Introduction
In 2011, the U.S. Institute of Medicine (IOM) released a report on the future of the nursing profession, education, and practice. The report outlined some of the key issues in contemporary nursing and suggested possible areas for improvement. The report has made a significant contribution to the development of nursing, particularly by enhancing the nurses’ role and establishing goals for nursing education. Assessing the effects of the report is essential to outline the gaps that are still evident in the nursing profession and education. Therefore, the present paper will seek to discuss the impact of the IOM’s report on the role of nurses in today’s healthcare environment.
Impact on Education
The proposition of the IOM (2011) regarding nursing education was to enable nurses to pursue higher levels of education by enabling them to progress through academic stages easily. The report was among the first publication that positioned nursing as a “platform for continued lifelong learning” (IOM, 2011, p. 163). In order to achieve this effect, the authors of the report proposed a series of recommendations for improving nursing education. First of all, they proposed concrete goals, such as to increase the proportion of nurses with a Baccalaureate Degree or a Doctorate. In addition, the authors proposed that nursing schools and medical institutions should provide more continuous learning opportunities for nurses to develop their skills.
It is evident that some progress on these recommendations has been made in the past few years. Altman, Butler, and Shern (2016) review the progress made on the IOM’s recommendations over the next few years. The authors state that the enrollment of nurses in baccalaureate programs increased substantially since 2011, both for entry-level baccalaureate and for accelerated programs, which is a major success. Similarly, the enrollment of nurses in DNP programs increased substantially (Altman et al., 2016). However, the share of nurses with a Ph.D. degree increased only by around 15% (Altman et al., 2016). As for academic transition, few efforts were undertaken to provide lifelong learning opportunities. According to the authors, one of the reasons for the lack of progress in this area is the absence of data on continuing nursing education. Further development of nursing is thus essential to achieving the goals and fulfilling the recommendations set out in the report.
Impact on Practice
Nursing practice is arguably the most crucial area of policymaking that affects nurses and their work. The IOM (2011) also indicated some issues in nursing practice, mainly that the vast share of nurses were unable to achieve their full potential due to various barriers to practice. Indeed, regulatory restrictions, such as scope-of-practice regulations, often prevent nurses from improving the scope of their work and taking the initiative to advance patient outcomes. The key recommendation of the report was to address barriers to practice for APRNs. Arzouman (2016) states that, although some actions have been taken to improve the level of authority granted to APRNs and to remove other barriers to practice, scope-of-practice regulations are still evident in the United States, which sometimes prevents nurses from providing adequate care and using their skills to improve patient health. Removing scope-of-practice barriers could help nurses to reach their full potential and be more proactive in treating patients.
Impact on Leadership
Leadership is often perceived to be among the key challenges in nursing, yet it also provides numerous opportunities for nurses to advance patient care in their practice setting. As noted by Grossman and Valiga (2016), leadership is inherent to nursing as it allows nurses to become advocates for patient health and helps them in facilitating policy changes on multiple levels. However, there are a number of barriers to leadership in nursing that were recognized by the IOM (2011). For example, the report stated that nurses are often seen as inferior to other health professionals, regardless of their experience and education. This affects interdisciplinary partnership in healthcare and prevents nurses from becoming true leaders in their practice setting. The main recommendation of the IOM (2011) was to increase the number of leadership opportunities and positions open to nurses. Increasing the nurses’ role in decision-making could be useful in improving patient care and transforming the healthcare environment. However, the progress made in this area cannot be considered substantial. Altman et al. (2016) state that the percentage of nurses who were board members decreased from 6 to 5 percent between 2011 and 2014. Clearly, nurses still occupy only a small share of leadership positions available to other health professionals.
Conclusion
Overall, the IOM (2011) report offered a useful framework for redesigning health care to fulfill the increasing demand for services. Nurses represent a significant part of the medical workforce, which is why the authors focused on improving nurses’ capacity, authority, and education. However, recent research shows that few of the recommendations have been fulfilled to this date. Therefore, although the report served to provide a new and improved vision of nursing, it had a limited long-term effect on nursing practice, education, and leadership.
References
Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine report “The Future of Nursing”. Washington, DC: National Academies Press.
Arzouman, J. (2016). The future of nursing 5 years later – Where are we now? MedSurg Nursing, 25(1), 5-7.
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing (5th ed.). Philadelphia, PA: FA Davis.
Institute of Medicine (IOM). (2011). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.