1. Baker, Kathy A. PhD, RN, ACNS-BC, CGRN, FAAN

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As we start a new year, I am full of expectation and anticipation for nursing. In my 30-year career as a registered nurse, I have never been more optimistic about the future of nursing than I am presently. Healthcare reform, whether or not you agree with the politics surrounding it, has opened opportunities for nurses that have never before been available. The necessity to increase the number of primary healthcare providers to meet the needs of uninsured citizens, who must now be cared for, necessitates the need for removing barriers that prevent advanced practice nurses from working to the full extent of their education and certification. The recent Institute of Medicine consensus report (funded by the Robert Wood Johnson Foundation) on the future of nursing ( identified four key recommendations:

Kathy A. Baker, PhD,... - Click to enlarge in new windowKathy A. Baker, PhD, RN, ACNS-BC, CGRN, FAAN

* 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.


* Nurses should be full partners, with physicians and other healthcare professionals, in redesigning healthcare in the United States.


* Effective workforce planning and policy making require better data collection and information infrastructure.



The committee, chaired by Donna Shalala, former Secretary of Health and Human Services (Clinton presidency), was composed of a sophisticated interdisciplinary team (see institute-medicine-committee for the complete committee roster) that worked diligently to deliver a thoroughly researched report on the future of nursing within the current healthcare context. As you can see, the recommendations validate that nurses are a critical part of delivering high-quality healthcare services to the citizens of our country, not just in traditional roles but in expanded roles as well.


If you have never actively engaged in helping to shape healthcare policy, now is the time to become involved. It is critical to visit your state legislators' office and verbalize your support for utilizing advanced practice nurses to the full extent of their education and certification in order to meet the healthcare needs of your state citizens. Legislators listen to their constituents, especially those who care enough to deliver their message in person. Likewise, contact your federal legislators through a personal visit, e-communication, or written letter to communicate your support for increased utilization of nurses to meet the primary healthcare needs of U.S. citizens. And do not just do this once. Make it a point to communicate at least once a month so that you keep nursing issues at the forefront. Often, you may not be able to see the legislator; you will typically meet with a staff member. Just know that staff members brief the legislator, and they will share your information. Your message will be heard. Do not doubt that.


Another critical action is to join the American Nurses Association (which also gives you automatic membership to your state nursing association). Numbers speak. Typically, most physicians belong to both the American Medical Association and their state medical association, making them one of the strongest lobbying groups in the country. Unfortunately, nurses do not join the American Nurses Association; this sends a message to legislators that we do not want to be involved in shaping healthcare policy. We cannot afford to be perceived as disengaged.


Joining and giving to the nursing political action committees at the national and state levels are also vital. Even the smallest donation makes a difference; funding is critical for us to deliver our message in a powerful way, especially during the current legislative sessions. With more than three million nurses in the United States, if each of us gave just one dollar, imagine the impact politically. And that impact multiplies as we give more than just one dollar.


At this moment in time, silence from nurses is no longer acceptable. Disengagement is no longer acceptable. Being uninformed about healthcare policy is unacceptable. Nurses must make a commitment to be involved actively in policy issues at some level, in some way. This is our time. We cannot afford to be silent. We cannot afford to be disengaged. This is the decade for nursing-if we make it happen. No one else will do it for us. We are responsible. We must deliver. We owe it to the citizens of our country. We owe it to our discipline. We owe it to ourselves.