Back to the Future of Nursing

Back to the Future of Nursing: A Look Ahead Based on a Landmark IOM Report, part of the Rosenthal Lecture Series, was held today at the National Academy of Sciences in Washington, DC. The panel discussion focused on progress made in the past three years since the release of IOM report The Future of Nursing: Leading Change, Advancing Health (FON). The webcast recording of the event will be posted soon. Check out their infographic poster which is quite nicely done.

Some of the highlights that I picked up on during this panel discussion included efforts to increase diversity in nursing as well as career mobility, and national efforts to increase scope-of-practice for nurse practitioners. Currently there are 17 states that allow nurse practitioners to be fully independent and two additional states that allow nurse practitioners to be ‘almost’ fully independent (Maryland and Utah). In the past three years seven states have removed major barriers to practice, and Nevada recently gave nurse practitioners full practice authority. Opposition by state medical organizations blocked passage of similar bills in Connecticut, Kentucky, New York, and most recently in California. But the momentum is growing in favor of independent practice for nurse practitioners across the country. The Federal Trade Commission is challenging limits to nursing scope-of-practice in many of the recalcitrant states (including, I hope, my home state of Virginia).

At the end of today’s lecture there was an excellent televised address by Rissa Lavizzo-Mourey, MD, who is the director of the Robert Wood Johnson Foundation (sponsor the FON report and follow-up efforts). Among other things she spoke of the need to change the “caste system in hospitals” that treats nurses as second-class citizens. That seems to be a daunting task.

I have read the entire IOM FON report several times and think it is an excellent document. (Previous blog post Undoing Nurses as Functional Doers Nov 24, 2010). Of course, being a primary care nurse practitioner myself with previous run-ins with state health regulatory boards over scope-of-practice issues (see To Forgive, Divine blog post), I have been cheering the efforts in this area spurred on by the IOM Future of Nursing report. And being a nurse educator who loves teaching (and who abhors most approaches to nursing education–another nursing care plan anyone?), I applaud the IOM/FON report section on changes needed within nursing education.

So what has changed for me in the past three years since the IOM FON report? Many faculty members invoke the FON report from time-to-time when making various points about needed changes in the curriculum. Not many of our current students have even heard of the report (shame! I need to assign parts of it as required reading). I’ve seen a large uptick in the support for interprofessional educational experiences for students and faculty. And I’ve seen an increased emphasis on adding leadership content as well as political advocacy skill-building activities for students within our various programs (although there’s still a shameful paucity of resources and nursing role models in these areas). The other thing that bugs me in the area of politics and policy education for nurses is the emphasis on self-advocacy for nursing practice. While that’s important, nurses can and should be using their advocacy skills and energies for less self-serving health policy changes.