President’s Message

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• Linda Burnes Bolton, DrPH, RN, FAAN

Excellence, according to Booker T. Washington, is to do a common thing in an uncommon way. Creating and sustaining excellence in nursing education and service requires that we seek and try new ways of being and working together in uncommon ways. This special issue of Nursing Outlook contains wonderful examples of what needs to be done to ensure that the future of nursing and the individuals who provide nursing care remain healthy through nursing education and service partnerships. The American Academy of Nursing seeks to provide a forum for discussion on the directions nursing education and service should consider to achieve our common goal—safe, quality, equitable, efficient, patient-centered, and reliable care for all. We believe that it is essential to explore new pathways for the preparation of the nursing workforce, the creation of a faculty pipeline to assure the ability of our nursing schools to produce nursing professionals, and collaborative models to assure the ability of nurses to provide safe, quality patient care.

The Building Academic Geriatric Nursing Capacity is an exemplar of the work we hope to promote over the next several years. The Geriatric Nursing Centers have worked with academic and service partners to prepare scholars capable of improving the care of older persons. The support from the Hartford Foundation and Atlantic Philanthropies has led to new partnerships between academia and service. A proposal to extend this work to create a national center that will coordinate the development and adoption of evidenced-based nursing practice models in nursing homes and long-term care for the frail elderly is in development. It is our intent to link the work of scholars in the Nursing Centers to clinical settings and to utilize the evidence from the field (academia and service collaborative work) and research to improve health policy. We hope to promote a new infrastructure within the Academy that will support the testing and evaluation of models that can be widely disseminated and adopted by practice settings. We will seek funding from foundations to support the creation of centers in other initiatives generated by our Expert Panels, Commissions, Committees and Task Forces that are aligned with the Academy’s strategic plan.

We have several exploratory initiatives underway, including the activities of the Nursing Workforce Commission and its subcommittee on nursing education. Dr. Brenda Cleary and Dr. Margaret McClure and their committee are working on faculty pipeline ideas. The AAN Workforce Commission’s Committee on the Preparation of the Nursing Workforce has narrowed its focus to one priority issue—the nursing faculty shortage. We know that in order to increase the supply of nursing faculty, we must increase the pipeline of nurses educationally prepared to assume faculty roles as the first step toward enhancing faculty recruitment. Therefore, the committee will:

We also realize that, despite our best efforts in addressing the supply side of the faculty shortage, we will likely not reach an optimal number of faculty to sustain current models of delivering nursing education. In nursing education programs, just as in nursing service delivery, we must simultaneously address the demand side of the equation by developing transformative models for increasing efficient utilization of nursing resources and reducing unnecessary tasks and duplication of effort. While organizations like American Association of Colleges of Nursing (AACN) and National League for Nursing (NLN) and service partner American Organization of Nurse Executives (AONE) are best positioned to develop specific strategies, the Academy can leverage its influence by drawing attention to the urgent need for support for innovations in nursing education. The committee will develop a manuscript regarding broad areas of possible innovation and/or expansion in nursing education related to addressing faculty demand (e.g., simulation, core curricula, intra- and interdisciplinary shared faculty resources, distance teaching/learning technologies, clinical teaching associates).

We believe that fostering new ideas and engaging multiple stakeholders is essential to our work in transforming nursing practice and health policy. Fourteen schools of nursing nationwide are participating in the initiative “Transforming Care at the Bedside (TCAB)” sponsored by the Robert Wood Johnson Foundation in collaboration with the Institute for Healthcare Improvement. Patricia Chiverton, EdD, RN, FNAP, FAAN serves as Chair of the Academic Partners for TCAB. All levels of nursing students are engaging with practicing nurses to identify where change is needed, recommend and test potential solutions, and determine if the innovations should be implemented. Senior nursing students are working with Nurse Managers to better understand the leadership skills required on TCAB units, other students are members of the design teams that identify innovative solutions, while graduate students collect data to measure quality and cost outcomes. Through participation in this initiative, students see firsthand how small changes on medical-surgical units can significantly improve care and reduce cost.

This exciting initiative is creating a synergy between practice and education that will dramatically affect quality of care. While students and faculty are actively engaged on TCAB units, practice partners are becoming more involved in the education of nursing students. As adjunct faculty, they are providing guest lectures and engaging with faculty on curriculum committees to inform and generate the new content that is required in the nursing curriculum to prepare nursing school graduates to practice on these innovative patient care units.

The bringing together of faculty, clinicians, administrators, and students for the purposes of developing and testing innovative approaches to care and generating knowledge concerning the impact of care delivery processes on the individual provides a vital link between the classroom and the patient care unit. The students who have participated on TCAB units understand the importance of taking an active role in designing and implementing quality initiatives and they will spread this knowledge to patient care units nationwide.

We must continually support the quest for knowing and provide opportunities to use the collective wisdom within and outside the profession. According to Florence Nightingale, were there none who were discontented with what they have, the world would never reach anything better. The profession must continue to seek new partnerships to improve our ability to meet health care needs.

The Academy will play an active role in creating and supporting new partnerships that benefit the profession and, ultimately, the public. We believe that inviting others to the table to support nursing scholarship and inquiry in the testing, evaluation, and adoption of models that improve practice and healthcare policy is a strategy worth pursuing. We applaud the contributors in this special edition for providing us with examples of creative partnerships for improvement.