Still hampered by workforce（劳动力） shortages and barriers that impede（阻止，妨碍） their ranks from delivering health care to the full extent of their education and training, nurses may have gotten the much-needed shot in the arm they need to transform their profession with the release of an Institute of Medicine (IOM) report recommending sweeping changes for improving their profession. The report, the product of a special committee chaired by University of Miami President Donna E. Shalala, recommends everything from higher levels of education and training for nurses to greater opportunities for their ranks to hold leadership positions and the removal of "scope of practice" obstacles imposed by states, federal agencies, and health care agencies that impede nurses' ability to practice their profession to its fullest.

"This is, we believe, a landmark report," Shalala said at the National Press Club in Washington, D.C., where she and a contingent（队伍） of other committee members and other key players detailed the major proposals of the document. "It will usher in（领进，引进） the golden age of nursing in which nursing takes its rightful leadership place in American health care."

The report, "The Future of Nursing: Leading Change, Advancing Health," comes two years after the Princeton, New Jersey-based Robert Wood Johnson Foundation (RWJF) partnered with the IOM to assess the needs of and look at ways of improving the nursing profession.

The need for nurses, especially advanced practice registered nurses, to deliver care without facing barriers will become even more critical now that millions more people will have access to health care with the recent passage of President Obama's health reform bill, the committee report says.

This recommendation in the report will have a significant impact in healthcare delivery, explained Rosa Gonzalez-Guarda, an assistant professor in the School of Nursing and Health Studies in the University of Miami who served as a member of the committee.

"It is important that nurses are able to practice to the full extent of their education and training," said Gonzalez-Guarda. "When nurses are used to their full capacity, it translates into better health outcomes in the American public."

A more diverse（不同的） U.S. population, which includes Baby Boomers and people of different racial and ethnic backgrounds, also will benefit from diversity in the profession, said Gonzalez-Guarda.

"Our recommendations do not specifically address diversity [in the nursing profession] but do so in an indirect way by promoting education at the community college level," Gonzalez-Guarda explained. "And the most diverse nurses are those trained at the community level."

The report calls for higher levels of education and training for nurses by recommending that over the next decade, 80 percent of the nurses in the U.S. have bachelor's degrees and during that same period, doubling the number of professionals with doctoral degrees.

"Nursing programs like the University of Miami are doing an excellent job educating nurses. To meet future patient care requirements, we need to expand nurse education at the baccalaureate（学士学位） , master's and doctoral level," according to Nilda Peragallo, Dean of the School of Nursing and Health Studies at the University of Miami. "Increasing the number of nurses with advanced practice and doctoral degrees will help us address the need to prepare the next generation of nursing professionals and confront（面对，遭遇） the growing demand for access to quality healthcare.

The report also calls for effective workforce planning and policymaking, saying that such a goal can only be achieved through better data collection and a more effective information infrastructure.