Assignment: Nursing: Today and Beyond
Assignment: Nursing: Today and Beyond ON Assignment: Nursing: Today and
BeyondWrite a 1500-2000 word essay (in APA style) addressing each of the following
points/questions. Be sure to completely answer all the questions for each bullet
point. There should be three main sections, one for each bullet below. Separate each section
in your paper with a clear heading that allows your professor to know which bullet you are
addressing in that section of your paper. your ideas with at least five (5) sources using
citations in your essay. Make sure to cite using the APA writing style for the essay. The cover
page and reference page in correct APA do not count towards the minimum word
amount. Your essay must include an introduction and a conclusion Assignment: Nursing:
Today and BeyondDescribe at least three challenges nurses face today in care delivery.
These can be ethical, legal, financial, or social. Provide at least one way to successfully
overcome each challenge.In the Institute of Medicine’s 2010 Future of Nursing report, the
committee developed four key messages. Choose one message, explain the message in
detail, and why it is important to the nursing profession (Please refer to page 29 of the
attached report).Explain each of the Institute of Medicine’s five core competencies and
describe ways in which nursing practice can meet each of these. Identify at least one
obstacle for each and explain in detail how it can be overcome.5 Core CompetenciesThe five
core competencies the IOM committee called for to reform health professionals’ education
are:The ability to deliver patient-centered care, taking into account an increasingly diverse
US population with varying cultural backgrounds, expectations, and values.The ability to
work in interdisciplinary teams and practice team-based skills, especially for patients with
chronic conditions.The training and ability to search and evaluate the scientific evidence
base upon which health care decisions should be made in practice.The knowledge and
ability to analyze the root causes of medical errors and quality problems and fix them
through system-wide approaches.A solid foundation and skills in using cutting-edge
information technology to deliver high-quality medical care, such as being able to search the
medical literature online or being able to use computerized order entry systems that
automatically flag pharmaceutical contraindications and errors.Assignment: Nursing: Today
and Beyondattachment_1Unformatted Attachment PreviewTHE NATIONAL ACADEMIES
PRESS This PDF is available at http://nap.edu/12956 SHARE ? ? ? ? The Future of Nursing:
Leading Change, Advancing Health (2011) DETAILS 700 pages | 6 x 9 | HARDBACK ISBN
978-0-309-15823-7 | DOI 10.17226/12956 CONTRIBUTORS GET THIS BOOK Committee on
the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of

Medicine; Institute of Medicine FIND RELATED TITLES SUGGESTED CITATION Institute of
Medicine 2011. The Future of Nursing: Leading Change, Advancing Health. Washington, DC:
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Copyright © National Academy of Sciences. All rights reserved. The Future of Nursing:
Leading Change, Advancing Health Committee on the Robert Wood Johnson Foundation
Initiative on the Future of Nursing, at the Institute of Medicine Copyright National Academy
of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing Health
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE:
The project that is the subject of this report was approved by the Governing Board of the
National Research Council, whose members are drawn from the councils of the National
Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
Assignment: Nursing: Today and BeyondThe members of the committee responsible for the
report were chosen for their special competences and with regard for appropriate balance.
This study was ed by Contract No. 65815 between the National Academy of Sciences and
the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or
recommendations expressed in this publication are those of the author(s) and do not
necessarily reflect the view of the organizations or agencies that provided for this project.
Library of Congress Cataloging-in-Publication Data Committee on the Robert Wood Johnson
Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The future of
nursing : leading change, advancing health / Committee on the Robert Wood Johnson
Foundation Initiative on the Future of Nursing, at the Institute of Medicine. p. ; cm. Includes
bibliographical references and index. ISBN 978-0-309-15823-7 (hardcover) — ISBN 978-0-
309-15824-4 (pdf) 1. Nursing— Practice—United States. 2. Nursing—United States. 3.
