New Study to Explore Issues, Vision for Next Decade of Nursing

A National Academies of Sciences, Engineering, and Medicine ad hoc committee met in a public session Wednesday to discuss the formal beginning of a new study, the Future of Nursing 2020 – 2030.

The committee was asked by the Robert Wood Johnson Foundation (RWJF) to develop a road map “for the nursing profession to help our nation create a culture of health, reduce health disparities, and improve the health and well-being of the US population in the 21st century,” according to a National Academies media advisory.

“In this study, the committee will need to confront issues related to health policy, health economics, and, central to the task, health disparities and health equity,” Sharyl Nass, PhD, director of the Board on Health Care Services of the National Academies (formerly known as the Institute of Medicine [IOM]), said at the meeting.

Other issues influencing the field of nursing include healthcare reform, the implementation of new technologies, patient-centered care, and respect for the nursing profession and nurses’ expertise.

The meeting follows a joint 2-year initiative between the RWJF and the National Academies, begun in 2008 to address the need for change in the nursing profession.

That initiative resulted in the 2010 report from the IOM and the RWJF: the Future of Nursing: Leading Change, Advancing Health.

The goal then was to produce a report with recommendations for an action-oriented road map for the future of nursing.

That report laid out a vision for nursing in 2020 that included four messages: “Nurses should practice to the full extent of their education and training; nurses should achieve high levels of education and training through an improved education system that promotes seamless academic progression; nurses should be full partners with physicians and other care professionals in redesigning healthcare in the United States; and nurses should have effective workforce planning policy making requiring better data collection and information infrastructure,” committee co-chair David R. Williams, PhD, MPH, said.

“The Future of Nursing report is consistently one of the IOM’s most-read reports. The…ebook version of the report has been downloaded over almost 200,000 times,” Victor Dzau, MD, president, National Academy of Medicine, said at the meeting.

But that is not enough, Dzau said. “Success is not measured by downloads and purchases but in action and implementation and impact. So that means we have to move from barriers to practicing care and expanding opportunities for nurses to serve as leaders and increase the proportion of nurses with a baccalaureate degree,” he explained.

Building on 2010 Report

The RWJF did not want the 2010 report to “sit on a shelf and collect dust,” Susan Hassmiller, RN, PhD, FAAN, senior scholar in residence and adviser to the president on nursing at the National Academy of Medicine, said at the meeting.

In 2010, the RWJF joined the American Association of Retired Persons (AARP) Foundation and AARP to develop the Future of Nursing: Campaign for Action to improve healthcare in America through nursing. The Center to Champion Nursing in America, which is also an initiative of the AARP Foundation, the AARP, and the RWJF, is coordinating the campaign.

Hassmiller said they approached the AARP, “the nation’s top consumer organization, and asked them to form a nationwide initiative with us. We launched the Future of Nursing Campaign for Action in late 2010, at the same time we launched the first report.” The committee will study the 2010 report’s recommendations and their feasibility.

“We thought that the best way to advance the recommendation was to partner with an organization focused on consumer health, because we believe that even though the report was about capacity building in the nursing workforce, it was, after all, about consumer health, was it not?” Hassmiller observed.

The 2010 report “became a blueprint that galvanized the nursing community and a broad spectrum of partners inside and outside of healthcare,” she added.

One of the 2010 report’s key recommendations was for 80% of registered nurses to have baccalaureate degrees by 2020. The nursing profession is making progress on achieving baccalaureate and advanced degrees, Susan Reinhard, RN, PhD, FAAN, senior vice president and director, AARP Public Policy Institute, and chief strategist, Center to Champion Nursing in America, said at the meeting.

The percentage of nurses with baccalaureate degrees has increased from 49% to 56%, “which is significant when you realize it’s on the base of four million nurses,” she explained.

The culture of nurses and employers has advanced to a point that baccalaureate and advanced degrees for nurses are expected, and the number of doctorate degrees has exceeded the report’s goal of doubling, Reinhard added.

There are now 28,000 employed nurses in the United States with doctorate degrees, she said, adding that the number of nurses with associate degrees who have gone on to earn their baccalaureate degrees has also increased markedly, from approximately 23,000 in 2010 to 62,725 in 2017.

The RWJF “has put more investment [in PhD education for nurses] into the Future of Nursing Scholars Campaign,” Reinhard added.

Issues for the Next Decade

The committee will examine the following issues:

  • The role of nurses in improving health by addressing disparities and barriers to care;

  • The use of nurses at all educational levels in settings across the care continuum, “including in collaborative practice models”;

  • Factors that encourage and hinder the development of a diverse workforce across all nursing education levels;

  • The nursing profession’s role in ensuring that individuals, families, and communities have a voice in the design and operations of their clinical and community health systems;

  • The training and competency development that nurses, including advanced practice nurses, need to work in nonacute care settings;

  • Nurses’ ability to act as agents of change to make healthcare delivery accessible to those with differing social needs;

  • The research needed to address healthcare gaps and disparities; and

  • The importance of well-being and resilience in nurses for the provision of high-quality care and community health improvement.

The committee will meet several times during the study. “In developing its recommendations for the future decade of nursing in the United States, the committee will draw from domestic and global examples of evidence-based models of care that address social determinants of health and help build and sustain a culture of health,” according to a statement from the National Academy of Medicine.

A new report will be issued at a later date, committee co-chair Mary Wakefield, PhD, RN, told the group.

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