Dominating the year's nursing news were articles about implementing recommendations in the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, and strides have been made on that front. A few examples include increasing numbers of advanced practice nurses (APNs) in primary care, especially in rural health care; expanded roles for nurses in the American Red Cross during disasters; and the growth of state-based action coalitions (now numbering 36) designed to implement the recommendations.
But 62% of RNs work in hospitals, and aren't yet feeling the impact of these changes. In fact, according to Katheren Koehn, a staff nurse for 34 years on a postsurgery spine unit at Abbott Northwestern Hospital in Minneapolis, most acute care nurses providing point-of-care services in hospitals "have little knowledge of the campaign, and if they do, find little relevance for their day-to-day work."
Koehn told AJN that the focus on training APNs as a way of improving primary care won't solve the problems currently facing acute care nurses, such as staff scheduling and burdensome documentation requirements. "The charting of nursing's future must address the continuum of practice, from direct care to advanced practice," said Koehn, and improving primary care nursing is only a start. "We need all nurses to lead the charge," said Koehn, adding that greater focus on acute care nursing is needed.-Carol Potera