Nursing, the Next 10 Years, a Brief Overview
Nursing is a dynamic profession with the potential for rapid change. The future of nursing is even more promising than the past, but there are some trends and predictions that will shape how nurses do their work in the next ten years.
What these trends and predictions mean for nurses' work can be summarized by four areas: clients; practice environments; health care system changes; and education. Nurses will need to adjust to clients who are healthier because they'll live longer, with more chronic illnesses such as diabetes and hypertension, especially if they don't have access to quality care at home or have been priced out of insurance markets due to rising costs.
The work environment will continue to be increasingly complex, and nurses will need to adapt to their changing profession. This trend is expected to spur much research on the positive and negative effects of changes in practice environments on nurses' health, productivity, and well-being. Education will continue to change—but a new emphasis on learning how technology can be used in a more cost-effective manner (e.g., online learning) will make nursing more accessible for many more students than it has been in the past.
The future of nursing depends greatly on how health reform legislation may affect hospitals, states and the workforce. Including additional nurses in financial resources made available by the Affordable Care Act, or ACA, will be critical, and could have a large impact on how nurses practice. It is not yet clear just how the ACA will change health care back home; however, it appears that all jobs, including nursing jobs, will be affected.
The economic downturn of 2008–2009 has contributed to an interest in nurse educators to help nurses and nursing students learn financial issues such as managing debt. At a time when people are searching for ways to cut health care costs (i.e., implementing wellness programs and offering incentives such as lower premiums), high-quality and timely education on cost-effective techniques can help nurses provide safe care while also reducing their practice expenses.
Nurses will continue to be the most important health care professionals, as well as be held to rigorous standards of practice. Education will continue to shift (from teaching clinical skills to theory-driven nursing), but nurses as a profession will also need to adapt. A focus on education—which includes communication, systems, people and place—will help nurses prepare for changes in how patients communicate and how systems are managed, possible shifts in the patient-nurse relationship due to aging and a possible changing role for the nurse in health care reform.
The scope of nursing practice is expanding beyond traditional hospital settings toward community clinics and home-based services. To meet these new roles will require nurses to work with people in the community and provide services such as disease prevention and health promotion. This shift toward home-based care is not new; in fact, it has been going on since the 1960s when Medicare implemented a change in reimbursement that shifted payments to hospital outpatient departments.
With increasing numbers of community-based clinics, there is an increasing need to educate practitioners at all levels about how to care for patients before, during and after discharge from traditional hospital settings.
Along with the expansion of role for nurses into ambulatory care comes some risks for employers and other health care professionals who are used to working with doctors only. This is particularly true for nurses who, in their previous jobs, were used to being with clinical physicians or nurses.
Nurses will continue to be under tremendous pressure from regulations from various levels of government. Increased regulations on nurses' work will, however, happen at the same time that a recent study found that the most essential elements for nurses were personal and professional satisfaction and having a strong support system. Nursing will continue to maintain its focus on wellness and patient-centered service, but it will also need to rethink how it delivers services so as to meet the needs of all clients.
The point at which a nurse is no longer needed might be different from that of any other profession. In some fields (e.g. architecture), the building stands well after the architect is gone. In other fields (e.g. engineering), the product keeps functioning well after the engineer is gone.
In nursing, however, when a nurse no longer provides care to a patient, it doesn't mean that a problem has been solved and that there is nothing more to be done; rather, it means that a nursing function (such as assessment or treatment) has been delegated to another health professional (such as an ACP or PA). While delegation is essential for quality patient care, there will always be work for nurses to do until the client is at home and recovered.
Fields such as architecture can have a lifetime of work in one design project. Fields such as engineering can design and develop products that last for a long time.
In nursing, however, there is always a possibility of needing further treatment. With one year from diagnosis of breast cancer, only 5–10% of patients die from breast cancer. Asymptomatic patients have a risk of 3%. This means that the majority of people are still at risk for heart disease, stroke, depression (possible side effects from chemo), etc.
Nurses may work in the same patient population for their entire careers (the baby boomer generation) or may move to another population (e.g., menopause). Nurses may get to know a family over a period of years (following them through the life cycle). There is always still more to be done in patient care that requires the expertise and judgment of a nurse.
Nurses become tired and stressed when they feel they are an important part of a solution but do not have the time or resources to complete all their work. When nurses have difficulties, their secret desire is for someone else (such as a manager or physician) to take the assignment off their hands so that they can get some much-needed rest.
It is true that some nurse leaders and authors have expressed concern that nurse turnover might be too high and that nurse burnout might be under-reported. However, it is not clear that higher turnover or higher rates of burnout have any effect on patient care outcomes as opposed to the cost of replacing nurses; meanwhile, the cost of replacing nurses can be several times their annual salaries.
Nursing turnover may also reflect increased advancement in education among nurses. Studies have shown that nursing students entering baccalaureate programs have higher expectations for their work options and salaries than they did when they entered diploma programs 40 years ago. The result is that nurses are more qualified to move into leadership positions.
There are a variety of things nurses can do to help them stay committed to their longstanding career. The most important thing they can do is to remain aware of a nurse's purpose in caring for others. Nurse leaders should encourage nurses to keep these purposes in mind when caring for patients in order to enhance job satisfaction and health.
The field of nursing operates within the infrastructures and systems of society, including political, economic and social structures. The societal structures include laws, regulations and policies that affect the practice of nursing through such factors as education, pay, staffing ratios, relief time gaps and social security benefits.
Conclusion
Nursing is an area that has experienced tremendous change in the last few decades. Challenges remain to ensure that the future of nursing provides opportunities for all nurses. There are a variety of ways nurses can contribute to their communities, including the ability to educate other health care workers in their own community. Nurses can also help support patient advocacy, which serves both their local communities as well as other healthcare professionals who specialize in different areas such as mental health and oncology. Finally, nurse leaders have found ways to increase nurse satisfaction and loyalty among employees.
The fact that there are more nurses than ever before does not necessarily mean there is more work for them than ever before.