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Future of American Nursing and How to Implement It

In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) joined their efforts in order to create a plan for transforming the healthcare system in the U.S. by improving nursing care education. Operating under-consumption that high-quality care is impossible without qualified and educated nurses, the cooperation was aimed at making nurses become partners and leaders in the healthcare system. The blueprint compiled two years later outlined the steps for creating affordable and seamless health care. The essay given analyzes and summarizes the importance of this plan as well as its implementation by state-based action coalitions.

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To create a report, RWJF and the IOM established a 2-year Initiative on the Future of Nursing in order to “examine the capacity of the nursing workforce to meet the demands of reformed health care and public health system” (Institute of Medicine, 2010). A Committee led by Donna Shalala, former U.S. Secretary of Health and Human Services, was formed so as to create a list of implementations that should be taken on a governmental, state, and local levels.

To do so, the Committee held three technical workshops and hosted three public forums which dealt with nursing education. Also, the Committee visited some educational and healthcare facilities to estimate how they function. Vast research which incorporated public opinion was carried out by the IOM. Released in October 2010, the report The Future of Nursing: Leading Change, Advancing Health initiated the dramatic changes in the healthcare system.

The IOM report The Future of Nursing includes a list of recommendations aimed at more effective delivery of care by developing innovative solutions. According to the document, a nursing workforce might play a crucial role in healthcare, so nurses should be “better educated and more ready to take on new roles as care providers and leaders in health reform” (Robert Wood Johnson Foundation, 2013). Therefore, significant attention in the report is paid to the development of nursing education, nursing practice, and nursing workforce as crucial factors for addressing the aims of the document.

According to the first key message of the IOM report, nurses should practice to the full extent of their education and training. This will enable them to improve the health care system and overcome the professional barriers which might be caused by lack of practice. The second key message highlights that nurses ought to achieve higher levels of education. In this regard, the report points to the importance of an increase in the formal training of America’s nursing workforce.

The percentage of nurses with a bachelor or higher degree in nursing is expected to be no less than 80 by 2020 (Institute of Medicine, 2010). In the third key message, it is stated that leadership promotes a transformed health care system; therefore, leaders among nurses should be full partners with health professionals. Such a step will enable to implementation of changes in healthcare regarding its quality and value. The last message of the report speaks of the importance of collecting workforce data for efficient planning and an appropriate increase in the supply of nurses.

The Future of Nursing: Campaign for Action was created by the RWJF and the AARP within the IOM The Future of Nursing report. The Campaign is considered to transform the nursing profession in accordance with the key points listed in the document. Action coalitions were formed as part of the Campaign; they mainly consist of nurses and healthcare providers. State-based action coalitions are established in 50 states, and they are considered to be the driving force of the Campaign because they operate as a network within the country.

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The main aim of state-based action coalitions is to implement recommendations of the Future of Nursing: Leading Change, Advancing Health report; in particular, create initiatives in order to increase the percentage of nurses with BSN degree up to 80 by 2020. Action coalitions receive funding from the Campaign as well as some external sources such as government, educational institutions, and business organizations.

According to the National Academies of Sciences, Engineering, and Medicine (2016), the funds are mainly spent on the education of nurses (45%), leadership (6%), practice and care (3%), capacity building (17%), inter-professional collaboration (2%), residency (4%). So, the funds are managed in compliance with the recommendations of the report.

Formed in 2011, the Florida Action Coalition serves as the driving force for the implementation of the IOM report key messages. The organization helps nurses to become leaders and true professionals so that Floridians could experience high-quality and seamless health care. It was in 2017 that the Florida Action Coalition undertook the Board Service Initiative for emerging nurse leaders with support from the RWJF and the Florida Blue Foundation.

The purpose was to educate the nurses from across Florida. The program embraced diversity, so highly qualified nurses of any race and ethnicity were selected to study a course led by a BroadSource consultant. The nurses were taught the responsibilities of administrators of organizational board membership as well as the principles of governance (Florida Center for Nursing, 2017). Such a program allowed for promoting nurses as leaders and advancing nursing in the health care system of the U.S.

The second initiative, which was spearheaded by the Florida Action Coalition, regards the enhanced nurse licensure compact (ENLC). This is an agreement that increases access to care while maintaining public protection at a state level. ENLC lets nurses practice across state lines with a multistate license. With the assistance of the Florida Action Coalition, Florida has become the third state to sign this agreement. On the one hand, it promotes better and bipartisan access to healthcare. On the other hand, it also gives nurses increased mobility to practice their skills. All applicants for multistate licenses will be required to meet the same standards.

Still, there are barriers to advancement in the health care system. In particular, this regards poor cultural diversity among the nurses in Florida and many other U.S. states. It is generally known that the majority of nurses (approximately 90%) are white women (Campaign for Action, 2016). One may note that there is a need to build more diverse nursing personnel in accordance with demographics in Florida.

This would undeniably add up to the competency of health care and minimize disparities between ethical and gender groups. In particular, meetings for diverse nurse leaders may be arranged to find solutions for implementing nursing policy on the basis of diversity.

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To sum up, the IOM The Future of Nursing report addresses the crucial issues on how to improve the health care system by strengthening its largest component, nurses. This entails creating opportunities for nurses to gain education and practice it to the fullest extent, encouraging leadership among nurses and making them full partners with healthcare professionals. In order to advance goals stated in the IOM report, state-based action coalitions have been formed to spearhead initiatives on a state level.


Campaign for Action. (2016). Building a more diverse nursing workforce. Web.

Florida Center for Nursing. (2017). Professional board training. Web.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health.

National Academies of Sciences, Engineering, and Medicine. (2016). Assessing Progress on the Institute of medicine report the future of nursing. Washington, DC: The National Academies Press.

Robert Wood Johnson Foundation. (2013). Celebrating a sustained commitment to improving health and health care through nursing: RWJF marks its 40th anniversary

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