Q&A with Nurse Educator, Liana Orsolini-Hain on the Future of Nursing: Campaign for Action speaks with Liana Orsolini-Hain, PhD, a nursing instructor at City College of San Francisco. Liana served on the committee for the Future of Nursing: Campaign for Action, a Robert Wood Johnson initiative at the Institute of Medicine geared to create a plan for improving and advancing the role of nurses on national, state and local levels. In October, 2010, the Institute of Medicine released the highly influential report, the Future of Nursing: Leading Change, Advancing Health. Among other things, this report highlighted the importance of continuing and advanced education at all levels of nursing. In the interview below, Dr. Liana Hain discusses this report and its implications for nursing students as well as what nurses can expect for the future of the field.

Q: What is your current position?

I'm a nursing instructor at City College of San Francisco, an associate degree nursing program.

Q: What is the Future of Nursing: Campaign for Action and how does it affect nursing?

Actually, I got a hold of Susan Hassmiller, who's directing the project from the Robert Wood Johnson Foundation. I have a statement from her:

The Campaign for Action is a multi-year initiative to advance comprehensive change in health care for patients and the country by fully utilizing the expertise and experience of all nurses, on both national and local levels.

It will advocate and support actions that enhance a nurse's ability to contribute as an essential partner in care.

The campaign has already elevated discussion of the role and potential of nurses, as well as energized regional coalitions of nursing groups, health professionals and consumer advocates.


The real change to nursing practice will happen when payment reform happens.

The mechanism to change nursing practice is in place and it is actively happening.


Q: What should an aspiring nurse know about the Institute of Medicine's Future of Nursing report?

There seems to be quite a bit of consensus - four out of eight recommendations in the report have to do with education.

Keep going back to school for advanced degrees because that will give you the skill set and tools to be a really great nurse in the future in a reformed health care system.

We also need a lot more nursing educators. There is a lot of press about the nursing shortage.

There is very little press about the faculty shortage.

Q: What is the best entry point into nursing?

The beauty of nursing is that there are multiple entry points.

Many people choose to come in at the associate degree level. Another good entry point for someone with a baccalaureate degree in a different field is an accelerated RN to master's program.

Q: Should students continue to pursue ADN or LVN degrees?

I think the ADN degree will be around for at least the next hundred years.


The nursing community is getting much older and getting near retirement. I kind of foresee this massive exodus of nurses and nurse educators, some of whom hold two jobs. [New nurses will need to fill those jobs].

The level of diversity among LVN, rather than RN, nurses more closely resembles the diversity of the population.  It makes sense in the future to have more LVN to RN or LVN to BSN programs.

We're going to need all nurses, whether they have an associate, bachelor's, or master's degree.

Q: How important are bridge programs for advancement in nursing?

Some programs bridge you into coursework or subject matter that you've already learned. In that case, you have a lot of curriculum redundancy, and it's not a very good program because it wastes your time and money.

If, however, the program is something seamless like the Oregon Consortium of Nursing Education in which community colleges are linked up with a university system to collaborate on and develop a curriculum, that might be a better option. The first day at the community college nursing program is the first day of the baccalaureate curriculum, and you're co-enrolled between the community college and the university. The schools share resources and faculty.

Q: Why is advanced education crucial for nurses today?

Go for your master's degree any way you can. Look for scholarships, especially if you want to go into nursing education.

I've noticed with my career that the higher level degree opened up more leadership positions.

Q: How is health care reform going to impact nursing?

I kind of picture hospitals in the future being big intensive care units because everyone else is being so well managed in the community and the home.


Technology is going to have an impact as well - things like Skype, Twitter and Facebook. Populations will be connected to their health care providers through many different avenues, which we haven't explored yet.

We need reforms that eliminate curriculum redundancy and make going for your BSN or MSN value-added.

We owe something to nurses who go on for a higher degree. We have to make it worth it for nurses.


There will be a pull for nurses to be a bigger part of the care team.  We talk about that now, but I don't really see it in my practice as much as I'd like to see it. That's probably going to be a big change.

Q: Why should someone become a nurse now?

Well I think there are fabulous opportunities and communities for nurses now. I'm biased because I love it so much.

Come on into nursing.  We need you!   It would be devastating for the population if the nursing shortage worsened.

I love participating in health care and taking care of patients.

I get to spend hours with my patients. It's so great at the end of the night to reflect on what I did at the hospital or my practice with my nursing students.

Q: What should nurses graduating in the next few years expect?

Well right now it's difficult to find a job if you're a new graduate, just like it is in all professions. Be as mobile as you can, especially for the first two years. If you can, get at least two years of experience in an acute care setting, but be open to other settings as well.

Q: Any other recommendations for aspiring nurses?

Come into nursing, and take what nursing has to offer, but offer something back. Get involved. Join your professional organization and volunteer in your nursing community.