Reflection on the IOM Future of Nursing Recommendations
Reflection on the IOM Future of Nursing Recommendations
The IOM report gives a sound analysis of the current nursing workforce on which is based several recommendations meant to allow nurses to take on central roles in redesigning the country’s healthcare system in order to meet the changing needs of the population (IOM, 2010). Three of the recommendations are concerned with enhancing nursing education so that nurses are equipped with the knowledge and skills to provide quality healthcare in a variety of settings and assume leadership in constantly improving care. Among individual nurses, acceptance of and support for the transformation comes from assurance that they can successfully adapt to the changes brought on by each recommendation. Personal reflection facilitates this process.
One recommendation highlights the need to increase the number of nurses with a BSN degree and is based on the fact that there are currently multiple pathways to the nursing profession including LPN, ADN and BSN. The preference for the BSN pathway is supported by research that BSN RNs are able to provide higher quality care (Hendricks et al., 2012). Insert study. This is not surprising given the theoretical component of the BSN curriculum which lays the foundation for competencies in interdisciplinary collaboration, leadership and management, organizational change, nursing research and EBP, all of which are required of nurses today (IOM, 2010). The integration of conceptual and practical knowledge helps the nurse achieve exemplary practice, resolve problems, become a visionary, advocate for policy changes and use nursing knowledge as well as help generate it. In pursuing a BSN, I am contributing significantly to the attainment of this recommendation. I also feel I will be better prepared to fulfill what would be expected of nurses now and in the future.
On the Recommendation to Seek Postgraduate Education
Another IOM recommendation is to increase the number of registered nurses with doctorate degrees. A bottleneck in resolving the nursing shortage is the lack of nursing faculty, which is worsening as more of them retire, and thousands of applicants to programs have been turned away in recent years (Scherzer, Stotts & Fontaine, 2010). A master’s degree followed by a doctorate prepares RNs for the academe to take on teaching, research and curriculum development roles. I cannot see myself fitting into this recommendation because I am more interested in a career in the clinical setting. Thus, my personal goal for postgraduate education within five years from graduation would be to take up an MSN which I feel is what will be needed in the future for me to effectively assume leadership and management roles and improve the care I provide.
On Lifelong Learning
The third recommendation aims to promote lifelong learning among nurses. New knowledge is generated everyday creating the need to integrate new concepts into practice and refine practice guidelines on a continual basis. At the same time, there is increased utilization of different technologies in healthcare including the electronic health record system and equipment used to diagnose, monitor and provide treatment to patients. More importantly, the health care needs of the population change as an effect of changing health status, demographic characteristics, lifestyle and economic status. For example, the aging of the population, the prevalence of unhealthy lifestyles and the increasing number of the uninsured give rise to challenges in public health as well as acute and long-term care.
These realities point to the need to be continuously learning in order to provide the best care possible across the lifespan in the RN’s chosen setting (Davis, Taylor & Reyes, 2013). Choosing to work in an organization that encourages this kind of education would be the best strategy. Being part of a culture of lifelong learning, it is easier to seek the resources and support needed for education and there would also be greater professional motivation.
On Level of Education and Job Competitiveness
Health care reform has spurred higher standards in the education of the nursing workforce through pressure from accreditation agencies and CMS among others. State legislators are also looking into how the BSN degree can be mandated. As an ADN graduate, I deferred going back to school because of family concerns but realized that the opportunities for my level of education are narrowing. To have a sense of job security I have no choice but to obtain a BSN now. As hospitals strive to meet regulations and standards, and as the link between quality care and an RN’s education is increasingly being recognized, hospitals now prefer to hire new RNs with a BSN and also require their staff nurses to earn their degrees (Duncan, 2012). For example, hospitals seeking Magnet status need to have 80% of their direct care staff to be BSN nurses by 2020 (The impact of education, 2012).
Increasing my education to postgraduate level will further broaden my options. This is because another Magnet criterion is for nurse managers to have a master’s degree. Hence, getting an MSN will help me secure leadership and managerial positions as well as practice with competence in these roles. Although experience is helpful in leading and managing, experiential knowledge and skills are further enriched when infused with theoretical knowledge. Having the ability to approach a broader range of responsibilities in a more scientific manner gives the MSN nurse an edge over others. Further, there are old and new roles that require a master’s degree including advanced practice nurse, clinical nurse leader, clinical nurse specialist, nurse anesthetist and certified nurse midwife (MSN careers, n.d.).
On Level of Education and My Role in the Future of Nursing
Seeking a BSN and later on an MSN will positively impact my role in the future of nursing. Developing the required competencies will allow me to meaningfully participate in planning and implementing change, promoting EBP and research, advocating and lobbying, socializing the next generation of nurses into the nursing role and improving patient safety and quality of care. For example, staffing and its impact on the quality of care is a prominent issue. Many states have enacted policies that will ensure optimum staffing levels primarily because of lobbying by nurse organizations and individuals. Another example is the need for tighter fiscal management because of cuts in reimbursement. Nurses are faced with the need to reorganize care to provide the highest quality of care at the lowest cost (Gapenski, 2007). Empowerment from learning and education gives me the confidence to be more actively involved in helping transform the workforce, the workplace and the profession.
Conclusion
Nursing education is a key component in improving healthcare and there is value in the IOM recommendations calling for higher levels of education in the workforce. This can pose challenges to work-life balance and financial resources. However, change is a constant phenomenon and individual openness to change in the workplace as well as in the areas of the personal and professional enable effective adaptation. Achieving higher levels of education leads to more job opportunities, promotes job security and allows nurses to help reform healthcare in more effective ways.
References
Davis, L., Taylor, H., & Reyes, H. (2013). Lifelong learning in nursing: A Delphi study. Nurse Education Today, in press, corrected proof.
Duncan, K. (2012). Our journey on the path to Magnet status. Journal of Radiology Nursing, 31(2), 70-75.
Gapenski, L.C. (2007). Understanding healthcare financial management, 5th ed. Chicago, IL: Health Administration Press.
Hendricks, S.M., Phillips, J.M., Narwold, L., Laux, M., Rouse, S., & Dulembia, L. (2012). Creating tomorrow’s leaders and innovators through an RN-to-Bachelor of Science in Nursing consortium curricular model. Journal of Professional Nursing, 28(1), 163-169.
MSN careers – A lifetime of opportunity (n.d.). Retrieved from http://onlinemsn.usfca.edu/news-resources/msn-resources/msn-careers-a-lifetime-of-opportunity/
Scherzer, T., Stotts, N.A., & Fontaine, D. (2010). Meeting the nursing faculty shortage challenge: An accelerated doctoral program in nursing. Journal of Professional Nursing, 26(6), 366-370.
