5/4/2013 10:32:00 AM National Nurses Week: RNs as Leaders
During National Nurses Week 2013, ANA is calling attention to registered nurses (RNs) and their contributions to the health care system, both in the role they play as expert clinicians in diverse care settings and as leaders who can dramatically influence the quality of care and overall performance of the system into the future.
Now more than ever, RNs are positioned to assume leadership roles in health care, provide primary care services to meet increased demand, implement strategies to improve the quality of care, and play a key role in innovative, patient-centered care delivery models. The nursing profession plays an essential role in improving patient outcomes, increasing access, coordinating care, and reducing health care costs. That is why both the Affordable Care Act and the Institute of Medicine's (IOM) Future of Nursing report place nurses at the center of health care transformation in the United States.
The public wants leaders they can trust — and nurses consistently rank at the top of a respected annual poll as the most trusted profession.
Here we outline the history of National Nurses Week and the characteristics, opportunities, and challenges of the nursing profession.
How a recognition week was established
A "National Nurse Week" was first observed in 1954, based on a bill introduced in Congress by Rep. Frances Payne Bolton of Ohio, an advocate for nursing and public health. The year marked the 100 th anniversary of nursing profession pioneer Florence Nightingale's mission to treat wounded soldiers during the Crimean War. The International Council of Nurses (ICN) established May 12, Nightingale's birthday, as an annual "International Nurse Day" in 1974. But it wasn't until the early 1990s, based on an American Nurses Association Board of Directors action, that recognition of nurses' contributions to community and national health was expanded to a week-long event each year: May 6-12.
Nursing: The nation's most trusted profession
In 2012, Americans again voted nurses the most trusted profession in America for the 13th time in 14 years in the annual Gallup poll that ranks professions for their honesty and ethical standards. Nurses' honesty and ethics were rated "very high" or "high" by 85 percent of poll respondents.
The nursing workforce
RN survey and projections — Nursing is the largest of the health care professions, and continues to grow. More job growth is projected in nursing than in any other occupation between 2008 and 2018. But a convergence of demographics — an aging population of nurses who will soon leave the workforce coupled with the demands of an overall aging nation — will widen the gap between the supply of nurses and the growing demand for health care services.
Despite growth in the proportion of younger nurses for the first time since 1980, the nursing workforce still features a disproportionate number of nurses nearing retirement age.
Other trends show that nurses' educational level has increased significantly over three decades, and that the workforce has become more racially and ethnically diverse. In addition, more men are choosing nursing as a career.
Key facts from the most recent U.S. Health Resources and Services Administration's National Sample Survey of Registered Nurses (2008), an every-four-years snapshot of the nursing workforce, include the following:
The U.S. has 3.1 million licensed RNs, of whom 2.6 million are actively employed in nursing.
The profession has grown by 5.3 percent since 2004, a net growth of more than 150,000 RNs.
Nearly 450,000 RNs, 14.5 percent of the RN population, received their first U.S. license after 2003.
The average age of employed RNs is 45.5.
The proportion of RNs under age 40 increased for the first time since 1980, to 29.5 percent.
About 250,000, or 8 percent of all RNs, are advanced practice registered nurses (APRNs) — nurses who have met advanced educational and clinical practice guidelines. Common APRN titles include nurse practitioner, certified nurse midwife, certified registered nurse anesthetist and clinical nurse specialist.
Nurses' role in health care system transformation
The public's high regard for the profession, coupled with nurses' education and skills, makes them well positioned to help transform the health care system into one that places more emphasis on prevention, wellness, and coordination of care.
Significant events occurred in 2010 that set the stage to optimize nurses' contributions, including the following:
Health reform — The Patient Protection and Affordable Care Act of 2010 expanded opportunities for nurses to provide primary care and wellness services and serve as key participants in new and innovative patient-centered care systems. The law also spurs movement toward the goal outlined in ANA's Health System Reform Agenda : a redesigned health care system that provides high-quality, affordable, accessible health care for all. And it makes strides toward improving what ANA has identified as the four most critical elements of reform: access to care, quality of care, health care costs, and a workforce that can meet demand.
The Future of Nursing report – The Future of Nursing: Leading Change, Advancing Health provides a blueprint to transform nursing so the profession can meet future health care demands and contribute fully to improve the quality of health care. The recommendations from the joint Robert Wood Johnson Foundation and Institute of Medicine initiative include removing barriers that prevent RNs from practicing to the full scope of their education and training and ensuring that RNs are full partners with physicians and other health care professionals in a redesigned health care system.
Nurse shortage and safe nurse staffing
Numerous studies have shown that patients fare worse when there is inadequate nurse staffing on a care unit — problems include poorer health outcomes, more complications, less satisfaction, and greater chance of death. A current study on nurse staffing, published in the New England Journal of Medicine in March 2011, links inadequate staffing with increased patient mortality.
Nurse shortages contribute to higher error rates, diminish time for bedside care and patient education, and lead to fatigue and burnout that decrease nurse job satisfaction and prompt nurses to leave the profession.
One recent estimate by prominent nursing workforce researchers pegged the shortage of nurses at 260,000 by 2025, primarily the result of a wave of impending nurse retirements. A shortage of nursing faculty at teaching institutions, which restricts capacity and results in qualified applicants being turned away, also compounds the problem.
To help ensure patient safety, ANA helped craft and supported a bill in Congress (S. 58/H.R. 876) that was intended to require hospitals to establish flexible staffing plans for each nursing unit and shift, based on varying unit conditions and with direct-care nurse input.