The Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, published in 2010, highlights the need for highly educated nurses. To quote Donna E. Shalala, Ph.D., Chair of the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine (IOM) “This report is really about the future of health care in our country. It points out that nurses are going to have a critical role in that future especially in producing safe, quality care and coverage for all patients in our health care system.”Nurses make up a large segment of the healthcare force. As internal stakeholders nurses play an important role in managing changes that are evolving in healthcare. Working in close contact with patients, nurses have a unique opportunity to effect these changes. According to the IOM report a number of barriers prevent nurses from being able to respond effectively. These barriers need to be overcome to ensure that nurses are well- positioned to lead change and advance health. Nurses need adequate education and support to take on a greater role.
To play a transformative role in healthcare, health professionals including nurses need to acquire competencies that would enable them to deliver high quality patient care. These competencies include leadership skills, informatics skills, team work, communication and collaborative skills among other, as health care for the patient spans the continuum of care. In today’s hospital environment, nurses are expected to possess not only excellent nursing skills but also be able to make critical decisions, have systems thinking and team leadership skills. Health is managed not just in the hospital encounter but across coordinated efforts with other teams providing patient care, especially in the management of chronic diseases such as diabetes.
According to the Bureau of Labor Statistics (2012) “employment of registered nurses is expected to grow 26 percent from 2010 to 2020, faster than the average for all occupations. Growth will occur primarily because of technological advancements; an increased emphasis on preventative care; and the large, aging baby-boomer population who will demand more healthcare services as they live longer and more active lives”. Yet, high nursing staff turnovers is a major issue being faced today. Nurses as leaders are taking on expanded roles and responsibilities in the changing healthcare environment. Leadership styles among nurse managers and nurse leaders have an impact on staff nurse job satisfaction and retention (Kleinman C., 2004). Emotional intelligence has been acknowledged (Akerjordet, K. and Severinsson, E. 2008) as supporting nurse leadership. Nurses who develop and exhibit high emotional intelligence enhance organizational, staff and patient outcomes by fostering a healthy work environment and creating inspiring relationships based on mutual trust.
The important role to be played by nurses in the future of healthcare is also highlighted by the HITECH environment which emphasizes meaningful use and the implementation of electronic medical records. The nurses role is pivotal in organizational transformation using Electronic Health Records and other health information technology (Westra & Delaney, 2008). Historically, nursing education did not include informatics competencies. Today, nurses need to be adequately prepared to use or lead change in the use of health information technologies. To deliver effective care in the future, nurses would have to use health information technologies and systems limited to not only electronic medical records for inpatient and outpatient care, but also health information applications in the performance of core clinical processes (eg. Computerized Physician Order Entry), clinical decision support (eg. checking drug interactions, alerts, reminders), business intelligence applications to measure efficiency and quality, and health information exchange technologies to exchange clinical information between providers.
In conclusion, the future of healthcare depends on this large community of nurses and how well they embrace new information technologies and develop their leadership skills to play a leading role in bringing about transformative changes in the emerging healthcare environment.