Top 5 Challenges Facing Nursing in 2012

Rebecca Hendren, for HealthLeaders Media , November 15, 2011

The holiday decorations are going up in my neighborhood, Thanksgiving is next week, and my mind has already turned to end-of-year activities and planning for what's in store in 2012. With these things on my mind, I thought I'd turn in the annual retrospective/prediction column a little early this year.

2010 may have been the year when enormous healthcare changes began, but 2011 was the year these changes hit nursing. In addition, the Institute of Medicine's landmark Future of Nursing report was released at the end of 2010 and much of this year has been spent digesting its recommendations and searching for ways to put them into practice.

At last month's Nursing Management Congress I realized that the full ramifications of value-based purchasing have hit home in nursing and have trickled down to the unit level. It's no longer something that is only happening at the administration level and that only concerns nurse executives. Now every nurse leader and manager is actively planning for its impact.

Here's a quick rundown of the most pressing issues right now and into 2012:

1.Advanced degrees are no longer optional

I have been cheered that discussion of the IOM's recommendation for 80% of all RNs to have a baccalaureate degree by 2020 has not veered too intensely into the old ADN vs. BSN quagmire. Instead, the profession is focusing on ways to engage nurses in lifelong learning so that associate degree nurses can find realistic ways to obtain BSN degrees.

In addition, BSN nurses are encouraged to be leaders in evidence-based practice and research and it's becoming more common—and crucially, more expected—for nurses to pursue master's degrees. And the creation of the doctor of nursing practice degree has taken off better than anyone could have expected.

In the last six months, any time I'm in a group of nurse executives, the conversation always turns to who has already entered a program and how long it's going to take the rest of the group to do so.


2.Patient engagement gets real

If you haven't found a way to drive home the importance of patient experience to direct-care nurses, find it now. You know how much reimbursement is at stake, but the rank and file caregivers still don't get it. I've written before that the term "patient experience" has a way of annoying bedside caregivers. '"We're not Disneyworld," is a common refrain; people don't want to be in the hospital. "I'm here to save patients' lives, not entertain them," is another common complaint.  

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6 comments on "Top 5 Challenges Facing Nursing in 2012"

Dawn (6/7/2012 at 2:53 PM)
While the topics covered in this article may be hard to accept...accept them we must. This is the future of nursing. It is up to the bedside nurse to decide how to influence the mandates that are being encountered now and in the future. A recent article revealed that nursing is under represented in the health care reform process. That means business leaders, physicians, and politicians are deciding our practice. Unfortunately, we are letting them instead of letting them hear the voice of the 2.9 million nurses there are in the United States.

Ali RN (1/11/2012 at 9:14 PM)
This article was immensely offensive to bedside nursing. I am a BScN RN, and I think that if associate degree/diploma nurses want to get their full BSN, then great. If not, that's okay too. Experience is more valuable any day. All nurses are taught from day 1 about the patient experience. We all know that the patient's perception of health care can have a huge impact on the healing process. To imply that nurses do not understand this is insulting. To call us "rank and file" care givers is degrading. Nurses understand that the patient experience has nothing to do with "molly coddling" as you put it. If you want nurses to be involved in patient safety and held accountable, you need to start listening to us. We don't need to feel involved, we need to BE involved. We all understand about cost cutting, and that nurses are largest part of the budget. However, nurses also make up the largest population of health care workers are any given hospital. Agile staffing sounds to me like hiring more casuals, which means less experience on the ward when I need it. Although you might not have meant it, this article is very offensive to nurses.

SparrowRN (12/30/2011 at 6:48 PM)
Demand that nurses have at least a BSN if not an MSN and then preach to them about making patients happy and safe. Nurses cannot be told how to speak with scripting and to round every hour taking care of pain, position, and potty (be sure to use baby words with the BSN/MSN RNs) and then be expected to think critically. Either there is trust in RN judgement and ability or there isn't. If you want a responsible, critically thinking, compassionate nursing staff treat them as responsible, smart, caring people. Stop micro-managing. Share information, encourage nursing input, actually listen to them, and act upon nursing ideas. Stop soliciting RN input so the hospital can get Magnet status when in fact that input is routinely ignored. Finally stop preaching at all of us and fire the bad apples, including the bad apples in management. It is going to take a long time for health care management to remake their image and be the leaders they claim to be.




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