Robert Wood Johnson Foundation Committee Robert Wood Johnson Foundation, in the year 2008, proposed a collaborative program with the IOM (Institute of Medicine) for evaluating and responding to the necessity of transforming the profession of nursing. Realizing that nurses encounter numerous difficulties and barriers when meeting national health requirements and the assurance of creating a reformed system of healthcare, the two organizations launched a program on the nursing profession's future, lasting two years. The keystone of the program was the committee made responsible for formulating a report consisting of suggestions for an action-based plan for nursing's future, including local-, state- and national-level changes to institutional and public policy. The committee explored nurses' ability to satisfy the requirements of a restructured system of public health and healthcare. It came up with a group of bold recommendations to be applied on a nationwide scale, including some which deal with nursing service delivery in an environment with a dearth of nursing staff and nursing education's capacity. The committee report outlined an explicit action plan and agenda, including local-, state- and national-level amendments in institutional and public policy. The recommendations dealt with an array of system modifications, including inventive means for resolving the nationwide issue of nursing staff shortage (Fitzpatrick, 2010). Recommendations pertaining to the problems listed below were explored and offered by the committee, with an aim to identify critical nursing roles with regard to the design and implementation of a more efficient and effective system of healthcare:

Re-conceptualizing nurses' role by considering the overall staff, the dearth in nursing professionals, existing and upcoming technology, and societal issues;

Enlarging nursing faculty, enhancing nursing education and training institutes' capacity, and reforming nursing education for ensuring that it is capable of producing a sufficient number of adequately-prepared nursing professionals qualified to handle present and upcoming healthcare needs;

Looking into innovative solutions pertaining to education and care delivery of the general health profession, and, in particular, nursing education and nursing service delivery; and Attraction and retention of qualified nurses in various health care settings, which include primary care, acute care, ambulatory, long-term patient care, public and community healthcare (Fitzpatrick, 2010).

Ever since the release of IOM's report labeled "Future of Nursing: Leading Change, Advancing Health," a significant amount of progress has been witnessed, including increased awareness of healthcare professionals' contribution to improving health in the U.S., supporting the academic progress of nurses, and promoting reform in nurses' practice scope to enable them practice their licensure and educational ability's utmost extent (in fact, the preliminary major message communicated by the aforementioned report is this last point) (IOM, 2010). This important message has two main subcategories: with regard to practice scope and nurse residency initiatives. The next major message communicated by this report is the need for nurses to acquire higher educational and training levels by means of a better system of education, which fosters smooth academic progress (IOM, 2010). A third important message conveyed expresses the need for nurse-physician partnerships (and partnerships with other health professionals as well) for the purpose of redesigning American healthcare structure (IOM, 2010). For attaining this objective, a transformation in nurses' perspective of their obligations to their patients, in addition to their relationships with team members at the workplace, is needed. Moreover, nurses need to obtain the requisite educational preparation for being able to work and cope with this newly-designed healthcare framework. The report's fourth major message is efficient planning and formulation of policies, which necessitates upgraded information infrastructure and improved data gathering (IOM, 2010). Two key subcategories are found under this message: with regard to policy formulation and efficient planning (Hinkle, Sullivan, Villanueva & Hickey, 2012). This report's recommendations are aimed at individual lawmakers; local, state, and federal governmental authorities; payers; healthcare professionals (including physicians and nurses), research scholars and managers; and larger groups like educational institutions, licensing authorities, consumer advocacy groups, and charitable organizations. A collaboration of the above entities may aid in ensuring that the nation's transformed healthcare structure offers smooth, superior quality, and reasonably-priced healthcare, which results in improved health and can be accessed by all (Fitzpatrick, 2010).

The Future of Nursing: Campaign for Action labeled forty-eight state-based partnerships as "Action Coalitions"; their goal is making sure every American citizen can access patient-centered, superior quality care, with maximum possible nurse contribution. These partnerships work together with the above mentioned campaign for implementing the IOM report's recommendations. They consist of countrywide leaders from the fields of healthcare (including nursing), consumer care, and business. The coalitions have primarily been instituted for advancing the Action Campaign. The presence of stakeholders from different fields ensures: sustainable regional or state level change; capturing of best practices; determination of research requirements;...

The campaign requests the active involvement of national organizations, states, and people hailing from the governmental, healthcare, educational, philanthropic, and business sectors, for ensuring that translation of IOM recommendations into actions leading to patient-focused care improvements (American Nurse Association, n.d). The Campaign, in particular, endeavors to implement IOM report recommendations with a focus on the areas listed below:
1. Strengthening nurse training/education.

1. Authorizing practice by nurses to the utmost limit of their training and education.

1. Promoting inter-professional partnership between different healthcare workers for ensuring better and coordinated patient care.

1. Bringing about improvements to healthcare staff data collection for increased assess and projecting of workforce requirements

1. Expanding the ranks of leadership for ensuring nurses can voice their views in boardrooms, management teams, and policy discourse (American Nurse Association, n.d).

The Action Coalition of New Mexico attempts to offer strategic direction by means of grassroots efforts and community cooperation, and the involvement of major stakeholders in transforming New Mexico residents' health. This Coalition represents a true alliance of individuals and organizations whose enthusiasm spurs the nursing profession's progress as a powerful partner and ally in improving state health (Campaign for Action, n.d). A couple of initiatives of New Mexico State are as follows:

1. New Mexico Nursing Student Diversity Assessment

The state of New Mexico distributed a diversity evaluation, recently, to all of the seventeen publicly-financed state nursing programs. The Academic Progression in Nursing (APIN) Diversity Committee will utilize the information garnered via this assessment to lead the New Mexico Nursing Education Consortium's (NMNEC's) diversity efforts. Frameworks will be put forward by the committee to assist nursing programs with engaging an increasingly diverse population of nursing students (Campaign for Action, n.d).

2. New Mexico "APIN's" advancement towards the target of 80% Bachelor of Science in Nursing (BSN) nurses by the year 2020, set by the IOM report

In a bid to achieve IOM's target of increasing BSN workforce, NMNEC has put in place a system in which community colleges team up with universities for offering BSN as a novel alternative. This was feasible, owing to the application of a state-wide common curriculum, which helped achieve curricular standardization. The state has, between 2012 and 2014, witnessed a 122% rise in enrolled BSN candidates: a 32% rise in student enrolment in the BSN course in Community Colleges where it is a novel option, and a 90% rise in student enrolment in the BSN course through Expansion of University Program (Campaign for Action, n.d).

The dearth in nursing staff has long- and short- term perspectives. From a short-range approach, one might contend that no nursing shortage exists. Historically, vacancies in nursing positions inversely indicate the nation's economic status. At times of economic growth, higher vacancies exist for nurses, whereas the number of vacancies drops at times of economic slumps. Nursing education financing is crucial for meeting future demands. Most funding is provided by the state's funding formula. There isn't any transparency regarding the application of this formula at the level of the program, within any institution (Centre for New Mexico nursing excellence, n.d).

Advocates must share a common goal: improving the profession of nursing through experience-sharing in order to make the process of hiring more efficient, as a number of recent graduates might face difficulties in finding employment. Economic depression is a significant factor affecting newly graduated nurses' employment, resulting in a torrent of veteran registered nurses who were thinking of retiring or had already retired, or shifted from part- to full-time work. But once an improvement takes place in the economy, together with a decrease in unemployment, a critical RN shortage will be witnessed (Chacon, 2015).