Sometimes the rewards aren’t immediately clear. But nurses taking care of kidney patients should heed the recommendations of a recent Institute of Medicine report and pursue higher education as a way to improve their profession. That was the message from keynote speaker Suzanne Miyamoto, PhD, RN, at the American Nephrology Nurses Association’s annual symposium in Louisville this week.

Miyamoto, senior director of government affairs and health policy at the American Association of the Colleges of Nursing in Washington, acknowledged the challenge that obtaining higher education may not lead to advancement and higher pay. But she said nurses have to think about the bigger picture: The professional benefits for members who now have the tools to become leaders in their field.

“Where do we as a profession want the endpoint (of education) to be?” she told the audience of more than 400 nurses. “We need to agree on that entry point, and push for that. It’s not an easy decision when you have to take out loans, juggle family…It’s hard to make the change. But it is not about individual nurses, it is about the profession. It is how we contribute” to the field of nursing.

Citing a quote from Florence Nightingale––“I attribute my success to this – I never gave or took any excuse” ––Miyamoto said nurses with higher education can have a greater influence in public policy and getting heard in Congress. Nurses are well respected for their ability to provide care for patients, Miyamoto said, but higher education can give the profession great stature and show that it can tackle major health problems. The association, for example, was able to get involved with a White House initiative to quell concern over opioid use disorder and overdose. It received pledges from 191 schools of nursing with advanced practice registered nurse programs to educate their students on the Centers for Disease Control and Prevention’s guideline for prescribing opioids for chronic pain.

The IOM recommendations

Miyamoto reviewed the recommendations for nursing from the IOM, the Institute’s second report in five years about the nursing profession. The IOM had published a report in 2011 on the topic of nursing practice:

“The Future of Nursing: Focus on Education, Advancing Health”––and followed up in 2016 with a second report. The reports were based on research done from 2008-2010 by the Robert Wood Johnson Foundation and the IOM to “respond to the need to assess and transform the nursing profession.”  As part of its 2011 report, the two organizations determined that “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression,” the IOM said.

The 2016 recommendations were similar to what the IOM has presented in its 2011 report, said Miyamoto, including increasing the number of baccalaureate degreed nurses from 50% to 80% by 2020 and doubling the number of nurses with a doctorate. These were recommendations that the American Nurses Association had also pursued, said Miyamoto.

The IOM report breaks down its recommendations into four categories: practice, education, leadership, and data.


  • Build common ground around the scope of nursing practice


  • Continue pathways toward increasing the percentage of nurses with Baccalaureate degrees and doctorates in nursing, as well as create and fund transitions to practice residency programs


  • promote nurses’ interprofessional and lifelong learning
  • make diversity in the nursing workforce a priority (including encouraging more men to join the field)


  • conduct more outcomes-based research using data sources

“Nurses are the best patient advocates; let us translate that to a professional level with greater education,” said Miyamoto. “We have to decide if we are going to do this or not.”