Javier:

Week 8 Discussion

Since the Institute of Medicine (now the National Academy of Medicine) issued "The Future of Nursing: Leading Change, Advancing Health" in 2010, the nursing profession has come a long way in implementing its recommendations. There have been many achievements, but four will be examined. First, advanced practice registered nurses (APRNs) have greatly extended practice authority in nursing (Rehka, 2020). After the report was published, many states reformed their scope-of-practice regulations to enable APRNs to practice to the full extent of their education and training. Similarly, by 2023, over half of U.S. states will allow nurse practitioners with full practice authority (eliminating physician supervision). In rural and underserved areas, where they now provide primary care, APRNs’ role in addressing these healthcare access gaps has been particularly influential in this regulatory evolution.

Second, substantial progress has been made in the proportion of nurses with baccalaureate and higher degrees. The Campaign for Nursing's Future, set in response to the IOM report, has an ambitious goal of 80 percent of nurses holding a BSN by 2020, as per Reynolds (2024). Although this goal was not 100% realized, the percentage of nurses with a BSN has substantially increased from just over 50% in 2010 to greater than 65% in many states. The advancement of education has been fostered by the development of unique academic progression pathways, including many RN to BSN programs and partnerships with community colleges and universities, allowing for seamless education transitions.

Third, nursing's role in healthcare redesign and policy development has grown remarkably. Nurses now occupy more executive positions in healthcare organizations, serve on hospital boards, and participate in health system governance. Started in 2014, the Nurses on Boards Coalition has helped place thousands of nurses on corporate and non-profit boards. Furthermore, nursing has amplified its voice in policy-making by facilitating boards such as the American Academy of Nursing and increased recognition in federal advisory councils (Hassmiller et al., 2020). They have also been influential in nurses' quality improvement initiatives and have aided in decreasing hospital-acquired conditions and readmission rates by implementing evidence-based practice.

Fourth, data collection and analysis on the nursing workforce have been substantially improved. In partnership with The National Forum of State Nursing Workforce Centers, the National Council of State Boards of Nursing conducts regular, comprehensive surveys of the nursing workforce to provide critical data on supply, demand, and demographic trends. Many states have set up nursing workforce centers that gather standardized data and thus provide a more accurate prediction of future needs. At the same time, these improved data systems have enabled targeted interventions to address nursing shortages in critical specialties and geographic areas, and they have assisted in fostering diversity to create a nursing workforce that more closely reflects the population it serves.

While presenting IOM achievements, DNP Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking has stood out. Aligning with nurses’ newfound assignments in healthcare remodeling, policy engagement, and management. Nurses are now taking up executive positions and being involved in health system governance, further strengthening quality improvement and healthcare's strategic transformation delivery (DeNisco, 2023). DNP Essential VIII: Advanced Nursing Practice was also incorporated. This essential demands a push towards higher education levels as well as seamless academic pathways like RN to BSN programs to provide for advanced clinical competency. These skills are applied by DNP-prepared nurses during complex clinical situations and they also help to mentor future nursing professionals (DeNisco, 2023). Expanded leadership roles, implementation of evidence-based practice, advanced education, and more involvement in policy development have strengthened role-specific professionalism competency and reinforced nursing's influence and accountability in healthcare.

References

DeNisco, S. M. (2023). Advanced practice nursing: Essential knowledge for the profession. Jones & Bartlett Learning.

Hassmiller, S. B., Beauvais, A. M., & Shellenbarger, T. (2020). The Future of Nursing Report 10 years later: Where is nursing and what work remains? Nursing Education Perspectives, 41(5), 272-273.

Rekha, S. G. (2020). The future of nursing: leading change, advancing health (2020). IP J Paediatrics Nurs Sci, 3(3), 60-3.

Reynolds, L. R. (2024). Factors Impacting BSN Degrees in Community Colleges in Illinois and Exploring Community Colleges to Address Nursing Education Reform: A Mixed Methods Study (Doctoral dissertation, DePaul University).