Leadership—United States. I. Robert Wood Johnson Foundation. II. Institute of Medicine
(U.S.) III. Title. [DNLM: 1. Nursing—trends—United States. 2. Education, Nursing—United
States. 3. Health Policy—United States. 4. Leadership—United States. 5. Nurse’s Role—
United States. WY 16 AA1] RT86.7.C65 2011 610.73—dc22 2010052816 Additional copies
of this report are available from the National Academies Press, 500 Fifth Street, N.W.,
Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the
Washington metropolitan area); Internet, http://www.nap.edu. For more information about
the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2011 by the
National Academy of Sciences. All rights reserved. Printed in the United States of America
Cover credit: Photos reprinted with permission from Tom Semkow; Gregory Benson; Lisa
Hollis, Cedars-Sinai Medical Center; and Sam Kittner/kittner.com. The serpent has been a
symbol of long life, healing, and knowledge among almost all cultures and religions since
the beginning of recorded history. The serpent adopted as a logotype by the Institute of
Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in

Berlin. Suggested citation: IOM (Institute of Medicine). 2011. The Future of Nursing:
Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Copyright National Academy of Sciences. All rights reserved. The Future of Nursing: Leading
Change, Advancing Health “Knowing is not enough; we must apply. Willing is not enough;
we must do.” —Goethe Advising the Nation. Improving Health. Copyright National Academy
of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing Health
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of
distinguished scholars engaged in scientific and engineering research, dedicated to the
furtherance of science and technology and to their use for the general welfare. Upon the
authority of the charter granted to it by the Congress in 1863, the Academy has a mandate
that requires it to advise the federal government on scientific and technical matters. Dr.
Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of
Engineering was established in 1964, under the charter of the National Academy of
Sciences, as a parallel organization of outstanding engineers. It is autonomous in its
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Sciences the responsibility for advising the federal government. The National Academy of
Engineering also sponsors engineering programs aimed at meeting national needs,
encourages education and research, and recognizes the superior achievements of engineers.
Dr. Charles M. Vest is president of the National Academy of Engineering. Assignment:
Nursing: Today and BeyondThe Institute of Medicine was established in 1970 by the
National Academy of Sciences to secure the services of eminent members of appropriate
professions in the examination of policy matters pertaining to the health of the public. The
Institute acts under the responsibility given to the National Academy of Sciences by its
congressional charter to be an adviser to the federal government and, upon its own
initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg
is president of the Institute of Medicine. The National Research Council was organized by
the National Academy of Sciences in 1916 to associate the broad community of science and
technology with the Academy’s purposes of furthering knowledge and advising the federal
government. Functioning in accordance with general policies determined by the Academy,
the Council has become the principal operating agency of both the National Academy of
Sciences and the National Academy of Engineering in providing services to the government,
the public, and the scientific and engineering communities. The Council is administered
jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr.
Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
www.national-academies.org Copyright National Academy of Sciences. All rights reserved.
The Future of Nursing: Leading Change, Advancing Health COMMITTEE ON THE ROBERT
WOOD JOHNSON FOUNDATION INITIATIVE ON THE FUTURE OF NURSING, AT THE
INSTITUTE OF MEDICINE DONNA E. SHALALA (Chair), President, University of Miami, Coral
Gables, FL LINDA BURNES BOLTON (Vice Chair), Vice President and Chief Nursing Officer,
Cedars-Sinai Health System and Research Institute, Los Angeles, CA MICHAEL R. BLEICH,
Dean and Dr. Carol A. Lindeman Distinguished Professor, Vice Provost for Inter-professional
Education and Development Oregon Health & Science University School of Nursing,
Portland TROYEN A. BRENNAN, Executive Vice President, Chief Medical Officer, CVS

Caremark, Woonsocket, RI ROBERT E. CAMPBELL, Vice Chairman (retired), Johnson &
Johnson, New Brunswick, NJ LEAH DEVLIN, Professor of the Practice, University of North
Carolina at Chapel Hill School of Public Health, Raleigh CATHERINE DOWER, Associate
Director of Research, Center for the Health Professions, University of California, San
Francisco ROSA GONZALEZ-GUARDA, Assistant Professor, School of Nursing and Health
Studies, University of Miami, Coral Gables, FL DAVID C. GOODMAN, Professor of Pediatrics
and of Health Policy, and Director, Center for Health Policy Research, The Dartmouth
Institute for Health Policy and Clinical Practice, Hanover, NH JENNIE CHIN HANSEN, Chief
Executive Officer, American Geriatrics Society, New York C. MARTIN HARRIS, Chief
Information Officer, Cleveland Clinic, OH ANJLI AURORA HINMAN, Certified Nurse-Midwife,
Intown Midwifery, Atlanta, GA WILLIAM D. NOVELLI, Distinguished Professor, McDonough
School of Business, Georgetown University, Washington, DC LIANA ORSOLINI-HAIN,
