Professional Nursing Practice Concepts and Perspectives Seventh Edition

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) ª 1965: Position paper ª 1978: Levels of preparation in universities • ADN and BSN ª 1985: Different titles for nurses • RN/BSN and RN/MSN ª 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 ªEvolved from nurse practitioners and the clinical nurse specialist – National healthcare changes ªIncreases 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 ªInformed consent ªPatient 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 ªComputers ªElectronic health record ªPersonal 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 ªKnowledge of software programs ªAbility to use spreadsheets ªSkill with search engines ªAbility 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 ªFewer professional nurses in hospitals ªMore 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 ªBreak the monopoly held by physicians over the delivery of health care to American citizens ªPlace health care on the free market ªMake 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 ªCompetency based ªBroad to allow for change ªDefinitive to ensure provider is qualified ªQuality control would be the key ingredient in determining universal standards ªState 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 ªCloning technology ªTreatment of highly infectious diseases with potent chemicals ªUse of machines for procedures and for keeping people alive ªMedications ªMedical 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 ªPharmacological advancements requiring nurses to expand their knowledge of pharmacology ªEscalated ethical dilemmas ªGreater need for understanding of the community and aggregate care ªTeaching 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 ªOnly continuous learners will keep pace with rapid changes ªFocus on wellness and prevention ªChallenge 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