Nursing in US: Challenges in Leadership, Practice, and Training - Essay Sample

Introduction

The nursing profession in the United States is currently one of the largest segment of the health workforce across the world. Fundamentally, it comprises of more than three million subscribers (Nardi & Gyurko, 2013). Despite the presence of a large number of the members, it is undeniable that the US nursing profession experiences numerous challenges that include ineffective leadership, improper interpersonal collaboration, insufficient nursing practice, and training. Additionally, the rapid increase in diversity has prevented the nurses to respond effectively to the rapid changes within the healthcare setup. Along with these challenges, the health professional has continued to play crucial roles in assisting in the implementation and achievement of the healthcare goals as outlined in the "2010 Affordable Care Act" (Nardi & Gyurko, 2013). Although a critical milestone has been established, studies have shown that there are still needs to eliminate some of these barriers so that the nurses experience to enhance better positioning to encourage the change of the initiative. With the proper structural framework, nurses can also enhance the advancement in healthcare (Nardi & Gyurko, 2013).

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Work of Robert Wood Johnson Foundation and IOM Research

The Robert Wood Johnson Foundation (RWJF) and IOM report constituted a two-year plan developed as a response to the challenges that nurses were experiencing in the United States (Fineberg & Lavizzo-Mourey, 2013). Ideally, the report majorly focused on the evaluation and transformation of the nursing profession, in addition to the development of the action-oriented teams that could work to improve the situation of nursing in the future. As part of the deliberations, both the RWJF and IOM committee created four major fundamental issues that were treated as the recommendations. Notably, the IOM established a committee on the RWJF initiative aimed at developing a report that would be critical in making the recommendations for the action-oriented blueprint for the future of nursing.

Primarily, the report identified the necessity to practice their profession by their level of education as well as the training (Fineberg & Lavizzo-Mourey, 2013). Because licensure and practicing terms differ from one state to another, the report suggested that the decision regarding the practice scope should be developed in a manner that they exert varying outcomes on the nurses' performance. Regarding the scope and freedom of the nurse practice, the RWJF and IOM report offered the indication that the regulations created by the state have tremendous impacts on the activities of the nurses (Fineberg & Lavizzo-Mourey, 2013). For instance, it state regulations that permit the nurses to attend to patients and provide medical prescriptions without the necessity of the doctor's supervision helped to enhance the efficiency and practicing of the nurses. This indicates that the responsibilities and roles of nurses do not depend on their level of education or training but by the state in which the nurses practice.

Secondly, the report suggested the need for nurses to attain a higher level of education and training. The committees demonstrated that the academic progression constituted to one of how both the state and federal governments could ensure that the nurses deliver high quality, safe, and patient-centered healthcare services (Fineberg & Lavizzo-Mourey, 2013). It is undeniable to mention that the patient both in the United States and other nations across the world have become a complicated one. As such, high quality healthcare among the nurses, which is only possible through the attainment of the required level if education has become critical. It implies that the nurses must be competent in whatever they are doing (Fineberg & Lavizzo-Mourey, 2013). The competency traits must include leadership, health policy, system improvement, collaboration, research, integrity, and teamwork (Fineberg & Lavizzo-Mourey, 2013). Additionally, the achievement of the higher level of education as per the recommendations from the report is critical for practicing nurses to fill their professional passions.

The Intent of the Future of Nursing Campaign for Action

As observed in the report, several aspects related to the future of change in the nursing profession. One of these is through how the nurse's practice. The recommendation by the RWJF and IOM committee suggested the removal of the scope of practice barriers or challenges (Fineberg & Lavizzo-Mourey, 2013). Ideally, this process would need the expansion of the Medicare program to integrate the coverage of advanced registered nurses. Additionally, they would also require to perform the authorization of the advanced practice of the registered nurses to conduct the assessment for the admission into home health or the long-term care facilities.

The Rationale of State-Based Action Coalitions

On the state level, the report suggested that they would be required to embrace reforms scope of practice regulations aimed at conforming to the National Council of State Boards of Nursing Model Nursing Practice Act. It would also comply with the Model Nursing Administrative rules. As such, the states would be required to revise how advanced practice nurses are reimbursement (Fineberg & Lavizzo-Mourey, 2013). This would make it easy for them to get paid for the services, provided that they are within the scope of practice in their state. In reality, this IOM and RWJF recommendation provides a room for the expansion of the Personnel Management that would need the insurers to include coverage of services provided by a Nurse Practitioner (Fineberg & Lavizzo-Mourey, 2013). The move would, therefore, allow the patients to avoid long waits to see the doctor based on the fact that they have also become short-handed.

State-Based Action Coalition and Two Initiatives

The nursing education constituted another critical aspect of the IOM report. Ideally, several other recommendations emerged regarding this area. It suggested the establishment of nurse residency programs to improve the efficiency of nurses' delivery and performance. Acquiring all the entities such as the state boards of nursing, the Secretary of Health, Human Services, Health care organizations involved in the development and funding continuing education for nurses would be critical in ensuring that this goal is achieved (Dossey & Keegan, 2013). Noteworthy is the fact that the education recommendations continues with the increasing number of nurses with BSN degrees. This figure is expected to increase to 80 percent by the year 2020 (Nardi & Gyurko, 2013).

The development of the education program will create a good foundation to help make the nurse leaders in the same standard that employers need. The expansion of opportunities for nurses would be aimed at promoting and diffusing the collaborative improvement efforts was as suggested. As part of the IOM and the RWJF, this recommendation would permit the nurse to collaborate more with the doctors in leadership to perform research tailored towards improving healthcare delivery (Fineberg & Lavizzo-Mourey, 2013). It would further assist in the redesign of the healthcare system. Academic nurse leaders must, therefore, partner with the health care organizations leaders from the primary and secondary school systems as well as other agencies to recruit and advance diverse nursing students (Altman, Butler, & Shern, 2016).

References

Altman, S. H., Butler, A. S., & Shern, L. (Eds.). (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. National Academies Press. http://www.academicprogression.org/resources/docs/Assessing-Progress-on-the-IOM-Futue-of-Nursing-Report.pdf

Dossey, B. M., & Keegan, L. (2013). Holistic nursing: A handbook for practice. Jones & Bartlett Publishers.

Fineberg, H., & Lavizzo-Mourey, R. (2013). The future of nursing: A look back at the landmark IOM report.

Nardi, D. A., & Gyurko, C. C. (2013). The global nursing faculty shortage: Status and solutions for change. Journal of Nursing Scholarship, 45(3), 317-326. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jnu.12030