How Florida NPs Are Meeting the IOM’s Goals

Various collaborative efforts have helped Florida NPs advance toward the IOM’s goals.

Florida legislators made important strides in moving the nursing profession forward during the first 2016 legislative session, passing bills that will help us implement the recommendations outlined in the landmark report issued by the Institute of Medicine (IOM): The Future of Nursing: Leading Change, Advancing Health. This report, which was published in 2010, set a course for advancing the role of nurses across the United States.

Passage of the Nurse Licensure Compact and the Advanced Registered Nurse Practitioner (ARNP) prescribing legislation, re-named the Barbara Lumpkin Prescribing Act in honor of longtime Florida Nurses Association (FNA) lobbyist Barbara Lumpkin, marks more than two decades of committed effort coming to fruition. The passage of ARNP makes Florida the 50th state to allow its nurse practitioners to prescribe controlled substances.

This progress gets Florida NPs closer to the goal of practicing to the full extent of their education and preparation. In addition, this improves access to care for the citizens of Florida, a region where there is a growing shortage of physician primary care providers. These successes have been made possible through the leadership and activism of RNs and ARNPs with the work and support of the Florida Action Coalition, the FNA and other nursing specialty organizations.

Five Years Since the IOM Report

It has now been more than five years since that IOM report put forth a road map to help the nursing profession reach its fullest potential in our nation’s health care system. These recent milestones in Florida are a reminder that we need to keep this road map “top-of-mind” to continue the progress.

The IOM’s report included 8 policy-changing recommendations to contribute to the transformation of the nursing profession-changes that will ensure that all nurses are prepared to “lead change to advance the nation’s health.”1

Since then, states across the country have formed coalitions to see that the recommendations become reality. There has been increased attention and conversation throughout the nursing community regarding nursing and leadership. The nursing literature, curriculum, journals, electronic resources and conferences are replete with information about the importance of leadership in nursing and the need for nurse leaders in all areas of practice, education, research and advocacy.

But I would like to highlight two IOM recommendations specific to nursing leadership, because I believe it is important to remind the nursing community to stay focused on transforming these recommendations into reality. For clarity, I have included the full language of the two recommendations:

  • Recommendation 2: Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. Private and public funders, healthcare organizations, nursing education programs, and nursing associations should expand opportunities for nurses to lead and manage collaborative efforts with physicians and other members of the health care team to conduct research and redesign and improve practice environments and health systems. These entities should also provide opportunities for nurses to diffuse successful practices.1
  • Recommendation 7: Prepare and enable nurses to lead change to advance health. Nurses, nursing education programs, and nursing associations should prepare the nursing workforce to assume leadership positions across all levels, while public, private and governmental health care decision makers should ensure that leadership positions are available to be filled by nurses.1

The Case for Leadership

Registered nurses are commonly recognized as one of the most trusted professions. Within the profession, you can find many leaders, including those who are clinicians, educators, researchers and administrators. However, nurses are woefully underrepresented in policy-making boards, legislative task forces and other bodies where health policy is made. These are the venues where “health policy” is developed and adopted. The most important and influential policy-making “tables” include elected officials in Congress, state legislatures, hospital boards, and local governing bodies.

The Future of Nursing Campaign for Action

The Future of Nursing Campaign for Action is an initiative that was launched in 2010 as a response to the IOM’s report by the Robert Wood Johnson Foundation (RWJF), the American Association of Retired Persons (AARP) and the AARP Foundation.2 The goal of its coordinating body, the Center to Champion Nursing in America (CCNA), is to fulfill the IOM report’s recommendations.

CCNA is working to facilitate efforts to ensure that all Americans have access to high-quality care, with nurses playing a significant role and contributing to the full extent of their educations, skills and capabilities. Fifty-one state-based Action Coalitions, health care providers, volunteers, consumer advocates, policy makers, academic leaders, state nurses associations and philanthropies drive the campaign.

A Case In Point: The Florida Action Coalition

The Florida Action Coalition, which I was involved with for several years, was established because all Floridians deserve access to high quality, patient-centered care.3 It is a collaborative effort of diverse healthcare stakeholders who are leading changes in nursing and health care delivery so that more Floridians can access high-quality care at a reasonable cost.

Florida Blue, which is Florida’s Blue Cross and Blue Shield company, is a member of the Florida Action Coalition, providing monetary and consultative support. Nurses and other health care professionals have joined forces with these executives to support other health foundations, including the Florida Blue Foundation (a separate philanthropic affiliate of Florida Blue) and other businesses, universities and government entities to advance the nursing profession’s leadership, education and practice in Florida.

Leadership Initiatives

The Florida Action Coalition was awarded a statewide implementation program (SIP) grant to address the 7th IOM recommendation: “prepare and enable nurses to lead change to advance health.”3

This report, the first of its kind, revealed some major issues related to nursing leadership in Florida, including an aging nurse leader population, lack of sufficient planning in place to replace nurse leaders, and a lack of diversity among nurse leaders to reflect the highly diverse population of Florida.2

In 2015, the Florida Center for Nursing and the Florida Action Coalition were awarded a second SIP grant with the goal of creating and mentoring a pool of diverse leaders prepared to serve in leadership positions and lead the development of health policy.3 In addition, more resources are being developed in order to assist in the growth of Florida’s nurse leaders.

Opportunities and Resources

Applications to serve on the Florida Action Coalition Board Service Initiative for Emerging Nurse Leaders are closed for 2016; however, the organization has plans to establish another board in the near future.

Nurses who possess a strong sense of professional commitment, have the capacity to develop robust professional relationships, and who are interested in and wish to make a long-term commitment to promote and improve the health of all Floridians are encouraged to apply.4

Additional leadership resources are available to all nurses in Florida at the Florida Action Coalition website.5 Included is a toolbox of nurse leadership development resources, nurse leader recognition programs and interviews with Florida Nurse Leaders. Opportunities are here for every Florida nurse to expand and develop their leadership skills, so they can help advance nursing leadership and lead the change for quality health care for all Floridians.

Ann-Lynn Denker is the chief clinical officer at Plaza Health Network in Miami. She is also a past statewide implementation program (SIP) grant project director for the Florida Action Coalition, an organization which aims to provide leadership in advancing the nursing profession.


  1. Institute of Medicine of the National Academies (IOM). The Future of Nursing: Leading Change, Advancing Health. Oct. 2010.
  2. Future of Nursing Campaign for Action. Campaign History.
  3. Florida Center for Nursing. Statewide Implementation Program Grant.
  4. Florida Center for Nursing. 2016 Florida Action Coalition.
  5. Florida Center for Nursing. Nurse Leadership Development Resources.

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