IOM Envisions Nurses as Policy Makers

Part 4 of a 4-part series

By Catherine Garner, DrPH, RN
Dean, Health Sciences and Nursing

In November of 2010, the Institute of Medicine (IOM) issued a special report titled “The Future of Nursing: Leading Change, Advancing Health.” It’s an in-depth look at the role nurses should play in a changing healthcare system, as the new legislative reforms are phased in over the next decade. The report contains three key messages related to nursing. Part 1 of this series looked at IOM recommendations for transforming nursing practice. Part 2 looked at methods of transforming nursing education, and Part 3 looked at empowering nurses and leadership.

In its report on the future of nursing, the IOM’s third key message is that “nurses should be full partners with physicians and other health professionals, in redesigning health care in the United States.” One of the ways nurses can participate in healthcare reform is by taking an active role in shaping policy.

Nursing’s involvement in policy-making

In its recent report, the IOM also strongly calls for nurses to become engaged in the policy-making process, at both the organizational and government level. Influencing policy-making can be as simple as engaging school board members in a discussion about the value of school nurses in helping students to manage chronic conditions.

According to the IOM report:

Nurses may articulate what they want to happen in healthcare to make it more truly patient centered and to improve quality, access, and value. They may even have the evidence to support their conclusions. As with any worthy cause, however, they must engage in the policy-making process to ensure the changes they believe in are realized. To this end, they must be able to envision themselves as leaders in that process and seek out new partners who share their goals.

The report includes several case studies about nurses as policy makers and suggests the following lessons can be learned from them:

  • First, nurses must build strong alliances within their professional communities, so they can speak with a unified voice about the issues that matter to them the most.
  • Second, nurses must build relationships with existing policy makers, including legislators from both major political parties, at the local and state level.
  • Third, nurses must find allies and supporters outside the nursing profession, particularly in business and other influential communities.

The IOM concludes its section on leadership by recommending that:

Public, private, and governmental health care decision makers at every level should include representation from nursing on boards, on executive management teams, and in other key leadership positions.

For more information

This article concludes a series that is meant to briefly summarize the three key messages presented in a new report by the Institute of Medicine, titled “The Future of Nursing: Leading Change, Advancing Health.” You can download the full report in PDF version or browse it for free online at

Be sure to get your free copy of my latest paper, “Powerlessness is Bad Practice,” about how, with leadership skills, any nurse can become an empowered facilitator of change.

Also, see my short videos about nursing leadership: “The Difference Between Managing and Leadership” and “5 Skills a Nurse Executive must Have.”

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