Health care reform will change nurses' roles, responsibilities and education according to report
A report by the Institute of Medicine says the nursing profession must evolve significantly to deliver on promises made in the Affordable Care Act of 2010, and expectations for nursing education must change as well to ensure nurses are up to the challenge.
The report, titled "The Future of Nursing: Leading Change, Advancing Health," says health care reform will create explosive new demand for care in the United States, and nurses as the largest segment of the health care workforce must increase their responsibilities for primary care to ensure quality care is accessible and available to all. Specifically, the report calls for removal of limits on nurses' scope of practice to allow nurses to perform many of the primary care tasks currently reserved for doctors. To prepare for this new role, the report calls for an increase in the percentage of nurses who earn bachelor's degrees to 80% by 2020 and a doubling of the number of nurses who pursue Ph.D.s. The advanced education combined with greater participation in the primary care of patients will allow the health care system to reap the full benefit of nurses' training, skills and knowledge, according to the report.
The report's authors believe a revamp of education expectations for nurses is needed because nursing is the only health care profession that allows multiple tracks by which an individual can attain education and licensure. A nurse may have a diploma, associate's degree or bachelor's degree, but job title and basic duties are identical regardless of the level of education attained. All doctors, by contrast, must achieve very specific educational credentials and participate in residency programs to aid the transition from education to working practice. A residency program for nurses is also among the report's recommendations.
The Institute of Medicine also encourages public and private organizations to provide resources to help nurses with associate's degrees or diplomas pursue a Bachelor of Science in Nursing degree within five years of graduation. This mirrors highly publicized "BSN in 10" initiatives that were proposed as legislation in several states. Many hospital systems, especially in the northeastern United States, already require newly hired nurses without a bachelor's degree to enroll in BSN programs, and the degree is quickly becoming standard for nurses who seek leadership and management positions.
Embracing leadership roles is also recommended to nurses in the report. Because nurses spend more direct time with patients than any other member of the healthcare workforce, their ranks should be well represented and their ideas and perspectives given considerable weight when health care leaders collaborate to implement system-wide changes. More effective patient care is only possible when professionals from a variety of fields can effectively communicate and share ideas, and the report encourages nurses to step up to this challenge and prepare themselves for greater interaction with doctors and health care executives.