Nursing as a profession is the largest component of the healthcare workforce in America. There are 3 million Registered Nurses in the country, and the Healthcare settings have been changing since the “2010 Affordable Care Act” (ACA). Nurses are the most influential in this fundamental transformation.
However, a number of obstacles prevent nurses from being up to the professional code in their responsibilities and practices in the changing Healthcare environment, and these hurdles need to be jumped to lead change and advance health (IOM Report, 1) The Institute of Medicine is an independent organization that gives reports and advice to the government about improving health.
The opinions of IOM are highly regarded, and can make or break legislative decision.
The I. O. M report released in October 2010 outlines major categories of change needed in the nursing profession to address healthcare needs of the Nation. NRS430V Lecture 4) I. O. M produced this report, and made recommendations for an action-oriented focus in the future of nursing.
The IOM report has great impact on nurses’ role in reforming the healthcare system. 1. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. (IOM Report, 1) Major changes in the nation’s healthcare system and workplace environment will require some improvements and education reform for nurses before and after they get their license.
Improvement in education system is the keystone to ensure safe, high quality, patient-focused care in all areas especially primary care and in community health. Medical and nursing care has become very complex in hospitals and public settings. Nurses are coordinating care with social workers, physicians, pharmacists, physical and occupational therapists. A majority of them have masters or doctoral degrees. To work effectively with highly educated workforce, nurses should also have higher education.
Importance is given to increase the diversity to ensure nurses are able to provide care for a culturally diverse patient population. IOM report recommended increasing the proportion of nurses with baccalaureate degree to eighty percent by 2020 (IOM Report, 12). It recommended that healthcare organizations should encourage nurses with associates and diploma degrees to enter baccalaureate nursing programs within 5 years of graduation by offering tuition reimbursement, and providing a salary differential and promotions (IOM Report, 12).
IOM also recommended to double the number of nurses with a doctorate by 2020 with attention to increasing diversity (IOM Report, 12). IOM recommended nurse residency programs after they completed a pre licensure or an advanced practice degree program or when they are transitioning into a new clinical practice area. This improves retention of nurses, expands competencies, and improves patient outcomes . IOM Report, 12) 2.
Provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts. IOM strongly recommends the need for nurse leaders to act as full partners with physicians, and other health care professionals (IOMReport,4) The need of leaders from various levels in nursing is emphasized.. Nurse leaders are expected to shape policies, and engage in implementation of new policies related to health care reform. IOM made it clear that leadership is important to advance the profession.
It stressed the importance of embedding leadership related competencies throughout nursing education, and to develop a culture that promotes and values leadership. (IOM Report,8) Nursing education programs should combine leadership and business practices across the curriculum, including clinical practice. Public, private and governmental healthcare decision makers, at every level, should include representation from nursing, on boards, on executive management teams, and in other key leadership positions. IOM Report, 14)
This would prepare nurses to be leaders at various levels of patient care. 3. Nurses should practice to the full extent of their education and training. Nurses have the knowledge and capabilities to improve the health care system. However, there have been various regulations and policy barriers that curtail a nurse’s efforts, and ability, in widespread transformation. (IOM Report, 5) Different states have different rules in what the scope of practice for a nurse can be.
A Nurse practitioner may be allowed to see patients and prescribe medications, admit patients to the hospital, assess patient’s condition etc. in one State, but she may not be able to do so in another State. So the committee recommended removing barriers in scope of practice. Advanced Practice Registered Nurses should be able to practice as far as their education allows them to. It authorized advance practice registered nurses to assess admissions, patient certification to home health care services, and to conduct admission to hospice or other skilled nursing facilities.
Also it recommended extending the increase in Medicaid reimbursement rates for primary care physicians included in “ACA” to Advanced Practice registered nurse providing similar primary care services (IOM Report, 10). I highly appreciate the report of IOM on the changes in the nursing field, especially in the primary care practice. As I have a wealth of nursing experience in various areas in the clinical field, I would like to practice primary care after I become a nurse practitioner . The IOM report gives me lot of confidence in the future of nursing.
As I am heading towards Baccalaureate degree and then Master’s program in Nursing, to become Advance Practice registered nurse, I have a great faith that the Nurse practice Act will be changed according to the IOM recommendations, thereby APRNs will be eligible for clinical privileges, admitting privileges and membership on medical staff. (IOM Report,10) IOM report elevates the standard of nursing profession, and it gives us a chance to practice in autonomy. This report has had a great impact on my current nursing practice as a Registered Nurse – to move on to the next level of Advance Nurse Practice, Registered Nurse, without fear.
The recommendations made by IOM are highly valuable, but the power to institute them depends upon governments, healthcare institutions, professional organizations, and insurance industries, healthcare researchers, licensing bodies, educational institutions, individual policy makers, payers, and consumer advocates. Together, these groups can transform the healthcare system to provide direct, inexpensive, quality care that is widely available, patient oriented that leads to greater health for all.
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