The Impact of the Institute of Medicine Report
The impact of The Institute of Medicine Report (IOM) 2010 has a major influence on nursing education. The first issue addressed in the report is an increased emphasis on public and community nursing. In the past, only nurses holding a bachelors degree were experienced and trained in community and public health, and the IOM wants to change that.
One particular area of change is that now associate degree nurses are being trained in these areas in order be able to transition into these fields more smoothly and directly from nursing school. Another area that is addressed in this report is to increase the number of BSN degree nurses to 80% of all nurses by the year 2020. There are many reasons that this would benefit nurses and patients alike. Overall, nurses with higher degrees have a stronger foundation in their knowledge.
Also, studies have also shown that they adapt to changes in the ever changing healthcare system, much better. A number of hospitals, especially teaching hospitals, prefer BSN to ADN. Teaching hospitals have a goal of at least 90% of their nursing staff to be bachelor degree nurses. Thus, more education will only help a nurse to obtain and retain employment and give him/her the tools needed to more capably care for their patients. The American Association of Nurses stated, “The need to increase the number of BSN prepared nurses will deliver safer and more effective care”.
As the baby-boomers get older and sicker, the care that nurses offer is becoming more complex, thus requiring nurses to have excellent critical thinking skills, in hospitals and clinics alike. However, in order for more nurses to become bachelorette licensed, a number of things must take place. First, nurses need to step up to the plate and take the initiative to go back to school and continue their education.
Secondly, employers need to make continuing education 2 ore appealing to theiremployees, possibly by offering higher tuition reimbursement, incentives for obtaining a BSN, and onsite classes. Therefore, in my opinion, nurses that have a higher education, will also have a broader range of skills, such as; more comprehensive critical thinking skills, leadership skills, management experience, and research tools. Ultimately, it is up to each and every nurse, to make the choice to apply themselves, and go after a higher education. The next area of great concern is the nurse’s role as a leader.
Improved and concise leadership will be a necessity, in order to fulfill the growing number and needs of patients, and the ever changing healthcare system. According to the IOM report, “Strong leadership is required, to realize the vision of a transformed health care system”. This can be achieved by a close evaluation of the system as a whole, and looking at nursing specifically. Also, ongoing reform of the healthcare and nursing system will need to be a priority. Advocacy from nurses and organizations alike is a key factor in making this work.
Lastly, implementing the above area is critical to making the entire program work as a whole. Another area that holds priority in nurses as leaders is research. Research is a very important part of leadership, in relation to research that is applied to practice and policies. This can be done with reform and experience, and needs to be developed and shaped by nurses with years of experience, and by nurses that belong to committees and advocacy groups that have strong beliefs in changing nursing and the healthcare system for the better.
One other area that needs to be addressed in order for nurses to become strong leaders is competencies. First, the entire multi-disciplinary team of nurses, 3 doctors, pharmacy, physical therapy, etc. , need to work together as a true team and collaborate for the patients’ best interest, best outcome, and overall health. This can be achieved, according to the American association of colleges of nursing, by having a generalized set, as well as a distinct set, of competencies.
Having generalized competencies will be helpful in creating a strong foundation for all nurses to have the same basic skills. The distinct set of competencies will be more geared towards specific areas of nursing in order for nurses to be experts in their specific field of nursing. In conclusion, leadership in nursing can be achieved by evaluating the nursing practice as a whole and by making changes when necessary. Also, nurses continuing to be on the frontline of research is key to maintaining leadership.
Lastly, by making sure that nurses collaborate well within the multidisciplinary team, in order to provide the best patient care possible. The last area that needs to be addressed is the portion of the IOM report that discusses the impact of nursing practice, particularly primary care. The American Association of Colleges of Nurses defines standards of practice as an outline to better guide nurses skills, judgment, knowledge, and attitudes, in order for nurses to practice cautiously and safely. (AACN 2010).
Therefore we as nurses need to maintain the high level of practice that we took an oath to, upon graduating nursing school. One of the first areas that nurses can be invaluable in the community and in primary care is to be an advocate for education related to diseases and the disease process. By educating our patients upon discharge, at a level that they fully understand, will help the patient to be healthier, feel better, live longer, and prevent hospital re-admission.
By educating our patients about chronic diseases such as congestive heart failure and diabetes, our patients will benefit overall and the hospital will also be able to decrease the number of re-admissions. I believe that each and every patient that becomes admitted to a hospital, nursing home, rehab, or any other facility, deserves individualized care, that is specific to them and them alone, not the “cookie-cutter” approach so many of us nurses have become accustomed to in the years we have worked in these settings. I will work to change and improve my nursing practice to meet the IOM’s requirements by refining my patient education.
I plan to accomplish this by meeting with my manager to implement a new and improved discharge education plan that will be specific to each patients needs and at a level that my patients can comprehend. In conclusion, I believe that The Institute of Medicine Report (IOM) 2010 is a well written and well thought out, report that needs to be achieved in order for our patients to receive the best possible nursing care available to them, and for nurses to be able to practice to their full potential.
The biggest barrier in the above mentioned areas of change; education, leadership, and nursing practice, is government regulation. Education requirements vary from state to state and even from one nursing school to another. This needs to be rectified, and a general set of standards needs to be put into place for all states, in order for nurses graduating from nursing schools and going out into the workforce, to achieve these goals smoothly.
Also, a general set of competencies needs to be agreed upon so that ADN nurses can seamlessly transition to a BSN degree. As for leadership, the same challenge faces each state as to what the definition of a nursing leader is. A clear and concise plan needs to be in place to promote nurses into leadership positions. Lastly, the federal trade commission, the board of nursing, congress, the AACN, and other advocates and committees, need to determine national standards for nursing education, nursing leadership and nursing scope of practice, and clear up the state by state regulatory differences.