It is no surprise to me that Miss Nightingale had it right all along. It seems like the healthcare system has finally seen the light and is something that nurses have known about a long time. The old strategy or paradigm included a system that focused on numbers and profits; physicians and their decisions; procedures and tests; local providers and services; and making patients better customers. The key, according to Porter and Lee, in their article, “The Strategy that Will Fix Health Care”, is switching to a system that values patient outcomes over profitability. The new system places the patient at the center of all functions and activities and has a name, patient centered care. Patient centered care is everywhere these days and patient empowerment and advocacy are at the heart of the salvation of healthcare. Florence Nightingale knew this back in 1860 (Notes on Nursing) and wrote regarding how the nurse must keep the patient at the center of nursing care. She is also credited with saying, “The very first requirement in a hospital is that it should do the sick no harm”, the very first quality and safety policy for sure.
The Institute of Medicine recommends to realize the necessary changes to the health care system, nurses need strong leadership in place at the unit level as well as in the highest levels of management. Now is the time for nurses to take the lead, as they are in the best position to initiate a practice they have been practicing since the beginning of modern nursing (thank you Florence). Policy and the fundamental changes to the system should be something that nurses shape instead of something that is dictated to them. In order to be ready and make this happen, competencies concentrating on leadership skills should be employed, mentoring programs should be available, and a culture of leadership should be adopted. Most importantly, all nurses have to take charge of their professional development and growth, while at the same time, developing partnerships with other health care professionals.