On Oct. 5, the Institute of Medicine (IOM) issued the conclusions of its two-year assessment of the nursing profession with a call for changes needed to harness the expertise of nurses in a reformed health care system. Among its sweeping recommendations:
* Eliminate collaborative agreements and physician oversight of advanced practice nurses.
* Compensate advanced practice nurses at the same rate as their medical colleagues under Medicare, Medicaid, and private carrier for performing the same work.
* Make advanced practice nurses full partners in the leadership of medical homes.
* Lift practice barriers that make it difficult for nurses to get patients the care they need, such as putting nurses on provider panels and giving nurses authority to admit patients to hospitals and hospices.
* Double the number of nurses with doctorates, raise the educational bar for entry-level nurses, and create a seamless educational ladder.
University of Maryland School of Nursing Dean Janet D. Allan, PhD, RN, FAAN, issued a statement applauding the recommendations of the IOM study, which was sponsored by the Robert Wood Johnson Foundation (RWJF).
"The IOM report on the future of nursing marks a new dawn for a profession instrumental to the nation's well-being, but constrained by institutional and regulatory bonds that limit its ability to perform to the full measure of its potential."
She continued, "The IOM's call to unleash the power of nursing is especially welcome at this point in history, as we grapple with how to make good on the promise of affordable, accessible, high-quality health care for all. Advanced practice nurses have proven time and again their competence as autonomous, independent decision-makers to deliver safe, effective primary care, anesthesia care, obstetric and gynecological care; to treat mental health disorders; and to stabilize those suffering from chronic diseases and keep them in the best shape possible. They are the backbone of the health care system at every level.
"We must put aside protectionist rhetoric in the interest of public welfare and give nurses the authority to do what they do best," said Allan.
She continued, "As one of the largest nursing schools in the nation, with some 1,000 students enrolled in master's and doctoral programs, we are excited about the prospects for our future graduates and our alumni, who constitute a significant share of Maryland's nursing work force. We are committed to using our resources to advance the implementation of the IOM's recommendations."
IOM Committee Chair Donna E. Shalala, PhD, president of the University of Miami in Florida, said in a news release,"The report's recommendations provide a strong foundation for the development of a nursing work force whose members are well educated and prepared to practice to the fullest extent of their training, meet the current and future needs of patients, and act as full partners in leading advances in the nation's health care system."
Shalala will speak on the University of Maryland campus in Baltimore on Oct. 19 on the topic, "The Unfinished Business of Health Care Reform." She is scheduled to deliver the 2010 Daniel Thursz Social Justice Lecture at 5 p.m. at the School of Social Work. The event is free but registration is required.
The Institute of Medicine describes its mission as "advisor to the nation to improve health." It is an "independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public." RWJF is "the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans."