Analysis of the Institute of Medicine Report: The Future of Nursing


The current paper concisely introduces the initiative launched on the part of the Robert Wood Johnson Foundation (RWJF) in collaboration with the Institute of Medicine (IOM) in 2008. The goal is to develop a feasible report assessing the condition of a healthcare field in the US, as well as outline recommendations in the following four key areas: nursing practice, nursing education, the status of nursing, and improved nursing infrastructure. The current paper highlights the major recommendations, as well as introduces a personal reflection upon the IOM recommendations and their practical implementation.

IOM Future of the Nursing Report and its Significance

The nursing profession is one of the oldest professions in the United States. Nursing holds an incredible degree of respect, it alone is of importance to the US and its culture. According to the Institute of Medicine, with more than 3 million members, the nursing profession is the largest part of the nation’s health care workforce. According to the Bureau of Labor Statistics, in 2016 there were 2,955,200 nurses employed in the United States and it is expected that by 2026 it will have increased by 15 percent. This information shows that nursing is huge and it is only going to expand. Nurses practice in different settings, whether it be home health, hospitals, schools, clinics, and many more. They also have many different levels of education such as associate degrees to bachelors to masters, and have different levels of skills, licensed practical nurses, registered nurses, nurse practitioners to name a few. With the increase demand for nurses and its peaking interest, it is vital to progress and improve our education to increase patient outcomes and improve the quality of care.

In the US, there was an issue with healthcare and professionals, the healthcare field was shattering, there were major differences between the patients and healthcare professionals, and patients weren’t having the best quality of care. There was a need for a comprehensive study to find various ways to improve the field of healthcare provision in order to offer affordable and patient-centered service in the future. In 2008, The Robert Wood Johnson Foundation (RWJF) and Institute of medicine collaborated to launch a 2-year initiative to respond to the need to assess and transform the nursing profession (Institute of Medicine, 2010). The basis of the program was to conduct a study that the main goal was to have a transformational report on the future of nursing.

A committee was formed to take action and to make recommendations and changes for the future of nursing. The committee took into consideration nurses’ roles, settings, and education levels in its effort to envision the future of the profession (IOM, 2010). The project focused on amending policies at the national, local and state levels. The Institute of Medicine began the essential and long-awaited transformation in the field of nursing (RWJF, 2014). The committee established four key messages. The first was that nurses should practice to the full extent of their education and training. The second was that nurses should attain higher levels of education and training. The third is nurses should participate with physicians and other health care professionals, in restructuring health care in the United States. The last was effective workforce planning and policy making require better data collection and an improved information infrastructure (IOM, 2010).

“We believe our nation cannot adequately address the challenges facing our health care system without also addressing the challenges facing the nursing profession,” said Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO of RWJF. “For health reform to succeed, and for patients to receive better care at a cost we can afford, we must change the way health care is delivered. And nursing is at the heart of patient care.”

There have been reported many incidents, when the opinion and advice of nurses are overlooked. Furthermore, the hospitals have unhealthy work environments because of the conflicts between nurses and physicians. Hence one of the directions the report is working towards, is to establish effective strategies to manage conflicts and nurture a healthy environment for nurses’ empowerment (Eide et. al, 2007).

As one of the goals, the IOM report emphasizes on transforming the existing nursing

education. To confirm the delivery of safe, patient-centered care across settings, the nursing

education system must be improved. Patient needs are becoming more demanding and nurses

need to learn to skills and competencies to keep up with the changing goals and priorities to be

able to deliver better quality care to patients. Continuing our education prepares us for improved and better effectiveness, improves our actions and thinking and provides us with professional information. Nurses need to continue education courses in order to grow their skills. Studies show that knowledge gained through basic professional education has a half-life of 2.5 years, and needs to be updated (

Zohreh Shahhosseini

, 2014). Lack of continuing education can lead to poor services to our patients. It is necessary to highlight a certain point within the recommendations of the IOM report, as it actively encourages to “increase the proportions of nurses with a baccalaureate degree to 80% by 2020” (IOM report, 2010, p. 2). Not only does the program specify potential nurses obtain a bachelor’s degree but also urges healthcare organizations to reimburse the tuition fee. Institute of Medicine in general is aiming to enhance and change the nursing field for the better by setting forth practical recommendations.

I believe that as the IOM report is a stapled document, every nurse should attempt to include as many recommendations and goals in his/her practice as possible. If we do contribute on an individual level, that will eventually lead to a global change. In order to follow the IOM recommendations, I personally foster inter-professional association and attempt to encourage nursing leadership in the work setting. Pursuing a Bachelor’s degree is just another step toward recognizing the importance of nursing education, as it promotes seamless academic progression. In my view, a nurse should practice to the full extent of her academic training and capabilities, as well as do his/her best to take part in various training,

residency, and research programs to always stay connected with the new findings and information in the field. Naturally, this should not be purely a nurse’s concern, as the healthcare institution

should also prioritize training its personnel, however, in many cases, a personal effort for self-development may encourage the institution to meet the needs of its staff.

I believe that the power to transform the healthcare system and improve patient outcomes lie in the combination of both individual and institutional efforts. It is essential for every healthcare practitioner to consciously be aware that nurses are an essential part of the healthcare system, and without evolving and empowering nursing it would be impossible to better the healthcare services in general.


  1. Bureau of Labor Statistics. (2016). Occupational Outlook Handbook: Registered Nurses. Retrieved from:
  2. Institute of Medicine (IOM). (2010). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press. Retrieved from
  3. Eide, Y., Hansen, J., Keller, P. et al. Implementation of the IOM Future of Nursing Report: A Wisconsin Profile. (2010). Retrieved from:
  4. Robert Wood Johnson Foundation, (2014). Our mission: to improve the health and health care of all Americans. Retrieved from
  5. The Future of Nursing Leading Change, Advancing Health, Report Recommendation. Retrieved from Institute of Medicine of the National Academies
  6. Shahhossein. (2014). The Facilitators and Barriers to Nurses’ Participation in Continuing Education Programs: A Mixed Method Explanatory Sequential Study. Retrieved from  Global Journal of Health Science




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