A toolkit for healthcare reform: What role will nurses play?

Some have anticipated a shortage of healthcare providers in the coming decades as the U.S. population ages. With that in mind, the Alliance for Health Reform has produced a toolkit focused on “nursing, the coming shortages, how [shortages] might be avoided, and how health reform is contributing to the changing role of nursing.” The following excerpt provides context:

Currently there are about 3 million licensed registered nurses in the United States. Most, about 60 percent, work in hospitals. Almost 266,000 are advanced practice registered nurses (APRNs).

It is projected that 260,000 additional nurses will be needed by 2025 to care for the increased population, the increase in insured population and the explosive care needs for chronic diseases in the population and geriatric care in older age groups.

Several factors are thought to contribute to the projected shortage in nursing. These include a decline in RN earnings relative to other career options, an aging nursing workforce, job dissatisfaction among nurses, and an aging, sicker population that will require more intense health care services.

An October 2010 report by the Institute of Medicine recommended that nurses be allowed to practice to the full extent of their education and training, yet scope of practice laws vary from state to state. Is the time right for states to update these laws to mitigate the shortage of providers especially in primary care and especially in rural areas?

Among the resources provided in the toolkit is Patty Jones’ paper entitled “The Nurse’s Role in Accountable Care,” which considers the important role registered nurses will need to fulfill if accountable care organizations (ACOs) are going to be successful under healthcare reform. Here is an excerpt from her paper:

Nurses currently work in a variety of organizations likely to be involved with [ACOs], including practitioner offices and clinics, hospitals, insurers, and community health organizations. As a result, they often are in a position to help address one of the key needs of accountable care: improving care delivery and coordination across a variety of settings and types of care.

…Most organizations will need to take stock of their current resources, fill in gaps, and re-engineer their process. Most can leverage their current resources and help ensure the success of their program by accurately assessing and augmenting the skills of their nursing staff.

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