Health disparities have made it harder for some individuals and communities to receive quality healthcare services, resulting in calls for improvement that involve the nursing profession. These changes are intended to benefit both nurses and patients, as well as entire communities across the U.S. The latest NAM Future of Nursing Report fully explores these challenges and offers thorough advice on how to achieve improvements.
Intro to NAM
What is NAM? The National Academy of Medicine, formerly The Institute of Medicine (IOM), founded in 1970, is a nonprofit organization that offers authoritative guidance and advice to the general public as well as decision makers. The organization’s name changed to the National Academy of Medicine (NAM) in 2015. NAM is an independent organization that provides advice without any bias. In 2003, the organization came up with core competencies that healthcare professionals should follow in order to coordinate successful care. NAM competencies are designed to help improve healthcare services throughout the healthcare field. These competencies include providing patient-centered care, working in interdisciplinary teams, using evidence-based practice, applying quality improvement, and utilizing information technology and informatics.
Overview of the NAM Report
NAM (previously IOM) and the Robert Wood Johnson Foundation collaborated on an initiative known as the Future of Nursing and published a formal report in 2011. Called “The Future of Nursing: Leading Change, Advancing Health,” this report explored ways to improve the healthcare system through the nursing workforce, such as focusing on continuing education and requiring better data collection.
In 2021, NAM published another report known as The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” which examined how nurses can help reduce disparities in healthcare services. This report focuses on the ways in which nurses can promote health equity in the U.S. to benefit everyone. While the 2011 report served as a foundation for improving healthcare through nursing, the latest report builds on those recommendations and carries them further.
For those who work in nursing or plan to, being familiar with the recent NAM report is important. As the report notes, nurses play a crucial role in healthcare, communities, and education. This role can be used to make healthcare services more equitable across the U.S., resulting in system wide improvements in the healthcare field.
The latest NAM report explores the factors that contribute to health inequities in the U.S., such as high poverty rates, income inequalities, race and ethnicity, living conditions, and sexual orientation. The COVID-19 pandemic has highlighted and exacerbated healthcare disparities in the U.S. that lead to poor health outcomes and shorter lifespans for some, while others have access to higher-quality healthcare and better health outcomes.
The report identifies key areas to target for strengthening nursing, including education, leadership, workforce, emergency preparedness, and well-being. Improving these areas is expected to help improve health equity and healthcare equity, resulting in overall healthier individuals and healthier populations in the U.S. The report offers a roadmap to achieve these goals with the following key messages:
1. Removing Nurse Practice Barriers
Many barriers exist that prevent nurses from being able to practice to the full extent of their training and education. These regulatory and practice barriers have an impact on individuals’ ability to access high-quality care. Restrictions that limit the scope of practice in nursing, especially for registered nurses and advanced practice registered nurses, make it difficult to meet the needs of individuals with more complex healthcare and social needs. Nurses often have the skills and expertise needed to provide healthcare to underserved communities in rural and urban locations, but they often face barriers to using said skills due to federal and state laws.
Making changes to or removing regulatory barriers would allow nurses to provide much needed care in underserved communities, helping promote health equity. Expanding the use of telehealth technology might also remove difficulties in accessing healthcare by allowing patients to receive care from home in their local community. However, removing practice barriers would still be needed.
2. Valuing Nurses’ Contributions
The NAM report recommends making changes to payment mechanisms and systems in order to support private healthcare and public healthcare nurses. This involves making sure public health and school nursing has enough funding, reforming value-based patient and fee-for-service payment models, and changing alternative payment models. These changes are needed in order to allow nurses to address social factors and needs that contribute to health disparities. Since the healthcare system does not place value on dealing with health disparities or promoting health equity, this is considered a major change.
Valuing nurses’ contributions through these changes and getting rid of restrictions that affect the scope of practice for registered nurses and advanced practice registered nurses will lead to improved healthcare services and better access to care for those in underserved communities.
3. Preparing Nurses to Tackle and Understand Health Equity
Nurses must be able to receive education and training that helps them understand and promote health equity. Advanced degrees should include curriculum that addresses health disparities and provides nursing students with the knowledge, skills, and tools needed to tackle these challenges and achieve health equity. For example, schools might encourage more nurses to pursue PhD degrees with a focus on health disparities and ways to improve health equity. Nursing schools should also offer more diverse environments for training and diversify faculty and classes to ensure that all communities, including underserved communities, are able to receive quality care.
Schools will need financial resources to make these changes possible, such as offering scholarships or loan repayment opportunities to attract more students to nursing programs. Nursing schools will also need to have enough faculty available to act as mentors in helping nurses address health disparities and promote health equity.
4. Supporting Nurses
Healthcare organizations and other healthcare employers must provide nurses with the support needed for their own well-being, so that they can care for others. Nurses face hardships and difficulties on the job that can contribute to high levels of stress, affecting both mental and physical health, as recently seen during the COVID-19 pandemic. For nurses of color, additional stress that affects their well-being comes from dealing with discrimination at work and school, as well as cultural and structural racism.
Nursing leaders should address job and education discrimination that occurs based on identity, such as race, gender, and sexual orientation. These leaders are also responsible for addressing discrimination based on other factors, such as mental health conditions, disabilities, rural locations, and urban locations. Nursing leaders should do their part in creating systems and structures in society that address these issues, along with cultural and structural racism, in order to achieve health equity.
5. Shared Agendas to Address SDOH and Achieve Health Equity
The NAM report recommends that every national nursing organization should join together and create a shared agenda aimed at addressing social determinants of health (SDOH). These determinants, such as water and air pollution, low income, racial discrimination, unsafe housing, lack of transportation, and lack of access to nutritious foods, can contribute to health inequities and disparities. For example, language barriers can make it harder for individuals to communicate with healthcare providers and receive the care they need. A lack of transportation can make it difficult for individuals to get to appointments for care or emergency rooms and hospitals for immediate care.
Nurses should use their power as leverage to work toward advocating for policies that improve these conditions, so that individuals and communities can receive quality healthcare services. As part of this, the NAM report states that nurses should look after their own physical and mental well-being. This helps ensure they can focus on addressing social determinants, including cultural racism, structural racism, and discrimination in nursing in both practice settings and educational settings. Healthcare leaders and educators should be working with nurses to accomplish these goals.
6. Nurses Should Practice to the Full Extent of Their Education and Training
When nurses are allowed to practice to the full extent of their education and training, the report suggests that this can help the U.S. have the nursing workforce needed for providing improved primary care. These nurses would also be in a better position to use their skills to provide patient-centered healthcare services that benefit entire communities, including underserved communities.
If you are interested in advancing your education and career, please contact American Sentinel College of Nursing and Health Science at Post University. Our Registered Nurse to Bachelor of Science in Nursing (RN to BSN) program provides an accelerated path to earning your degree. This fully online program has monthly start dates available.
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