The Future of Nursing: Leading Change, Advancing Health


The IOM (Institute of Medicine) report presents the findings of a qualitative examination of the way the responsibilities, education, and the roles of the nurses work to influence the general status of the public healthcare. Accordingly, the report highlights how the responsibilities, education and roles should change to accommodate the evolving needs of the changing demographics of the elderly and other population groups (Safriet, 2010). The report also highlights that the healthcare systems are experiencing significant changes, and the evolution explains the need for the nursing profession to embrace equal measures for improving the healthcare delivery. The report highlights the critical intersection between the readiness of the working nurses and the patients’ needs, which would be shown to change through the lifespan. As such, through the recommendation, the Institute would shape the direction of the policy makers towards empowering the nurses for improved healthcare across all demographics in the country (Shalala, Bolton, Bleich, Brennan, Campbell & Devlin, 2011). This paper, therefore, evaluates the importance of the report to nursing and the recommendations fronted through the report and related literature on the development of nursing as a profession. In addition, the paper will also outline some recommendations on the future of the nursing profession based on the country’s changing needs.

Professionalism of Nurses

The United States takes the challenge in transforming the healthcare system by embracing a holistic approach towards empowering the nursing professionals. An improved healthcare system would provide affordable, seamless, quality, and patient-centered care to all for improved outcomes (Ulrich, Krozek, Early, Ashlock, Africa, & Carman, 2010). It is worth appreciating that such changes would only be realized through remodeling various aspects of the system, and this paper focuses on the role of the nurses in the care system. Nurses represent the largest section of the working professionals in the healthcare system. As such, the intended change would only be realized through ensuring that nurses are fully empowered through training and the education system (Ulrich, Krozek, Early, Ashlock, Africa & Carman, 2010). Secondly, improving the education system for the nursing profession would also prepare them for the market needs. Thirdly, nurses would be empowered to realize full potential through leadership positions and active participation in the healthcare improvement efforts. Finally, such required improvement or professionalism would be realized through improving the research capacity of the nurses (Fitzpatrick, 2010).

Nursing Education

Among the other recommendations contained in the IOM report is the aspect of expanding and strengthening the education programs for the nursing professionals (Fitzpatrick, 2010). The education would work to empower the nurses in skills and competence. Besides, the education would empower the nurses for career development and growth as these are necessary for a changing healthcare environment in the country (Fitzpatrick, 2010). The recommendation of the report to have as many as 80% of the nursing professionals acquire a minimum of a baccalaureate degree by the year 2020 would be applauded. Such efforts, if embraced by the government, would revolutionize the discipline and improve service delivery by the nurses (Shalala, Bolton, Bleich, Brennan, Campbell & Devlin, 2011). There is, therefore, the need for coordinated efforts by the stakeholders in the education sector, the employers, and the government towards investing in empowering the nurses through quality education, which is confirmed by the market needs. A partnership between the academic accreditation organizations, the academic leaders, the government agencies, employers, and the financiers in creating an enabling environment for the nurses to realize full potential is important in changing the healthcare sector (Melnyk,  Fineout-Overholt, Gallagher-Ford & Kaplan, 2012). As the IOM report highlights, the importance of the relationship or partnership would be to ensure that the education system is diversified, well monitored, empowered, and funded for quality education delivery (Shalala, Bolton, Bleich, Brennan, Campbell & Devlin, 2011). This paper also supports the mechanisms that would improve the quality and quantity of the graduating teams from all over the country.

Another observation is that the IOM’s commitment towards doubling the number of the postgraduate program qualifications by the nurses by 2020. Accordingly, one would note the commitment towards ensuring that future practitioners are adequately educated for improved standards and quality of service (Ulrich, Krozek, Early, Ashlock, Africa & Carman, 2010). As such, the report recommends the need for creating the capacity for the health education institutions to enroll as many postgraduate students at any point as possible. This paper equally supports the need for nurses to pursue education or improvement as a lifelong engagement.


If the healthcare system in the country is improved, as is the call for the IOM report, then the stakeholders would have to invest in serious leadership structures and programs (Melnyk & Fineout-Overholt, 2011). Among the factors blamed for causing poor performance of the healthcare system in the country has been poor leadership structures and performance. It is worth noting that the nursing profession requires improved leadership systems as it is the backbone of the entire healthcare system. However, as previously observed and reported in the report, relatively few career nurses regard embracing leadership responsibilities in the profession. Nevertheless, this paper equally highlights the need for the nursing profession to empower and produce leaders to participate in the general decision-making process (Melnyk & Fineout-Overholt, 2011). Besides, the nursing professionals should be empowered to interact harmoniously with other players in the healthcare system for improved care delivery. Therefore, according to the report, leadership plays a critical role in facilitating such interactions and relations at the place of work. Without the empowerment to participate in decision making or to make independent decisions, nurses remain passive players in the healthcare system and would be blamed for contributing to the arguably low-quality service delivery (Melnyk,  Fineout-Overholt, Gallagher-Ford & Kaplan, 2012). Leadership also facilitates harnessing nursing education and practice through research, development, and policy changes. Besides, the interactions between the various players in the healthcare system will facilitate the change in the general structure, as has been observed throughout the years (Melnyk & Fineout-Overholt, 2011). However, the leadership systems and structures to be embraced should be cognizant of the diversity and the professional composition of the discipline to be included in the professional composition.

