President Shalala delivers the Institute of Medicine’s prestigious Rosenthal lecture.

Three years after a special Institute of Medicine committee issued a series of recommendations to improve the nursing profession, the proposals it put forth—such as removing barriers that restrict nurses from practicing to the full extent of their training, and clearing pathways for them to earn advanced degrees—remain critical to transforming the workforce.

That was among one of the major messages University of Miami President Donna E. Shalala delivered Wednesday during the institute’s 2013 Richard and Hinda Rosenthal Lecture. Held in Washington, D.C., the forum highlighted the impact of The Future of Nursing: Leading Change, Advancing Health report produced by the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing committee chaired by Shalala.

“The fact is, we cannot meet the growing demand for quality health care in this country without all hands on deck, and to accomplish this, we’ve got to ensure that nurses and other health care professionals are able to perform to the top of their education and training,” Shalala, who was the longest serving U.S. secretary of health and human services, said to an audience at the National Academy of Sciences Building. “We simply can’t afford to constrain our well-trained health care workforce, particularly nurses, by outdated barriers and regulations that restrict our ability to provide access to so many people who need quality care.”

Nurses with first-class training “can do all the things we need them to do,” said Shalala, noting that in New Hampshire and 16 other states nurses, for the most part, have been allowed to administer health care to the full extent of their training, without restrictions.

With tens of thousands of people now signing up for insurance through the government’s health care exchanges created under the Affordable Care Act, Shalala said the need for health care reform is driven by the same factors that drive the need to strengthen the role of nurses. “The two are inextricably tied together,” she explained.

She repeated the committee’s recommendations that more nurses should achieve higher levels of education and training through an improved educational system that promotes seamless academic progression and that nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the U.S.

“Our recommendations are really about changing our system so we can provide better care to more people. Each of us plays an important role in the functionality of that system. We can blame the system as much as we like. But at the end of the day, we are the system,” said Shalala, adding that patients also play a key role in reform. “We need to value patient education and personal motivation. Their active engagement in their health enables us to focus more on wellness and prevention. Nursing has known this for decades,” she said.

Since its release in 2010, The Future of Nursing report has had a major impact, spurring the Robert Wood Johnson Foundation and the AARP to partner on a new initiative, the Future of Nursing: Campaign for Action, aimed at improving the health of Americans by transforming the nursing profession.