facing them, identification of areas that need improvement and implementation of plans to steer the way forward. Nurses need leadership training and mentorship programs to improve their leadership competencies to increase their value in patient care (Bleich, 2011). The creation of a National Healthcare Workforce Commission will ensure the collection of workforce data and improve the coordination of healthcare information at the different levels of government. The information on the role of nurses, the scope of practice, nursing activities and other relevant information are scanty, and there needs to be an improved information infrastructure to create a systematic and organized healthcare framework.
One of the important roles of the state-based action coalitions is to remove the scope of practice barriers so that nurses can practice to their full extent their training and education. One of the ways used by the state-based action coalitions is to push for legislative measures such as reimbursement of practicing nurses that are practicing within the scope of the state laws. The state-based action coalitions are pushing for amendment of Medicare programs to allow nurses to have more roles such as administering medications without physician supervision. Drive increase in state funding for states adopting National Council of State Boards of Nursing advanced practice registered nurse model rules and regulations.
The second role of state-based action coalitions is to increase the number of nurses with a baccalaureate degree and higher in the profession and also to prepare the nursing workforce to meet the healthcare needs and demands currently and in the future. These efforts can be achieved through creating seamless access for nurses for transitioning from high school to colleges and eventually to the nursing practice. The state base action coalitions collaborate with stakeholders from learning institution, healthcare organizations, and other relevant stakeholders to provide joint training opportunities, review critical areas in education and training and increase the intake of students and nurses. The state-based action coalitions also ensure lifelong learning by collaborating with other health professional to provide mentorship to nurses all through their practice.
One of the programs carried out by the New York action coalition is the Nurses in Action outreach program. The initiative aims at increasing the public awareness on the important role that nurses play in the healthcare industry. The program further persuades members of the public to either join the nursing industry as a profession or further their education if they are nurses. The main achievement of this program is the persuasion of more individuals to join the program which has reduced the demand for nurses in New York. The main challenge of this program has been inadequate funding to reach more individuals. The coalition has been also holding state wide events such as the NYSW nursing education summit that was held in 2012 and Summit on transforming health care in 2011. The summits have been crucial in discussing on the way forward to implement the IOM report recommendations. Funds have been an hindrance in carrying out these summits frequently. New York has been performing quite well in ensuring there is seamless transition to nursing profession. The main thing that the New York coalition can do is to reach sponsors who can fund their projects and initiatives.