The Washington Post

Health reform: Shaping the field of nursing

SPECIAL ADVERTISING SECTION: Health & Science Career Advice

Healthcare reform measures enacted last year grant 32 million people greater access to the healthcare system, and registered nurses are on the front lines as millions more patients seek care.

“We know that many of these individuals will need access to primary care providers, and we have a shortage,” said Cheryl Peterson, director of nursing practice and policy for the American Nurses Association. “In order to fill that gap, we’re likely to look to nurse practitioners and mid-wives to serve in a primary care capacity. Opportunities for nurses in those advanced practice areas are going to grow dramatically.”

There are about 2.6 million registered nurses currently employed, making nurses the single largest segment of the healthcare workforce. According to the Bureau of Labor Statistics, registered nursing is projected to be the top field in terms of growth through 2018, with more than 500,000 new nursing positions. As the population ages and more people have access to healthcare, demand for nurses is expected to rise.

“We’re opening the door by removing barriers such as access to health insurance for people who have been uninsured or underinsured,” said Jeanne Matthews, interim chair of the School of Nursing and Health Studies at Georgetown University Medical Center. “This requires significant increases in nurses at both an advanced practice level and basic level who are able to take care of that population.”

Waves of retirement make the threat of a nursing shortage real. Between 2004 and 2008, more than 400,000 nurses received their licenses, but the nursing workforce grew by only about 150,000.

In an effort to address the anticipated demand for care, the 2010 Affordable Care Act (ACA) funds educational and career development opportunities and offers scholarships to nurses and students. These measures include grants for nurses pursuing advanced degrees in geriatric care; workforce diversity grants; and grants for schools and hospitals to develop primary care training programs.

In addition, the ACA expands the Nursing Education Loan Repayment and Scholarship Program, which repays student loans for nurses who go on to serve at least two years as faculty members at nursing schools.

“We’re dealing with a nurse faculty shortage,” Matthews said. “If we want to be able to increase the pool of nurses, we have to have qualified faculty in place to handle the demand for nursing education.”

The ACA provides financial support for nurse-managed health centers where advanced practice registered nurses (APRNs) provide comprehensive primary care and wellness services regardless of a patient’s income or insurance status. The law also establishes loan repayment programs for nurses who serve for at least three years in areas underserved by healthcare professionals.

Susan Reinhard, senior vice president of the AARP Public Policy Institute and chief strategist for the Center to Champion Nursing in America, explained that healthcare reform offers more coverage but also new priorities for patient care. “We need a workforce prepared for changes in thinking about chronic care, primary care, and care coordination,” she said. “It’s not just the number of nurses; it’s their skill sets.”

There are also provisions in the law to educate and prepare nurses for taking care of people outside of the hospital as well as measures to lower the frequency of re-admittance to hospitals within a short period of time. “This is new for nurses—and for all healthcare professionals—in many ways,” Reinhard said. “But healthcare reform, the ACA, and in general new thinking about healthcare delivery is driving change very significantly at a real, direct care level. It’s a big change.”

This special advertising section was provided by Haley Edelman, in conjunction with The Washington Post Custom Content department. The production of this supplement did not involve The Washington Post news or editorial staff.


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