This month, we celebrate the 50th anniversary of a group of federal programs that have helped shape the face of nursing and health care. In 1964, U.S. lawmakers recognized the importance of nursing care—and of having sufficient nurses to meet our nation’s ongoing needs—by creating Title VIII, or Nursing Workforce Development, programs. Investing in the nursing workforce back then was a wise decision. It’s equally important now.
Through institutional grants and individual loans and scholarships, Title VIII programs offer aspiring registered nurses (RNs) the chance to pursue a nursing education and begin their practice, including RNs from underrepresented populations. These programs also help practicing nurses advance their education and take on new roles, and ensure that patients in rural and other critical-need areas have access to nursing care and services. From fiscal years 2006 to 2012 alone, Title VIII supported the education of more than 450,000 nurses and nursing students, as well as the workforce-building efforts of numerous academic institutions and healthcare facilities.
To recognize the lasting impact of Title VIII, the American Nurses Association (ANA) and 59 other national nurses associations planned a Congressional reception for September 8 and visits to lawmakers on Capitol Hill September 9 to advocate for continued support and federal funding of these programs. Current federal estimates predict that the nation needs to produce more than 1 million RNs by 2022 to fill new positions and those opening up as a large number of nurses eventually retire. Nursing college faculties will need to grow by 50% to offset projected instructor retirements.
There are other critical components we must focus on if we want a relevant and secure workforce now and in the future. Although ANA has been successful in promoting nurses to serve on national panels and in key policy roles, we must ramp up our efforts to raise nursing’s visibility and voice. We need more nurses at local, state, and national tables participating in and leading discussions on how we can best deliver care in an evolving landscape. I urge all nurses to get involved and take your advocacy national.
As the Affordable Care Act and other influences continue to shift healthcare delivery away from acute, inpatient care, we need to develop a blueprint in which we define meaningful and financially sustainable roles for nurses where the new jobs are likely to be located—outpatient and other community-based settings. This blueprint should include our best thinking on ways to prepare nurses for these roles, as well as determine indicators that concretely measure nurses’ impact on patient outcomes in these settings. We were successful in demonstrating nursing’s impact on quality in acute care; given the sharp focus on value-based care now, we must demonstrate it in this arena as well.
In terms of immediate workforce needs, nurses already have the expertise in care coordination, and we should stake our claim in this growing area. Palliative care, health promotion, health information technology, and quality are other areas that can benefit from our expertise if we are willing to prepare and take an even greater role in those activities. ANA has many resources to help nurses become more knowledgeable in care-coordination efforts, build their leadership and other skills, and advance their careers at www.nursingworld.org.
Finally, ANA and the greater nursing community are asking federal lawmakers to approve $251 million for Title VIII funding for fiscal year 2015 because, like 50 years ago, the need for nursing care is vital to health care and our patients. We also need to invest in ourselves by creating a plan that’s both visionary and realistic, preparing ourselves and those just entering the pipeline for new roles, and being open to what lies ahead. It’s the wise thing to do.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN
President, American Nurses Association