"We consistently find that it doesn't cost a lot of money to change the work environment. It's the No. 1 thing hospitals should be doing rather than just throwing a lot of money into staffing without changing some of these other factors," Aiken says.
Since the passage of the Patient Protection and Affordable Care Act, Aiken says, providers are starting to realize how important the nursing staff is to achieve high quality scores and reduce readmissions, two areas where performance is keyed to Medicare payment incentives and penalties.
"We've been influential because we've been able to convince hospitals that if they really want to have these better outcomes and meet these performance targets set by CMS, they need to look at their nurse staffing, nurse education, and the quality of the nurse work environment.
"That's what we're famous for and I think that's where we've had the biggest overall impact, and not just in the United States."
In addition to her domestic work, Aiken's impact is now global. She's involved in numerous projects to examine nursing shortages and nursing migration in 30 countries, funded by the National Institute of Nursing Research and the European Union.
How does Aiken think the nurse's role will change in the next 10 years?
"The majority of nurses will have bachelor's degrees, and nurses will have more responsibility in hospitals, nursing homes, and every other setting."
And, we may hope, all nurses will have enough pillows for their patients.