As a practicing baccalaureate-prepared nurse in rural health at the time, I worked side by side with LPN/LVN, diploma, associate degree, and advanced practice nurses, including a nurse practitioner, a clinical nurse specialist, a nurse midwife, and a certified nurse anesthetist. I was able to see firsthand the impact that each of us had on providing high quality, safe patient care based on our individual scopes of practice.
Since then, the health care system has become ever changing and more complex. The level of knowledge required to reason clinically, leading to safe decision-making, has increased. With the Affordable Care Act in place, opportunities for all types of nurses, particularly advanced practice nurses, are expanding, with a focus on prevention and chronic care.
Nurses play a major role in interprofessional, collaborative practice and the coordination of care. And more doctorally prepared nurse educators are needed to prepare the future nursing workforce. While the League has always been a champion for multiple entryways into nursing practice, we also support lifelong learning as a means for meeting our mission: "to promote excellence in nursing education to build a strong and diverse workforce to advance the health of the nation and global community."
The 2011 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, offers two recommendations with particular salience for the NLN:
* Nurses should practice to the full extent of their education and training.
* Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
To achieve a seamless pathway for nurses to progress along the educational continuum, two goals were identified for the year 2020, only five years from now: 1) Increase the proportion of registered nurses with baccalaureate degrees from 50 percent to 80 percent. 2) Double the number of nurses with doctoral degrees. Meeting the first goal in the 2020 timeframe will be an arduous task because of barriers to academic progression that continue to exist. With the creation of the Doctor of Nursing Practice (DNP) degree, meeting the second goal seems to be within reach.
Mechanisms have been put into play to begin to meet the first goal. In 2012, the Robert Wood Johnson Foundation (RWJF) created and funded the Academic Progression in Nursing (APIN) program that awarded nine states, known as Action Coalitions, funding to develop models for creating a more highly educated and diverse nursing workforce. As these models are implemented and evolve, it is vital to lift barriers to academic progression and offer such incentives as tuition assistance and flexible scheduling. Especially important is the need to expand enrollment capacity.
Present evidence supports that patient outcomes improve, higher levels of quality and safe care are provided, and costs decrease when care is provided by better educated nurses. To produce the type of workforce needed to advance the health of our nation and the global community, it is imperative that lifelong learning becomes a way of life and the expectation for all nurses. The NLN is there to support nurse educators and their practice partners in the quest to promote lifelong learning and academic progression and provide quality nursing education for all nurses at all levels.