Episode Transcript
Interviewer: It seems impossible to turn on the news and not hear something about Healthcare Reform, but what role do nurses play in these big changes? Pamela Cipriano, President of the American Nurses Association and graduate of the Ï㽶ÊÓƵ of Utah College of Nursing will be sharing her insight on the future of nursing.
Announcer: These are the conversations happening inside heath care that are going to transform health care. The Health Care Insider is on The Scope.
Interviewer: Hello, Dr. Cipriano, and welcome to the studio. First, I just want to congratulate you on being the distinguished alumni for the Ï㽶ÊÓƵ of Utah School of Nursing, as well as being elected as the President of the American Nurses Association within the same year. This has been quite a big year for you.
Dr. Cipriano: It really has. Thank you so much, and I'm very honored to be the distinguished alumna for this year. As you know I completed my PhD in Nursing in 1992 and it was a very rewarding experience. It's been a very important part of my career.
Interviewer: We hear a lot about health care reform but very little about how nurses play a role. Where do nurses fit into the big changes taking place in health care?
Dr. Cipriano: The Affordable Care Act is probably one of the most significant pieces of legislation that we've seen since the mid-20th century. So when we think about all the changes of now additional people having health care coverage, being able to seek care from the provider of their choice and make sure that we're also looking at the preventive health care needs, nurses are playing a significant role in that transition.
We like to think of it as nurses helping transform health care. We have nurses that are now working in settings other than the hospital, where they actually have been working in public health departments and clinics and offices, but there's been a huge expansion in the post-hospital environment. We have many more nurses working in home care and transitional care, hospital and programs, so nurses are everywhere that people need care and they're also helping to make sure that people can be independent and stay at home and stay healthy.
Interviewer: What would you say is the number one thing nurses need to be doing to tackle the issues that we're seeing in health care right now?
Dr. Cipriano: Well, there's a number of nursing issues as well as overall health care issues. I would focus attention on the Institute of Medicine's report on the future of nursing that was released on October of 2010. It really put together a road map for some of the improvements that we really need to see for nursing to reach its full potential to help transform the health care system. Those are things like really increasing the education of all nurses across the country. There are many, many efforts to make sure that nurses are pursuing not only their bachelor's degrees but advanced degrees, master's and doctoral degrees.
We want to remove the barriers to advanced practice nurses so they can practice more independently and have parity in being able to be compensated appropriately. We also have a number of efforts focused on making sure that nurses are placed in leadership positions. Even though there is over three million nurses in the United States, registered nurses, they're not necessarily always at the decision-making tables and we really believe they have a lot to offer as we look at health care. And then the fourth part of the recommendations from this report was to make sure that we have really good data about the nursing workforce because we know that as we've had nursing shortages that can lead to problems with outcomes in patient care.
So those four areas are really focused on strengthening nursing, but I think the other part of your question is really saying what else do nurses need to be involved in, in terms of helping to move the whole health care industry forward. Part of it is nurses are really great partners for patients and families. We really look to nurses to help be translators. When we think about some of the challenges and having an individual sign-up for health care insurance through the new marketplace options, nurses are there to help them.
When we think about management of chronic diseases and medications and things like that, nurses are there to help them. So nurses are really an important part of educating and partnering with the public to make sure that we're focused on the goals for the future, which include prevention, health maintenance as well as being able to get the kind of care that's necessary if you do have a situation that requires any urgent or hospital care.
Interviewer: Now you mentioned about having nurses in leadership positions. You, yourself, are a nurse who has been in a leadership position. You've just been elected as the President of the American Nurses Association which is a national organization representing 3.1 million nurses. Can you tell us what your role is there and how you hope to guide this organization in the future years?
Dr. Cipriano: The ANA is really the most comprehensive organization that does represent the interest of registered nurses in the United States. My role is really to provide leadership to our board of directors and through that, help the State Nurses Associations that are our members in addition to other specialty organizations that are affiliated organizations that work with us to do several things.
One is to really again sort of broaden the reach of nurses to be sure that they are occupying leadership positions in their communities and their states and nationally. We participate in political advocacy activities to make sure that we are supporting the kinds of laws and regulations that will improve health care.
We also look very carefully at the improvement of quality for patients and for nurses. We want an environment that not only keeps patients safe but keeps nurses safe. We also advocate strongly for healthy nurses so we have nurses engaged in doing their own health assessment, looking at their nutrition, looking at their exercise levels, their own personal screening and making sure that they're staying healthy and that their workplace supports an environment that allows them to be healthy.
We also believe it's really important that nurses make sure that they are continuing their education. We believe in lifelong learning. We believe in certification and other credentialing, but again, really focuses on nurses being able to practice to the full extent of their education and licensure. We also are supporting efforts across the country in each state to make sure that advanced practice nurses are able to practice to the full extent of their abilities as well, because they are a really important part of increasing access to care in many of our communities, particularly the underserved communities, whether they be urban or rural, the places where we know that people really need to receive health care.
So we have a broad range of initiatives that also includes strengthening our own membership across the country, but more importantly, focused on how we can make sure that health care is in the different locations where patients and families really need access.
Interviewer: That all sounds incredible. Is there one area that you are just particularly excited about for the future?
Dr. Cipriano: One of the things that we know is that health care continues to grow as one of the most important areas of our gross domestic product and as we look at employment. The registered nurse job continues to be one of the most sought after and one we continue to project the demand. Part of that demand is that the baby boom generation is living longer, wanting to be healthy, and so in addition to consuming health care services, they're also really focused on how to life a longer healthy life where they are active and can maintain the level of exercise and involvement in their communities.
So when we look at the role for nurses, we know that there is going to continue to be a very high demand, and so that's really why we're focused on making sure that we have continued federal funding support for nursing education. We just celebrated 50 years of Title A which is Nurse Training Act funds which has helped educate nurses at all levels for 50 years, and we know that when that funding is in place we don't see shortages of nurses, so we really want to maintain and increase that funding.
But in addition, we want to make sure that nurses are in roles, again, not only in the hospitals where they are critically important but across our communities, in the home, in new jobs that are really looking at the transitions of care and able to coach and manage care for patients to keep them healthy. So we see a very bright and rosy picture for nurses and a continuing demand because nurses are really a critical component to the health care team. Interviewer: Finally, can you please share where you see the future of nursing heading?
Dr. Cipriano: Nurses will continue to be very involved in advocating for patients and families, and so our relationship with consumers will only grow. Similarly, that some of the changes that we see happening is much stronger teamwork within the health care team. Education, together with other disciplines, so we would have nursing, medicine, pharmacy, social work, therapies, we're going to see a much more intense teamwork environment just as we expect that we're going to see continued improvement in the quality and outcomes because we're going to have people working together more closely, really focused on involving that patient and family in their care, in the planning, in the decision making, so that what we'll see is a health care system that is not provider-centric only, but really again is very much involving the patient and family because we think that's really important.
In addition, as we've seen the explosion of technology, we know that patients as consumers will continue to be contributing more and more data about their care, taking a greater interest in staying healthy, and nurses are often the bridge between that technology and the health care setting. We will continue to see a whole field evolve where, again, nurses are not just occupying the traditional roles that we've seen that we think about, which again are critically important but are really moving into new roles where they are helping patients and families be an active part of their care.
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