Future of Nursing

Mijourney · Mar 15, 2000

Hi,

Back in the late 1980's, a former CEO of one of the local hospitals where I live stated that he felt nurses ought to be replaced by robots because he, at that time, was feeling the pinch of a nursing shortage, and he felt that another nursing shortage would occur in the future. I personally would not feel comfortable with an all "bot" or "Borg" staff at my bedside. But, I can tell you that there is a potential for something like this to occur with the type of exploitative mentalities that are in our society. Right now, I have read, we don't have enough qualified entrants into nursing. Also, the fact that the U.S. population is aging with increased chronic illnesses and more single people who are not attached to an extended family or have no close ties to their immediate ones, makes this a possibility. Since its inception, nursing has been in the shadow of medicine. I don't ever see that changing in my lifetime. Therefore, it will behoove all nurses to become functionally literate, even an expert in high tech hardware and software so that they can have an opportunity to stay viable in the labor market in the future.

Need to add that before we get to robots here in the U.S., that we may find a significant increase of nurses from other countries or nontraditional areas of the U.s. which potentially may change the complexion of nursing. Best wishes on your study.

[This message has been edited by Mijourney (edited March 15, 2000).]

markbeer · Mar 15, 2000

Hi

I can't really comment on what i think will happen specifically on your side of the atlantic but i think that one of things that will effect nursing globally is the use of the internet and IT in general.

I think that this will effect how good examples of nursing practice will be disseminated and hopefully implemented quicker. Our patients will be more aware of their conditions/ilnesses etc... and so in turn will we also have to be not only to keep up with them but also to check what they have found out is indeed accurate.

Also the "paperless office" is already with us and so more time will perhaps be spent tapping information about patients into a computer and less time at the bedside.

Regards

Mark

http://www.rnld.co.uk

Nursing Links

NurseRachet · Mar 15, 2000

I have been a nurse for 29 years, so I have seen it full circle. I believe we are currently in a nurse shortage, and it will continue to critical shortages within the next 5-10 years. This is due to other disciplines utilized in taking care of the patient - on in the name of "saving money". I also believe that the nurse will need to have not only technical skills in patient related equipment, but especially in the computer field. Documentation will all be completed via the computer as well as order entry - obviously, this takes time and keeps the nurse from the bedside. I think families will be more involved in patient care, as nurses are scarce and can only be stretched so far. I think this is one area we have overlooked - education of the patient and family that they are not going to get waited on for simple things, and will be expected to help care for the patient. We are now seeing that more and more. Good luck with you survey.

mmmmitty · Mar 24, 2000

Thank you for responding.

I think the future will be a mix of both good and bad. I think technology will make paper work easier and care more efficient. Then this efficiency will cause the hospitals to think that nurses can handle more patients with higher acuity. I am afraid that with such high patient loads that there will be some serious mistakes made. Only when nurses start loosing their licenses that this will cause other nurses to start refusing to take so many patients. Unfortunately this means that some nurses will be sacrificed till nurses start sanding up for themselves. Either that there will be a mass exodus of the profession altogether.

What do you think?

Mitty

MollyJ · Mar 24, 2000

I think within the next 20 years America will finally have to confront their "health care appetite" and tort issues in medical care. Between a voracious appetite for medical care and tort issues which mandate perfection and "doing it all" regardless of age or extenuating factors, we have seen medical care consume a disproportionate share of our GNP. Grad students, what is this percentage up to now? It was, I think 12% several years ago, the highest of all of the industrialized nations.

Only financial collapse of some sort will cause health care consumers to thoughtfully weigh what we consider to be necessary care. Public health folks (of which I am) would say "basic" preventative services should lead the band: vaccination, pre-natal care, early intervention on chronic diseases which can be managed and maintain people's working productivity, emphasis on a healthy lifestyle. Things that may be looked at and questioned: expensive end of life care for elderly (but NOT basic care that emphasizes comfort, I hope); aggressive care of very early premie babies (again, we hope comfort care isn't thrown out...), high tech care for renal failure, etc. etc.

With managed care, the emphasis within the health care INDUSTRY has been providing the reimburseable service. I guess I would imagine two possible realities: the collapse of the reimbursement system with nothing to replace it OR a very narrow and targeted definition of reimburseable services along the line of the target areas I listed above. How many of us would sign on to be a guarantor, that is the payor, for our 82 year old grandma's stay in the ICU to include technologies like IABP or renal dialysis? What if the health care system did reimburse comfort care for grandma? "Ew, gross!" sorta questions aren't they, but I think they are the questions that we will face as we look at our priorities.

For the future: Gee, I am really hoping that we will have some strong nursing voices up there who are willing to say in the planning stage what "comfort care" should look like to babies or aging adults [since I'm heading in that direction]. Hopefully, compassionate nurses and docs would have a strong voice in the actually giving of this care. I think home care will remain strong. If much of what is done in the ICU these days becomes "private pay" services, ICU's I guess would shrink.

Comments? Too Orwellian? Nurses will need to be strong in this scenario in order to keep things compassionate.

Nancy1 · Mar 24, 2000

In reading through these postings, I have to say that there is so much shown on television with all these hospital shows and agressive treatment. Is it necessary to agressively treat someone who has asked for comfort measures, but the Health Care POA who happens to be a family member that is not ready to say good-bye so they want everything done.

This just happened to someone I know. From what I understand there are those who will do what the family member wants because the family member will still be around to sue. Mom was ready to let go and let God, but the son said "Do what you need to do to save her."

I saw a program on one of the education channels entitled "Whose Death Is It Anyway?" It raised the question about families wanting more done than the patient did. It was interesting to me.

We have all this technology that people want to use to keep others alive longer. But are they considering the quality of life the individual will have.

I ask the question "Just because we have the technology, is it necessary to use it all the time?"

Personally I think technology is a wonderful thing, but when it came to my father and respiratory failure, the option to let him die (his directives said "no machines") or take him to the hospitals and let him go on a vent. I was so proud of my mom who said "He wants no machines." My dad at the time was 64 and an invalid secondary to a stroke 5 years previous. Technology could have kept him alive. But we chose not to accept the offer. This was before I became a nurse. I totally agree with my mom on her decision.

Now that I am in LTC, I STRONGLY encourage families to accept mom or dad's decision.

This is one way we can save some nurse time.

I have heard people at my organizational meetings say "There is no shortage, there is a higher demand for nurses, therefore there are less at the bedside. "

I have no idea where nursing or health care in general will go, but I do know I will do my best to help people make informed decisions. As nurses that is one thing we can all do. NA