"the future days"

txredheadnurse, BSN, RN · Apr 21, 2012

I think there will definitely be more bedside technology that will intervene via automated protocols. I also believe there will be little if any human contact, bedside-type nursing being done. I think the RN will basically be overseeing everything from a central location and if patients desire or want hands on human performed personal care they will either have to hire an aide or family will have to perform it. In the very beginnning of hospitals as such it was rather expected that the majority of the personal care would be provided by family members. In the older style military hospitals up to and during most of the Viet Nam war the soldier patients assisted each other a great deal with feeding, pushing wheelchairs and walking each other in the halls. They also looked out for each other and alerted the nurses when there was a problem.

So my projected model of the hospital nurse in the future would make the big business boys happy....hardly any nurses just machines that don't need to be paid or earn benefits.

onyx77 · Apr 21, 2012

Potassium pills will become smaller so all these little old folks will be able to swallow them!GoLytely will not be a huge gallon jug but a small pill!Ativan 2mg po will be a nursing order so we can give it to anxious family members!

:rotfl: I totally agree! I wish I could give the Ativan to certain coworkers as well!!!

Thunda · Apr 21, 2012

I will never understand why Hospital beds don't have leads for vitals, or maybe there are and I live in a small town and am just graduating in May, but you'd think stuff like that would be on the TV shows with the technology being advertised like the medications are...

A while back I though I read that there was a state pushing to allow LPN's to do pretty much everything an RN can (ofcourse to save money)

Where do you see Nursing in the next 30 years?

I think GP's will be a thing of the past, DNP's will take the roll since few if any MD's want to do anything but specialty work (can't blame them considering the pay difference, and aren't NP's in Oregon allowed much more freedom of practice than most anyway?)

nerdtonurse?, BSN, RN · Apr 21, 2012

30 years from now. The majority of the baby boomers will have passed through the health care system, and just like we had all the refuse of the boomer's passing when I was in elementary school (half empty class rooms, desks piled in corners 5 feet tall, schools closing and merging) there will be a glut of beds in geriatric care (LTC, assisted living, skilled nursing, etc.). There will be a period where there's not enough beds for the folks who need them, and you'll see the gov't deciding it's cheaper to keep people in their homes (if you're home, you're paying property taxes, tags, titles, etc., if you're in a facility, you're probably not). So I think Medicare/Medicaid reimbursement for NH/SNF placement will have such tight regulations most people won't qualify, but because of the sheer volume of the boomers, it'll still be a lot of people who need care. The rich will get care, the poor won't.

What I think your average healthcare experience will be:

1) In general, health care will be delivered in the home unless it's something you just can't physically do in the home. Think about what we can do in the home now -- vents, trachs, PD dialysis, chemo. I think it may be that if you need ICU level care, the hospital drops an internal room or "pod" at your home, and the patient and rotating caregivers stay in the pod, but the patient is still "home." Still paying taxes.

2) I think we are way overdue for a major, serious killer outbreak. Bird flu, pig flu, ferret flu, something that is going to come in and cause massive fatalities due to limited numbers of vent/ICU beds and folks who won't/can't be immunized, assuming they can even develop a vaccine. You call in with respiratory symptoms 30 years from now, they aren't going to tell you to come in, they are going to send a home health nurse to collect sputum samples, and decide if you need to be quarantined -- I don't think we're going to have very many antibiotics or antivirals that work 30 years from now. And because we -- nurses -- will have been exposed, I think people will avoid us in case we're carriers. Most docs will interface with the patients via some kind of tele medicine -- patients are dangerous, therefore, docs don't touch them.

3) When you do have come into the hospital, we're not going to just swab your nares -- we're going to get sputum, urine, fecal, and whatever else we can get and scan you for whatever is going to be the "MRSA/ORSA" 30 years from now. I think you're going to see tons of things like Fournier's Gangrene, for example, and skin samples from any red area aren't going to be assumed to be cellulitis, you're going to be treated like you've got the worst possible disease until proven different. And I think there's going to be people in isolation because they don't test positive for something. And we'll be taking their DNA and getting detailed histories on those folks for the NIH.

4) I think you'll see a lot of long term things that are no longer covered, because we can't afford to cover it anymore. I don't think they'll continue to pay for dialysis -- temporary, sure, but long term, if you're not a transplant candidate or can't afford the cost, it's just not going to be covered anymore. The days of folks getting 5 liters pulled off, going out into the parking lot and tipping up a 2 liter bottle of soda (seen that one myself) are going to be over. Frequent flyers who treat the ER like a vending machine for food, drugs and social interaction are going to be limited to a specific number of visits, and I think triage will be like stepping into a PET -- they don't see anything, you get turned around and sent back to the curb and told to get a home health nurse visit arranged. You show up beyond your allowable number of visits, your care comes out of your check. Your check goes negative, you're not even triaged. Keep in mind, at this point, there will still be a ton of people receiving whatever kind of pared down Medicare/retirement that still remains. Your care will be tied to your ability to pay. Medicare/medicaid goes dry, a lot of people are going to die. I think you'll see people burning hospitals and clinics because they won't be accepted, so they'd rather nobody got help if they couldn't.

5) I think a lot of care is going to be focused on comorbidities and they will be used to exclude futile care. If you're buhzillion years old with a million things wrong with you, medicare/medicaid will not pay for things like vents and trachs and dialysis that will only serve to prolong your death. You'll have to meet fairly harsh critieria to be accepted into life prolonging programs. Over time, the bar you have to pass to get that care is going to be set higher and higher, until you're basically going to have to be rich to afford it.

I think it's going to be a dark ride, folks.

FORTHELOVEOF!!!! · Apr 21, 2012

Our hospital is starting a system where doctor's input their own orders!!!!!!!!! No more reading chicken scratches and being yelled at for calling to verify orders :yeah: The doc's are of course not happy and throwing a fit about it but it looks like it should happen by the beginning of the year, woo hoo, that's technology I can get on board with!

Creamsoda, ASN, RN · Apr 21, 2012

30 years from now. The majority of the baby boomers will have passed through the health care system, and just like we had all the refuse of the boomer's passing when I was in elementary school (half empty class rooms, desks piled in corners 5 feet tall, schools closing and merging) there will be a glut of beds in geriatric care (LTC, assisted living, skilled nursing, etc.). There will be a period where there's not enough beds for the folks who need them, and you'll see the gov't deciding it's cheaper to keep people in their homes (if you're home, you're paying property taxes, tags, titles, etc., if you're in a facility, you're probably not). So I think Medicare/Medicaid reimbursement for NH/SNF placement will have such tight regulations most people won't qualify, but because of the sheer volume of the boomers, it'll still be a lot of people who need care. The rich will get care, the poor won't.
What I think your average healthcare experience will be:
1) In general, health care will be delivered in the home unless it's something you just can't physically do in the home. Think about what we can do in the home now -- vents, trachs, PD dialysis, chemo. I think it may be that if you need ICU level care, the hospital drops an internal room or "pod" at your home, and the patient and rotating caregivers stay in the pod, but the patient is still "home." Still paying taxes.
2) I think we are way overdue for a major, serious killer outbreak. Bird flu, pig flu, ferret flu, something that is going to come in and cause massive fatalities due to limited numbers of vent/ICU beds and folks who won't/can't be immunized, assuming they can even develop a vaccine. You call in with respiratory symptoms 30 years from now, they aren't going to tell you to come in, they are going to send a home health nurse to collect sputum samples, and decide if you need to be quarantined -- I don't think we're going to have very many antibiotics or antivirals that work 30 years from now. And because we -- nurses -- will have been exposed, I think people will avoid us in case we're carriers. Most docs will interface with the patients via some kind of tele medicine -- patients are dangerous, therefore, docs don't touch them.
3) When you do have come into the hospital, we're not going to just swab your nares -- we're going to get sputum, urine, fecal, and whatever else we can get and scan you for whatever is going to be the "MRSA/ORSA" 30 years from now. I think you're going to see tons of things like Fournier's Gangrene, for example, and skin samples from any red area aren't going to be assumed to be cellulitis, you're going to be treated like you've got the worst possible disease until proven different. And I think there's going to be people in isolation because they don't test positive for something. And we'll be taking their DNA and getting detailed histories on those folks for the NIH.
4) I think you'll see a lot of long term things that are no longer covered, because we can't afford to cover it anymore. I don't think they'll continue to pay for dialysis -- temporary, sure, but long term, if you're not a transplant candidate or can't afford the cost, it's just not going to be covered anymore. The days of folks getting 5 liters pulled off, going out into the parking lot and tipping up a 2 liter bottle of soda (seen that one myself) are going to be over. Frequent flyers who treat the ER like a vending machine for food, drugs and social interaction are going to be limited to a specific number of visits, and I think triage will be like stepping into a PET -- they don't see anything, you get turned around and sent back to the curb and told to get a home health nurse visit arranged. You show up beyond your allowable number of visits, your care comes out of your check. Your check goes negative, you're not even triaged. Keep in mind, at this point, there will still be a ton of people receiving whatever kind of pared down Medicare/retirement that still remains. Your care will be tied to your ability to pay. Medicare/medicaid goes dry, a lot of people are going to die. I think you'll see people burning hospitals and clinics because they won't be accepted, so they'd rather nobody got help if they couldn't.
5) I think a lot of care is going to be focused on comorbidities and they will be used to exclude futile care. If you're buhzillion years old with a million things wrong with you, medicare/medicaid will not pay for things like vents and trachs and dialysis that will only serve to prolong your death. You'll have to meet fairly harsh critieria to be accepted into life prolonging programs. Over time, the bar you have to pass to get that care is going to be set higher and higher, until you're basically going to have to be rich to afford it.
I think it's going to be a dark ride, folks.

