This paper examines the projected growth of the nursing profession and the transformative forces reshaping nursing practice in the United States. It reviews workforce data indicating strong demand for registered nurses, discusses key frameworks such as the Institute of Medicine's recommendations and the Affordable Care Act of 2010, and explores models like Nurse-Managed Health Clinics and Patient-Centered Medical Homes that are expanding nurses' roles. The paper also presents firsthand perspectives from practicing nurse practitioners, military nurse officers, and nursing faculty, illustrating how policy changes, regulatory reform, and clinical leadership opportunities are redefining what it means to be a nurse in a rapidly evolving healthcare system.
The aging of both the general population and healthcare providers, coupled with ongoing reforms to healthcare, will raise demands for professionals in the field while also expanding the required skill sets and roles of existing professionals. Physicians, physician assistants, nurse practitioners, nurses, and medical assistants are all included in this growth area. Fortunately, healthcare is characterized by a swiftly expanding and large workforce — with approximately 23,000 new entrants every month nationally — and this sector progressed even during recent economic recessions (Survey, 2013).
Registered Nursing (RN) is one of the leading U.S. occupations, projected to grow 26% and add the highest number of new jobs by 2020 — an estimated 1.2 million RNs overall — according to the U.S. Bureau of Labor Statistics (Survey, 2013). This growth stems from a projected rise in demand as well as the need to replace the current aging RN workforce. Nursing careers are increasingly being pursued in America; the number of students enrolled in Bachelor of Science in Nursing (BSN) programs increased by approximately 20,000 (5.1%) in 2011 compared to 2010 figures. At the same time, there are indications that qualified applicants are being turned away from training programs due to limited financial resources and faculty shortages (Survey, 2013).
An American Association of Colleges of Nursing survey conducted in 2011 revealed the number of BSN graduates to be over 80,000 students, including approximately 28,000 (or 35%) from BSN completion courses and 52,922 from entry-level courses. BSN completion-course enrollments have risen annually for nine consecutive years, with the 2011 increase reaching 15.8% (Survey, 2013).
The Institute of Medicine (IOM) report on the future of nursing identifies hurdles, explains new opportunities and systems, and offers a particular vision regarding the crucial contribution of Advanced Practice Nurses (APNs) to healthcare. The report addresses all nursing levels while placing the greatest emphasis on APNs. It details three Accountable Care Organization examples, along with how nurses' full potential can be harnessed to deliver high-value, high-quality healthcare (Ridge, 2011). Restructuring and expanding nurses' roles can help achieve positive outcomes in value, quality, and access by maximizing nursing's scope relative to education and training.
Kaiser Permanente's Vice President of Patient Services Program Office has stated that the future is not just on the horizon — it is already here. Kaiser Permanente, the Veterans' Affairs (VA) department, and Geisinger Health System are three healthcare delivery organizations that are maximizing nursing's scope. They have adopted programs that provide real-world proof of how nursing practice at its best can positively impact patient health outcomes and the broader healthcare system (Ridge, 2011).
The VA's shift to a care-focused system bases itself on the maximization of nurse practitioners (NPs) as primary healthcare providers. VA NPs conduct their practice within an environment of professional teamwork. As a result, by 2007, VA patients were able to obtain more accessible, higher-quality healthcare than comparable Medicare recipients. The report also highlights Geisinger, a private nonprofit, for its transformation from a specialty-focused, high-cost healthcare facility into a high-value organization (Ridge, 2011).
"NMHCs and PCMHs as vehicles for nursing-led care"
"NP, military officer, and faculty voices on reform"
"Leadership and investment needed to sustain nursing growth"
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