The 2010 Affordable Healthcare Act (ACA) is the largest change to the United State Health Care system since the Senate passed the Medicare and Medicaid program in 1965. The Affordable Medical Care Act of 2010 will provide affordable insurance coverage to 32 million more Americans; this will require a higher demand on the health care system. With only 3 million registered nurses in the United States, questions were raised as to what kind of responsibilities nurses will have to assume while providing safe, quality health care service. In 2008 Robert Wood Johnson Foundation (RWJF), the largest health care foundation dedicated to improving health and health care in the United States, and Institute of Medication (IOM) developed in 1970 as a non-profit organization whose purpose is to advise on biomedical science, medicine and health partnered to create a report that can act as the cornerstone for the future of nursing. The 2010 IOM Report: The Future of Nursing: Leading Change, Advancing Health focused on many different topics related to health care this paper will discuss Nursing Education, Practice, and Leadership to deal with the increasing demand on health care system (“The future of,” 2011, p. 1). Nursing Education
Florence Nightingale’s pioneering work in nursing and nursing education provided an increased understanding on health care; however, the healthcare field has come a long way since then. In the 20th century the United States health care system was primarily designed to deal with illness and injuries. As patient care need have changed so has the nursing education in the 21st century; nurses today have to be much more flexible due to the expanding role of health care specialization.
Even though a BSN is not a requirement to practice nursing at most hospitals, a more educated workforce can provide better health care support. Care in hospitals has become much more complex. Nurses today are required to make decisions or conduct duties that in the past were only done by physicians. They are also required to have an understanding of information systems that require analysis and synthesis. The IOM report recommends that by 2020 80% of practicing nurses should have a minimum of a baccalaureate degree. The committee maintains this is a necessary step to help expand the nursing force (“The future of,” 2011, p. 168).
Improving the education system is crucial in order to achieve the recommendation made by the committee; this can be accomplished by the traditional RN to BSN program or a 4 year BSN program which can be taught at traditional universities or community colleges. In addition to increasing BSN prepared Nurses, nursing schools should also prepare more students at the graduate level to help increase the leadership, research, and teaching of future nurses. This can be accomplished by providing bridge programs that allow students to achieve BSN to MSN or ADN to MSN degrees (“The future of,” 2011, p. 170).
A study published in the American Journal of Nursing in 2007 showed that nearly a third of the nurses wanted to change their jobs, while 14% of newly hired nurses changed positions within the first year. The IOM team recommendation to alleviate this problem is for nursing programs to offer transition-to-practice residency program which allows the student to make a transition from school to practice, thus developing the student’s skills and improving the quality of service for the hospital (Gosset, 2011, p. 1).
Health care has truly evolved over the last 40 years, Advanced Practice Registered Nurse APRNs are able to enter the workforce and provide more care today than ever before. The IOM Report suggests that nurses should play a larger role in the health care system, both delivering care and decision making. The committee argues that today’s nurse provide more than health promotion and disease prevention; they also incorporate services from other areas such as social work, nutrition and therapy (“The future of,” 2011, p. 85).
There are not enough primary care physicians to provide care for today’s aging population. By 2020, 20% of the United States population will be 65 or older, and the new ACA will require an even growing need for more physicians as more patient obtain insurance coverage. No study suggests that APRNs are less able to provide health care that is sufficient to the one provided by a physician, yet most state regulations limit the ability of a nurse to provide care legally. Current state laws hamper an APRNs ability to be able to provide health care solutions. This law has caused nurse practitioners to leave primary care and work as specialists at hospitals while others have left the practice all together to join staff nursing (“The future of,” 2011, p. 92).
The committee strongly recommends that states eliminate their outdated regulations and allow nurses to practice to their full extent and utilize the education and training that they have received. US healthcare is transforming and in the coming months will require more trained professionals in the health care system. By eliminating some of these regulations it will allow nurses to be able to provide seamless, affordable and quality health care (“The future of,” 2011, p. 97). Nursing Leadership
According to the IOM, for the vision of the new healthcare system to be realized it would take strong leadership in the nursing role. The report suggests that nursing should produce leaders at every level of the system whether it is a leadership role in policy, politics or practice. The new health care system will demand that nurses become leaders in their community to be able to provide high-quality patient care (Poter-O'Grady, 2011, p. 34).
Nursing plays a critical role in patient care. Nurses are in charge of coordinating, integrating and facilitating to ensure quality patient care. As nurse leaders they are charged and with providing strategies to increase quality, access, and value in a patients care. The IOM suggests that for true nursing leadership to be accomplished it needs to be developed at every level of nursing education whether it be the academic or clinical arena (Poter-O'Grady, 2011, p. 36). Conclusion
With over 3 million licensed nurses, the nursing profession is the largest health care workforce in the United State. The challenge that this profession faces is the growing population that will require health care service. With 20% of the US population reaching the age of 65 plus by 2020, the Bureau of Labor Statistic February 2012 report suggest another 1.2 million nursing jobs will be needed by 2020 which is an increase of 26% (Rosseter, 2012).
With the Senate passing the ACA, the ever growing need for quality health care is going to be even more prevalent. According to the IOM report, nurses will need to be more educated to handle the broad scope of the nursing profession, while continuing to improve their leadership skills that suggesting smarter not harder ways to provide quality care. Lastly, the nursing professional will need to revise or eliminate their current policies that limit the nursing profession.
The future of nursing: leading change, advancing health. (2011). Washington, D.C.: The National Academies Press. Retrieved from http://www.nap.edu/catalog.php?record_id=12956 Gosset, N. (2011, January). What is the nursing turnover rate average? eHow. Retrieved from http://www.ehow.com/about_6645244_nursing-turnover-rate-average_.html. Poter-O'Grady, T. (2011). Future of nursing special: leadership at all levels. Nursing Management, 42(5), 32-37. Retrieved from http://www.nursingcenter.com/lnc/journalarticle?Article_ID=1163290. Rosseter, R. (2012, April 2). Fact sheet: Creating a more highly qualified nursing workforce. American Association of Colleges of Nursing. Retrieved from http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf.