Nursing News

Transforming the Future of Nursing: Turning Plans into Action

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By Debra Wood, RN, contributor 

The Future of Nursing: Leading Change, Advancing Health from the Institute of Medicine created a buzz in the nursing community at its release a year ago. Since then, the Robert Wood Johnson Foundation and AARP have established and guided the Future of Nursing Campaign for Action to implement recommendations in the report.

“Addressing nursing issues is key to our mission at the foundation to improve health care for all Americans,” said Susan Hassmiller, Ph.D., RN, FAAN, the Robert Wood Johnson Foundation senior adviser for nursing. “This campaign is about transforming and improving our health care delivery system by using nurses more effectively.”

Nursing Campaign for Action
Susan Hassmiller, Ph.D., RN, FAAN, reports that the Future of Nursing Campaign for Action is in full swing, raising people’s awareness about nursing and how the issues will affect them, their families and their businesses.

The report indicates nurses’ roles, responsibilities and education should change significantly to meet the increased demand for care that will be created by health reform and to advance improvements in America’s increasingly complex health system. But to make that happen, changes are needed in laws that currently restrict nurses from performing to the full extent of their abilities and in reimbursement methodologies.

“All nurses must practice to the scope of their education and training,” Hassmiller said.

David L. Knowlton, president of the New Jersey Health Care Quality Institute and co-lead for the campaign’s New Jersey Regional Action Coalition, added, “The intention is to expand nurses’ horizons.”

A high-level advisory committee provides advice on message and strategy, which guides the campaign’s five components: (1) stakeholder outreach; (2) policymaker outreach; (3) communications; (4) field strategies; and (5) research, monitoring and evaluation.

In addition, AARP is working with nursing groups and has formed a non-nursing coalition, with business groups, educators and faith-based organizations, to help implement the report’s recommendations.

“We’re trying to energize and bring people into the campaign and align the incentives with what nurses have been trying to accomplish for decades,” said Julia Alexis, vice president of strategic initiatives at AARP’s Public Policy Institute in Washington, D.C. “It’s all about delivering quality health care, and nurses are the ones that do it.”

The campaign currently is focused on stakeholder outreach, raising awareness among nursing and non-nursing groups about the issues and suggestions presented by the Institute of Medicine.

“The recommendations are tough to implement and, therefore, we need all of these other groups--government, business, public health, other health care providers, presidents of universities, accrediting bodies--to make this happen,” Hassmiller said. “We’re presenting it as a societal issue.”

Research results are used in creating strategies and targeting what to work on in which region. A communication team helps shape messages for the various stakeholders as campaign committees educate people about how nursing applies to them, how implementing these changes will lead to better care for them and their families.

Hassmiller equates the strategy to the approach Florence Nightingale took as the nursing pioneer sought to improve health care.

“She knew if she was going to make policy and health care delivery improvement changes, she needed to call on important people--royalty, the government, high-level officials in the military, business people.” Hassmiller said. “She used her network to get things done.”

The current campaign will help educate policymakers about what a better-educated nursing workforce will mean to them and their states. Members also are monitoring what other groups are working on, including nursing organizations.

Regional action coalitions (RACs), led by a nurse and non-nurse leader, provide the field strategy at the state level.

“That’s the heart of this campaign and the most exciting part,” Hassmiller said.

AARP has developed a technical assistance center for the RACs to help with content formation and strategic planning.

“States are taking a look at data, what their priorities are, what their resources are and putting together a plan of action on how they will move forward,” Hassmiller said.

The New Jersey RAC created a task force, with members from unions, the chamber of commerce and other walks of life, to address each of the report’s four pillars: practice, education, leadership and workforce. Knowlton has found people receptive to the message and actively involved in the work groups.

Michigan already had organizations working on issues associated with the IOM’s recommendations, so it is beginning to educate nurses and non-nurses about the report.

“The RAC is looking at the work being done and focusing our effort on the communication piece,” said Carole Stacy, RN, MA, MSN, director of the Michigan Center for Nursing and co-lead of her state’s RAC. “People are not aware of the role of nurse practitioners or doctors of nursing practice or what an RN does or an LPN, so we are putting something together to bring concerns of the stakeholders forward.”

The Michigan RAC plans to have its campaign materials ready for nurses by May and for consumers, business leaders and other people by this fall.

Ten states joined the national network in February 2011. They include Washington, Idaho, Utah, Colorado, New Mexico, Illinois, Indiana, Louisiana, Virginia and Florida. Florida is one of the states just starting up. Leads from the Florida Center for Nursing and Blue Cross and Blue Shield of Florida Foundation are pulling together a steering committee and benchmarking efforts currently under way, such as work to streamline RNs’ earning a bachelor’s degree, said Michael S. Hutton, Ph.D., project leader for the foundation.

“We’re also looking at some easy projects to start to move the needle for all of the recommendations,” Hutton said.

Florida plans to position nursing as an economic issue, based on the fact businesses want to locate and grow in regions with quality health care.

“Nurses are at the center of any health care delivery, and there has been a looming workforce shortage,” Hutton said. “That will upset health care delivery. We recognize that issue at the foundation, and we need to make sure other people know this could impact the quality of health care in our state.”

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