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Opinion Column

Give Nurses A Bigger Role In Improving Health Care

Skilled health provider. Sympathetic caregiver. Trusted dispenser of medicines. Capable interpreter of complicated medical instructions. Coordinator of care. Triage expert.

All those phrases describe the roles nurses play in our health care system, but it’s just a part of the story. Nurses also are uniquely positioned to help reduce medical errors, increase access to health care, manage and improve care coordination, identify ways to contain costs, and much more.

The Robert Wood Johnson Foundation has been investing in nurses for decades. As a Foundation with a mission to improve the nation’s health and health care, we have long recognized that nurses are integral to effective reform. The public agrees. Poll after poll finds that nurses are either the most trusted group of professionals, or one of the most trusted groups, in the country.

But at this critical moment, with the nation poised for the most significant health reform in generations, we wanted to see what opinion leaders-from academia, business, the health industry and elsewhere-think about the roles nurses should play as we strive to reform our country’s health care system.

So we partnered with Gallup to conduct an opinion leader survey. It found that, across-the-board, opinion leaders say that our country is not taking advantage of all that nurses have to offer in terms of leadership, innovation and reform. We aren’t fully utilizing the skills and talents that nurses offer-and that’s a waste of a valuable resource.

In the survey, opinion leaders ranked nurses behind six other stakeholders when it comes to who they expect will influence health reform over the next five to 10 years. Seventy-five percent said government officials will have a great deal of influence in health reform in the next five to 10 years, compared to 56% for insurance executives, 46% for pharmaceutical executives, 46% for health care executives, 37% for doctors, 20% for patients-and just 14% for nurses.

But that’s not what they want to see. Large majorities of opinion leaders said they would like to see nurses have more influence in a number of key areas, including reducing medical errors and improving patient safety (90%); improving quality of care (89%); promoting wellness and expanding preventive care (86%); improving health care efficiency and reducing costs (84%); coordinating care through the health care system (83%); helping the health care system adapt to an aging population (83%); and increasing access to health care (74%).

So why don’t nurses have more influence? These opinion leaders identified as major barriers to increased influence that nurses are not perceived as important decision makers or revenue generators, especially when compared to doctors.

These barriers cost us a lot. They prevent the best ideas from being implemented and sometimes even heard. They prevent the best policies from being developed and refined. And ultimately, they prevent the best care from being delivered to patients.

It’s time for change. And in this survey, opinion leaders said so. A strong majority said that nurses should have more influence than they do now on health policy, planning and management. They want the barriers removed, and they want nurses themselves to step up.

So let’s pay attention. Let’s learn from this survey and remove the barriers that prevent nurses from taking leadership positions more often, and that prevent our health care system from benefiting fully from their knowledge, wisdom and expertise.

I am convinced that successful reform must enlist nurses as skilled health providers advisors, caregivers, dispensers of medicine, interpreters of complicated medical instructions, care coordinators, triage leaders-and also as experts, thinkers, planners, advocates, reformers, board members and catalysts for change. At this moment, when we are challenged to muster all our resources to make our health care system work better and as it should, the full engagement of the nursing profession is exactly what we need.

Risa Lavizzo-Mourey, M.D., M.B.A., is president and CEO of the Robert Wood Johnson Foundation,

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