Nurse Role Expansion Necessary for Effective Patient Care

December 2010

Nurses represent the largest segment of United States health care employees, numbering over three million.  Nurses have significant patient contact as the frontline providers at the bedside. However, various barriers limit their ability to function at their full capacity. A new report developed by the Robert Wood Johnson Foundation and the Institute of Medicine (IOM), titled "The Future of Nursing: Leading Change, Advancing Health,” offers several recommendations to promote advancements in health care by expanding the role of nurses.

The IOM report, backed by significant research within the United States and globally, suggests that nurses are in the right position to: bridge the gap between health care coverage and access; coordinate care; practice within the full scope of their training and contribute to health care cost reductions. The IOM report notes that nurses are an excellent resource to meet the growing need for seamless, affordable, quality care because nursing practice covers a broad spectrum of care. To benefit from the care nurses can provide, the IOM report presents several key messages and recommendations.

One key message is that nurses should practice to the full extent of their education and training. The report indicates that nurses are qualified to serve as leaders and are valuable assets that will help advance patient care outcomes. Additional research shows that RNs are qualified to function in expanded health care roles when provided with appropriate training.

The IOM report mentions several barriers that limit the ability of RNs to transform the United States health care system. A significant barrier is scope of practice limitations created by a lag in state regulations. Policy changes at state and federal levels that reflect the evolving nursing profession are recommended. Additionally, the report suggests that nurse involvement in lifelong learning processes, with support from their employers, will help nurses establish the competencies, knowledge and skills they need to minimize health care costs and greatly impact how care is provided. A final message in the report is that nurses must become full partners with physicians and other health care professionals in redesigning the health care system.

Nurse education programs and nurses unions will be vital partners, according to the IOM report, to prepare nurses to function as leaders within the workplace. The recommendation charges both nurse education programs and nursing associations like UNAC/UHCP to provide entrepreneurial professional development so that nurses develop the leadership skills needed to create programs and organizations that contribute to quality patient care. Additionally, the IOM report recommends that decision makers must include nurses on boards, executive management teams and other key leadership positions as a necessary approach to improve our health care system.

A free PDF of “The Future of Nursing: Leading Change, Advancing Health” can be downloaded from: http://www.nap.edu/catalog/12956.html