1. Potera, Carol


Editor's note: Each January AJN examines the major stories affecting nurses and health care during the previous year. This year's top stories aren't too different from those we highlighted last January: the continuing debate over the Patient Protection and Affordable Care Act and how to fix the floundering economy continue to top our list. And while we hoped that Congress would move past its partisan squabbling to address these incredibly important issues, it didn't happen, even among members of the bipartisan deficit "super committee," which failed to find a compromise solution to reduce the deficit. For nursing, it was all about whether the Institute of Medicine's Future of Nursing report would create change. Clinical news shows that consumers are still wary of vaccines and confused about screening guidelines; on a global level, the focus seems to have shifted from AIDS to noncommunicable diseases.


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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.

Linda Burnes Bolton ... - Click to enlarge in new windowLinda Burnes Bolton (left) and Susan Hassmiller at the October 2011 launch of the IOM's

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