The healthcare system is highly dynamic due to changes in legislation, technological advancement and changes in supply and demand. In the report: The Future of Nursing: Leading Change, Advancing Health,” IOM is seeking to define the role of nurses in transforming the healthcare system to improve the outcomes of healthcare delivery. The report encourages paving way for changes in healthcare system and expanding the scope of nursing practice. The major areas of concern are: to remove the barriers that limit effective and rapid nursing response, enhance nursing leadership, achieving high quality training and education for nurses and fostering cooperation and partnership between healthcare professionals (Institute of Medicine, 2011) . Firstly, it is important to note that the IOM report recognizes that nurses have a great unleashed potential which when fully explored can improve the delivery of healthcare. However, this potential cannot be explored because of the innumerable barriers that exist; poor training and education, regulation barriers, high rate of turnover of novice nurses and aged workforce.
The report has had an immense effect on nursing education. Due to the strong dynamics of nursing practice and increase in complexity of healthcare demand, clients demand especially for the old are increasingly becoming complex while technology is continually revolutionizing (Remnick, 2007) . Due to these changes, and the need pushed by IOM for better healthcare delivery, better education is recommended for nurses to achieve a proper mix of trained workforce. In other words, it has been a template for soliciting for strong education institution and provision of quality education (Remnick, 2007) . To achieve quality healthcare for patients and families, better education is key. The report suggested that Nurses should expand their scope of study and educational training which will ensure that they can take up extended roles and provide practical solution to tricky and complex situations. After the release of the report, the institute of medicine was prompted to revise their training strategies to be able to be compatible with the needs of IOM.
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Previously, there existed barriers for diagonal or horizontal advancement and movement of nurses in practices where traditional nursing was dominant. However, currently, nurses have the ability to freely advance their carrier in either direction to be able to widen their scope of understanding in nursing practice and provide solutions to nursing problems with increased utility (Institute of Medicine, 2011) . Therefore, nurses get improved learning experience to be able to confront healthcare problems without greater ease. They are also able to adapt to the rapid changes that takes place in the healthcare industry due to vast and flexible knowledge (Finkelman, 2012) . Therefore, we can succinctly say that the report by IOM has prompted medical institutions to widen their scope of training, remove education barriers and enhance their quality of education to nurses. It has also been evident in the increase of the number of graduate nurses every year who take the responsibility of the old retiring nurses thus reducing nurses’ deficiency.
When it comes to nursing practice, the report stipulates that nurses will not be confined to one area of practice alone but are required to expand the scope of their practice (Remnick, 2007) . This requires that apart from just delivery the direct service of medical care, nurses will have extra responsibilities such as counselling and teaching of patients regarding general health matters and well-being. In other words, nurses will not only be responsible for the physical health of patients but also their social and psychological well-being. Some of the ways for which this idea has been put into practice is the introduction of Physician Assistants and Advance Practice Registered Nurses (Remnick, 2007) . Patients spend less time in hospitals and queues while they reap maximum satisfaction from the services they receive.
Also, person centered care is recommended where family members and the patients themselves are involved their recovery process. This ensures that wellness is not only defined by the improvement of syndromes previously diagnosed, but also evaluated on extent of which the patient has achieved the goals set by their family members depending on factors such as belief, culture, literacy levels and economic status (Remnick, 2007) . Due to the recommendations put across by IOM on their report, medical institutions have adopted patient centered care system. Delivery is done depending on the client’s preferences, the patient is well educated on the type of medication administered to them and family members are also involved. This kind of care is more meaningful and valuable to patients because their views are considered and thus they respond positively to treatment routines (Remnick, 2007) . With respect to patient centered care, a lot of changes have been made in the healthcare industry. The first one is respecting of patients views and considering their preferences in medical delivery. Patients have unique tastes and choices that must be recognized. Secondly, is proper coordination and integration of healthcare services which includes clinical practices, patient records and auxiliary services. Thirdly, is providing patients with full information and education on their progress, response, promotion and clinical status always. Another is providing comfort. Comfort could be provided for physical problems such as pain or emotional problems such as stress. Lastly is involvement of family and friends (Finkelman, 2012) .
IOM puts more responsibilities on nurses because they are the ones who are directly involved with patients while providing medical care. It is important to understand the requirement and recommendations put across by the report. As a nurse, I would ensure that I continually advance my education and scope of study. Also, be able to fully partner with other professionals as a way of enhancing interprofessional education and collaboration (Remnick, 2007) . Besides, I would strive to demonstrate my leadership skills in whatever setup by ensuring that I think outside the box and provide practical solutions to problems. lastly, I will make sure that I focus on the elements such as teamwork and collaboration, quality advancement, nursing informatics, patient centered nursing and good listening skills.
This report recognizes nurse as leaders and gives them huge leadership roles in a healthcare setup. Nurses are expected to be at the forefront when devising and making policies regarding patient care. The report requires that they are engaged in decision making processes especially those that touches on the welfare of patients (Remnick, 2007) . Thus, nurses are given more roles compared to the previous times which means they directly and hugely impact on the welfare of patients as well as the sustainability of the healthcare system. The future of nursing depends on how nurses play their role and how effectively they cultivate a vision to improve quality of medical care (Remnick, 2007) . From the report we recognize that nurses act as leaders in healthcare systems because they have the ability to provide healthcare to any person regardless of their facet, they manage the wellbeing and the general health of the public, they are capable of transforming healthcare outcomes, they are able to take care of patients, both for physical and emotional needs with great compassion, they control the drivers of healthcare systems and finally they have the ability of enhancing inter-professional relationship within healthcare systems.
References
Finkelman, A. (2012). Teaching IOM: Implications of the Institute of Medicine Reports for Nursing Education. Amer Nurses Assn.
Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. New York: National Academic Press.
Remnick, D. (2007). Reporting: Writing from the New Yorker. Vintage.
