The Institute of Medicine's 2011 most recent report, "The Future of Nursing," doesn't mince words. "The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century," it reads.
Only 14 years into the 21st century, most nurses in the United States were, in fact, educated in the 20th century. This seems to indicate, based on the IOM's unequivocal statement, that America's nurses are in need of educational opportunities.
The trouble with nurse competency as it stands isn't necessarily the inherent fault of the educational system. According to the IOM's report, the combination of rapidly aging baby boomers and more complex care environments have made it very difficult to be fully-equipped as a nurse leader with only traditional training.
To succeed in an increasingly value-based system, modern nurses must be jacks-of-all-trades, fluent in the language and skill sets of "leadership, health policy, system improvement, research and evidence-based practice, teamwork and collaboration, […] community, public health and geriatrics." The IOM's list is exhaustive.
Value-based care is, of course, the United States' biggest effort to modernize the health system, and it's an effort that requires all hands on deck. Accordingly, nurses associations are stepping up.
The Association of periOperative Registered Nurses is investing in helping its members rise to the next level of competency. Until recently, AORN focused mostly on helping perioperative nurses practice safe care backed by scientific evidence. Now it has begun to expand its leadership resources, creating the Center for Nursing Leadership as a resource for clinical nurses to seek out resources to strengthen their management competencies. The organization is also helping nurses with leadership plans connect face-to-face; AORN is set to hold its OR Executive Summit Mar. 30 of this year. Major companies like Stryker have taken notice of AORN's initiative; AORN recently received half a million dollars from the device maker to fund its educational mission.
AORN's Executive Director and CEO, Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN, says new models of care delivery — exemplified in the inevitable transition from traditional inpatient care to outpatient clinics and physician offices — are changing the nursing profession for good, necessitating the focus on education. "It used to be nurses moved into [an administrative] role with a strong set of clinical skills but maybe with fewer administrative skills," she says. Now, she notes, nurses themselves are realizing they need more comprehensive skills and pushing for the change: "Nurses want this knowledge. They want to know how to be good administrators," she says.
According to Ms. Groah, additional education for nurses has innumerable applications in value-based care, from financial management to patient safety. Negotiation training helps in financial and operational decisions and facilitates teamwork. Management skills help clinical nurses see a bigger picture, allowing them to better integrate clinical and evidence-based considerations in their day-to-day routines.
Extra education isn't just for nurse managers. It's also invaluable on the front lines of care. Ms. Groah hypothesizes an all-too-real scenario in which five surgeons are using different prostheses for joint replacement. Five prostheses could mean a wealth of inefficiencies, potentially including five different costs and five different methods of joint replacement.
In a scenario where highly educated nurses are the norm, an OR nurse who assists all the surgeons with their operations might notice the problem right away and might be better equipped to catalyze the solution. Such a nurse could alert the appropriate parties and help the group work through rationale for standardizing the joint replacement process. "Through additional education, the nurse will be negotiating from a much better place," she says.
The world of medical education seems receptive to this notion. The push for nursing education has spurred an increase in the supply of available additional nursing education programs in a wide variety of settings. According to Ms. Groah, there are certificate programs, specialty exams and even accounting, management and marketing courses for nurses. Nurses can more easily elect to do specialized residencies in their positions, go for a bachelor of science in nursing or even study to receive a nursing doctorate.
The expansion, according to Ms. Groah, is "happening pretty rapidly" since the IOM report came out. "Nursing has recently become aware of the fact they need to make access to advanced degrees much easier," she says.
The most important thing now is for the deluge of educational opportunities to continue, and for nurses to empower themselves to be the best leaders they can be, according to Ms. Groah. "The OR is one of the hardest places to find good leadership," she says. "This [education] is something perioperative nurses need, whether they're current leaders or want to become leaders."