Nursing Instructor, City College of San Francisco, CA YOLANDA PARTIDA, Director, National
Center, Hablamos Juntos, and Assistant Adjunct Professor, Center for Medical Education and
Research, University of California, San Francisco, Fresno ROBERT D. REISCHAUER,
President, The Urban Institute, Washington, DC JOHN W. ROWE, Professor, Mailman School
of Public Health, Department of Health Policy and Management, Columbia University, New
York BRUCE C. VLADECK, Senior Advisor, Nexera Consulting, New York Copyright National
Academy of Sciences. All rights reserved. The Future of Nursing: Assignment: Nursing:
Today and BeyondLeading Change, Advancing Health Project Staff SUSAN HASSMILLER,
Study Director ADRIENNE STITH BUTLER, Senior Program Officer ANDREA M. SCHULTZ,
Associate Program Officer KATHARINE BOTHNER, Research Associate THELMA L. COX,
Administrative Assistant TONIA E. DICKERSON, Senior Program Assistant GINA IVEY,
Communications Director LORI MELICHAR, Research Director JULIE FAIRMAN,
Distinguished Nurse Scholar-in-Residence JUDITH A. SALERNO, Executive Officer, IOM
Consultants CHRISTINE GORMAN, Technical Writer RONA BRIERE, Consultant Editor vi
Copyright National Academy of Sciences. All rights reserved. The Future of Nursing: Leading
Change, Advancing Health Reviewers This report has been reviewed in draft form by
individuals chosen for their diverse perspectives and technical expertise, in accordance
with procedures approved by the National Research Council’s Report Review Committee.
The purpose of this independent review is to provide candid and critical comments that will
assist the institution in making its published report as sound as possible and to ensure that
the report meets institutional standards for objectivity, evidence, and responsiveness to the
study charge. The review comments and draft manuscript remain confidential to protect the
integrity of the deliberative process. We wish to thank the following individuals for their
review of this report: John Benson, Jr., University of Nebraska Medical Center Bobbie
Berkowitz, University of Washington George Boggs, American Association of Community
Colleges Marilyn P. Chow, Kaiser Permanente Jordan J. Cohen, The George Washington
University Nancy W. Dickey, Texas A&M Health Science Center Tine Hansen-Turton,
National Nursing Centers Consortium and Public Health Management Corporation Ann
Hendrich, Ascension Health Beverly Malone, National League for Nursing Edward O’Neil,
Center for the Health Professions, University of California, San Francisco Robert L. Phillips,
Jr., Robert Graham Center Joy Reed, North Carolina Department of Health and Human

Services Thomas Ricketts, University of North Carolina School of Public Health vii Copyright
National Academy of Sciences. All rights reserved. The Future of Nursing: Leading Change,
Advancing Health viii REVIEWERS Vinod Sahney, Institute for Healthcare Improvement
Charlotte Yeh, AARP Services Incorporated Heather Young, Betty Irene Moore School of
Nursing, University of -California, Davis Although the reviewers listed above have provided
many constructive comments and suggestions, they were not asked to endorse the
conclusions or recommendations nor did they see the final draft of the report before its
release. The review of this report was overseen by Kristine Gebbie, School of Nursing,
Hunter College City University of New York and Mark R. Cullen, Stanford University.
Appointed by the National Research Council and Institute of Medicine, they were
responsible for making certain that an independent examination of this report was carried
out in accordance with institutional procedures and that all review comments were
carefully considered. Responsibility for the final content of this report rests entirely with
the authoring committee and the institution. Copyright National Academy of Sciences. All
rights reserved. The Future of Nursing: Leading Change, Advancing Health Foreword The
founding documents of the Institute of Medicine (IOM) call for experts to discuss, debate,
and examine possible solutions for the multitude of complex health concerns that face the
United States and the world. Equally important is the timely implementation of those
solutions in a way that improves health. The United States is at an important crossroads as
health care reforms are being carried out and the system begins to change. The possibility
of strengthening the largest component of the health care workforce—nurses—to become
partners and leaders in improving the delivery of care and the health care system as a
whole inspired the IOM to partner with the Robert Wood Johnson Foundation (RWJF) in
creating the RWJF Initiative on the Future of Nursing, at the IOM. In this partnership, the
IOM and RWJF were in agreement that accessible, Assignment: Nursing: Today and
Beyondhigh-quality care cannot be achieved without exceptional nursing care and
leadership. By working together, the two organizations sought to bring more credibility and
visibility to the topic than either could by working alone. The organizations merged staff
and resources in an unprecedented partnership to explore challenges central to the future
of the nursing profession. To this collaborative effort, the IOM welcomed staff from RWJF,
as loaned employees, to provide specific content expertise in nursing, research, and
communications. Combining staff from two different organizations was an experiment that
integrated best practices from both organizations and inspired us to think in fresh ways
