Mapping the Future of Nursing

We recently marked a historic day for nursing. The meeting “Partnering to Transform Healthcare in Pennsylvania,” part of a national effort, brought together more than 200 nurses and nursing students here at Penn earlier this month to discuss an action plan for the future of healthcare in the state. It is clear that nurses in Pennsylvania have great potential – and responsibility -- to make much-needed changes to the healthcare system.

To this end, the Pennsylvania State Nurses Association, a co-leader of the Pennsylvania Action Coalition, joined a 50-state campaign to advance the recommendations of the Institute of Medicine’s 2010 Future of Nursing report. Leading the campaign are the Robert Wood Johnson Foundation (RWJF), the Center to Champion Nursing in America, and the AARP Foundation.

Chaired by Julie Fairman, PhD, RN, FAAN, the Nightingale Professor at Penn Nursing, the steering committee of the Pennsylvania Action Coalition is developing a mission statement and strategic plan -- or “map” – to meet the IOM’s recommendations in Pennsylvania.

Time is of the essence. Pennsylvania ranks fourth in the nation among states with a population aged 65 and older, after Florida, West Virginia, and Maine, according to the 2010 Census, with similarly high rates of diabetes, hypertension, and asthma. The demand for healthcare providers of course is growing in tandem.
To meet the increasing healthcare needs of the U.S. population, the IOM report recommended:

• Increasing the proportion of nurses with a baccalaureate degree to 80 percent by 2020
• Doubling the number of nurses with a doctoral degree by 2020
• Developing nurse leaders to advance health
• Building an infrastructure for the collection and analysis of interprofessional healthcare workforce data to ensure equitable distribution of resources.
Advancing the education of nurses is particularly important. The national average for nurses with a bachelor’s degree is about 50 percent, and in Pennsylvania it is about 41 percent. Susan Hassmiller, senior adviser for nursing with RWJF, spoke not about a so-called “nursing shortage,” but about a faculty shortage. Estimates show that some 3,000 eligible nursing students are turned away every year by education programs in Pennsylvania for insufficient numbers of faculty to teach them.
As she pointed out, having more highly educated healthcare professionals will lead to safer and more effective care, and having more nurse practitioners and midwives in practice would help create a more cost-effective system.

The Pennsylvania Action Coalition will next establish regional coalitions co-led by a nurse and a non-nurse partner.  This is where the real work will take place. When you are called to participate, I urge you to join.

You have a role in ensuring more equitable care, state-by-state, in a country in increasing need of it.

125 Years of Nursing at Penn

One hundred and twenty-five years ago -- one year before the founding of the National Institutes of Health, several years before the discovery of penicillin, and many decades before the establishment of Medicare -- the Hospital of the University of Pennsylvania was breaking boundaries in nursing education.  Since the creation of the Hospital of the University of Pennsylvania Training School for Nurses in 1886, one of the first formal nursing education programs in the country, and the founding of the University of Pennsylvania School of Nursing in 1950, Penn has been home to dedicated healthcare professionals, innovative scientists, and inspiring leaders in nursing.

To commemorate this milestone, the Nursing Alumni Association of the Hospital of the University of Pennsylvania commissioned alumna and artist Kathleen Shaver to create an art installation. “The History of Nursing As Seen Through the Lens of Art” in the Ware Lobby of Fagin Hall will be formally unveiled this weekend. The event launches a year-long celebration of 125 years of nursing at Penn.

All year we will pay tribute to the greats in nursing education who devoted themselves to HUP and to Penn.  We hope you will join us! For a preview of the art installation, a listing of 125th celebratory events, and a look at the history and future of Penn Nursing, visit www.nursing.upenn.edu/125th

The Power of Nursing Science

Nursing is a discipline that affects people one-by-one, community-by-community, and nation-by-nation. As nurses, we take seriously our moral commitment to the world to work toward the health and well-being of individuals and populations.

I recently participated in an initiative called the Global Advancement of Practice and Research in Nursing (GAPRIN), which was co-sponsored by the U.S. Department of State and the National Institute of Nursing Research (NINR).  I was one of two leading U.S. academic nurses invited to travel with a delegation to Bangladesh where nurses, for the first time, were invited into the boardroom to join discussions with health care leaders from around the word. Our purpose was to empower and catalyze nurse leaders to guide others in creating an evidence based culture and a more person centered approach to health care.  We met with governmental officials, academicians, and clinicians to discuss the importance of building strong nurse training programs in research and clinical practice that evolve into lifelong career paths for nurses. The outcome was remarkable.

In developing nations like Bangladesh, the concept of nursing research is novel, even unheard of. After hearing about the significance of nursing research in producing the evidence for quality care, the Executive Director of ICDDR,B (International Centre for Diarrheal Disease Research, Bangladesh), Dr. Alejandro Cravioto, committed $25,000 for competitive proposals in nursing research – the first such funding for nursing research in Bangladesh. The NINR and the U.S. Department of State will support nurses in Bangladesh in developing research programs as well as in empowering nurses to use evidence in their practice.

Together we will start to build an aspect of nursing that is critical for Bangladesh and for every country in the world – the capacity for nursing science.

Welcome to the Golden Age of Nursing

We were so proud to have Dr. Donna Shalala, a revered public servant and current president of the University of Miami, speak to our graduates at Commencement last week. As chair of the Committee on the Future of Nursing for the Institute of Medicine, Dr. Shalala emphasized that healthcare systems around the world are poised to benefit from the expertise of nurses at a higher and more expansive level than ever.

With the passage of the 2010 Affordable Health Care Act, the discipline of nursing is front and center. We must seize the moment by investing in nurse scientists and advancing the scholarly field of nursing science. Scholarship in nursing is vital for developing and translating best practices for quality care. The objective of a research career is to provide the evidence for equitable, quality healthcare for all populations. Of course the ultimate goal is to develop policies and practice standards that positively influence the care of all people.

To achieve that, academic and practice institutions must uphold and fortify their research mission.

On a recent visit to Universidad de Costa Rica, I spoke about creating a culture of scholarship. In sum, the keys are:

• Practice – Having an engaged and well-supported practice program
• PhD Education – Preparing nurses for the highest level of competency and integrity
• Passion for the Discipline – Inculcating a strong identity and integrating research and practice
• Post-Doctoral Education – Supporting novice scholars
• Protecting Researchers – Providing time, mentorship and support
• Productive Communities – Creating environments that value scholarship, mentoring, and intellectual engagement
• Partnerships – Creating local, national and global relationships, and clinical-academic partnerships
• Policies -- Knowing and influencing healthcare priorities and research agendas and using media to market findings.

We are on the threshold of the Golden Age of Nursing. Today’s graduates are beginning their nursing careers at the best possible time. Let us ensure that every door is open to them and to every nurse scientist.