Health care remains the focal responsibility of every nation that values and protects the welfare of its citizens. Health plays a pivotal role in determining the countrys daily well-being and economic stability. Health of the nation must be primarily considered since it predetermines any countrys wealth. The US government has always demonstrated momentous concern about the state of health in the whole nation, but changing times always bring new and unique demands. There has been a dire need to initiate an overhaul reform agenda in the United States health sector. Among the efforts required for this crucial exercise was the prerequisite task of evaluation of the health sector, which was undertaken by the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine (IOM). Led by Donna E. Shalala, Ph.D., the committee spearheaded research activities that resulted in the drafting of a comprehensive report that would be a blueprint for the necessary transformation required to be implemented in healthcare. This essay unveils the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine that influenced creation of the IOM report Future of Nursing: Leading Change, Advancing Health. The paper discusses the importance of the report in nursing practice, education and workforce development. Moreover, it identifies the role of state-based action coalitions and the way they advance goals of the initiative called Future of Nursing: Campaign for Action. Lastly, the essay reviews the progress report of Florida by focusing on two initiatives of its Action Coalition, as well as the ways in which they advance nursing profession and the barriers that hinder the process.

Significance of IOM Future of Nursing Report

The report of the Robert Wood Johnson Foundation (RWJF) and the IOM-FON is considerable in a number of ways. First, through its intensive research of the state of affairs of the health care facilities and nursing practice in general, the report explicitly unveiled the strengths and weaknesses that characterize the health care sector. Some of the areas that attracted much concern were under-utilization of education and training by nurses across board. Widespread laxity and complacency deprived the sector of capacity to realize the objectives enshrined in the national health scheme (Campaign for Action, 2014). Similarly, there was a dire need for review of the nursing curriculum that would match the current state of educational and technological demands. Most of the registered nurses proved to be below the required levels of education and training, which resulted in substandard service delivery. Besides, as observed, there was a blatant lack of partnership between nurses and physicians, which contributed to failure in redesigning healthcare throughout the United States. Finally, the committee spotted massive irregularities in data collection systems and information programs, which hindered effective workforce planning and policy making (Campaign for Action, 2014).

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Other significant aspects of The Future of Nursing report are recommendations and guidelines that the committee raised, which, if well implemented, will transform the US health care into the best one, and the whole world will follow its example. Some of these recommendations are directed to individual policy makers, local government leaders, as well as state and national authorities (Campaign for Action, 2014). Health care researchers, medical executives, and professionals, as well as superior groups, such as licensing bodies, learning institutions, charitable organizations, and consumer advocacy organizations are all among entities targeted by the IOM report. It is hoped that the healthcare provided will ultimately be affordable, seamless, accessible to everyone, as well as multifarious and qualitative due to concerted efforts employed by these diverse groups.

To ensure that nurses are in the best position to respond effectively to rapidly changing healthcare settings, the committee recommended an overhaul approach in order to eradicate the existing barriers that have disfigured the healthcare sector and caused unnecessary inflation affecting the cost of facilities, which is subsequently transferred to the patients. The committee also expressed optimism about the success of recommendations due to luxuriant enrolment of approximately 3 million registered nurses across the US. Thus, it is hoped that they will swiftly and comprehensively put the new methods into practice (Campaign for Action, 2014).

Among the recommendations cited are efforts to remove practice barriers, which would enable the registered nurses to practice their education and training. Reportedly, the sector had a number of nurses with high qualifications, which were acutely underutilized. Besides, there would be a need to expand opportunities for nurses to lead and diffuse collaborative efforts of improvement. This would involve public and private funders, healthcare organizations, nursing education programs and nursing associations. Through these collaborative efforts, it is expected that the members of the health team will conduct researches that are necessary for redesigning and improving the environment and health systems.

Nurse Residency programs were also among the recommendations contained in the IOM report. This would enable nurses to undergo a complete transition to practice program after the completion of their pre-licensure degree program. Furthermore, IOM recommended an increase in the number of nurses with Bachelors degree from 50% to 80%; such prospects are to be attained till 2020 (Campaign for Action, 2014). The academic nurse leaders would also be required to cooperate with the accrediting educational bodies, private and public funders and other employers to ensure they get sufficient funding. It also involves monitoring progress and increasing diversity of students as a way of creating a workforce prepared to meet the dynamic demands of populations from diverse backgrounds.

Simultaneously, there was a crucial need to double the number of nurses with doctorate degree by 2020 (Campaign for Action, 2014). This would prompt the accrediting bodies, academic administrators and university trustees to employ all the necessary strategies that would help the practicing nurses to advance their studies in order to meet the demands posed by the contemporary health issues. This measure will ensure that nurses engage in lifelong learning to align with the changing times. Nurses will have the right capacity to spearhead the change and adapt to advanced health care through adequate knowledge and skills. Some of them will also attain the right status to be entrusted with leadership responsibilities in the health sector.