about how we conduct our work. We are indebted to RWJF for the leadership, , and
partnership that made this endeavor possible. I am deeply grateful to the committee—led
by Donna Shalala, committee chair and former Secretary of the Department of Health and
Human Services, and Linda Burnes Bolton, committee vice chair—and to the staff, especially
Susan ix Copyright National Academy of Sciences. All rights reserved. The Future of Nursing:
Leading Change, Advancing Health FOREWORD Hassmiller, Adrienne Stith Butler, Andrea
Schultz, and Katharine Bothner, who produced this report. Their work will serve as a
blueprint for how the nursing profession can transform itself into an ever more potent and
relevant force for lasting solutions to enhance the quality and value of U.S. health care in
ways that will meet the future health needs of diverse populations. The report calls on

nurses, individually and as a profession, to embrace changes needed to promote health,
prevent illness, and care for people in all settings across the lifespan. The nursing profession
cannot make these changes on its own, however. The report calls for multisector and
interprofessional collaboration. In this sense, it calls on all health professionals and health
care decision makers to work with nurses to make the changes needed for a more
accessible, cost-effective, and high-quality health care system. Since its foundation 40 years
ago, the IOM has produced many reports echoing the theme of high-quality, safe, effective,
evidence-based, and patientcentered care. The present report expands on this theme by
addressing the critical role of nursing. It demonstrates that achieving a successful health
care system in the future rests on the future of nursing. Harvey V. Fineberg, M.D., Ph.D.
President, Institute of Medicine Copyright National Academy of Sciences. All rights reserved.
The Future of Nursing: Leading Change, Advancing Health Preface This report is being
published at a time of great opportunity in health care. Legislation passed in March 2010
will provide insurance coverage for 32 million more Americans. Assignment: Nursing:
Today and BeyondThe implications of this new demand on the nation’s health care system
are significant. How can the system accommodate the increased demand while improving
the quality of health care services provided to the American public? Nursing represents the
largest sector of the health professions, with more than 3 million registered nurses in the
United States. The question presented to the committee that produced this report was:
What roles can nursing assume to address the increasing demand for safe, high-quality, and
effective health care services? In the near term, the new health care laws identify great
challenges in the management of chronic conditions, primary care (including care
coordination and transitional care), prevention and wellness, and the prevention of adverse
events (such as hospital-acquired infections). The demand for better provision of mental
health services, school health services, long-term care, and palliative care (including end-of-
life care) is increasing as well. Whether improvements in all these areas of care will slow the
rate of growth in health care expenditures remains to be seen; however, experts believe
they will result in better health outcomes. What nursing brings to the future is a steadfast
commitment to patient care, improved safety and quality, and better outcomes. Most of the
near-term challenges identified in the health care reform legislation speak to traditional and
current strengths of the nursing profession in such areas as care coordination, health
promotion, and quality improvement. How well nurses are trained and do their jobs is
inextricably tied to most health care quality measures that have been xi Copyright National
Academy of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing
Health xii PREFACE targeted for improvement over the past few years. Thus for nursing,
health care reform provides an opportunity for the profession to meet the demand for safe,
high-quality, patient-centered, and equitable health care services. We believe nurses have
key roles to play as team members and leaders for a reformed and better-integrated,
patient-centered health care system. This report begins with the assumption that nursing
can fill such new and expanded roles in a redesigned health care system. To take advantage
of these opportunities, however, nurses must be allowed to practice in accordance with
their professional training, and the education they receive must better prepare them to
deliver patient-centered, equitable, safe, high-quality health care services. Additionally, they

must engage with physicians and other health care professionals to deliver efficient and
effective care and assume leadership roles in the redesign of the health care system. In
particular, we believe that preparation of an expanded workforce, necessary to serve the
millions who will now have access to health insurance for the first time, will require
changes in nursing scopes of practice, advances in the education of nurses across all levels,
improvements in the practice of nursing across the continuum of care, transformation in the
utilization of nurses across settings, and leadership at all levels so nurses can be deployed
effectively and appropriately as partners in the health care team. In 2008, the Robert Wood
Johnson Foundation (RWJF) approached the Institute of Medicine (IOM) to propose a
partnership between the two organizations to assess and respond to the nee …Assignment:
Nursing: Today and Beyond