Download The Future of Nursing

Professional Nursing Practice
Concepts and Perspectives
Seventh Edition
Chapter 25
The Future of Nursing
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Learning Objectives
25.1 Identify past events that have shaped and molded nursing.
25.2 Discuss projections of future events that will affect nursing.
25.3 Identify anticipated changes in health care and nursing in the future.
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Hallmark Features
• A focus on foundational knowledge related to
professional nursing
– Includes nursing history, nursing theory, ethics, and
legal aspects, etc.
• An overview of professional nursing roles, issues,
and changes in the profession
– Discusses nurses as healthcare providers, learners
and teachers, and leaders
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Challenges and Opportunities
• Nursing roles expanding at rapid rate
• Old roles and skills no longer adequate
• Challenge to take control of changes and become
proactive in meeting society’s needs for health
care
• Opportunity to create better healthcare system
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Learning Objective 25.1
Identify past events that have shaped and
molded nursing.
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Healthcare Reform
• 2010 U.S. Congress passed Patient Protection
and Affordable Care Act
– Intent to transform healthcare system
– Goal to provide seamless, affordable, accessible
quality care
– Family-centered and evidence-based
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Healthcare Reform
• Nursing profession challenges
–
–
–
–
Lack of diversity
Need for more advanced level of education
Restrictions on scope of practice vary by state
Professional tensions undermine care
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Healthcare Reform
• Robert Wood Johnson Foundation (RWJF) and
Institute of Medicine (IOM) established two-year
Initiative on Future of Nursing; four key messages
– Nurses should practice to full extent of their education
and training
– Nurses should achieve higher levels of education and
training through improved education system
– Nurses should be full partners in redesigning U.S.
health care
– Effective workforce planning and policy making require
better data collection and improved information
infrastructure
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Events that promoted nursing’s growth and
development
– Women in the workforce during and following World
War II
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Events that promoted nursing’s growth and
development
– Education changes brought by American Nurses
Association (ANA)
1965: Position paper
1978: Levels of preparation in universities
• ADN and BSN
1985: Different titles for nurses
• RN/BSN and RN/MSN
1995: Reaffirmed its position
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Events that promoted nursing’s growth and
development
– Development of two-year and four-year nursing
programs in Canada
– Development of baccalaureate nursing programs in
Australia and Great Britain
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Events that promoted nursing’s growth and
development
– Development of the advanced nurse practitioner
Evolved from nurse practitioners and the clinical nurse
specialist
– National healthcare changes
Increases in number of for-profit healthcare corporations
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Events that have indirectly affected nursing
–
–
–
–
Medical advances
Cost-containment measures
Managed care in the United States
Public policy
Informed consent
Patient Self-Determination Act
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Past Events That Have Affected Nursing
• Social movements and technological initiatives
that have affected nursing
– Women’s movement
– Information age
Computers
Electronic health record
Personal digital assistants (PDA)
– Worldwide community
– Advances in health care
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Learning Objective 25.2
Discuss projections of future events that will
affect nursing.
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Population Changes
• U.S. population expected to expand over next 40
years
• Population becoming more racially and ethnically
diverse
• Aging population may require increased focus on
chronic illness
• Lack of assimilation can lead to language barriers
and misunderstandings
• Income disparities and poverty
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Four kinds of futures
– Possible, what can happen if some changes are made
– Plausible, likely outcome when specific efforts are
made to accomplish desired outcome
– Probable, most likely outcome if things continue
unchanged
– Preferred, outcome that is wanted
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Drivers of change are likely to include
–
–
–
–
–
Consumerism
Disarray of managed care
Biotechnological innovation
Information technology
Community focus
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Computer technology and its effect on health and
nursing care
– All healthcare providers will be required to have
knowledge and practice skills in using computers
Knowledge of software programs
Ability to use spreadsheets
Skill with search engines
Ability to adapt to ever-changing systems
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Computer technology and its effect on health and
nursing care
– Use of virtual reality in learning environment
– Online patient information resources will be
increasingly used
– Online continuing education and formal education
– Telehealth
– Electronic medical record
– Robotics
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Healthcare system changes
– Managed care
Fewer professional nurses in hospitals
More multiskilled workers supervised by professional nurses
– Hospital stays will be shorter and care will address
acute phase of illness and pain management
– Basic care will change as technology takes over
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Healthcare system changes
– Jeffrey Bauer proposes that the healthcare system
Break the monopoly held by physicians over the delivery of
health care to American citizens
Place health care on the free market
Make the consumer free to choose from expanded menu of
qualified providers
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Healthcare system changes
– Hospitals become smaller, and health care will move to
the community
– Complementary and alternative therapies will continue
to grow
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Regulatory changes
– National standards for licensing entry-level nurses
– National standards for measuring competency of
nurses over time
– Regulations of physician and nonphysician healthcare
providers at the national level
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Regulatory changes
– Regulations would be
Competency based
Broad to allow for change
Definitive to ensure provider is qualified
Quality control would be the key ingredient in determining
universal standards
State could provide the entry examination
– Competency standards, not titles, would drive
decisions
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Continued medical, surgical, and pharmacological
advances
– Possibilities include
Cloning technology
Treatment of highly infectious diseases with potent chemicals
Use of machines for procedures and for keeping people alive
Medications
Medical treatment for chronic conditions and infections
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Continued medical, surgical, and pharmacological
advances
– Possibilities include
Pharmacological advancements requiring nurses to expand
their knowledge of pharmacology
Escalated ethical dilemmas
Greater need for understanding of the community and
aggregate care
Teaching others how to teach will consume more of a nurse’s
time
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Looking Toward the Future of Nursing
• Continued medical, surgical, and pharmacological
advances
– Possibilities include
Only continuous learners will keep pace with rapid changes
Focus on wellness and prevention
Challenge of live sight and touch versus visibility through a
medium
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Applying Past Lessons to the Future
• Healthcare delivery system in the United States is
flexible
• Changes have occurred rapidly and without
warning
• No one entity is in control of the healthcare
system
• Healthcare providers have made major strides
each time the system changed
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Learning Objective 25.3
Identify anticipated changes in health care and
nursing in the future.
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Visions of Tomorrow
• Health care will be provided mostly in the
community
• Independent nonphysician providers will deliver
significant proportion of primary care
• Nurses will work collaboratively with physicians
and nonphysician providers
• The new providers will be much more attuned to
what consumer wants
• Informed consumers will become more selfdirected and assume more responsibility for their
health
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved
Visions of Tomorrow
• Access to health care/consultation will resemble
the market for other services and products
• Education for nurses will reflect the changes in
healthcare delivery system and application of new
educational technologies
• Nursing practice will have a global focus
• An imperative and important looming change is a
decision on basic preparation of nurses
Copyright © 2016, 2012, 2009 Pearson Education, Inc. All Rights Reserved