Chief Strategist's Message: Nurses, Consumers, and a Reformed Health Care System

In 2009, health care reform was the most widely discussed issue in the United States because it affects every single American in every corner of the country. Whatever shape final legislation in Washington might take, we can expect greater numbers of Americans seeking primary and preventative care and, regardless of reform, greater numbers of older Americans seeking care as the baby boom generation matures. Combine these factors with technological and other transformations in health care delivery and it becomes clear that nurses and the nature of the nurse workforce have never been more important.

The U.S. will face a shortage of as many as half a million nurses by 2015; there are roughly 140,000 unfilled nursing positions in hospitals and nursing homes combined; half of all nurses are planning to retire in the next 15-20 years just as a nation of baby boomers will put unprecedented demands on the nation’s health care system. And scores of studies demonstrate that when it comes to hospital patients, the more nurses on staff, the better the health outcomes and the lower the mortality rates—a fact that affects every American family.

But numbers are only part of the story. We know the importance of a nurse workforce with the skills required by a reformed health care system to serve the Americans who will be using it in ever greater numbers. Nurses occupy an increasingly central role on care delivery teams and they can and should have a more prominent role in the delivery of primary and chronic care management. There is abundant evidence that advanced practice nurses provide high quality—and highly affordable—care in areas where no regulatory barriers limiting their practice.

As the health care workers who spend the most time providing medical care, nurses must also have more advanced education and skills. This is why we devote so much attention to ways of expanding nurse education to create a pipeline of new nurses—and nurse educators. Faculty shortages, limited clinical sites and even classroom space resulted in nearly 100,000 applicants being turned away from nursing schools last year—qualified applicants who want to devote their careers to caring and advocating for patients. While there are innovative solutions to the education crunch being implemented around the country, expanding education will most certainly require increased funding. We have worked hard to make this happen.

We believe that every American deserves a highly skilled nurse when and where nursing skills are needed. A richly skilled, effectively integrated nursing workforce—with enough professionals to meet the need—is essential to delivering high-quality health care. We will continue to act as an information resource on health care reform. The Center is collaborating with our AARP colleagues to advance the roles of nurses in increasing access to primary care, transition care and chronic care management in a reformed health care delivery system.