Back to The Future of Nursing: A Look Ahead Based on a Landmark IOM Report - Office of Nursing Services (ONS)
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Back to The Future of Nursing: A Look Ahead Based on a Landmark IOM Report

Dr. Donna Shalala and Dr. Chris Engstrom at IOM Meeting
Dr. Donna Shalala and Dr. Chris Engstrom at IOM Meeting
On December 11, 2013, Acting Chief Nursing Officer Christine Engstrom and other ONS leadership attended the Richard and Hinda Rosenthal Lecture at the Institute of Medicine entitled "Back to the Future of Nursing: A Look Ahead based on a Landmark IOM Report." As the keynote speaker, Donna Shalala stated that the context for the Future of Nursing report was the Affordable Care Act with the need for expansion of access to care and patient outcomes. She explained that we're all in this together. She explained that the University of Miami is offering RNs BSN classes for free with University of Miami onsite. She advocated for the continued use of LPNs, being respectful with clear pathways to training. The Future of Nursing is making the case for improving the patient experience and quality, and such a campaign is relevant to anyone wanting to improve patient care. She said "We are the system". A panel discussion with Linda Burns Bolton, Susan Hassmiller, Carmen Alvarez, David Vlahov and Darrell Kirch made the following points:

  • Nurses have great leadership capacity: to not have a nurse at the table is to miss out on a reality call. Action Coalitions need to educate and engage people about nursing potential.
  • We need to gather stories of delays and inconsistencies: patients may travel across state lines to get greater access to care from nurses in independent practice states. There has been growth in the number of nursing school programs, but there are continual challenges in funds, clinical placement and precepting.
  • Greater access to care is compromised by economic interests, and emphasizes tension between professions..
  • Instead of using the term independent practice, the term interdependent is more applicable. Healthcare professionals work together as teams.
  • We need all hands on deck: 10,000 people turn 65 every day. One out of six physicians are over the age of sixty-five, rapidly converting healthcare providers to patients. No one discipline can meet this need alone.
  • The notion of who owns healthcare is changing to a consumer driven movement about access, convenience, and managing your own care.
  • The work nurses do is different than the work of physicians; this work needs to be captured - it is currently invisible because of our billing system.
  • VA's Patient Aligned Care Teams is a real world example of how changing of care models should happen. Residents prefer VA rotations because it's the way of the future - they see this as better than a paying University.
In twenty five years, panelists would like to see accomplishments including a shift to keeping patients out of acute care hospitals, increasing access to patients through telemedicine, preparing healthcare professional to do population health management, and increasing educational opportunities, including supporting PhD nursing to prepare the next generation of academic leaders.