Nursing
Children's Nurses Support The Future of Nursing Report
In 2010, the Robert Wood Johnson Foundation and the Institute of Medicine released a hallmark report that some people refer to as "a call to action" entitled "The Future of Nursing: Leading Change, Advancing Health." Boston Children's Nursing staff are committed to working with regional and national nurse leaders and other stakeholders to advance the objectives laid out in the report.
Four Key Messages of the Report

Nurses should practice to the full extent of their education and training.
The Eight Report Recommendations & What They Mean for Staff Nurses
| Recommendation | Why It Matters | What You Can Do |
|---|---|---|
| Remove scope-of-practice-barriers. | This is largely about the ability of advanced practice registered nurses (nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, and certified nurse midwives) to practice to the full extent of their education and training. However, to efficiently provide the best care to patients, improve access to care and improve health care quality, it is important that the practice of registered nurses at all levels and in all settings practice encompasses the full extent of their education and training. | Know the your scope of your own practice! The Board of Registration in Nursing (link at bottom of page) is a great resource for this information. Work with your nurse leaders to identify barriers in practice at your institution and in your state, and work to ensure your scope of practice accurately reflects the extent of your education and training. Starting the conversation is a great first step. Professional organizations are another good resource for scope-of-practice questions. |
| Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. | Nurses are on the frontlines of patient care and understand what is working well and where improvements are needed. This understanding positions nurses to lead health care transformation. By working collaboratively with providers throughout the health care system, nurses at all levels can participate in developing networks and care delivery models to improve health care for all patients in America. | Talk with your managers and nurse leaders about opportunities for collaboration within your organization and practice environment to advance patient care. Look for opportunities to work across disciplines to develop new ways of providing care. Participate in decision-making forums within your place of employment, professional organization, or school of nursing. Follow health policy debates and participate. A nursing prospective enhances the conversation. |
| Implement nurse residency programs. | Residency programs offer training that is more specific to a particular practice setting than the content offered in formal education programs, and more specific than material provided during a general orientation program. Pilot residency programs demonstrate that filling this educational gap leads to a high degree of satisfaction in nurses entering practice and nurse preceptors. Stakeholders in nursing are encouraged to support nurse residency programs for those who have completed pre-licensure or advanced practice degrees, or for nurses are transitioning to a new area of practice. | Share your practice! Building such programs takes a range of expertise, so think about how you can contribute. If you enjoy teaching and mentoring, work with educators and nurse leaders in your area on how to best help new nurses (of all levels) transition into a successful practice. |
| Increase the proportion of nurses with a BSN to 80% by 2020. | Nurse leaders and educators have an obligation to prepare a nursing workforce that is well equipped to meet the healthcare needs of a diverse patient population across the lifespan. Currently 50% of the nursing workforce has a BSN, but the demands of an increasingly complex healthcare environment will require different skill sets than nurses have today. Nurses develop many of these skill sets through continuing formal education. | Examine your own needs, priorities and goals. Where would like your nursing career to go? Talk with nurse leaders about educational opportunities that would help you meet your goals. Follow the work of the Massachusetts Action Coalition as the group works to define pathways for seamless academic progression for nurses at all levels of practice. |
| Double the number of nurses with a doctorate by 2020. | Advanced nursing degrees prepare nurses not only to meet the needs of a diverse patient population across the lifespan, but also impact the transformation of the American healthcare system. Doctorally prepared nurses are needed to widen the pipeline of nurses prepared to enter the workforce, to advance practice at the bedside, in public policy forums, and everywhere in-between, and to continue to advance the science of nursing through research. | Examine your professional goals. Reach out to nurse leaders and mentors about educational opportunities that might interest you. If you don't wish to pursue a doctoral degree right now, think about how you can support others in their advancement and how you can support the work being done to improve nursing care at the bedside, promote education, and shape healthcare policy. |
| Ensure that nurses engage in lifelong learning. | Staying informed on changing practices and trends in care is critical to providing high quality patient care. So whether through formal education at a school, or continuing education programs at your place of employment or professional organization stay committed to staying informed about best practices, shifting patient demographics, care needs, new technologies, and health policies related to nursing practice. | Look for educational programs that interest you. Talk to your colleagues about programs they are attending, and think about topics that could help you advance or enhance your practice. Talk to nursing leaders about your ideas and contribute to the education planning in your area of practice. Certification in a specialty is another great way to stay up to date on current practice trends. |
| Prepare and enable nurses to lead change and advance health. | Nurses are recognized and appreciated for their holistic and patient- centered view of the health care system. This recommendation urges nurses to share this perspective in a productive way. Preparing nurses for leadership positions across all levels of the health care continuum is an essential part of developing the nursing workforce of the future. Likewise, public, private and government health care decision makers should ensure positions are available to and filled by nurses. | Get involved and participate in the nursing governance structures that surround your practice, whether you work in a hospital, in the community, at a school of nursing, or within a professional organization. Work with nursing leaders to develop your ideas, and learn about others’ ideas for improving patient care and health care. |
| Build an infrastructure for the collection and analysis of interprofessional healthcare workforce. | Reliable data is needed to effectively identify and address issues such as nursing shortages, specialty nursing preparation, levels of education, nurses’ contributions to preventive, curative, and palliative care, and demand for nurses. Building these data sets will require collaboration between many national and state agencies including the Department of Labor and state boards of nursing. | One way to support this recommendation is to answer all questions on your nursing license renewal form as well as any questionnaires, research, or surveys you are selected or requested to complete. |


