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Chapter 16: Nursing’s Future Challenges

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Chapter 16: Nursing s Future Challenges Bonnie M. Wivell, MS, RN, CNS Overview U.S. is the wealthiest of the industrialized nations and still falls short of the ... – PowerPoint PPT presentation

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Title: Chapter 16: Nursing’s Future Challenges


1
Chapter 16 Nursings Future Challenges
  • Bonnie M. Wivell, MS, RN, CNS

2
Overview
  • U.S. is the wealthiest of the industrialized
    nations and still falls short of the goal of
    having a healthy nation in spite of spending
    nearly 2 trillion annually on health care
  • 45 million Americans have no health insurance
  • Infant death rates remain high nearly 5 per
    1000 babies
  • Fitness levels declining as obesity is increasing
  • U.S. spends more of its GDP (16 in 2004) on
    health than any nation in the world

3
Societal Challenges
  • Demographics study of vital statistics and
    social trends
  • Birthrates
  • Morbidity rates (illness)
  • Mortality rates (deaths)
  • Marriages
  • Ages of various populations
  • Migration patterns
  • Futurists people who try to project what will
    occur, draw conclusions about what these trends
    mean for the future

4
Societal Challenges Contd
  • Aging Population
  • By 2020, 21.8 million will be 75 years old
  • Baby boomers knowledgeable, expect more and
    tolerate less
  • Centenarians represent one of the fastest
    growing groups in the U.S.
  • 1 of 2 people over 90 will develop Alzheimers
  • Euthanasia/assisted suicide Netherlands and
    Belgium legalized it
  • End of life care/palliative care

5
Societal Challenges Contd
  • Poverty
  • Working poor basic needs not met has grown since
    reform of 1996
  • Medically indigent dont qualify for Medicaid but
    cannot pay for health care
  • Disenfranchised have no power in political system
    limited access to health care,
  • Government with limited resources must look at
    more strategies for health care for these
    vulnerable populations

6
Societal Challenges Contd
  • Cultural diversity people from different racial,
    ethnic, religious, social, geographic
    backgrounds
  • Homogeneous similar cultural beliefs and
    practices
  • Heterogeneous cultural mix
  • Nurses need to take cultural beliefs, values and
    practices into consideration when planning and
    implementing nursing care
  • Urbanization move from rural areas to cities
  • Decaying inner cities with large populations of
    poor people create major social problems
  • Homelessness, drugs, gangs, single-parent
    households, mental illness, violence, and crime

7
More Societal Challenges
  • Environment gradual deterioration of the worlds
    air, water, and plant and animal life
  • Acute and chronic respiratory diseases,
    debilitating allergic reactions and cancers are
    increasing
  • Epidemiologists study origin/spread of disease
    and believe that environmental decline increases
    incidence of certain diseases
  • Emerging MDRS of organisms will challenge health
    care resources
  • Disasters an event or situation that is of
    greater magnitude than an emergency disaster can
    be natural of man-made
  • Core preparedness competencies
  • Practice 2 times/year

8
More Societal Challenges Contd.
  • Bioterrorism refers to use of biological or
    chemical agent as a weapon
  • Keep up with emerging information to be prepared
  • See CDCs bioterrorism website
  • Unhealthy life styles obesity, tobacco use, lack
    of exercise, eating disorders, stress, HIV/AIDs
    and drug use
  • Cost Containment must do more with less
  • Regulation of Health Care costs rise with aging,
    increased use of advanced practice nurses for
    primary health care

9
Challenges in Nursing Practice
  • Differentiated Practice Levels ADN/BSN, MS
  • Should have different, well-defined roles
  • Possibly different levels of licensure
  • Only health care profession for which entry into
    practice is less than a baccalaureate degree
  • Credential for entry into a profession and
    educational standards are rising in all fields
    but nursing
  • This has hampered nursings quest for
    professionalism
  • Differentiated practice can only be realized if
    we give up the notion that a nurse is a nurse is
    a nurse

10
Challenges in Nursing Practice
  • Cost Containment managed care, capitation
  • Nurses will need resource management skills
  • Business expertise will be needed as much as
    clinical experience
  • UAP utilization and delegation
  • Autonomy Accountability
  • Shared governance participation by nurses on
    strong policymaking hospital committees mandated
    by JACHO
  • Practice in community settings autonomy and
    accountability will become increasingly important
  • Life long learning a requirement

11
Technology Nursing Informatics
  • Nursing informatics the organization and use of
    nursing data continue to change
  • Telecommunication (telemedicine) will improve
    access to medical services for rural and elderly
  • Genetic engineering genomic revolution
  • Makes it potentially possible to treat prevent
    genetically transmitted and predisposed diseases
  • Designer medicines are drugs tailor made to treat
    patients based on their individual genetic makeup
  • Complementary alternative therapies more
    utilized as persons take responsibility for their
    own health
  • Internet can provide reliable medical health
    information

12
Challenges Continued
  • Practice in Community Settings Nurse managed
    clinics serve inner city/rural areas school
    nurses needed in large numbers as well as hospice
    nurses and those specializing in gerontology and
    chronic illnesses
  • Cultural Competence patient/families health
    care providers cultural sensitivity due to change
    in the nations demographics
  • Maintaining Health Work Environment needle
    sticks, latex allergy, shift work, risk of
    violence in workplace, bloodborne diseases, back
    injuries

13
Challenges in Nursing Education
  • Outcome-based Education student competency and
    evidence-based education required to maintain
    accreditation
  • Diversity students reflect US demographics
    culturally competent education distance learning
    increases access
  • Education about chronic diseases, gerontology,
    hospice
  • Foreign language requirement for BSN
  • Culturally competent care as an outcome criterion
    for graduates

14
Challenges in Nursing Education Continued
  • Technology Nursing Informatics Impact
  • Computer competence
  • Internet utilization
  • Faculty required to actively practice to keep up
    with changes
  • Lifelong learning a requirement
  • NCLEX changes
  • New grad internships

15
Challenges Continued
  • Collaboration Nurses with more education equal
    footing with physicians others,
    interdisciplinary
  • Reforms in Health Care Higher Education
  • Graduate education producing practitioners to
    meet consumer demands
  • Curricula standardized streamlined to reduce
    cost and confusion and improve student mobility
  • Nurses will need to be well versed in the costs,
    budgeting and finance of health care
  • Faculty Shortage/Student Shortage current
    faculty retire, few younger nurses into education
    as salaries lag students turned away as no one
    to teach them fewer students means fewer nurses
    medical schools respond by producing hospitalists
    (care for patients only while hospitalized)

16
Challenges to Entire Nursing Profession
  • As the largest health care profession in the US,
    nursing should have a powerful voice and presence
    at every table where substantive health care
    issues are discussed.
  • Use of Collective Power to resolve issues, but
    only 10 of all nurses belong to their
    professional association
  • Nursing Agenda for Future
  • 2001 Nursing Profession Summit (ANA grant)
  • Steering committee formed and established the
    document entitled Nursings Agenda for the Future
  • How nursing should look and where it should be by
    the year 2010 you help decide involve nurses in
    charting own future
  • Nurses can accomplish more working together
  • FOCUS, UNITE, ACT!
  • Be the change you wish to see in the world
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