Clinical Nurse
Leader Remarks
Delivered by AACN President Kathleen Ann Long
at the Business Meeting on Monday,
October 27, 2003 I.
Brief History In 1999,
nurse educators were faced with the fifth consecutive year of declining enrollments
in baccalaureate nursing programs. At the same time, the Institute of Medicine
released its landmark report, To Err is Human: Building a Safer Health System,
which called on health care systems to reorient their efforts to reduce medical
errors and improve patient safety. In this climate, the AACN Board of Directors
identified some primary concerns related to care delivery. Board
of Directors Concerns - In general,
we have not succeeded in differentiating practice of RNs with different educational
preparation.
- In general, numerous reports have
shown that care provided to patients is not high quality (series of reports, IOM,
AHA, JCAHO, RWJ and our own experiences as patients or family members of patients).
Every general trend has exceptions and, in some places, excellent patient care
is available.
- The knowledge base for nurses has
increased dramatically (e.g., genetics, pharmacology) and delivery system is much
more complex.
Based on these 3 complex
issues, the AACN Board of Directors was compelled to take action and formed the
Task Force on Education and Regulation for Professional Nursing Practice #1 (TFER
#1). Task
Force on Education and Regulation for Professional Nursing Practice #1 - Seeking
Answers - The task force developed new
educational models, including a "New Nurse" graduate, educated beyond
a 4-year baccalaureate program, with a new license and legal scope of practice.
- After consultation with nurse executives, regulators
and others, TFER #1 determined that a new role was needed in order to differentiate
scope of practice and create a new license.
- NCSBN
declined to create a separate license for associate and baccalaureate degree graduates
since entry-level roles are not well differentiated across the board.
Click
here to download the Final Report of the TFER #1 Task Force released in April
2002. Task
Force on Education and Regulation for Professional Nursing Practice #2 - Moving
Forward In July 2002,
the AACN Board created the TFER #2 task force to continue the work begun by TFER
#1. - TFER #2 members focused on what nurse competencies
are needed in current and future health care system to improve patient care.
- The task force examined what the "New Nurse"
role might look like. This work resulted in the publication of the draft white
paper on The Role of the Clinical Nurse Leader in May 2003.
- Representatives
from education and practice were invited to participate in a discussion of the
new nursing role at AACN's Fall Semiannual Meeting in October 2003 and at other
stakeholder meetings.
II.
Follow-up Activities from the October 2003 Meeting The
AACN Board of Directors appreciates the valuable input received at the October
2003 pre-conference and will use this information as it takes these next steps:
- Transcribe meeting tapes and summarize notes.
- Locate
an external reviewer to help identify themes and conclusions from the meeting
(a report will go to all members).
- Develop one-page
talking points papers on key issues such as licensure and the fit of new education
approaches with existing ones (e.g., fit with practice doctorate).
- Seek
external funding to support pilot projects for schools and practice partners that
wish to participate in new models.
- Move forward
with developing 1, 2 or maybe 3 education models partnered with practice (participants
in October 2003 meeting were asked to indicate their preferred model).
- Be sure that evaluation of patient outcomes is built into
each model.
- Encourage the placement of articles
in the Journal of Professional Nursing which explore issues related to the new
nurse and foster regional forums to engage and inform more nurses, nurse administrators
and educators in the process.
- Plan a follow-up
conference in March 2004 with clear direction for the roll out of the pilot programs.
We hope that many schools and practice
settings eager to move forward will wait until March 2004 or be willing to adapt
their approach to one of the models that is adopted at that time. This will allow
for adequate evaluation of new education and practice approaches and avoid the
"N of 1" phenomena.
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