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State of Nursing in the State of California

The National Summit on Advancing Health through Nursing was held in Washington, D.C., yesterday to officially launch a report called The Future of Nursing: Leading Change, Advancing Health. It listed the developments that need to happen in nursing during health care reform.

“This is the first day of the future of nursing,” Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation, said at yesterday’s summit. “This is the day when we fill the critical piece of the health care picture. We are here not to reform but to transform how care is delivered.”

Donna Dolinar is on the board of the California chapter of the American Nursing Association, and she was at the D.C. conference.

“This gives us an impetus,” Dolinar said after the the release of The Future of Nursing study.  “We were all together for the day, all the different parts of nursing. This brings us all together and on the same page.”

What happens in California, Dolinar said, might need to happen a little more quickly than in the rest of the country, because California is ahead of the curve in implementing health care reform.

“But in some ways we are behind,” she said. “Like in terms of collaboration with physicians, we’re behind.”

The national nursing shortage will become more acute, Dolinar said, as the pressure increases on delivery of primary care medicine. More people will be covered under health care reform, and the aging boomer population will also increase demand for primary care provider services.

“Clinical nurse specialists [such as nurse practitioners and midwives] can fill that void,” Dolinar said. “But we need to increase prescriptive authority, especially in rural areas.”

Dolinar hopes clinical nurse specialists will get a little more autonomy. “In some states, like Colorado, Utah, Oregon,” she said, “they’re not even overseen by physicians.”

And California is ahead of the nation on one important front, she said: “We’re the only state that has staffing ratios,” Dolinar said. “And it’s my understanding that [U.S. Senator] Barbara Boxer might be interested in making that a national law.”

Because of the 1999 California state law establishing nurse staffing levels, she said, patient safety in California has improved, and retention of nurses is higher. “If you know that you will be going to work with decent ratios, when you know how many patients you’re going to be taking care of, that makes a big difference to coming into work,” she said.



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