AACN members reaffirmed the need to address pervasive inequalities in health care by ensuring the preparation of nurses who can meet the needs of all in an increasingly diverse American society, including ethnic and geographic diversity. AACN and its member schools are committed to accelerating diversity, inclusion and equity initiatives to prepare current and future caregivers to reflect the society they serve while meeting society`s expectations and needs.53 Proposed measures to achieve this goal include: Responsible for training the nurses of tomorrow, University nurses should be proactive in responding to the changing higher education landscape and the demands of employers, prospective students and the public. Ensuring graduates are ready for contemporary practice requires faculty who are aware of changing changes and understanding of the science of learning and who are committed to adapting curricula, teaching strategies, and student learning assessment. Providing graduates with the knowledge, skills and values to embrace change and innovation through lifelong learning is paramount. Nurses are required by law to report abuse, neglect, gunshot wounds, dog bites, certain communicable diseases, and any unsafe and/or illegal practices of another health care provider. Recent advances in educational neuroscience – a term used to describe the interrelationship between neuroscience, teaching strategies and psychology – have led to a new understanding associated with how people learn. This area of science provides evidence of good practice in the classroom to encompass strategies that engage the learner in challenging and focused learning and integrate reflection on that learning. Advances in immersive technologies offer more and more opportunities to engage learners in their learning experiences. As with other educational needs, nurses provide educational activities to clients, family members and other staff on legal issues that may affect the care they provide. In addition to following the policies and procedures of the respective health care organization, nurses must also follow and comply with all federal and state laws regarding interpreters and interpreters. In 2002, the AACN Education and Regulation I Working Group (TFER I) found that at the time, it was not possible to make efforts to differentiate between licensure for bachelor`s degree graduates and nurses with an associate`s degree.41 However, there is still evidence that a higher mix of NSOs and more educated registered nurses in the workforce improves nursing outcomes.42-45 In 2003, a second working group (TFER II) was set up. responsible for identifying the knowledge and skills that future nurses will need to fill the many gaps in health care and improve outcomes.
The TFER II report, White Paper on the Role of the Nurse Clinician Leader, outlined the results of the training and the expectations for a new nurse prepared by the master. The AACN Board of Directors not only approved the white paper, but also passed a motion to take the initiative to develop a new area of legal practice and qualification for the new master`s nurse, the Clinical Nurse Chief (CNL). CNL`s certification exam was launched in 2007 and to date, more than 6,000 master`s nurses have been certified as part of this exam. As reports increasingly show improved quality of care, reduced costs, increased patient satisfaction, and better care outcomes associated with this new provider, health systems continue to integrate CNL into caregivers.46-50 The Macy Report should be considered in light of the 2017 nursing workforce supply and demand projections that highlight the unequal distribution of nurses in the United States. This is the first time we have had a debate on this subject. While a shortage of registered nurses is a problem, the biggest problem lies in the distribution of nurses across states, especially in rural areas. Rural communities are severely affected by the poor distribution of health workers, which has a significant impact on access to primary and acute health care. Regions with a higher proportion of low-income residents and minority residents, such as rural areas, tend to suffer the most from an insufficient supply of health care providers. The number of RNs employed per capita has remained much lower in rural areas than in urban areas, and the wages of RNs living in rural areas remain lower than those in urban areas. Variables that influence caregiver misdistribution include lower reimbursement rates, less ability to hire and retain health professionals, higher rates of uninsured patients or Medicaid/Medicare patients, and fewer rural educational institutions.
Most future health professionals come from urban areas, as rural students are often educationally disadvantaged in preparing for math and science and developing successful academic and learning skills.32,33 All licensed practical nurses or licensed practical nurses must currently be licensed to practice nursing in their state of practice. The license protects the consumer public and guarantees that the nurse has completed a state-approved nursing school, passed her licensing exam, and has also met the requirements of the license within each two-year period without suspension or revocation of her license. In addition to traditional new students seeking education and degrees, more secondary learners are returning to school to retool their skills to better meet the demands of the workforce.