Changes in Health Care System


Changesin Health Care System

Nursingprofession is indispensable today and it still remains vibrant in thefuture this is due to the critical role that nurses play. Despitethere being challenges that face the nursing profession, there isneed to realize changes that will change or transform the future ofnursing. In 2008, a central initiative was begun with an intention ofassessing and transforming the nursing profession as the U.S. healthcare system underwent key changes. The Robert Wood Johnson Foundation(RWJF) together with the Institute of Medicine launched a two-yearproject that was to release a report and make recommendations for thefuture of nursing. This was a critical step in ensuring that thefuture of nursing remains bright. According to the Institute ofMedicine (2010), nurses will be better positioned in leading changesand advancing health. This report will focus on discussing how thenursing practice is projected to grow and change in the future. Thereport will discuss the expected roles of nurses.

Thenursing profession needs to be changed in terms of leadership,practice, and education in order to fulfill its delivery role in theU.S. healthcare. Institute of medicine report has been on the centerof the future of the nursing profession through describing newstructures as well as opportunities and offers an overall visionconcerning the significant contribution of APNs towards thehealthcare system. One of the major changes that are expected in thenursing roles concerns the Accountable Care Organizations (ACO). ACOsare currently allowed by the Accountable Care Act (ACA) and arereceiving great attention from healthcare organizations. AccountableCare Organizations are positioning themselves in the newly redefinedhealthcare marketplace, which is designed to change the primary focusfrom fee-for-service for the chronically and acute ill to capitalizedpayments or shared savings for enhanced quality care and effectivecost through increased care coordination and management. As a result,APNs can now be utilized to their fullest in terms of training andeducation. Therefore, it is expected that APNs will be in a positionto take roles such as chronic disease management, health prevention,health coaching, and transitional care in Accountable CareOrganizations (Ridge, 2011).

TheACA also encourages health/medical homes to become community-basedinter-professional teams that would include nurses, physicians, aswell as other healthcare professionals (Ridge, 2011). The increase ofmedical homes is an important aspect to the future roles of nursingbecause nurses would be expected to play a critical role of providingprimary care to patients without focusing on just children withspecial care needs, but with a focus of both children and adults.Therefore, instead of nurses providing specialized care to childrenhaving special needs, nurses will have the role of proving bothmedical and non-medical care. Besides, the increased focus onCommunity Health Centers (CHCs) is also likely to change the role ofnurses since they are likely to have an increased role in providinghome visits and administrative roles of the community centers (Ridge,2011). Therefore, the role of nurses is likely to change to home caregivers with the increased CHCs since there will be a need to visitpatients at their homes in order to know their response to care orany other need within a community.

Furthermore,with the adoption of information technology, the role of nurses isalso likely to change. Information technology will influence theroles of nursing since it will make nurses adopt new roles. Becauseof the emerging technologies, nurses will adopt the role ofmonitoring their patients without having a physical contact. Forinstance, in this case, nurses will be capable of monitoring theirpatients through remote devices and know the condition of theirpatients. Alternatively, through the use of information technology,nurses will be in a position to use mobile workstations and attend topatients. In addition, due to emerging technologies, the future ofnursing will change to telenursing. Through telenursing, patientswill not be required to visit physical hospitals, if deemed notnecessary. In telenursing, nurses will have much easier task inattending to patients because there will be minimal physicalencounters with the patients. Nurses will use devices like computersto monitor the welfare of patients and, in the provision of care,nurses will be in a position to provide instructions to patients orcare givers close to the patients on how to proceed or handle a givenissue. Thus, through information technology, nurses are likely tobecome telenurses a move that would give a new role to the nursingprofession. Nurses will have to adopt online communication in orderto be capable of handling telenursing roles (Kumar &ampSnooks, 2011).

Moreover,the role of nurses is projected to change in the future and nurseswill become clinical research nurses and nurse researchers. Clinicalresearch nurse role is on the increase emanating from the growth ofthe research network infrastructure in the United States (Dreher&amp Glasgow, 2011).An increase in clinical research in different organizations will helpin the growth of the nursing profession. Besides, because of theincreasing need for research, the role of nurse researcher will alsobecome more appreciated in the future. This implies that more nurseswill be willing to join the researching role in the nursingprofession.

Feedbackfrom Colleagues

Oneof the colleagues indicated that she expects the role of nurses tochange, such that, nurses will be in a position to grow asentrepreneurs. Nursing entrepreneurship offers nurses the opportunityto become self-employed this aids them in pursuing their passion andpersonal vision in improving health outcomes (Wilson et al., 2012).According to this colleague, although some nurses have entered thisfield, it is expected that more nurses will assume this role. This isconsistent with what I have already projected because, as nursesadopt new technologies in their profession, they will be capable ofproviding care without the need of moving to a physical facility. Inthis way, a nurse will have some time that he/she can use inattending to nursing business. For example, a nurse may use the timein providing consultative nursing care which in this case will beconsidered a personal business.

Asecond colleague indicated that, in the future, he expects the roleof nursing to change, where nurses will be seen in differentleadership positions. This is consistent with the research that hasalready been carried out since, as community health centers becomeencouraged, most nurses are likely to move to the health centers tooffer administrative and other leadership roles. Besides, due to thechanging perspectives of nursing profession, nurses will consideradvancing their education and training so as to occupy leadershippositions. With the advanced education, they will developprofessional leadership and occupy leadership positions.

Athird colleague pointed out that he projects a change in nurses’role, where nurses will offer more personalized care. This is alsoconsistent with the research findings because, with the emergingtechnologies, nurses will be capable of offering personalized caresince patients will be in a position to engage them personallywithout the need of involving a third party. For example, a patientwill be in a position to contact a nurse through video conferencingor through emailing. In such a scenario, home-based care will be onthe increase.


Nursesplay a significant role in the provision of both medical andnon-medical services. Because of their important role, it is expectedthat the future of nursing will be more developed and advanced thanit is. Different changes are expected in the roles of nursing in thefuture. One of changes in the role entails APNs being in a positionto take roles such as chronic disease management, health prevention,health coaching, and transitional care in Accountable CareOrganizations. Besides, the increased focus on Community HealthCenters (CHCs) is also likely to change the role of nurses since theyare likely to have an increased role in providing home visits andadministrative roles of the community centers. In addition, the roleof nurses is projected to change in the future and nurses will becomeclinical research nurses and nurse researchers. Clinical researchnurse role is on the increase emanating from the growth of theresearch network infrastructure in the United States. Furthermore,because of emerging technologies, the future of nursing will changeto telenursing.


Dreher,H. M., &amp Glasgow, M. E. S. (2011). Roledevelopment for doctoral advanced nursing practice.New York: Springer Pub. Co.

Instituteof Medicine (2010). TheFuture of Nursing: Leading Change, Advancing Health.Washington, DC.

Kumar,S., &amp Snooks, H. (2011). Telenursing.London: Springer.

Ridge,R. (2011). Future of Nursing Special. NursingManagement,Volume 42 Number 6, p 32 – 37.

Wilson,A., Whitaker, N., Whitford, D. (2012) &quotRising to the Challengeof Health Care Reform with Entrepreneurial and IntrapreneurialNursing Initiatives&quot OJIN:The Online Journal of Issues in NursingVol. 17, No. 2.