IOM Paper: Issues in Nursing Profession

IOM Paper: Issues in Nursing Profession
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IOM Paper: Issues in Nursing Profession
Introduction
The United States needs to restructure its healthcare system in providing efficient, affordable, quality, and equitable access to care to everyone, regardless of socioeconomic status and ethnic background. This care system also needs to prioritize the needs of patients and be based on evidence, thus leading to improved health of populations. As a result of this transformation, many aspects of the healthcare system will need to be redesigned. Nurses, who make up the bulk of the healthcare profession, are particularly vulnerable. The 2010 Institute of Medicine (IOM). The report provides recommendations that, when taken together, form a strategy for ensuring that nurses can provide care to the fullest capacity based on their knowledge, skills, and experiences (Institute of Medicine, 2011). The report recommendations require nurses to take up leadership positions and be active participants in healthcare innovation and improvement. Data collection must be improved for workforce planning and policymaking. However, there are issues that the profession of nursing is witnessing today which need to be addressed to ensure efficient care delivery. This paper describes the practice limits, nursing education and training, and nurse shortage and burnouts as important issues facing the profession of nursing practice as well as the scope, impact, and why these issues are of importance and significance in improving healthcare systems.
Practice Scope and Limits
Nurses have a lot of promise when it comes to spearheading innovative healthcare reform initiatives. Several constraints related to historical, policy, and legal frameworks have hampered nurses' efforts to affect broad change. Fragmentation of the healthcare system, increasing rates in nurse turnover, challenges for nurses to transition from school to healthcare practice, as well as an aging population and other demographic issues, are just a few of the additional challenges (Droll et al., 2022). A majority of these roadblocks have been witnessed due to structural weaknesses in the US healthcare system; others are the result of workplace limits or the nursing workforce's talents and demographic composition. Regulatory roadblocks are particularly inconvenient. The scope-of-practice boundaries set out by state laws vary substantially. Some are fairly comprehensive, while others include vague rules that may be construed in several ways. To stay up with the growing healthcare system, several states have altered laws regulating their practice scope to permit nurse practitioners to visit patients and administer prescriptions devoid of supervision or aid of a physician. On the other hand, many laws enacted in different states in the United States have lagged in this regard.
The many challenges facing nursing practice have been influenced by the political choices that the electorate makes. What nurse practitioners may achieve after graduation is heavily influenced by the political choices made by the state in which they work, rather than their competence, education, training, or safety concerns. In the United States, different states have limitations on the limits of nursing practice that may restrict or prevent them from medication prescription, patient admission to hospitals, examination of patients’ conditions, and requesting or analyzing tests. Because many of the challenges involving distinct practice scopes are due to a collection of laws in individual states, the executive branch is ideally positioned to facilitate successful improvements by collecting, disseminating, and recognizing recommended practices from around the nation. The Federal Trade Commission (FTC) has historically been involved in the investigation of anti-competitive activities in the healthcare sector, such as putting restrictions on healthcare providers' business practices and enforcing laws that might prevent new competitors from entering the market (Harper & Benson, 2019). As administrators and payers, both the Office of Personnel Management (OPM) and the Federal Employees Health Benefits (FEHB) have a duty to uphold and allow workers to have access to competent and affordable care providers.
According to equity considerations, measures guaranteeing that all practitioners, regardless of geographic location, are allowed to practice complete, evidence-based medicine should be supported. Finally, since the Centers for Medicare and Medicaid Services (CMMS) is responsible for promulgating regulations that encourage Medicare and Medicaid payees in accessing quality care, it can guarantee that its regulations and policies are an indication of licensed providers' growing practice skills. High turnover rates among fresh nurse graduates indicate the significance of stronger attention on managing the changes from education to practice, and to impediments linked to the nursing practice limits. In 2002, the Joint Commission suggested the establishment of nurse residency programs that can help nursing graduates to gain the information and skills they need to practice nursing. The future goals of nursing practice are geared towards the provision of safe, cost-effective, and quality care adhering to established (organization or professional body) practice standards (Asamba, 2022). A majority of these programs are financed by hospitals and large healthcare systems, with a focus on acute care. Since many new graduates secure their first tenure in acute care settings, and the percentage of new nurses is quickly growing, this has been the area of highest demand. Nevertheless, the development and assessment of these programs in other settings other than in acute care are critical.
Nursing Education and Training
Major transitions in the U.S. healthcare system and nursing practice environment will need similar radical transformation in nursing education, both before and following licensure to practice. In ensuring that present and tomorrow’s nurse practioners offer quality, safe, evidence-based, and patient-centric care in all healthcare settings, particularly in primary care, community, and public health, a better-quality education system is needed. The nursing profession ranks among the few health professions in the U.S. with numerous educational tracks that lead to entry-level licensure (Droll et al., 2022). For over four decades, nurses, nursing organizations, academic institutions, and a variety of other players have disputed the qualifications and the level of education necessary for nursing profession admission. The required competencies for nursing practice have grown throughout time, especially in community and public health.
The educational system and curriculum have been put under pressure partly due to the new capabilities of the nursing practice. Both public and community-based care have also gotten more sophisticated. Practicing nurses must make critical decisions about the treatment of the sickest and weak patients as they work with innovative and life-saving solutions. Nurses need to fulfill primary care duties and assist populations in managing chronic diseases, addressing the importance of managing acute illnesses and preventing disease progression (Pittman, 2019; Wakefield et al., 2021). They will be required to employ a range of technical tools and sophisticated Information Management Systems (IMS) to i...