Thanks for that, unfortunately I agree with much of what you said, it's going up be a sad sad world

Dazglue, ADN, BSN, MSN, RN · Apr 21, 2012

Our hospital is starting a system where doctor's input their own orders!!!!!!!!! No more reading chicken scratches and being yelled at for calling to verify orders The doc's are of course not happy and throwing a fit about it but it looks like it should happen by the beginning of the year, woo hoo, that's technology I can get on board with!

Already being done at my job. Love it! The doctors actually love it as well! Fine with me, no more he said, she said and chicken scratch!!

tokmom, BSN, RN · Apr 21, 2012

Our hospital is starting a system where doctor's input their own orders!!!!!!!!! No more reading chicken scratches and being yelled at for calling to verify orders The doc's are of course not happy and throwing a fit about it but it looks like it should happen by the beginning of the year, woo hoo, that's technology I can get on board with!

We do that now and the doc's even have the capability to do it from their office. No more excuses, lol

OCNRN63, RN · Apr 21, 2012

Nursing will continue to get dumbed down to the point that the need for licensed, professional nurses will drastically decrease with the exception of a few key ares,

GitanoRN, BSN, MSN, RN · Apr 21, 2012

everything that it has been discussed here, and in previous posts has already taken place in the medical field. for example: there are doctor robots making rounds in hospitals, robots delivering meals to patient units, and other robots are being used for delivery of lab.specimens. in addition, just last year japan introduced a life like robot to hospitals to see how people interact with their presence. undoubtedly, healthcare robots can deliver medicine and help with physical therapy. at this present time, robots can run activities in nursing homes. needless to say, we all know technology monitors blood pressure and other vitals, telemetry monitors any changes in hearts. consequently, in many ways it’s frightening how much technology can do for us, all for the sake of advancement. with that said, i'm in favor of advancement in technology to assist in healthcare. however, nothing can replace the human touch and compassion that we offer to our patients. having said that, below you'll find a several links that demonstrate these robots in action.

[video=youtube_share;kinxbtpxzow]http://youtu.be/kinxbtpxzow

[video=youtube_share;q65aheugb84]http://youtu.be/q65aheugb84

[video=youtube_share;_wthlmpkqpu]http://youtu.be/_wthlmpkqpu

[video=youtube_share;matfzydzg8c]http://youtu.be/matfzydzg8c

whichone'spink, BSN, RN · Apr 21, 2012

Nursing will continue to get dumbed down to the point that the need for licensed, professional nurses will drastically decrease with the exception of a few key ares,

This constitutes part of my rationale for wanting to go into the ED and/or ICU. They can't get rid of nurses in those areas completely.

Guttercat, ASN, RN · Apr 21, 2012

One of the hospital employees brought his super-duper-techno-advanced, radio controlled toy helicopter to work (holy moses those things have come a long way), and flew it around outside.

We RN's sat around joking that one day we'd be able to make rounds and deliver meds by flying our 'copters into patient rooms.

"Yes sir? Can I help you?"

"I need a pain pill!"

"Please stand by, the helicopter is on the way. Please remove the pill from the transport basket once the helicopter is hovering over your bed."