The U.S. healthcare system is currently in a state of crisis. Although political debates rage over the issue of healthcare reform, one factor all sides agree upon is the need for more health care providers. The existing nursing shortage will only worsen if we succeed in expanding coverage to all of the estimated 47 million Americans who currently lack healthcare coverage.

According to the American Nurses Association (ANA), the four most critical elements of healthcare reform from the perspective of the nursing profession are access to healthcare, the quality of healthcare, the cost of healthcare and the healthcare workforce (ANA, 2009).

Since the ANA views access to healthcare as a basic human right (ANA, 1998), the organization reaffirms its support for a restructured healthcare system that ensures universal access to essential healthcare services for all Americans. Access must be affordable, accessible and acceptable. Improved access can be achieved by expanding the availability of healthcare services and by broadening services that provide reasonable patient choices.

Most nursing leaders agree that healthcare should be safe, effective, patient-centered, timely and efficient. They also point out that improving the safety and quality of the healthcare system requires an understanding of the relationship between nurse staffing and patient outcomes. A growing body of research (AHRQ, 2007; ANA, 2000) has established that this relationship is indeed measurable; and more knowledgeable and skilled providers will produce better patient outcomes.

Recognizing that the cost of healthcare is a very complex issue, ANA supports a single-payer mechanism as the most desirable option for financing a reformed healthcare system. Specific to the nursing profession, there must be a shift of thinking, from viewing nursing services as a cost to the system to recognizing that nursing care can save money by focusing on wellness and on prevention of complications and adverse events.

For healthcare delivery to be effective, fair and affordable, there must be an adequate supply of well-educated, well-distributed and well-utilized registered nurses. Addressing registered nurse shortages will require the implementation of strategies dedicated to each of these four areas. More importantly, maintaining a stable registered nurse workforce will require the political, legislative and policy focus to implement and maintain these strategies over the long term (ANA, 2009).

For additional information, see the American Nurses Association Health System Reform Agenda