By Jennifer Larson, contributor
January 10, 2014 - What will 2014 hold for the nursing profession? No one knows for sure. But even without a crystal ball, some of the industry’s top leaders are making some predictions of nursing trends to watch for, based on what has been happening in health care and in nursing specifically over the past year.
Most nursing leaders agree that the profession will continue its focus on implementing the recommendations in the Institute of Medicine’s (IOM’s) 2010 landmark report The Future of Nursing: Leading Change, Advancing Health, including the effort to increase the presence of nurses on hospital, state and federal boards.
Karen Daley, PhD, RN, FAAN, president of ANA, said that nurses need to be in more policy-making positions to provide their perspective and advocate for patients.
Karen Daley, PhD, RN, FAAN, president of the American Nurses Association (ANA), emphasized the continued importance in 2014 of being proactive and creating mechanisms to help nurses gain board positions and other policy-influencing roles.
“Otherwise, our perspective is missing, and it’s an important perspective,” she said. “We speak for the patients. There’s no one closer to the everyday needs and care that we provide.”
Vicki Good, RN, MSN, CENP, CPSS, president of the American Association of Critical-Care Nurses (AACN), said,
“In 2014, we’ll need more than ever to maintain our focus on ensuring safety and quality in patient care.”
Good cited the Joint Commission’s national patient safety goal on alarm management as proof that alarm management is a high priority in the critical care field. The prevention of healthcare-acquired infections (HAIs) will continue to be a priority this year, as well. “We’ve made modest strides, but haven’t come close to what our patients require,” she said.
Vicki Good, RN, MSN, CENP, CPSS, president of AACN, said that nurses will be focusing on key patient safety issues in 2014.
There is also an ongoing struggle over nurse–patient ratios, with seven states and the District of Columbia having introduced staffing bills similar to California’s law mandating certain ratios, according to the January issue of the American Journal of Nursing. While there may be progress in this area in the coming year, it remains an uphill battle.
Experts also acknowledge that the rollout of the Affordable Care Act will continue to have an impact on nurses. More and more care will be delivered in community-based settings, Daley said. Many nurses, including newer nurses, may be taking positions in these settings, whereas in the past, they may have spent many years in a hospital first. The educational system may also have to continue evolving to accommodate this shift.
“We have to shift our thinking,” Daley said.
The 80-20 movement
The IOM report called for 80 percent of nurses to be prepared with at least a baccalaureate degree by 2020, with the explanation that an increasingly complex patient population, many with multiple chronic conditions, will require a more highly educated nursing workforce.
In 2013, a growing number of hospitals and health systems began drawing the proverbial line in the sand, saying, “We only will hire nurses with a BSN.” Mary Rita Hurley, MPA, RN, said this trend is likely to continue in 2014.
“We’re seeing more of that around the country,” said Hurley, executive director of the Oregon Center for Nursing and president of the National Forum of State Nursing Workforce Centers.
The future for nurse practitioners
In 2013, Nevada became the latest state to pass a law granting nurse practitioners the freedom to practice independently, without a collaborative or delegated agreement with a physician. That brings the total to 17 states. Could more states soon be following suit?
“I believe that other states will move slowly but will eventually see the resource that they have in nurse practitioners and be more willing to grand them the ability to practice in accordance with their education,” said Kenneth P. Miller, PhD, RN, CFNP, FAAN, co-president of the American Association of Nurse Practitioners (AANP).
“We saw many states moving to allow NPs to practice to the full extent of their education, and I believe that 2014 will continue this,” added Angela K. Golden, DNP, FNP-C, FAANP, AANP co-president.
In fact, if the nation wants to meet its goal of providing care to the many uninsured and underinsured people, per the Affordable Care Act’s goals, nurse practitioners must be included. “It is going to take all health care providers working together to achieve that goal,” Miller said.
That means it’s also a good time for nurses who may be contemplating the advanced practice route to follow that path.
“It is not only a good time, it’s the right time for nurses to further their education and careers by becoming nurse practitioners,” Miller said. “No one discipline will be able to handle the influx of new primary care patients, and nurse practitioners are educated to assist in that need.”
Many baby boomer nurses delayed their retirements when the economy soured. That phenomenon, in turn, affected many younger nurses who had trouble finding jobs in certain regions of the country. But that could be changing.
“We’re starting to see, for the first time since the economic downturn, people are finally retiring,” said Hurley.
Daley agreed. “As the economy improves, we’re going to see a huge exodus,” she predicted. But she, like many others, is concerned about the nursing educators and nursing school deans who will also retire, leaving gaps that must be filled to educate a steady flow of nurses to meet the needs of the population in the future.
Hurley noted that some are nervous about changes on the horizon, with some changes already unfolding, but she thinks it’s an exciting time to be a nurse.
“There are going to be some incredible opportunities for nurses,” she predicted.
Daley hopes to see more opportunities for registered nurses to practice at the top of their abilities.
“RNs are not being utilized to the extent that they should be in terms of the unique skill sets and competencies that we bring to care,” she said.
Nursing leaders point out that individuals must remember why they went into nursing and keep their focus, no matter what the future holds.
“It may sound cliché, but we need to keep our eye on the ball, which is our patients and their families,” said Good. “It’s so easy to become overwhelmed and distracted by the inevitability of change that we forget on whose behalf we do what we do.”
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