Nursing education.
* Faculty shortages continue. According to a 2013-2014 report by the American Association of Colleges of Nursing, U.S. nursing schools turned away 78,089 qualified applicants from baccalaureate and graduate nursing programs in 2013, with almost two-thirds of the schools blaming faculty shortages. Contributing factors include faculty aging out of the workplace and higher practice-sector compensation luring nurses away from teaching.
* Interprofessional education. Although innovation in nursing education continues-with the creation of simulation labs, for instance-most schools educate nurses in essentially the same way they've been doing for years. In particular, learning "silos" isolate professionals and block collaboration. Federal facilitation of collaborative models could help overcome such obstacles, according to a report from the Robert Wood Johnson Foundation (http://bit.ly/11i2HlI).
Nursing practice.
* RN jobs. According to the Bureau of Labor Statistics, RNs held 2.7 million jobs in 2012-some 61% in hospitals. But that proportion is changing. A study by Kovner and colleagues in last February's AJN comparing two groups of graduating nurses found that more-recently licensed RNs were much less likely to be working in a hospital setting or direct care and more likely to be enrolled in a formal education program. Hospital job cuts and the national movement requiring higher levels of nursing education could be driving factors.
* Support for RNs. The rollout of the Affordable Care Act (ACA) is expected to bring a flood of new patients and pressures on health care providers across the country, and staffing will continue to be a critical issue. Some, like the union National Nurses United, believe mandating nurse-to-patient ratios continues to be a solution to delivering the best patient care, although many say it's not the only solution. The American Nurses Association, for example, supports staffing that's tailored to the unit, which gives facilities the flexibility to consider the "intensity of patient[s'] needs, the number of admissions, discharges and transfers during a shift, [the] level of experience of nursing staff," and other factors (http://bit.ly/1vmQMzI).
* Advanced practice. The passage of the ACA, along with the implementation of the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health, spurred a proliferation of advanced practice RNs (APRNs) practicing in primary care. Eleven states had full practice authority bills under consideration during the 2014 legislative session, but results were mixed: in May, Minnesota became the 19th state to offer patients full and direct access to NP care. In April, NPs in Nebraska were handed a defeat on a similar bill. The Federal Trade Commission has added its voice to the debate with a March Policy Perspectives report calling for state legislators to avoid placing limits on APRN practice authority (http://1.usa.gov/1np2SkA).
Safety issues.
* In addition to calls for safe working environments and clear protocols for health care professionals caring for patients with Ebola virus infection, issues of workplace violence continue to be of concern. (Also see "Safeguarding Health Care Workers" in the December 2014 issue and AJN Reports in the November 2014 issue.) RNs working in EDs are particularly vulnerable, according to the Emergency Nurses Association, and many have considered leaving their jobs because of it. -Laura Wallis