Institute of Medicine

The health challenges facing the nation has significantly changed in the21st century. In the present century nurses with more skills, expertise, and knowledge is required to keep up with changing health care. These changes helped the nurses to expand their knowledge and search various opportunities in all aspects of health care. There are some obstacles, which prevent nurses from responding effectively to a quickly shifting healthcare settings and developing health care system.

In 2008, a two- year project to identify and resolve the problems facing the health profession developed by The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM). This passage will explain the effect of IOM report on nursing education, practice, and nurse’s role as a leader. The IOM report -The Future of Nursing Leading Change, Advancing Health released in Oct 2010. The IOM selected the Com¬mittee on the RWJF to plan on the expectations of Nursing, with the rationale of developing a report and that would make suggestions for an advanced future of nursing.

According to this report, there are so many challenge that facing the education in nursing and some resolutions that will be essential to progress the structure. In this present century, the patient’s requirements and health care settings became more multifaceted, the nurses needed to require competencies to convey expert nursing care. To meet this rising difficulty, the IOM committee recommended that nurses should accomplish top levels of education and recommended that they should cultured in specific ways to practice them to meet the requirements of the patients.

The committee suggested that the nursing curriculum to be examined again, restructured, and proficiently transformed with respect to the patient needs. Competencies must progress from task-based proficiencies to high-level competencies that give a base for care administration, comprehension and decision making skills in various clinical care settings. Nursing is the sole amongst the medical care professions in the United States, which has various learning methods leading to an entry, which permit to practice.

As care within the hospitals continues to produce more multifaceted, nurses having to make important decisions related with care outside the hospital becomes further complex as well. The need for largest proportions of nurses with BSN aroused in developing medical care system. According to the committee, by 2020 the proportions of nurses with BSN degree will be increase to 80 %. The committee also recommended doubling the number of nurses with doctorate degree by 2020, by offering tuition programs and pay differential in order to meet the demands and needs of the population.

The committee proposed that nurses and nursing students maintain their education and participate in lifelong education to expand their skills required to offer care for various populations. Another proposal was to implement nurse residency programs. Conversion to practice residency programs could helps to expand management and scientific skills in order to provide efficient care. The IOM committee recommended that the nurses should perform to the full extent of their knowledge.

Nurses should participate in a significant place in shifting the health care system to make proficient, safe and more affordable care. Basic rethinking of the roles of several health care professionals including nurse is required to accomplish this transformation. According to IOM report, there are certain obstacles all nurses at all levels encounters as they take new roles. There are legal barrier in many states disallow advanced practice registered nurses (APRNs) from practices to their full extent. Committee suggested that these barriers need to be overcome.

The medical care system is in the middle of big change as care providers determine latest ways to offer patient-centered care; to convey more primary care as different to area of expertise care; and to deliver additional care in the community than in the acute care. Compared to the past several years the roles of APRNs and education has changed in many ways that they are qualified to provide more services. The committee stressed that physicians are skilled and well-qualified providers and that physicians only should provide certain services who received specific education than APRNs.

In order to satisfy the call for for the reasonable health care, nurses should be performing an important position in health care, both in delivering care and decision-making in care. Legal scope of practice that defines the actions that a competent nurse can practice is different in each state. In 2008 with the collaboration of numerous nursing organizations developed a compromise model for standardizing the guideline of APRNs together with education, endorsement, certification and licensure, which helps to expansion of reliable regulations that distinguish the competencies f APRNs among the states.

The necessity to construct the primary care nursing personnel (both RN & APRN) will develop as expediency to treatment and service settings. The Massachusetts practice gives support of this growth: course of health modification in 2006 led to considerable rise in demand for primary care services only some of which can be meet with the existing primary care resources. (Long, 2008; Long & Masi, 2009). As per this report, powerful leadership will be vital to understand the image of altered medical care system.

IOM committee recommended that nurses should be completely associates with physicians and many other healthcare professional, in designing health care in the Nation. Well-built management is significant to realize the image of a changed health care system. Nurses should involves in captivating responsibility for identifying potential harms and generating a solution for enhancement, tracking development and making adequate adjustments to achieve recognized goals. Nurse also should practice dynamically on advisory committees, commissions and boards in order to give better patient care.

Expert leadership among the medical team is essential to formulate and generate the changes essential to develop quality, access and to offer patient oriented care. It is important that all nurses – from students to bedside and community nurse, to chief nursing officers and members of nursing organizations to researchers –should acquire responsibility to develop leadership competencies for their individual and proficient growth. They must implement these competencies in all settings. (NAP).

Conclusion Nursing profession is the biggest sector of the nation’s health care. The IOM in collaboration with RWJF has established a main initiative on the future of nursing. As per the report, it is time to eradicate the old-fashioned system and educational obstacles that limit the ability of nurses to practice. Abolition of obstacles for all professions with an aim of mutual joint effort will exploit and develop well-organized care in entire health care system. The United States has the opportunity to transform its health care system, and nurses can and should play a fundamental role in this transformation.

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