IOM's Long Road to Reform Nursing Begins

Rebecca Hendren, for HealthLeaders Media , December 14, 2010

In October, the Institute of Medicine released its landmark report, sponsored by the Robert Wood Johnson Foundation, The Future of Nursing: Leading Change, Advancing Health. The report outlines how nurses are crucial to meeting the country's healthcare needs and says that to handle the increasing complexity of care and greater responsibilities, nurses will need higher levels of education and training.

The report calls for 80% of RNs to have BSNs by 2020 and for the number of nurses with doctorate degrees to have doubled in the same timeframe.

Recently, the IOM took the first step in outlining how to make this happen. The National Summit on Advancing Health through Nursing, held November 30 — December 1, in Washington, DC, brought decision makers and thought leaders—including Don Berwick—together to discuss how to implement the report's recommendations.

"The Foundation is committed to using the IOM Future of Nursing report as it is intended to be used, as a roadmap for future direction and action," said Risa Lavizzo-Mourey, president and CEO of RWJF said in a statement."We are doing this by convening leaders from all sectors, both public and private to join us as partners in this national movement to make these recommendations a reality."

The Future of Nursing: Campaign for Action, is working on five main areas:
• Preparing and enabling nurses to lead change
• Improving nursing education
• Removing barriers to practice
• Creating an infrastructure for interprofessional healthcare workforce data collection
• Fostering interprofessional collaboration

To begin with, the campaign has enlisted five states to work on developing best practices and programs that can be replicated elsewhere. These Future of Nursing Regional Action Coalitions (RACs) are located in New Jersey, New York, Michigan, Mississippi, and California. They have been tasked with capturing best practices, determining research needs, tracking lessons learned, identifying replicable models, connecting with the other RAC programs, and monitoring progress.

The stewards of the IOM report have a huge task on their hands. Some of their recommendations seem positively Herculean, such as the call for 80% of the country's RNs to have baccalaureate degrees by 2020. As I wrote in the summer, this issue has been argued about in nursing for decades and no topic has the capacity to divide the rank and file of the profession quite like this one.


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3 comments on "IOM's Long Road to Reform Nursing Begins"

vickie armstrong (12/20/2010 at 9:31 PM)
I can't agree with the IOM's initiative to improve nursing in this country. As an advance practice nurse I deliver quality health care to the sickest frailest population that we have-long term care residents but there are multiple barriers for me and others that practice in this setting. Examples: Anthem Insurance company does not recognize NPs or PAs, and those visits have to be billed as incident to physician and would be reimbursed at the higher 100% rate BUT incident to does not apply in long term care or skilled nursing SO it may not be paid at all! I have to be SUPERVISED by a physician here in Virginia but not other places. Home health care requlations that are starting effective 1-1-11 effectively bar me from ordering home health care service when I am discharging patients to home from SNF! Nursing education-let's start with requiring CEU's to renew nursing licenses in all states! It scares me to think that a nurse can be licensed 30 years ago and never have to learn or read another thing and can still practice. Employer requirements for CEUs? That won't happen because they don't want to pay for it. These are crucial needs and I hope that IOM and the initiative make a difference.

Michael Karns NP (12/17/2010 at 12:38 PM)
The work required is straight uphill, but what worthy goals these are to strive for. Do our patients deserve any less? All NP's need to roll up their sleeves and pitch in just as those before us did.

Christy Price Rabetoy, NP (12/15/2010 at 10:48 AM)
WOW!! Maybe the 1965 mandate for entry level for future nurses to be BSN prepared will become a reality. Maybe nurses will actually move from being the LEAST educationally prepared to being finally closer to all other health care providers. Maybe nurses will be able to have a true professional identity with a university, professioanl degree, in lieu of a technical, junior college degree.




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