Future of Nursing: the Challenges and Recommendations

Subject: Nursing
Pages: 5
Words: 1207
Reading time:
5 min
Study level: Bachelor


In the United States, nurses faced many challenges, which hindered fulfilling the healthcare sector’s goals. According to Roux (2017), the Robert Wood Johnson Foundation (RWJF) collaborated with the Institute of Medicine (IOM) to develop a report critical for transforming the current and future nursing profession. In 2008, the IOM initiated a team to steer the investigation on the challenges that nurses faced. The group’s significant deliberation was to assess the nursing profession and recommend vital changes for its advancement (Roux, 2017). The team devised a report, which the nursing organizations and other relevant bodies are applying to fulfill the four key messages. Therefore, it is vital to discuss the impact of the IOM findings and state-based action plans on the nursing field.

The IOM Report’s Recommendation

The committee’s task resulted in the formulation of a crucial message, which summarized the recommendations. They advocated that nursing practice should be based on the extent of training and improving the education system for the healthcare professionals. At the same time, they highlighted the need for partnerships between nurses and other healthcare providers and improving the information system and data collection to plan and make workforce policies effective (Hooper, 2016). The recommendations from the report have been effectively applied to advance the nursing field in the United States.

A significant number of states have effected changes in the nursing scope to broaden fields of services delivery. In the United States, nurses were prohibited to assess clients, ordering and evaluating the tests, and prescribing medicine. For example, advanced nursing practitioners can now review and freely prescribe medicine to clients in some states. However, in some other states, newly graduated nurses are limited in their areas of practice, which is a significant concern in the high-paced evolving healthcare system. In alignment with the IOM report, there is an increased need for liaison between the federal governments and health organizations for the full implementation of the recommendations.

Overwhelming healthcare needs in the United States demand competent and highly trained nurses. The requirements for entry into the nursing field have been a significant hindrance to the alleviation of the staff shortage challenges. Some areas, such as critical care, require highly trained employees. Nursing should adjust its educational system to allow an easy transition and specialization within the profession. The areas of specialization need to be expanded to create a diverse workforce (Hooper, 2016). To fully implement the committee’s recommendations, some programs are being offered online to encourage advancements.

Over the years, the main roles of nurses have been patient advocacy and implementation of orders from doctors. The IOM report recommended intense collaborations between healthcare workers, which require competent nurses who can critically think and make decisions related to patient care. Currently, nurses are allowed to participate in policy-making committees and advocate for patients. Leadership programs have been integrated into the nursing education system to produce competent leaders. Nurses are also encouraged to apply for managerial and leadership positions in their organizations.

Even though the United States is a developed country, staffing in the healthcare system has remained a big challenge. The committee recommended an advanced data system containing all healthcare workers’ information, such as work areas, qualifications, and skills. The data is fundamental in determining the workforce’s requirements and establishing the strategies to meet them, such as adjusting the system of education to prepare the nurses competent in a specific area of need. The National Health Care Workforce Commission was established, and it is among the bodies responsible for the implementation of the recommendation (National Academies of Sciences, Engineering, and Medicine, 2016). More bodies are required to collect and securely store the information of all the employed healthcare workers.

The Role of the State-Based Action Coalitions

Federal governments have developed the guidelines and policies, which shape the health sector to realize global healthcare goals. The states have been mandated the responsibility of enforcing the action coalitions. State authorities, in collaboration with the private sector, establish the strategies for complete implementations of the IOM report. Enforcement by the local government enables maximum participation by their citizens. Each state has developed unique laws, which spearhead the process. Local authorities are closer to the people; thus, people will feel more involved in the implementation. Healthcare providers are at the center of the IOM report and head the action coalitions (Hooper, 2016). Nurses are reactively involved in the solution of their needs and can take ownership of the initiative. Therefore, state-based action coalitions play a vital role in the improvement of the health sector.

State Action Coalition Initiatives

The Texas state is committed to remodeling its healthcare system to improve the quality of care delivered to its citizens. Nursing is the most extensive section in the healthcare system; thus, state governments should focus on transforming the IOM report’s recommendations, whose full implementation has been a challenge to a significant number of states (Roux, 2017). Realization of the healthcare goals is anchored on primary healthcare which is the central role of nurses. The Advancing Nursing Education Team was established to improve nursing education through adjustments in the educational system. The initiative is aimed at developing a standard learning curriculum for nursing schools. Competent healthcare workers are created based on care needs. Moreover, the team focuses on encouraging healthcare providers to be committed to lifelong acquiring of knowledge (National Academies of Sciences, Engineering, and Medicine, 2016). Currently, the evidence-based practice requires highly educated and updated nurses.

The Advancing Nursing Practice Team is aimed at ensuring that nurses dispense care services depending on their qualifications. The adjustments are made to the healthcare providers’ scope of practice to lessen the restrictions which hinder them from dispensing healthcare services to their level of education and training. The operations of the initiative are based on the findings in the IOM report. Currently, nurses in Texas can perform advanced roles in inpatient care without supervision. In 2017, legislation was passed to allow Advanced Practice Registered Nurses (APRNs) to review Medicaid and CHIP clients without supervision (Roux, 2017). Further investigations are critical to developing more recommendations on how nursing practice can be advanced.

The barrier to the Advancement of Nursing

Despite the remarkable achievements in improving the scope of practice of nurses, certain areas for improvement remain. For example, regulations prohibit nurses from signing death certificates, which becomes a significant problem in areas without physicians. Nursing leaders, in collaboration with their representatives in the government, are working hard to develop the laws which allow Nursing Practitioners (NP) to provide patient care depending on their levels of training, education, and experience (Hooper, 2016). The regulation will improve care outcomes by reducing client waiting time, especially in underserved areas.


The IOM report summarized the challenges nurses faced and formulated the recommendations to be considered in the nursing profession’s transformation. The process of action should start at the state level for maximum involvement of all parts of the United States. However, full implementation of the recommendations is still a challenge (Roux, 2017). Local authorities and healthcare representatives have a role in advocating for clients’ and nurses’ needs to create an environment, which satisfies both the patient and their care providers’ needs. Further research focusing on the transformation of nursing is required to move towards achieving global healthcare goals.


Hooper, V. D. (2016). The institute of medicine report on the future of nursing: Where are we 5 years later? Journal of PeriAnesthesia Nursing, 31(5), 367-369. Web.

National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the institute of medicine report the future of nursing. National Academies Press. Web.

Roux, G. (2017). Issues and trends in nursing. Jones & Bartlett Learning