What should we teach the nurse of the future?

Marla Salmon, dean of the UW School of Nursing will be a speaker a Forum on the Future of Nursing: Education sponsored by the Robert Wood Johnson Foundation and the Institute of Medicine as part of the RWJF/IOM Initiative on the Future of Nursing.

Below is Dean Salmon’s blog starting the conversation on the Foundation’s Future of Nursing Blog, reprinted with the Foundation’s permission.

Marla Salmon:

The call for more highly skilled nurses is not a new one. Nor is the question of what we should teach to prepare nurses for meeting this and other challenges in the future. What is new, though, is the opportunity for people to exchange ideas and answers in the “blogosphere” and to know that these will be shared with an exceptionally significant and timely national leadership group: the Initiative on the Future of Nursing. I’m very pleased to have an opportunity to begin a discussion now that focuses on the question of nursing education for the future.

“Nursing is at the center of caring.” We’ve all heard this; it’s where I want to start my comments. More than ever nurses are being looked to as an answer to the increasingly complex challenges of health care today. Nurses are at the crucial interface between the science, technology, financing, policy, service system, and the people whose lives and health are impacted by these. Nurses are not only delivering individual, family and community health services, they are leading in this work. And, they are supporting new and emerging enterprises that surround health in the US. It is clear that nursing’s capacity to provide even the most basic services is more challenged than ever, given the increase in chronic disease, demographics of our population and limitations on resources. Add to this the increasing system’s administrative and technological requirements associated with managing care, improving quality and safety, developing new and better ways to improve health, and educating future generations of nurses.

So, back to the question: what should we teach? Or, more importantly, what should one learn to be an effective nurse across the career span? It’s this latter question that I’m thinking about most. I have to admit, though, I don’t have a single or complete answer. However, I do believe that the right answers will be found through starting with a fundamental realization: nursing’s relevance and impact lie in its capacity to serve society. As such, our educational institutions and professions must really ground their work in making real—that is, effective and affordable—differences in the health and wellbeing of people.

As I’ve thought about this idea of relevance relative to nursing education, I’ve bumped up against a second, deceptively simple realization: education that really matters is only possible when institutions have what they need to educate. Nursing education today is seriously compromised by three key factors: the shortage of well prepared faculty, lack of optimal educational facilities and technology, and the need for more effective partnerships between education, practice, and learners to enable lifelong professional learning. A fourth factor maybe that this nation lacks clear, cross-sectoral roadmaps that help guide education in meeting the needs of students, the profession and society at large.

Before I give you an opportunity to weigh in, I’m going to throw out a couple beginning statements for your consideration. They are here to simply start the ball rolling.

Teaching is not learning. Learning takes place formally and informally across the lifetime. It needs to be somehow better connected. A good start would be strengthening the connection between initial, graduate and continuing education. These linkages are not well defined – nor are resources that are now separately associated with each. Perhaps we should think about the possibility of a lifelong learning “curriculum” or some sort of career development framework as a way of shaping some new conversations about education and learning. This could engage both our educational and service institutions in supportive and coordinated ways.

Education isn’t the only way to give nurses the knowledge they need. Nurses need to know more than ever to practice effectively – and, there is more knowledge available to meet that need. However, this doesn’t necessarily equate to adding years to degree programs and creating new programs. We are increasingly challenged to figure out what a nurse needs to know as a foundation for practice and what he or she needs to know to access, assess, manage and utilize the burgeoning knowledge that is now technologically available. The latter is an area of important focus for future education. The management and application of knowledge both during the educational process and in “real time” at the point of service are crucial to the future of both education and practice in nursing.

Nursing education really can’t do it all alone. If education is to really be on the “right” track, educators, practitioners, policy makers, funders and society at large need to have a shared sense of what nursing is being asked to do and what it needs to make that happen. While nursing must be a part of the discussions that shape this understanding, it will be through the work of the Initiative and other key leadership bodies that such understanding and guidance can be developed.

What nurses do today is not what they will need to do tomorrow. As we look to educate nurses for the future, we must not overlook a key, often invisible function: our ability to continue to improve the practice and impact of nursing on health. Nursing’s research capacity is crucial to discovering and translating the knowledge and innovation necessary to advance all that nurses do. Unless we educate future generations of well prepared nurse scientists, we won’t make the gains in education and practice that are required now and in the future. And we need to identify the key work that needs to take place in developing clarity, coordination, innovation and collaboration in the initial and ongoing education and training of nurses. As with the entire nursing workforce, this is an issue of increasing numbers while enhancing quality. This means increasing support for research-intense educational programs and their students, an area of discussion that has been largely ignored in the national discussion about getting more and better nurses out the door. This means that any national agenda or roadmap as relating to nursing education must address this crucial keystone for the future.

So, that’s it – the ball is rolling. I’m going to stop here. Fellow bloggers, it’s now in your court! Take a whack!

Marla Salmon, Sc.D., R.N., F.A.A.N., is the Robert G. and Jean A. Reid Dean in Nursing at the University of Washington School of Nursing. Dean Salmon will serve as a speaker at the Forum on the Future Nursing: Education in Houston, Texas on February 22, 2010.

Tags: Education, Nursing, Robert Wood Johnson Foundation, University of Washington

Category: Education, Nurses, Politics & Policy, University of Washington