The recent change in health care reform (2010), Affordable Care Act (ACA), has increase the demand in quality, safe, affordable, patient-centered and accessible care in the areas of community and public health and geriatrics. To be successful with this reform, Institute of Medicine’s (IOM) Report 2010, The Future of Nursing: Leading Change, Advancing Health, is calling upon nurses to expand their role by achieving higher level of education, attain competencies in leadership, research and evidence base practice in collaboration with team to create high quality workforce. The shift/change in care needs and improvement in technology and science, nursing needed to be reexamined and evolve with new emerging competencies.
The report has presented recommendation to enable nurses with their education and training to practice in meeting challenges and demands of diverse public health care needs in the future by: Proportion increase of nurses with BSN up to 80 percent by the next decade. By next decade double the number of doctorate degree nurses in the workforce. Improve education system to promote seamless academic transformation. Lifelong learning education program to ensure to continue competency education across the life span. Providing APRNs full extent of practice with in their scope of practice. Providing opportunities to diffuse successful practice in collaborative effort and leadership.
These recommendation, where it gives nurses the opportunity for higher level of education up to the doctorate level like other health care profession, to be the part of future effective workforce team. It is also adding layer of need of more qualified instructors in nursing schools and other organizations, in order to deal with adoption of current rapid changes in today’s very divers public health care in the curriculum to create nurses ready to deal with the new health care divers need of the public care. There are significant needs to overcome the shortage of nurses due to high turnover rates of new student nurses. There should be a plan to retain these students in the completion of the program in to entry level nursing in order to have current nurses to proceed to the next level of education and arenas of nursing.
APRNs and nurses are called upon increasingly in the area of primary care, because they are equipped and trained to provide that service, with unique understanding of the health care process with different theories of care. This uniqueness enables nurses to provide care in any setting of life. In order to utilize this unique knowledge of APRNs, the barriers in the practice should be eliminated like of other collaborative team professions, in order for nurses to participate fully in the research and evidence based data collection for the quality and affective delivery of care and overcome the future need of primary health care providers. In this report some authority recommendation are made for the APRNs, according to which APRNs should be able to: Perform assessment to make critical decision, within the scope of their practice, to admit patient in different areas of care.
Get reimbursement rates similar to physician by Medicate and other private insurance organization. Reform new scope of practice regulation in Nursing Boards NPA and Nursing Administrative Rules. Be eligible for the privilege of admission into the different level of care facilities. These recommendation will create a cost effective health care system in the primary and preventive care, which will overcome the future heightened need of the primary care providers. Nursing and nurses are the sole of providing care with skills and compassion. The full extent practice within the scope of practice provides opportunity to the nurses and APRNs to use their critical thinking and judgement in decision making for the patient health care. It will enable nurses to be the direct part of the research and participate in the decision making of laws and regulations in relation to the public health care, as nurses are the front line team of the health care system.
The function of the primary care provider is to examine, diagnose and treat the new onset of symptoms, and nursing knowledge and training is all about assessment, diagnosis, planning goal centered intervention and reassessment with their different theories of providing care. The nurse spent great amount of time with their patients not just in providing care but providing patient education, any counselling and further care coordination to the patient. The nurses and APRNs should involve in decision making of the public health care as nurses can come up with innovated ideas in bring the health care up. In conclusion I would say that the evolution of high technology hospitals, which created the possibility of office and hospital practice and work hour reduction of the physician, are hallmark innovations of the unique, versatile and adoptive nursing profession. To transform the health care system with safety and cost effectiveness for the public, nurses and nursing will play fundamental role in health care system. Nursing profession have the opportunity to lead and now the time has come to lead and advocate for the nursing profession and for the public health care system.