Easy solutions have been hard to come by in the continuing discussion about healthcare reform, but one factor has been plentiful: a nearly endless variety of opinions, expressed from a number of perspectives. Lawmakers, political consultants, hospital administrators, physicians and many other groups all have important voices to consider in the conversation.
RNs are the Rx
Nurse execs must promote quality, continuing education and nursing careers
In providing the bulk of care on a day-to-day basis, nurses have a unique breadth of perspective. Their input in the search for answers regarding healthcare reform is absolutely vital.
Nurses, of course, represent the front line in the delivery of healthcare in a multitude of settings, from hospitals, clinics and long-term-care facilities, to schools, homes, offices and military bases. Taken as a whole, the perspective of nurses covers the entire continuum of care. They have perhaps the best viewpoint to observe the overall system in action and comment on ways to make it more effective and efficient.
For example, healthcare reform is expected to add another 32 million people to the current system, stretching healthcare providers and facilities to unprecedented levels of capacity and operation. We cannot expect vast new buildings and legions of additional staff to accompany this influx. Instead, we must focus on improving the flow of patients through our existing systems, finding ways to improve efficiency and make the best use of facilities and staff around the clock. Recommendations from nurses in addressing this challenge will be indispensable, because they are instrumental in coordinating the delivery of care and helping patients navigate the often confusing array of options available to them. The hands-on experience of nurses will help identify new paths to explore and determine which ideas may be feasible.
Nurses also can be a conduit of valuable information from the patients themselves. Healthcare consumers are far more knowledgeable today about their care than in years past. Because nurses have ongoing contact with them and their families, they often receive subtle insights into the workings of the system and the accompanying impact on patients.
A critical factor in the discussion is the fact that, even considering this surge of new patients entering the system, safety and quality must remain the primary emphasis of everything we do. Again, nurses are the key to identifying the opportunities and the limitations inherent in any changes to the system that may impact the ability to keep patient safety the top priority.
All of this institutional knowledge within the nursing profession is a powerful tool to help evolve the healthcare system, but first it must be elicited and then used for it to have its due effect on the process. To discover and unlock the potential of this deep pool of information, nurse leaders are essential.
Many nurse leaders at all types of healthcare facilities place a strong value on shared governance models that continually include nurses in information loops and getting regular feedback on operational issues and where improvements are possible. Nurse leaders need to be asking nurses the right questions to get the best and most meaningful input possible. Nurses should identify what operational practices are leading to the best or most improved outcomes. They will have insights on how to be more cost-effective, where savings can occur while not diminishing the quality of care or patient safety, and how to maximize the use of the facility to deliver more care to more people while using the same amount of space and equipment.
Another role for nurse leaders is to be tireless advocates for ongoing improvements in care delivery. Technology that allows nurses to do their jobs better, such as the increasing use of electronic health records and telehealth, is one of the key components to ensuring this improvement. The American Organization of Nurse Executives is helping nurse leaders design, implement and evaluate patient-care delivery systems, as well as the technology that supports the systems.
The average age of a nurse in the U.S. is 46 years old. We must constantly promote nursing careers in order to continue serving succeeding generations of patients. Nurse leaders will need to keep their eyes on enrollment rates at nursing schools as well as grant pools that can help recruit and underwrite students' education as they pursue nursing careers.
Indeed, nurse leaders should promote continuing education at every turn. The 3 million nurses currently registered in the U.S. may be a powerful force in helping to address shortages of doctors as new patients flood the system. As more nurses advance their education and careers, growing ranks of nurse practitioners will be able to handle a variety of health issues presented by this new clientele. The healthcare system also would benefit greatly by more nurses obtaining Ph.D degrees in order to develop new research that will lead to additional insights.
The answers to transforming our healthcare system will not come easily. An invaluable source of information, ideas and leadership through the process is the nurse and nurse leader. They see, perhaps better than anyone, the tremendous impact that changes in the system may have on the lives of our patients, for better and for worse. We welcome our place within the discussion and look forward to fulfilling this vital role.
Cheryl Hoying is senior vice president of patient services at Cincinnati Children's Hospital Medical Center and also is president-elect of the American Organization of Nurse Executives.
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