With the Institute of Medicine (IOM) report revealing that there was a minimum of 44,000 deaths in1999 that could have been prevented, at minimum cost of $17 billion, many recommendations were made to change how we approach health care (Plawecki & Amrhein, 2009).

  With the Institute of Medicine (IOM) report revealing that there was a minimum of 44,000 deaths in1999 that could have been prevented, at minimum cost of $17 billion, many recommendations were made to change how we approach health care (Plawecki & Amrhein, 2009). One recommendation was to increase the number of nurses that have their BSN. The fact that we are all in this class with plans to continue our educations beyond the BSN, supports that this recommendation is being taken seriously.

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Another of the recommendations made in the future of nursing report, is regarding residency programs for nurses (Cipriano, 2011). At our hospital we have the Versant program which is an eighteen week program incorporating classroom learning, computer learning, and unit orientation, followed by a year of mentoring. This has greatly increased the retention rate for nurses. Decreasing turnover allows more focus on continued learning and less on training new staff.

Mary Wakefield talks about the new rules for healthcare redesign and the two most important ones are safety is the responsibility of the entire facility or system and the need for transparency (Wakefield, 2008). No longer is there a stigma for employees to speak up regarding errors made or witnessed. The atmosphere in my hospital when we have errors, is that we address why a process failed and not place blame on individuals. Employees involved in an error are invited to the multidisciplinary reviews to evaluate all processes and to develop and implement change to avoid the error being repeated. The employees are now more comfortable coming forward because there is an atmosphere of safety first.