Academic journal article Online Journal of Issues in Nursing

Registered Nurses as Professionals, Advocates, Innovators, and Collaborative Leaders: Executive Summary

Academic journal article Online Journal of Issues in Nursing

Registered Nurses as Professionals, Advocates, Innovators, and Collaborative Leaders: Executive Summary

Article excerpt

This OJIN topic considers barriers to RN scope of practice, and disseminates in several articles the work of the American Nurses Association (ANA) Professional Issues Panel (Panel), Barriers to RN Scope of Practice, to identify, analyze, and consider both opportunities and challenges to eliminate these barriers. Panel member authors started this series of articles with a guided imagery exercise during which we envisioned the preferred future for registered nurses (RNs) and how this future could be realized. Several articles individual consider individual RN roles in the health care delivery system that were identified throughout the work of the Panel RN as professional, RN as advocate, RN as innovator, and RN as collaborative leader.

In this article, we summarize this series with additional questions for all nurses: What is the preferred future for RNs? How are we going to effectively work to achieve, articulate, and demonstrate our value? We must define the optimal state for RNs and determine how they can practice to the full extent of their education, training, and license. Achieving these goals is essential to meet the recommendations articulated in the Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health (Future of Nursing Report) (IOM, 2011), and reiterated in the 2015 follow-up report (IOM, 2015).

This exercise pushes nurses as individuals and as professionals to envision what we, as RNs, could and should be. It forces us to consider: What impact could and should nurses have on those we serve? It engages us to determine: What value could and should we create? It demands accountability by asking: How will we articulate and demonstrate our value as RNs? These are difficult questions both to ask and answer. Nurses must do both. Our individual and collective professional future resides in the answers to these questions. If we neglect our responsibility to determine and control the scope of nursing practice, assuredly others will. It is every nurses' individual and professional responsibility to prevent that from happening.

The goal of our panel was to create our best determination of an "optimal state" of RN scope of practice. We then needed to discern the current state through an assessment. This assessment was the work of the panel and helped to frame our focus and determine what barriers exist that interfere with nurses' ability to act and practice to the fullest scope possible. Once these barriers were determined, we created an actionable strategy with tactics to eliminate or minimize their impact on nursing practice. This was an overwhelming, but achievable, task. In this summary article, Panel members describe their methodology, offer role definitions and recommendations, and provide individual recommendations for RNs to remove barriers and practice to the full extent of their scope of practice. We conclude with some future considerations.



In September 2014, ANA issued a call for interested nurses to serve on a panel focused on the barriers to scope of practice, emphasizing that the focus would be RN scope of practice, rather than advanced practice registered nurse (APRN) concerns. While some issues and barriers would overlap, there would be distinct additional differences and concerns to consider. Therefore, the panel focused specifically on the role of the RN. ANA and other organizations remain committed to removing barriers to APRN practice and care as well. Individuals seeking additional information on the topic of APRN scope of practice may visit the ANA APRN page, Advanced Practice Nurses (ANA, 2016a).

Expert nurses from a variety of disciplines were selected to serve on either the steering committee or on an advisory panel. The work of the Panel subcommittees began in early 2015. The Panel's charge concerning the elimination of barriers of RN scope of practice was to discern and quantify what those issues were and to make recommendations about pathways to eliminate or mitigate those issues. …

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