Nursing Leaders, We Need You Now

Nursing Leaders, We Need You Now

Editorial Nursing Leaders, We Need You Now W hile debates about the wisdom and politics of healthcare reform legislation are not over, the status q...

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Nursing Leaders, We Need You Now


hile debates about the wisdom and politics of healthcare reform legislation are not over, the status quo for nurses seems forever changed as a result of the new legislation. Nursing optimists hoped that reform would herald a new era in

which the contributions nurses make to healthcare would be recognized, sought, and utilized. By now, all of nursing is surely aware of the Institute of Medicine (IOM) report (The Future of

Nursing: Leading Change, Advancing Health, that finally addresses the heightened role that nurses might play in meeting the increased demand for healthcare. The report, calling for increased utilization and expansion of the role of nurses in primary care, is the end product of a study convened under the direction of the Robert Wood Johnson (RWJ) Foundation Initiative on the future of nursing and completed at the IOM. The report is based on the committee’s review of the scientific literature on the nursing profession and data obtained through a series of public forums to gather insights and evidence from other experts. The report in many ways mirrors what nursing leaders have said for some time—that nurses have many contributions to make that have been both ignored and unappreciated. Broader utilization of nurses, in particular advanced practice nurses, through removal of legislative and regulatory barriers would allow them to practice to the full potential of both their educational

Marilyn W. Edmunds PhD, NP

preparation and expertise. That an interdisciplinary group composed of 18 nurses, physicians, social workers, dentists, educators, clinicians, lawyers, policy analysts, NGO leaders, and healthcare industry representatives have come together, working within the IOM with RWJ Study Director Susan Hassmiller (also a nurse), is noteworthy and likely means that society will finally capitalize on nursing’s potential to do more and move to facilitate change. Obviously, nursing should be pleased by many of the report’s conclusions and recommendations. More than 3 million nurses are involved in providing patient care, and the report recognizes that nurses have “valuable insights and unique abilities to contribute as partners with other healthcare professionals in improving the quality and safety of care” envisioned by the Affordable Care Act (ACA). The report also emphasizes, “States, federal agencies, and healthcare organizations should remove scope of practice barriers that hinder nurses from practicing to the full extent of their education and training… Scope of practice barriers are particularly problematic for advanced practice registered nurses (APRNs). With millions more patients expected to have access to health coverage through the ACA, the healthcare system needs to tap the capabilities of APRNs to meet the increased demand for primary care.” Developing leadership skills will also be a higher priority as nurses assume more responsibility in this increasingly complex healthcare delivery system. This time represents an opportunity for which many nurse practitioners (NPs) have positioned themselves for years. Nurses, particularly NPs, must now step forward as leaders in redesigning the nursing role in the US. We don’t want to be in a position of having other professionals tell us what we can do and how we should do it. The report already suggests that the nursing profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor’s degree, and double the number who pursue doctorates. Nursing is a mature profession, and we have wise and knowledgeable members who must represent nursing in guiding these changes for the future. If nurses do not step forward and be involved, we run the risk of being in a position of being told by other professionals what we will and will not do. We don’t want to go in that direction again.

1555-4155/$ see front matter © 2010 American College of Nurse Practitioners doi:10.1016/j.nurpra.2010.09.004


The Journal for Nurse Practitioners - JNP

Marilyn W. Edmunds Editor in Chief Volume 6, Issue 10, November/December 2010