The health care industry is ever changing, requiring the practice of nursing to be continually transformed. Since nurses are in direct, constant contact with patients, we are in a position to facilitate change and it is our duty to be proactive in the processes that have a positive effect in our field. Likewise, it is imperative that nurses be actively involved in education in order to stay abreast of new evidenced based processes that will result in increased positive outcomes while elevating patient care. This paper will discuss initiatives set for the Robert Wood Johnson Foundation Committee (RWJF) on the Future of Nursing and the Institute of Medicine (IOM) research that resulted in the IOM report, “Future of Nursing: Leading Change, Advancing Health”.
Additionally, it will indicate the significance of the reports associated with the development of the nursing workforce, nursing education, and nursing practice and indicates the position of Florida created action committees and how they function to achieve the goals of the Future of Nursing: Campaign for Action. In 2008, a partnership was created by the IOM and the RWJF to create an initiative to a forward driven plan that would assess and actively transform the nursing profession (RWJF, 2008). As a result of this partnership, four key points were identified for the purpose of renovating the profession of nursing: 1) Nurses should practice to the full extent of their education and Training.
2) Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. 3) Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States. 4) Effective workforce planning and policy making require better data collection and information infrastructure (IOM, 2010).
In order to truly transform healthcare, multiple conglomerations must join forces in support and band together to effectively bring about
transformation within the field of nursing, which will result in improved outcomes for patients while providing a system of health care that is available to everyone (IOM, 2008). The alliances that will play vital roles in this change include industry leaders, government, insurance companies, nurses, educational institutions, and professional organizations. Transformation is attainable through active, supportive roles from the alliances and this is vital to the transformation of professional nursing.
The initiative of the RWJF and the IOM’s 2010 report supports transformation in the educational arena of nursing, which in turn, promotes a higher education level among the nursing community. Through the IOM’s support and promotion, one goal is that nurses who practice in the hospital setting should have their BSN by the year 2020. It is the writer’s observation that hospitals are in support of this action by way of financial support available to nursing staff through continuing education programs. Health care industry employers are joining with universities and colleges, offering tuition assistance and/or discounts on tuition to allow employees to acquire BSN degrees. Additionally, employers are allowing flexible work schedules that mold around school schedules in order to coincide with employee education and some employers even offer classes on site at the hospital campus.
Similarly, to ease the challenge of the nursing workforce when they return to school, many universities and colleges offer distance-learning programs. Positive advantages such as these are making the charge of returning to achieve higher education a goal that is attainable. The changes that are taking place are proof that initiatives identified in the IOM’s report were on point in supporting growth and development of the workforce.
In support of the landmark IOM’s published report “The Future of Nursing: Leading Change, Advancing Health”, a national initiative “The Future of Nursing: Campaign for Action” was born. This nationwide initiative was intended to guide recommendations and implementation of the IOM report. The visualization of The Campaign is a health care system that promotes high-quality care, in which nurses contribute to their practice to their maximum potential. These efforts are harmonized through an initiative of AARP, the Center to Champion Nursing in America (CCNA), the AARP Foundation, along with the RWJF (Center to Champion, n.d.).
The powerful forces behind The Campaign are Action Coalitions that function at the local levels as well as at the state levels. In this capacity, The Campaign can form strong, grassroots networks full of diverse stakeholders that work diligently in order to transform health care through nursing (Center to Champion, n.d.).
The Florida Action Coalition has a focused objective to promote the goals of the IOM report recommendations and transform health care at the state level through nurse led innovative solutions. Each state identifies and develops initiatives to promote and further support the IOM goals.
