?The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care.
Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing conditions in the healthcare system and new legislations to make the system more patients centered will place many demands on the healthcare professionals. The Affordable Care Act (ACA), which was enacted into law in 2010, is expected to add another 32 million people, who were hitherto uninsured, to the country’s healthcare sector.
The new law provides enhanced health care through extensive health insurance reforms making insurance providers accountable, reducing health care costs, and providing quality health care for all Americans. The report uses the terms Nurse, Nursing, and Nurse Practitioner (NP) to refer to the nursing profession. Since nursing is the most important and central core of the healthcare system, there is no doubt that the newly added 32 million people into the insurance sector will bring a tremendous impact on the nursing profession.
Acknowledging the fact that the health care system in the US is constantly changing, in2010 the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) brought out a report on the future of nursing after two years of intense discussions and consultations. In order to overhaul the nursing profession, the IOM report made the following suggestions in its report: 1. Nurses should utilize their education and skills to transform the healthcare system in a way to provide quality patient care.
2. Total overhauling of the nursing education and training is necessary to re-conceptualize the roles of nurses in a reformed healthcare system. 3. Nurses should take up leadership positions along with physicians and other healthcare professionals to provide high quality healthcare. 4. Effective workforce planning and policy making require better data collection and improved information infrastructure. The impact of the IOM report on nursing education:
The Affordable Care Act reflected a shift from Treatment Model to Prevention Model, which requires well-educated nurses with more scientific understanding and skill in the process of care continuum – promotion and prevention to treatment. Since the medical field is undergoing a transformation, there is an increased need for highly qualified and competent nurses to provide safe and effective patient care in the new system. As the healthcare system has undergone dramatic changes over the last many years, nurses are now required to qualify well to provide more services than they did before.
They also require to work as a team to provide optimum patient outcome. The Affordable Care Act also covers pre-existing conditions, which were once rejected by insurance providers. Such inclusion of the pre-existing conditions requires the nurses to increase their knowledge bases to cope with such medical situations. There is also an increased need to educate patients since there is an increase in the number of patients who bring more complications to the healthcare settings.
As a result, nurses need to earn higher levels of education and training to react positively to the changed scenarios. Continued education should be a norm for nurses as many changes and advancements in the healthcare sector take place. Nowadays there is an increased dependency on technology in the healthcare setting, especially in documentation and decision making. Information technology is widely used in medical billing and payments. Diagnostic and monitoring machines have proven inevitable in the treatment of many diseases.
There is an increased demand from nurses to pursue higher education, especially those nurses who entered the profession through the apprentice programs in hospitals or the Associate Degree. As new nurses enter in to the profession, in the changed scenario a Baccalaureate Degree in Nursing will become the minimum qualification to provide advanced and safe care to patients. Many of the universities, including Grand Canyon University, offer courses for nurses to pursue higher education such as RN to BSN and MSN programs to improve their knowledge and skills, which is essential in the transformed healthcare system.
The IOM report can also act as a guideline for teaching hospitals and other educational institutions to find new ways to improve the education and training of nurses in such a manner that they will be able to face the challenges of modern healthcare. The impact of the IOM report on nursing practice, particularly in primary care and how to change the practice to meet the goals of the IOM report: The Affordable Care Act which puts more emphasis on preventive care will bring heavy load on primary care providers and general practitioners.
This is reflected in the recommendation of the IOM report. Currently most of the primary care in the country is provided by nurse practitioners (NPs), together with physicians and physician assistants and their demand is increasing with the restructuring of the healthcare sector. Opportunities are abound for nurses in developing and implementing innovative strategies to improve the healthcare sector for better patient outcome. They also have more chances to assume leadership roles the sector.
The changes recommended by the IOM report require changes and awareness in the area of primary care for safe and effective patient care. “Nurses are crucial in preventing medication errors, reducing rates of infection and even facilitating patients’ transition from hospital to home” (Mary Naylor). Being a Medical/Surgical nurse, the changes the writer expects are mainly preventing medication errors and reducing rates of infections. Patient education is also paramount in obtaining maximum patient outcome.
With increased knowledge and education the discharge reports and patient education packets will be done with more care and attention to detail. There is an increasing awareness in the healthcare setting for nurses to work in partnership with physicians and other healthcare professionals. Nowadays nurses are in a better position to share their education and skills in promoting health care. In order to mould nurses to be fully competent in the changing healthcare system and practice environment, colleges should integrate leadership-related courses in their core curriculum.
Nurses should also take advantage of the technological advancement to improve their education and skills as leaders in the healthcare sector and promote nursing as a profession of leaders.
References 1. The Future of Nursing: Leading Change, Advancing Health. Robert Wood Johnson Foundation (RWJF) and Institute of Medicine (IOM). Released October 5, 2010. 2. The Patient Protection and Affordable Care Act (PPACA). Effective March 23, 2010. 3. Personal communication, Mary Naylor, Marian S. Ware Professor in Gerontology, Director of New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, June 16, 2010