Stakeholders’ Roles in the Nursing Profession

Having discussed education and leadership in the nursing profession, one would be interested in understanding how other disciplines or stakeholders are involved in re-defining the healthcare system in the country (Malloch & Porter-O’Grady, 2010). Therefore, there is the need to identify and re-defining the other stakeholder and their roles in facilitating the quality care delivery by the nurses in the country (Dossey, et al., 2012). The transformation process, as indicated, encompasses various elements of consideration. First, the revolution focuses on the system where the service delivery would be patient-centered. Secondly, the improved system would focus more on the preventive approach in the management of diseases than in the treatment (Malloch & Porter-O’Grady, 2010).

Thirdly, improving the focus of service delivery from the acute care settings to the home care settings would be a critical element in the system. Moreover, the improved care system would focus on the aspect of continuous care. Furthermore, the system would encourage the involvement of various disciplines and teamwork among the professional players (Dossey, et al., 2012). Finally, this paper highlights the need for all service providers to practice according to education, specialization, and skills. The support would reveal that by allowing all practices serve in the particular areas of competence, there would be improved the quality of the care delivered (Dossey, et al., 2012).

Similarly, improved efficiency, as observed through reduced errors and safety, would be realized by harnessing the stakeholders’ roles. However, the multi-disciplinary approach to restructuring the healthcare system faces various challenges, including resistance to inclusion by other health professionals such as the doctors (Melnyk & Fineout-Overholt, 2011). When the medics, through their professional medical association, fail to embrace the nursing professionals, there would be friction in care delivery because every sector will be working as an independent entity. Besides, the failure to embrace cohesion in care delivery would also be attributed to the poor involvement of stakeholders. It is worth appreciating that all the issues raised in the paper are the outcomes of defective healthcare systems in the country (Malloch & Porter-O’Grady, 2010). Thus, the organizational defects would explain the weaknesses of the healthcare system as a whole and support the need for the structural re-designing and re-focusing on the energy of the interdisciplinary players (Institute of Medicine (US). 2011).


Just as with other disciplines, innovations in the nursing profession entail developing such technology, which would effectively improve the diagnostics, treatment, and general health outcomes in the care system (Melnyk,  Fineout-Overholt, Gallagher-Ford & Kaplan, 2012). In fact, unlike the previous perceptions that healthcare would only be improved through technology, empowering the nursing professionals would go a long way in improving the care system. Therefore, the IOM report highlights the need for nurses to seek opportunities to embrace unique roles, which provide a wide scope of service for harnessing creativity and innovation (Safriet, 2010). Through such deliberate steps, the nurse practitioners embrace a wider scope of practice as well as filling the gaps that would otherwise be pointed out in the care system.  Indeed, the creative and innovative care delivery by the nurses has been shown to present an effective way to approach the discipline and realize possible improvement of the healthcare system in the country. Therefore, as noted by the IOM report 2010, the nursing discipline would be improved through innovations (Safriet, 2010). In essence, the innovation would take the form of technology and the improved competence of the nursing professionals. However, besides having the empowerment through the education system and the facilitation of other stakeholders in the healthcare system, the active involvement and deliberate effort of the nurses to improve the healthcare in the country has been shown to hold great potential (Melnyk,  Fineout-Overholt, Gallagher-Ford & Kaplan, 2012).


Based on the report by the institute of medicine in the United States, the nursing profession has been regarded as among the most influential healthcare department. In fact, the nursing profession has the largest number of professionals engaged in the healthcare system. Nevertheless, little empowerment and the lack of appropriate systems to facilitate the efforts of the nurses has been pointed out as a possible cause of the poor performance of the healthcare system at large. This paper has focused on the recommendations of the IOM report on the roles of the nurses and the nursing profession at large to improve the healthcare system in the country. Particularly, the paper highlights how the nursing profession would be empowered through education, professionalism, leadership, innovation, and the multi-disciplinary approach to their responsibilities. Therefore, the paper confirms that the future of the healthcare system in the country relies heavily on the nursing profession.



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