The Institute of Medicine report concerns various issues and problems in nursing, e.g. nursing education and practice, right leadership skills, and the Government’s role in the transformation of the medical system.
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The IOM report draws the reader’s attention to the importance of education for nurses and reviews its development in the XXI century. As the population of the United States grows older and often suffers from chronic conditions such as diabetes and mental illnesses, the education that is based on evidence and research from the XX century becomes irrelevant. According to the IOM, high-quality care implies that nurses are competent in leadership and health policy. Moreover, evidence-based practice is also a cornerstone of modern medicine as it provides a more profound approach to patients and their treatment.
As it is mentioned in the report, nursing education is focused on acute care and neglects other aspects such as primary care and long-term care (The IOM, 2010a). Although education facilities try to engage new information from studies and relevant sources in their programs, nursing curricula need to be reviewed and reexamined to ensure that they can respond adequately to the demands of clinical practice.
Although future nurses can choose different paths to their career (e.g. bachelor’s of science in nursing or associate’s degree in nursing), the BSN is considered to be the most suitable choice as it provides a broad range of information about health policy, public and community health, leadership, etc. (The IOM, 2010a). Thus, if more students are eager to become BSNs, it can be expected that future nurses will be more educated and better qualified for the sets of tasks that they need to perform.
According to the IOM report, the primary barrier that nurses have to face is the legislative one. Although nurses are trained and educated to provide a wide set of different services, specific laws and regulations do not allow them to provide these services, even if nurses are qualified. The health care system is changing, and nurses discover new ways of how they can provide primary care instead of specialty care. As states have different prescriptions, some nurses have limited possibilities to provide primary care, although they are qualified for this type of service. However, the USA does not have enough primary care physicians, and this lack of professionals leads to severe consequences. If nurses are regarded as equal to primary care physicians, the country will be able to resolve the problem of lacking primary care.
The IOM report indicates that nursing should be regarded as a practice that requires lifelong learning (The IOM, 2010b). Therefore, I would view my practice as a part of this lifelong learning, but I would also try to get any helpful information about nursing to ensure that my development as a professional will not stop at a particular moment. I do not believe that a nurse can know and understand everything about their profession because it keeps changing; as the progress in medicine becomes even more fast-paced than it was, nursing practices are also exposed to new rules and regulations that need nurses’ attention.
I also agree with the statement that nurses cannot be seen as substitutes of physicians; I would like to prove it through my practice and patient care that will include more modern and advanced approaches, including patient-centered care and EBM.
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Nurse’s Role as a Leader
The nurse’s role as a leader has been discussed in the nursing literature and corresponding journal articles for several years. Although nurses used to be seen as substitutes of physicians, they are capable of becoming leaders and providing innovative changes to the medical system. As leaders, nurses need to draw attention to their practice; nursing practice needs to regard every aspect of nursing training and education so that nurses are not assigned to perform only a specific set of tasks that do not fully cover their potential.
Another demand that nurses can express is to become full partners with other health care professionals in deciding what changes the healthcare system of the USA needs. Nurses need to take part in the development and implementation of specific improvements, participate in decision-making, and serve on advisory boards (The IOM, 2010c).
Being a leader also means that one is responsible for their actions and understands why self-reflection is important. To transform nursing leadership, nurses need to know what leadership styles exist, how they can be implemented, and what impacts they might have on patient care (Wong, Cummings, & Ducharme, 2013). Leadership competencies can have a positive influence on the work environment, relationships among medical staff, and patients’ satisfaction. If future nurses are to become leaders, they need to be acquainted with leadership styles and strategies while they are still studying nursing at educational facilities. Therefore, universities and colleges need to add materials on “leadership-related competencies” to their curricula (The IOM, 2010c, p. 4). Not everyone is born a leader, but they can be taught how to become one. Mentoring programs are also an option that needs to be considered by nurses at all levels.
The IOM. (2010a). The future of nursing. Focus on education. Web.
The IOM. (2010b). The future of nursing. Focus on scope of practice. Web.
The IOM. (2010c). The future of nursing. Leading change, advancing health. Web.
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709-724.