The Institute of Medicine’s 2010 report “The Future of Nursing: Leading Change, Advancing Health” is an attempt to resolve a multitude of problems that have arisen in nursing practice. It discusses the range of essential functions performed by nurses in health care settings, as well as challenges that arise in this area. These include the educational deficit, “restrictions on the scope of practice, policy- and reimbursement-related limitations, and professional tensions” (Institute of Medicine, 2011, p. 4). The purpose of this paper is to discuss the key messages of the IOM report and its influence on nursing practices, including education, leadership, and professional development.
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Key Messages of the Report
The first three messages relate specifically to nursing activities, education, entry into practice, and the characteristics of the functions that a nurse should perform. The report claims that the scope of a nurse’s practice should not be dependent on different states’ regulations, but rather on objective demands and skills acquired through education and training. It is also pointed out that due to the high personnel turnover, special attention should be paid to the transition of future employees from the educational environment to the professional.
According to the report, the evolution and complexity of the modern health care system, as well as the emergence of new competencies needed, require a review and improvement of the nursing education system. The necessity for full partnership between nurses and other health professionals and the participation of nurses in the policy-development process was emphasized.
The fourth message encourages the improvement of infrastructure for the collection and analysis of data on the quantity, demographics, and other characteristics of nurses in the workforce, which are essential for creating effective policies. The above messages fully cover the problem field related to nursing practice. Besides, their significance derives from the fact that they are accompanied by specific problem-solving recommendations concerning all of the designated areas.
Nursing Education and Nursing Leadership
The issue of access to education and the transition of nurses to the profession is particularly acute. According to Young, Bakewell-Sachs, & Sarna (2017), the “rising costs of college and escalating student debt, coupled with declines in state support for universities, pose new challenges for schools of nursing” (p. 267). In this regard, the IOM report suggests implementing nurse residency programs (Institute of Medicine, 2011). These programs will provide future nurses with confidence that they will be supported in their initial professional experience after expensive and time-consuming education.
Also, the report suggests increasing the number of nurses with bachelor and doctoral degrees. This measure will assist nurses in applying advanced and scientifically grounded knowledge and skills in a changing environment. Researchers note that “the changes in healthcare and population health shift the competencies required to practice, teach, and conduct research effectively” (Young et al., 2017, p. 267). The fact is that the provision of medical care to the aging and increasingly diverse population requires a lot of extended competencies mentioned above. BSN-prepared nurses will have the ability to use modern medical technologies, apply a broader range of skills to serve patients, and have the necessary background to provide leadership.
The report suggests that nurses should be increasingly involved in health care management on a partnership basis and assume leadership positions. According to Grossman and Valiga (2016), “professional nurses at all levels need to have a sense of stewardship their practice arenas – whether in the clinical area, education, administration, or research” (p. 27). In addition to a sense of responsibility, nurses also need to have leadership authority and the ability to influence workflow regulation. This will provide them with a more comfortable working environment, more independent planning, and better-paid jobs. Moreover, it will improve the quality of their professional performance and encourage a more receptive response to the condition of patients.
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Professional Development in Nursing Practice
The report is very much focused on professional nursing practice and its specifics. Maloney (2016) states that the “standards of professional practice are divided into two categories, standards of practice and standards of professional performance” (p. 327). Standards of practice define what exactly is included in nursing activities, and standards of professional performance describe how the standards of practice should be applied and implemented in the course of the nursing process (Maloney, 2016).
In order to better comply with these standards, the IOM report proposes to remove scope-of-practice barriers and to ensure that nurses engage in lifelong learning (Institute of Medicine, 2011). This provides nurses with a wider range of practices that they can use when caring for diverse populations. Lifelong learning provides nurses with the necessary knowledge and skills to care for both patients who cannot be cured across the life span and those who need assistance on the health-illness continuum.
In many respects, nurses are the link between other health professionals and patients and their families. Researchers note that the “public puts a great deal of trust in nurses, and the credibility of nurses is strong in the eyes of patients, families, legislators, and the general public” (Grossman & Valiga, 2016, p. 25). Thus, nursing competencies should include traditional empathy and support, as well as in-depth medical knowledge.
Nurses have always been seen as assistants, and now they are becoming increasingly involved in partnership and leadership. The report suggests expanding the scope of competence and authority of nurses, reviewing the education and training system, as well as engaging them in policymaking. These recommendations change the status of a nurse significantly, providing more flexibility and efficiency in caring for patients and the possibility to assume leadership positions and to get a better-paid and more challenging job.
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. Philadelphia, PA: F. A. Davis.
Institute of Medicine (US). (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.
Maloney, P. (2016). Nursing professional development: Standards of professional practice. Journal for nurses in professional development, 32 (6), 327-330.
Young, H. M., Bakewell-Sachs, S., & Sarna, L. (2017). Nursing practice, research and education in the west: The best is yet to come. Nursing research, 66 (3), 262-270.