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Finally, the IOM-FON report recommended building an infrastructure for the collection and analysis of data on inter-professional healthcare workforce. This would encompass the National Health Care Workforce Commission in collaboration with the Health Resources and Services Administration and Government Accountability Office. The collective responsibility undertaken by these entities would result in improved research, collection and data analysis on the requirements of healthcare workforce. The collaboration with the state licensing boards, state nursing workforce centers and the labor department is also necessary in an effort to foster adequate accessibility of data to the public.

Role of State-based Action Coalitions

State-based Action Coalitions are very significant in ensuring the Health Act is complete and properly functional, serving the purpose it was intended to. The state health officials would be responsible for the implementation of the highlighted recommendations, as directed by the IOM, under the supervision of the national governments health leadership. They receive direct orders and put them into practice, being liable for any development within their areas of jurisdiction (Blustein, 2011).

Furthermore, the Action Coalitions would ensure proper feedback to the national government concerning the progress of the health care projects. They will also make further remedial suggestions of amendments to the IOM recommendations depending on the prevailing circumstances. Apart from that, the coalitions are charged with the responsibility of maintaining the proper state of health facilities by ensuring that the required infrastructures are functional and fulfilling renovation and expansion plans. They also make necessary orders regarding stocks of implements and medicinal drugs, additional staff, educational and training facilities, among others.

In addition, the Action Coalitions oversee day-to-day administration and supervision of nursing activities. They are responsible for delegation of roles to various nurses, making them accountable for their actions. They are in charge of deployment of staff when it is required, conducting routine assessment and facilitating quality assurance workshops and seminars. Finally, the states Action Coalitions ensure the welfare of nurses and clinical officers by reviewing their terms, from time to time depending on their productivity. They also ensure conduciveness of the environment in which they work and reside. Security of the staff while on and out of duty is the most important aspect.

Initiatives of Floridas Action Coalition

In Floridas Action Coalition, nurses and doctors are working together to improve and transform the nursing profession and the general state of health in the entire state. The Action Coalition has first identified the need to fully utilize their education and training by devising practical projects which are geared towards boosting the health standards of individuals (Campaign for Action, 2014). They also intend to reach out to individuals through social gatherings and other forums to sensitize them about the prevalence of some health dangers, as well as prevention of the occurrence of some contagious diseases. Its main purpose is not to make patients wait and suffer, spending much money on curative measures.

Another initiative is to improve proficiency of all nurses and medical practitioners through further training, workshops, seminars, and benchmarking within the best health centers and institutions in the entire country (Welton, 2011). They have co-opted members of the civil society in their doctor-led committees as a way of ensuring that new reforms conform to demands of common citizens as quickly and efficiently as possible. These initiatives have been overwhelmingly received by the citizens of Florida who have demonstrated high spirit of cooperation and support towards them. Therefore, there is a high likelihood that the initiatives will become profitable and change the face of Florida in terms of health.

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Barriers Hindering the Process of Implementation of the Initiatives

The biggest barrier to the implementation of these initiatives is the vagueness of health policies dictated by the national government, which are sometimes confounding to implement due to lack of conformity with a particular situation (Auerbach, 2012). It usually obliges the state health leadership to convene and redraft policies that suit the situation in the health sector. For instance, the national health insurance scheme usually has serious contradictions with the local health insurance schemes, which bring about much confusion.

Besides, the occasional cases of corruption, such as misuse of authority by health leadership, favoritism, and embezzlement of health funds, among others, have largely disfigured the health sector of Florida (Auerbach, 2012). It is also significant to emphasize sexual harassment cases that have been on the rise among the nursing staff, compromising the integrity of these nurses and other physicians, which led to low productivity.

Furthermore, there has been a problem of insufficient facilities, which has been compelling doctors to refer patients with complicated ailments to hospitals in other states or even outside the country for specialized medication. This has been the reason behind some deaths due to delays that were experienced during travels between different hospitals. However, Floridas government is lobbying for more funds from the national government and other financiers in order to address the identified shortfalls (Campaign for Action, 2014).


The IOM Future of Nursing report is opportune since it was initiated at the time when the world has made tremendous advancements in education and technology. It is the only way to assure the United States to develop its health care sector more quickly in order to address the challenges that have been disfiguring the health department. Overhaul transformation of the sector in terms of facilities and the training curriculum is necessary because it will ensure that medics are compatible with the current hi-tech infrastructure. Failure to harmonize the expertise with the facilities can be detrimental to both the patients and the nurses, which will result in massive loss of lives. It is the task of the US government to improve the current conditions of business and organizational regulations. To fully achieve this, the responsibility has to be extended to nurses, business entities, especially pharmacies and chemists, professional associations, health care organizations, and the insurance industry. All of them play distinct roles, but gear towards the common goal to improve health standards in the country. The recommendations provided in the IOM report are targeted at individual policy makers, including national, state, and local government leaders; health care researchers, executives, and professionals, including physicians and nurses; and funders of various health programs. Other significant parties include licensing bodies, educational institutions, humanitarian organizations, such as Red-Cross International and St. Johns Ambulance, and consumer advocacy organizations. The joint work of these numerous diverse parties is a perfect way to ensure that the system of healthcare provided throughout the United States of America is qualitative, seamless, affordable, and readily accessible to all who are in dire need for it. As the saying goes, health is wealth.

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