Future of Nursing

Within the health care settings, nursing care models have been used to offer critical insights on the way to improve the quality of patient care. In fact, research shows that clinical settings with more nurses have minimal medical errors, low rates of hospital stays, decreased hospital acquired infections, and low mortality rates (Shekelle, Wachter & Pronovost, 2013). This especially possible because nursesare uniquely trained to care for patients with chronic illnesses. Similarly, in health screening for early detection, nurse-led efforts have been linked to preventive care and reducing the burden of diseases. Unfortunately, the nursing profession faces a substantial number of challenges threatening to limit the nursing solutions. Among the challenges is the current nurses’ shortage, also projected to escalate by 2025. The shortage is exacerbated by the high number of nurses retiring and increases in the number of elderly Americans. In addition to the above, the nursing educational system is also lacking the capacity to train the next generation of nurses to match the advances in modern day clinical practices.

Future of Nursing Initiative

In order to address the many issues facing the nursing profession and to transform the state of healthcare in the United States, the Institute of Medicine together with Robert Wood Johnson Foundation launched an initiative on the Future of Nursing. The strategy was to identify the potential for improving the quality of healthcare, increasing access, while at the same time reducing costs by engaging nursing leaders, and embracing nursing care solutions. The committee reviewed the innovative models of nursing care and education. Ultimately, it was identified that it was difficult to address the challenges facing the health care system in the U.S., without solving the problems facing the nursing profession (Institute of Medicine, 2011). In fact, for health care changes to be effective, the first step is first to change the delivery of health care, and especially nursing. Sponsored by RWJF and conducted by the IOM the initiative came up with several recommendations including changes in public and institutional policies at the federal, state, and local levels. Chief among the committee’s recommendations was the recognition that nurses were uniquely positioned, and their extensive interaction with patients qualifies them to provide solutions to better care and at lower costs. In this context, the IOM report recommended re-conceptualization of the role of nurses in the entire workforce including shortage, current, and future technology. The second recommendation sought to expand the capacity of the nursing schools and redesigning education to ensure it produces professional nurses who can meet the current and future clinical practices. In addition, the report recommended the examination of innovative solutions concerning delivery of care and professional education by focusing on delivery of services and nursing, as well as attracting and retaining qualified nurses in multiple care settings.

Impact of IOM report on Nursing Practice

Since the recommendations made by the IOM report, hospitals and other health care facilities are responding and the impact is visible. For instance, following the recommendations to have a workforce that comprises of at least 80 percent of nurses with BSN by 2020, employers are adopting nurse residency programs to empower their nurses. Majority of the hospitals are also offering tuition reimbursement to nurses who want to pursue their BSN. Beyond the issue of education, the IOM report is projected to have a positive impact on the delivery of quality care within the nursing practice. Nurses interact with patients on a daily basis and creating a collaborative workforce will increase the quality and safety of care delivery.

Impact of IOM report on Nursing Education

Nursing education has numerous pathways that can lead to entry-level license for practice as a Registered Nurse. Some of these include hospital-based diploma program, associate’s degree, and BSN. Nonetheless, the IOM (2011) report deliberated that nurses should have higher education qualifications to meet the demand of the evolving healthcare system. In order to provide for uniformed care delivery, the report calls for an all BSN-workforce entry level. Ordinarily, this means that the number of nurses with BSN degrees will increase. Nurses with associate and diploma degree will also have to pursue BSN, thus creating a culture that fosters continuing education. Along with that, nurses will also be engaged in a lifelong learning process; thus a culture that promotes this should be established.

Impact of IOM Report on Workforce Development

Ideally, although nurses have a greater potential to lead innovative strategies, a variety of historical and regulatory policies barriers have limited the ability of the nurses to influence widespread transformation. However, the IOM (2011) report recommended re-conceptualization of nurses’ roles within the entire workforce in the United, and this is projected to have a significant influence on the workforce development. For instance, with the introduction of a standardized education system, it is expected that scope-of-practice regulations will be eliminated allowing access to proper care. Care within hospitals has also become complex, but with more qualified nursing personnel, nurses are projected to be able to fill the primary care roles and therefore preventing acute care episodes and curbing disease progression for improved quality care.

Role of state-based coalitions in advancing the future of nursing campaign

With Robert Wood Johnson Foundation leadership and other partners from diverse sectors, the Future of Nursing: Campaign for Action is set to create a transformed health care workforce through the recommendation outlined in the IOM report. The campaign is compounded on existing groundwork by enjoining the States, alongside new collaborations to implement the plan. The role of state-based coalitions in advancing the future of nursing campaign is focused on priority goals of the report and related activities. For instance, the IOM report recommends that the states are set to remove barriers of scope-of-practice by identifying areas of action crucial for optimizing the nursing practice. Such areas include streamlining the nursing education program to ensure a smooth transition of nurses with a diploma and associate degree to BSN degrees for easy diffusion into the workforce. In addition to the above, states have the responsibility to meet the recommended number of nurses in hospital and health institutions and to ensure that they have BSN degrees by 2020. Along with that, the states should guarantee the expansion of nursing leadership opportunities, by encouraging participation of nurse leaders in policy making and discussion boardrooms.

Initiatives Spearheaded by New York State Action Coalition

The foundation leading the Campaign for Action is committed towards the effort, but cannot do it alone. New York is committed and working with different stakeholders to ensure the successful implementation of the Institute of Medicine recommendations. In solidarity, the state has launched two initiatives; fostering inter-professional collaboration and transforming nursing education. By promoting the collaboration in healthcare, the state hopes to improve collaboration among nurses, other health care providers for improved quality of care (Stephen, 2015). The other initiative on transforming nursing education focuses on ensuring that more highly educated nursing professionals are in the workforce to handle the complex care (Campaign for Action, 2014). The state is set to implement this initiative through a nursing education curriculum program that addresses the needs and ensure smooth transition to the BSN degree program.

Overcoming Barriers

Barriers to the advancement of the future for the nursing initiative are all over and are almost similar in all the states. For instance, the initiative is projected to face professional resistance from nurses, physicians, and other health care personnel (IOM, 2011). The opposition is especially strong from doctors who believe that the quality of care may be compromised. Nonetheless, this barrier can be overcome by offering reassurance to concerned parties as well as outline the benefits of the initiative.


Campaign for Action. (2014). Transforming Nursing Education. Retrieved from: https://campaignforaction.org/transforming-nursing-education/

IOM (Institute of Medicine). 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.

Shekelle, P. G., Wachter, R. M., Pronovost, P. J., Schoelles, K., McDonald, K. M., Dy, S. M., Shojania, K., … Winters, B. D. (2013). Making health care safer II: an updated critical analysis of the evidence for patient safety practices. Evidence Report/technology Assessment. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK133362/

Stephen, A. (2015). Fostering Interprofessional Collaboration in Health Care. Campaign for Action. Retrieved from: https://campaignforaction.org/fostering-interprofessional-collaboration-healthcare/

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