The Future of Nursing: 10 Takeaways from IOM Report

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The Institute of Medicine recently released its “The Future of Nursing 2020-2030” report, a comprehensive analysis on the state of the industry that lays out a blueprint for the future of nursing.

“Nurses are powerful in number and in voice and the world needs their actions now more than ever on how individuals, families, and communities might best be served in a more equitable fashion,” wrote Dr. Victor J. Dzau, president of the National Academy of Medicine.

The report is a “navigational beacon” for healthcare and nursing leaders, said Earl Dalton, Health Carousel’s Chief Nursing Officer with more than 25 years of industry experience.

One big theme, Dalton said: Broadening access to care for underserved communities.

“This report would certainly validate and backup that ... the efforts our hospitals are putting into this should continue,” Dalton said.

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Dalton and the clinically led team at Health Carousel read through the 500-page report and pulled 10 key takeaways for nursing and healthcare professionals.

1. To build a nursing workforce that meets the growing needs of the U.S. population will require a substantial increase in numbers, types and distribution of the nursing workforce.

Meanwhile, in 2030, an estimated 73.1 million people, including all baby boomers, will be older than 65, according to the U.S. Census Bureau data from 2020. That’s 21 percent of the U.S. population.

To meet those needs will require an increase in the nursing workforce, as well as an education system that better prepares nurses for practicing in community-based settings with diverse populations.

“These improvements will occur more rapidly, more uniformly, and more successfully if programmatic, policy, and funding opportunities can be leveraged by health systems, governments, educators, and payers,” the report authors wrote.

2. Anticipate long-term impacts of the COVID-19 pandemic on the nursing workforce.

In the face of the COVID-19 pandemic, many nurses will experience more stress, feeling of inadequacy, compassion fatigue and physical exhaustion.

Some of these nurses may leave the profession. Many will need more help.

3. It is necessary to place more intentional focus on providing models and opportunities for the emergence of more diverse nurse leaders.

“The nation cannot achieve true health equity without nurses, which means it must do better for nurses. They must be supported in charting a path for themselves while they work to serve others,” the authors wrote.

A particularly critical role for nurse leaders is hiring and mentoring nurses from traditionally underrepresented communities to build a more diverse nursing workforce.

The report calls on organizations that employ nurses to provide nurses with ample opportunities, resources and mentorship to realize their full leadership potential.

4. The average age of the RN workforce has decreased to under 44 for the first time in years.

That’s because a large number of RNs from the Baby Boomer generation — estimated at 1.2 million — have retired, and younger nurses are entering the workforce.

Those changing demographics could impact everything from how patients are treated to how the industry markets and hires new nurses to hospital policies, Dalton said.

5. The number of first-time internationally educated candidates taking the nursing exam has dropped.

Internationally educated nurses (IENs) make up 8–15 percent of the nursing workforce in the United States, with a majority coming from the Philippines.

However, the number of first-time internationally educated candidates taking the NCLEX-RN exam dropped by more than 50 percent between 2007 and 2019, from 33,768 to 15,053.

The decreases in IENs can be attributed to factors that include visa retrogression and the economic recession of 2007 to 2009.

6. Fewer RNs are working in rural areas today than in the past (17 percent in 2005 versus 14.4 percent in 2018).

The decrease in rural practicing RNs occurred more rapidly among younger RNs (under age 40) than among RNs over age 40 (from 16.4 percent to 14.9 percent).

If this decrease continues, it will threaten access to care among the nation’s rural population, the authors write.

7. Because nearly one-third of LPNs are over age 55, their impending retirement over the next decade raises concern about a potential shortage of these nurses.

Such a shortage could mean that home care, long-term care, and care for individuals with disabilities and otherwise vulnerable groups will increasingly have to be provided by the RN workforce.

8. FTE NPs will more than double from 157,025 in 2016 to 396,546 in 2030.

That’s a projected growth of 6.8 percent annually for the NP workforce. It will be useful to overcome projections of primary care and specialty physician shortages over the decade.

9. In the longer run, the pandemic may lead to fundamental shifts in the demand for and supply of nurses.

On the demand side, there may be a substantial restructuring of care delivery, such as a shift toward telehealth or permanent staffing reductions in hospitals. On the supply side, the pandemic may either increase or decrease entry into nursing.

10. Nurses will play a pivotal role in health care equity in the future of healthcare, but this will require an expanded role using the full extent of their education and training.

It will be necessary to revise scope-of-practice laws, public health policies and reimbursement rules for Medicare and other payers, the authors wrote.

“If health care equity is to be fully achieved, nursing schools will need to focus on ensuring that all nurses, regardless of their practice setting, can address the social factors that influence health and provide care that meets people where they are,” the authors wrote.

To purchase the complete “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” click here.

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