Examining Nursing From A Futures Perspective

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Examining Nursing From A Futures Perspective
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Beliefs About Predicting Future

• The future will repeat the past
• Changes are caused by an external force
• supernatural power
• more powerful people
• governments
• Individuals have little or no ability to affect
  their future or the world

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Studying The Future

• Nursing has never had a greater need to
  understand the future, to envision a preferred
  future, and to develop strategies to create a
  preferred future than it does today.
• Sullivan, p. 4

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Why Study The Future?

• Engages people to think more effectively and
  creatively about the future
• Apply that thinking to present activities
• May be better able to define the future they
  prefer and work to create it while avoiding the
  future they fear

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Why Study The Future?

• Enables individuals and organizations to find or
  enhance the leadership necessary to move in
  desired directions
• Strategic management
• anticipation
• setting direction
• securing commitment

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Why Study The Future?

• Influences learning
• Encourages commitment to action
• Inspires those involved to question their sacred
  assumptions.

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What are some of our sacred assumptions in
nursing?
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Passive Thinking

• Apathy
• Feeling of impotence lack of control

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Have you experienced passive thinking among
nurses?
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Futurism

• A form of anticipatory democracy
• helping people decide what sort of future they
  want and how they might go about achieving it
  (Bezold, 1978 in Sullivan, 1999, p. 5)

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Futurism

• It is not enough to create a vision of a
  preferred twenty-first century health care
  system we need a vision of a healthier future
  for all (Hancock and Garrett, 1995 in Sullivan,
  1999, p. 5)

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Assumptions About the Future

• The future is uncertain
• We choose and create major aspects of the future
  by what we do or fail to do
• Visions and strategies linked to a clear sense of
  trends and scenarios make us better able to shape
  the future we prefer.

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Four Futures

• The possible future
• The plausible future
• The probable future
• The preferred future

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The Possible Future

• What may happen
• Everything that we can possibly imagine, no
  matter how unlikely, including science fiction
  futures that transgress presently accepted laws
  of science
• Includes wildcards those dramatic and seemingly
  implausible changes that can occur very swiftly.
  Low probability but high impact events.

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The Plausible Future

• Narrower scope - what could happen
• Possible futures that make sense given what we
  know today.
• The alternative futures approach enables us to
  compare a range of quite plausible future options
  and to choose among them.

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The Probable Future

• What will likely happen
• Based on our examination of our present situation
  and our appraisal of likely trends and future
  developments.
• Business as usual - the future is extension of
  present with little significant change
• the official future - government business
  planning

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The Preferred Future

• What we want to have happen
• Visions that generally begin by identifying and
  trying to create a future that does not yet
  exist.
• Vision moves reality beyond the present toward
  the best that can be.

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GROUP ACTIVITIY

• Determine what your group sees as examples of the
  4 futures?

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What skills and talents of nurses would fit into
the need for health and health care of such a
society?
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Nursings Future

• Bound to societys future
• Bound to the future of health care

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Determinants of Role Scope of Health Care In A
Society

• The value placed on health
• Willingness of society to expend its resources to
  improve or maintain health
• Societal beliefs that all citizens are entitled
  to health care
• Commitment to improve and maintain public health

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Future Scenarios for Nursing

• Possible but not likely - radical change in the
  structure of health care systems in which nurses
  act as the primary managers of care and
  physicians and all other health care providers
  report to nurses.

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Future Scenarios for Nursing

• Plausible - an expanded role for nurses in which
  holistic nursing care becomes the predominant
  value in the health care system.

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Future Scenarios for Nursing

• Probable (more likely) - the current invisibility
  of nurses will continue nurses will lack power,
  vision, and cohesiveness
• the health care system will continue to
  disempower nurses
• nursing care will decline as a societal value

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Future Scenarios for Nursing

• Preferable - the holistic care delivered by
  nurses will be recognized as integral to the
  health care system
• Nurses will serve as the first line of care in
  promoting health communities and will be
  recognized as integral to the health care team
  (Sigma Theta Tau International, 1996)

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Components of Health Futures

• Trends
• Scenarios
• Visions
• Strategies

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Trends

• A pattern of change over time.
• Focus on discrete topics
• e.g. health care costs
• disease prevalence
• therapeutic advances
• Involve plausible forecasts

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Trends

• The earlier a trend is spotted, the greater
  flexibility an organization has to respond to it
• Some organizations and most governments wait
  until trends become issues, often waiting for the
  issue to reach a crisis state before taking
  action.

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Trends

• When a trend is at a crisis state and is getting
  significant attention in the media, the decision
  costs for policy makers are higher and the range
  of options for solving the crisis are narrower.

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Scenarios

• Powerful tools developed for considering how
  interacting sets of trends might lead to a range
  of conditions in the future.
• Compilations of trends into differing images of
  the future
• Define what is plausible and what becomes
  possible if wildcards were to emerge

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Scenarios

• Invite us to think about the relative likelihood
  and relative preference of different futures
• Organizations focus their planning on reacting to
  more likely futures, reinforcing them and
  preventing the more desirable ones from occurring.

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Vision

• Scenarios are futures for the head.
• Visions are futures for the heart.
• Action is strongest when it comes from our deep
  commitments - from our heart.
• Vision is a statement of our values projected
  into the future we want to create.
• Visions define the best that can be.

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Vision

• A compelling, inspiring statement of the
  preferred future that the authors and those who
  subscribe to the vision are committed to
  creating.
• The critical dimension of a vision is not the
  statement itself but the commitment and behavior
  that the vision draws out of those who pursue it.

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Vision

• Vision becomes a living force only when people
  truly believe they can shape their future.

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WHAT ARE YOUR VISIONS FOR NURSING?
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THE FUTURE 2000

• INSTITUTIONALIZING NURSING AS THE PRIMARY HEALTH
  PROFESSION,PRACTITIONERS RESPONSIBLE FOR HEALTH
  CARE ALL PEOPLE
• INSURE NURSINGS PUBLIC ACCOUNTABILITY
• ESTABLISH APPROPRIATE SYSTEM OF NURSING EDUCATION

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THE FUTURE2000

• ENHANCE NURSINGS SCHOLARLY EFFORTS AND
  ACCOMPLISHMENTS
• RENEW NURSINGS ORGANIZATIONS
• PROMOTE APPROPRIATE IMAGE OF NURSING
• Schlotfeldt, M. Nursing in the Future, NO, May
  1981, 295.

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What are the visions of nursings future 2025?
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Are these visions compatible with your vision for
nursing?
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