Florida has developed the “Florida AC Toolkit to Address Leadership Barriers”. This toolkit identifies and addresses barriers in leadership for nurses and provides resources and guidance for Florida’s aspiring nurse leaders so they may improve their leadership roles within the nursing profession (Center to Champion, n.d.). Another accomplishment by the Florida Action Coalition is the partnership with the Florida Blue Foundation. Generously, the foundation awarded mini-grants to three Florida universities and one community foundation. Their effort supports the Florida Action Coalition, which follows suit in promoting the IOM and RWJF goals for nursing and workforce development. A focus area, the Florida Blue Foundation is improving the safety of patient care and quality.
The aim of the Foundation’s efforts are geared toward developing workforce that in turn will meet the needs our complex health care system along with needs of the individuals in Florida. This is supported via various grants such as one awarded to the University of Miami “The Future of Nursing Science – Encouraging Minority Nurses to Pursue a PhD through a Health Disparities Summer Research Program” and another grant awarded to the University of Central Florida College of Nursing “Leveraging Social Media and Digital Communications to Grow Support and Awareness” (Center to Champion, n.d.). Programs such as those listed help to advance awareness, communication, and development within the nursing profession.
Florida toolkit provides nurses with a valuable resource that aims to identify specific barriers that are perceived to hinder nurse development and advancement, and provides resources as well as support systems that can facilitate resolution through awareness, education, and fellow nurse support communities. Likewise, the Florida Blue Foundation efforts support nursing and role development through funding efforts at the educational level.
In the state of Florida, barriers that have been identified speak to the nursing shortage and barriers in education opportunities. The Florida Nurse Practice act and the rules associated with the Florida Nurse Practice act encompass four potential barriers that affect the state’s interventions to tackle the nursing shortage and its educational components. These are identified as: 1) Faculty credential requirements set in rule will increase, which may limit nursing programs’ ability to admit nursing students. 2) Clinical ratio requirements set in rule restrict the number of students that a faculty member can supervise during a clinical experience, which may limit nursing programs’ ability to admit more students. 3) Board rules limit the use of simulators, which thereby limits programs’ ability to increase the number of students obtaining the necessary clinical experiences, given the shortage of clinical placements in health care settings. 4) The Florida Statutes prevent nurse practitioners from prescribing controlled substances, which may inhibit these nurses from moving into the state (OPPAGA, 2007).
Although as of 2009, more lenient regulations were implemented in regards to the use of simulators and an increase in the clinical ratio requirements were made, these areas continue to be a barrier for the advancement in Florida nursing education. Nursing advocates can help to overcome these barriers and challenges in nursing by position themselves and be active in professional organizations that actively support the IOM report to lead and transform the industry in health care. Nurses should also strive to continually educate themselves through continuing education, and put into place current evidence based practice that supports safe effective care for our patients. In closing, it should be noted that nurses are key when it comes to facilitating change in the health care system. In health care, nurses are the backbone of the system and as such, we have the responsibility to position ourselves to actively support the Institute of Medicine’s goals. As such, nurses should pursue educational advancement, encourage change, and position themselves to take active roles in nursing leadership.
Center to Champion Nursing in America, (n.d.). Community posts. Retrieved from http://campaignforaction.org/community-post/florida-ac-toolkit-address-leadership-barriers Center to Champion Nursing in America, (n.d.). Community posts. Retrieved from http://campaignforaction.org/community-post/florida-blue-foundation-awards-2014-nursing-mini-grants Center to Champion Nursing in America, (n.d.). Campaign History. Retrieved from http://campaignforaction.org/about-us/campaign-history Center to Champion Nursing in America, (n.d.). State Action Coalitions. Retrieved from http://campaignforaction.org/states Institute of Medicine of the National Academies (IOM). (2010). The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx Office of Program Policy Analysis & Government Accountability (OPPAGA), (2007). Florida Nurse Practice Act and Board of Nursing Rules Create No Unreasonable Barriers to Producing New Nurses. Retrieved from http://www.oppaga.state.fl.us/reports/pdf/0704rpt.pdf Robert Wood Johnson Foundation, (2008). Initiative on The Future of Nursing. Retrieved from http://www.thefutureofnursing.org/about