IOM and RWJF Working for Change in Nursing

Introduction

One of the biggest questions following the Affordable Care Act was how on earth the American healthcare system would be able to keep up. This came up around the same time that the nursing profession realized it was again looking down the barrel of a major staff shortage. Both of these issues combined with the generally inefficient and unfair structure of the nursing profession led to the Committee on the Robert Wood Johnson Foundation and the Institute of Medicine joining forces to determine a path of change that could satisfy all three needs at once. The resulting report and action campaign have shown that a very promising future is possible for nursing and healthcare in general.

Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation worked with the Institute of Medicine to address the many issues that negatively affect nurses today. Some of their key concerns included correcting staff shortages, expanding the role of nurses in the workplace, increasing the number and expertise of the faculty of nursing schools, and reworking healthcare delivery to be more compatible with the higher dependence on nursing that the other elements would allow (IOM, 2013). The initiative had broad goals that went along with a bold objective, to positively transform the nursing profession in the United States.

Importance of IOM report

The Future of Nursing: Leading Change, Advancing Health report represents one of the most important healthcare movements of our day. Even though the passage of the Affordable Care Act was a huge step toward improving the health of our nation, it is a drop in the bucket compared to how much effort it will take to put the ACA into action. The aim of the “Future of Nursing” report was to take those more complicated and very necessary steps toward a healthcare system that can actually support the ACA (RWJF, 2011, pg. 2). The reports focus on nursing through every section indicates how important this initiative is to the nursing profession at all levels from education through the highest levels of qualification.

The intent of “Future of Nursing”

The Campaign for Action is the result of the Future of Nursing report published by the Robert Wood Johnson Foundation. This campaign’s purpose is to put into action the findings and recommendations of the report to create a healthcare environment where “All Americans have access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success” (“About us”, n.d.). The intent is to both renovate the focus of healthcare to being patient-oriented, improving the individual health of patients based on their specific priorities, and nurse-based, built on the ability of nurses to provide direct, primary care to patients thanks to more streamlined education and a bigger role as health care providers.

The rationale for state-based action

Focusing healthcare on patients instead of diseases is too complicated a task to be handled solely at a national level. The states are much better equipped to identify and meet the needs of their local population based on individual factors, rather than trying to create comprehensive plans to treat diseases rather than people, as has been done in the past. While the national coordination provided by the Campaign for Action helps keep the momentum going and keeps information available to everyone involved, it is the states who are ideally poised to “capture best practices, determine needs, track lessons learned and identify replicable models” (“Campaign for Action”, 2012). Individual states with a national coordinator can also work toward the goals of the campaign much faster. Each state can focus on different parts of the initiative, whatever they are best positioned for. While some states like Texas and Indiana are spending their efforts on certain aspects of nursing education, others like New Jersey and Virginia are more focused on improvements that can be made in practical environments (“Campaign for action”, 2012). This team effort where each member state contributes what they are best able to makes it possible for the overall campaign to make leaps and bounds that might not be possible without that cooperation at multiple levels.

New Jersey action coalition initiatives

The efforts of New Jersey’s action coalition are focused primarily on practicing nurses, though they are also giving some attention to education as well. Two of the priorities they have identified are the removal of scope of practice limitations and the expansion of leadership roles for nurses at different levels (“New Jersey action coalition”, n.d.). These are two of four priorities chosen by New Jersey and they are notable because they support each other very well in action. Of course, education is essential to both these elements as well, but many practicing nurses are more constrained by scope of practice limitations than by their education. By removing these limitations, nurses will be better equipped to care for patients in a primary capacity and to support doctors and other nurses when needed to improve the care of those patients as well. Granting nurses more leadership opportunities is also closely tied to education as it is an educational tool, but in relation to scope of practice it allows for clearer hierarchies and coordination among nursing staff as well as between nurses and doctors.

Conclusion

Thanks to the findings of the RWJF and the IOM and the efforts of the Campaign for Action on both national and state levels, the United States is now in the midst of a very exciting time for healthcare. Finally, it seems possible that nurses will receive the support and professional respect they are due as well as the educational opportunities they need to excel. Patients and other healthcare professionals will likewise benefit from these changes if they can be fully explored and successfully put in place. State action coalitions are in a position to play a major role in the future of nurses on a national scale and nurses both present and future are likely to benefit in almost every way from these developments.

References

About us. (n.d.). Future of Nursing: Campaign for Action. Retrieved August 23, 2013, from http://campaignforaction.org/about-us

Campaign for Action names 12 new state action coalitions to help ensure high-quality, patient-centered health care for all. (2012, March 6). Initiative on the Future of Nursing. Retrieved August 23, 2013, from http://www.thefutureofnursing.org/news/detail/campaign-action-names-12-new-state-action-coalitions-help-ensure-high-quality-patient-ce

IOM. (2013, January 27). Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine - Institute of Medicine. Institute of Medicine. Retrieved August 23, 2013, from http://www.iom.edu/Activities/Workforce/Nursing.aspx

New Jersey action coalition. (n.d.). New Jersey Nursing Initiative. Retrieved August 23, 2013, from http://www.njni.org/page/new-jersey-action-coalition

RWJF. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, D.C.: National Academies Press.