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IMPACT OF IOM REPORT ON NURSING EDUCATION ID Number: of Grand Canyon WordCount: 937 Date of Submission: September 18, 2011 IMPACT OF IOM REPORT ON NURSING EDUCATION Abstract The profession of nursing has evolved over the years and it is now undoubtedly a very complex undertaking for those who chose this path in their lives. Major advances in the scientific research field and new innovations in medical technology has imposed new demands on a nurse who is expected to keep abreast of all these developments in addition to doing a good job.
There are patients, doctors and other stakeholders in the health care industry who expect the nurse to be able to do a wide variety of tasks exceedingly well at all times although the trend today is going towards specialization in the numerous sub-fields in nursing such as pediatric care, surgical room attendant, geriatric hospital department and other specific areas of nursing practice. This paper is a discussion of some of the impacts of a report by the Institute of Medicine (IOM) on the effects of these trends in health care field on nursing education and current professional practice.
A trend in nursing today that clearly affects every nurse is the movement towards specialization in which a nurse is expected to be fully versed in the intricacies of a particular specialty, such as being the nurse of a cardiac unit, a pediatric unit or a geriatric unit in a large health care institution. This is a big challenge for nurses as they should undergo more frequent continuing medical education or CME programs to keep abreast of new knowledge. Hospitals and doctors now increasingly rely on a nurse to do more tasks even beyond their usual job descriptions.
The other major trend now is a move towards more nursing care in specialized settings other than a hospital such as nursing homes, retirement villages and other assisted-living facilities to provide the palliative end-of-life nursing care to the growing elderly population segment as the Baby Boom generation retires. The IOM Report on Nursing Education The nursing profession is today in a transition of sorts as it confronts new challenges in the health care industry such as higher expectations from activist consumers (the knowledgeable patients who actively demand participation in their nursing care) and the changed landscape of a health care industry such as growing consolidation of hospitals and health maintenance chains.
A movement towards cost containment likewise imposes additional burdens on nurses to cut down on unnecessary costs and re-examine the cost-benefit analysis of nursing care. Parents, students and nursing educators have to make the cost of nursing education really worth it. Nurses today are a vital part of the health care team and should play that role according to what is expected of them. However, nurses need to be competent in their areas of expertise to be able to deliver the required nursing care through relevant education and continuous training.
The Institute of Medicine report had correctly identified the two areas critical to letting the nurse do a job well to exceed expectations: increase the quality of nursing education to make it all the more relevant in a rapidly-changing health care industry environment and various nurse settings and secondly, pursuit of CME training programs to promote seamless academic progression. The rapid transformation of the health care system today demands that nurses continue to update their knowledge after leaving nursing school through relevant practice and educational programs to prevent obsolescence of that knowledge.
The IOM report emphasizes the need for a rational program to avoid the undue high expectations from nurses to do everything and know all about patient care (IOM, 2010, p. 1). The right response is to specialize in a specific field. Nursing in Primary Care – the continued exodus towards managed health care systems has reduced the number of primary care physicians (PCP). General practitioners are quite often overburdened with so many patients such that they had increasingly delegated most of the tasks to their nurse assistants, such as taking the physicals (blood pressure, heart rate, body temp).
The nurses now even perform first physical examinations of a patient to relieve the doctor although a definitive diagnosis is still given by the doctor. These functions require the nurse to be an APRN knowledgeable in a lot of areas previously reserved for doctors (RWJF, 2011, p. 1). A nurse must still be patient-focused (and not disease-oriented like the doctor) by providing needed personal humane care the patient needs which requires patience (Cox and Hill, 2010, p. 4). Nurses as Leaders – in the institutional health care settings, the nurse is expected to take the initiative in caring for their patients.
After all, nurses are more frequently in contact with the patients than their attending physicians, such as checking on the patient every hour, give them a medication or otherwise attend to a patient's other needs. Increased work loads due to reductions in manpower from cost-cutting measures has imposed on nurses added burdens such that most of adverse events in hospitals can be attributed to nurse error in giving wrong medication or dosage that compromised patient safety due to adverse drug events (ADE) in 648 patients in a tertiary-care teaching hospital (Dhillon, 2003, p. 94), as an example here.
Nurses must not be overworked and this can be achieved through workforce planning in a systematic way that the IOM report has recommended; profits should not only guide owners of hospitals but a wholistic approach that realizes the vital role of nurses in primary care settings. In retrospect, the Robert Wood Johnson Foundation (RWJF) did right in funding this study so that a refocusing of nursing practice and education can be attained and address its pressing issues. Reference List Cox, C. & Hill, M. (2010). Professional issues in primary care nursing.
Ames, IA, USA: John Wiley & Sons. Dhillon, B. S. (2003). Human reliability and error in medical system. River Edge, NJ, USA: World Scientific Publishing Co., Ltd. Institute of Medicine (2010, October 5). The future of nursing: leading change, advancing health. Retrieved from http://iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx Robert Johnson Wood Foundation (2011, August 29). APRNs a “Big Part of the Solution” to the primary care provider shortage. Retrieved from http://www.rwjf.org/humancapital/product.jsp?id=72775
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