A report titled The Future of Nursing: Leading Change, Advancing Health (FON) issued by the Institute of Medicine (IOM) stresses the importance of the nurse’s role as a leader in the process of creating a “better integrated patient-centered health care system” (2010, p. 14). The FON report outlined three primary goals of nursing education: preparing future nurses to meet patients’ needs, teaching nursing graduates how to assume leadership roles, and providing them with necessary tools for advancing medical science (IOM, 2010). It also suggested that the fundamental transformation of nursing education will help to meet those goals as well as address other issues related to the improvement of health care delivery.
According to the Committee for Assessing Progress on Implementing the Recommendations of The FON Report, the nation has seen a tremendous growth of health care practitioners’ desire to achieve higher levels of education (NASEM, 2015). Baccalaureate competition enrollment has risen from 77,259 in 2010 to 130,345 in 2014 (NASEM, 2015). The number of registered nurses seeking to obtain entry-level baccalaureate degree has also grown from 147,935 to 172,794 over the same period (NASEM, 2015). The findings of the committee show that enrolment in the doctor of nursing practice programs has doubled since 2010: from 7,034 to 18,352 (NASEM, 2015). Some data suggest a minor increase in leadership opportunities for nurses (NASEM, 2015). According to the statement issued by The National Council of State Boards of Nursing (NCSBN), the transition-to-practice programs aimed at lowering turnover rates among nurses entering practice that were outlined in the FON report have a beneficial impact on attrition rates and, therefore, need to be encouraged (2014).
The FON report noted that increasingly the changing landscape of the national health care system calls for a radical shift in the nursing practice (NASEM, 2015). It claims that advanced practice registered nurses (APRNs) should be able to exercise their knowledge to the full extent thereby providing the necessary support for building a better system for the delivery of primary care (NASEM, 2015). The FON report observes that even though the most of APRNs have received a sufficient amount of training, they are not being permitted to provide a vast array of services because of the numerous barriers such as state and federal laws and policies, old insurance reimbursement methods and restricting practices supported by many institutions (IOM, 2010).
According to the Committee for Assessing Progress on Implementing the Recommendations of The FON Report, 44 State Action Coalitions have made significant progress in removing scope-of-practice barriers since the time the report was published (NASEM, 2015). In 2010, only thirteen states met all the necessary criteria allowing APRNs to engage in the full practice (NASEM, 2015). However, the Future of Nursing: Campaign for Action initiated by the American Association of Nurse Practitioners (AANP) and the National Council of State Boards of Nursing (NCSBN) has helped twenty-five more states to transform their laws to eliminate scope-of-practice barriers (NASEM, 2015). Currently, twelve states fall into the category of restricted practice. Therefore, I would suggest lifting all existing legislative prohibitions and regulatory impediments that restrict some of the privileges for nurse practitioners to meet the goals of the IOM report.
The FON report stresses the importance of the nurse’s role as a leader arguing that effective transformation of the health care system is only possible with the direct involvement of nurse leaders in the process. It recommends that expansion of opportunities for RNs to “lead and diffuse collaborative improvement efforts” as well as preparation of health care practitioners for assuming leading roles could help to implement a new approach to the management of health care organizations (NASEM, 2015, p. 181). To this end, the FON report suggests that nursing education curricula should include courses developing leadership and entrepreneurship skills (NASEM, 2015).
According to the NASEM report, numerous nursing schools expanded their programs and incorporated their lessons from business and social entrepreneurship (Gilmartin, 2013). The year 2012 was marked by the launch of the AACN-Wharton Executive Leadership Program that was designed to enhance nursing leadership (NASEM, 2015). It focused on providing its participants with a set of skills necessary for managing and leading change in their clinical settings thereby significantly contributing to the increase of “value with internal and external stakeholders” (NASEM, 2015, p. 181). The American Academy of Nursing’s Jonas Policy Scholars Program was designed by the Jonas Center to provide postdoctoral nursing students with necessary leading skills (NASEM, 2015).
The FON report has also helped to instigate private organizations to support the education of nurse leaders. Numerous foundations have established programs for active support of leadership education in nursing and medical schools since 2010 (NASEM, 2015). The campaign has helped to establish the Breakthrough Leadership in Nursing Awards Program that provides awardees with scholarships at the Center for Creative Leadership. Even though there are no particular indicators that could serve as empirical evidence for the progress of the FON report in preparing nurses to lead, it is clear that the creation of numerous leadership programs significantly helped to promote the nurse’s role as a leader.
Gilmartin, M. (2013). Principles and practices of social entrepreneurship for nursing. Journal of Nursing Education, 52(11), 641-644.
IOM. (2010). The future of nursing: leading change, advancing health. Washington, DC: The National Academies Press.
NASEM. (2015). Assessing progress on the Institute of Medicine report the Future of Nursing. Washington, DC: The National Academies Press.
NCSBN. (2014). NCSBN’s Transition to practice study: implication for boards of nursing. Web.