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Submitted to:

Submitted by:
Mr.Ramdhan Gilla Manu
M.Sc(N) 1st year
S.n Topics
Vision for the future of nursing 1-3
Future of Nursing careers 03

2. Nursing’s future challenges 3-4

Nursing and higher education 05
Changing role and functions of 06
4. Nursing in the 21st century 06
Future directions for nursing 07
5. research
Continuing Education for 21st
6. 09
• Methods of obtaining nursing
Continuing Education 10
7. •
Journal reference

8. Bibliography



In many ways this is a time of chaos within health care systems around
the world. The economic downturn in the global society has impacted
on health care. In many places services have been cut and access to
services reduced. In addition, new diseases
Such as AIDS, SARS and the threat of bio-terrorism have entered our
lives. New technologies and treatments occur rapidly, but are often
expensive, and financing these advances can be difficult. Patients are
moved out of hospital rapidly, and those that remain are more acutely
ill than they have been in the past. Those discharged patients often
need more assistance at home and in the community than in previous
years, and those services can also be expensive. Nurses are a vital
part of the health care scene, but nursing shortages have appeared in
many areas,
The nursing profession needs to begin to recognize new trends and
patterns that are emerging in health care
1. Rapid changes in health care technology and therapies likely
mean continued lowered acute care stays. Driving forces include
increasingly sophisticated surgical technologies that are less invasive
and promote quicker healing. New therapies may reduce sick time,
hopefully even in areas such as cancer, HIV/AIDS and genetic
disorders. However, as those technologies have prolonged the life
span, reduced mortality has changed fatal illness into more chronic
illness, which may still require care and control. The growth of
telemedicine, telenursing, and telehealth will also change the way we
function, and have great potential and challenges for the development
of new nursing roles. With lowered acute care stays, many more
people will require care in their own communities. Nurses need to be
better prepared to work within this area; financial issues of care
provision need to be addressed and nurses need to be better prepared
to work with chronic care needs.

2. Demographic trends, epidemiological trends, and health

care statistics
These help us recognize health care needs for society and give
information for future planning of cost effective services. Increasing life
span is a driving force for the development of improved services for
the elderly. End of life care has received more attention over the last
few years, but nursing research into this area needs to be further
developed and findings disseminated. In many societies immigrant
issues have created the need for better cultural understanding of
health care needs and require resources for care.

3. Flow of resources. Where is the money going and where is it likely

to go? Money flowing into health care in the community will be a
driving force for changes in that area, but a blocked flow will be a
restraining force to preventive health care services. Nursing input and
political power can impact that flow to provide effective health care
programs and services.

4. Supply of manpower and competition.

Manpower shortages or surpluses in health care professions impact the
utilization of nurses and advanced practice nurses. Who are our
competitors for delivery of services and resources? This is a
particularly important area in times of nursing shortage to be sure that
less qualified health care workers are not used to substitute for the
sake of expedience and reduced costs. How can we develop
competitive and marketing strategies? How can we form coalitions to
reduce competition? At the same time we need to explore whether
more collaborative programs of care can be developed effectively, so
that we are not holding on to outmoded ideas of the profession but can
develop newer modes, such as advanced practice nursing, to work in
interdisciplinary collaboration. Collaborative rather than competitive
strategies can strengthen quality of care by better utilizing the
expertise of each participant.

5. Role delineation, role confusion. Are the jobs keeping up with

the expectations of nurses and with advanced practice nursing? How
are supports worker jobs defined? How do professional standards
interact with reality? How many people are required to do the job? Can
one person realistically do the job? How can job satisfaction be
increased in this era of high stress in the workplace?

6. Public opinion. Nurses need to be aware of the public perception

of their role. Development of coalitions and supporters within
communities and media can be a driving force for advanced nursing
practice. Consumer or professional opposition can provide barriers to
practice, and be a restraining force.

7. Global trends. We are a global economy and health care services

face similar problems
Internationally. We can learn and benefit from contacts in other
countries, and we can offer our services when appropriate to improve
overall healthcare in both developing and industrial countries. Global
terrorism needs to be addressed, and nurses need to be well prepared
to deal with the aftermath and to document its effects on those we
care for. Nurse educators need to incorporate disaster training and
stress counseling into the curriculum and to provide workshops in this
area for nurses already in practice. It is essential that nurses
participate in the political process to reduce this threat.

8. Nursing practice and theory. Nursing research and theory

development need to be
Supported and findings disseminated to continue to build our nursing
science and incorporate the results into practice. We need to increase
our core of nurses who have met high academic standards for carrying
out research and provide resources for their activities. Nursing
research and theory also have the potential to contribute to the body
of knowledge of other disciplines in the same way that we have
borrowed from other theorists to use in our practice. The role of
advanced practice nursing has been growing and has demonstrated
effectiveness in the health care system. These nurses are now able to
provide medical expertise in diagnosing and treating specific
conditions, but are not mini-doctors. The medical portion of their
practice is only one tool within their whole

tool box of nursing competencies for use in providing holistic nursing care and health.
9. Leadership within the profession Leadership within the profession also influences the
trends in nursing. Nursing is moving towards professionalism due to the untiring efforts
of nurses who have been dedicated to achieve the aim.

10. Working conditions

Working conditions for nurses are also changing. There is a gradual change towards
shorter and more convenient hours of duty, better accommodations and higher salaries

11. Patients Bill of Rights

After the development of the “Patients Bill of Rights”, the nurses are also accountable for
patients care and have legal responsibilities for the patient.

Future of Nursing Careers

Predictions are that in 10 or 20 years, it will look nothing like it does today! With new
technologies and drugs, changes in insurance and health care policies, and the shortage in
nurses, the profession will have to reinvest itself.
Many nursing functions will be automated. For example, documentation and updating
patient records, smart beds to monitor vital signs, bar codes, and automatic medicine carts
could reduce the time and errors in dispensing medications, and voice-activated
technology would eliminate the need to constantly write things down. Other nursing task
such as serving meals will be taken over by aides. This would give nurses more time to
provide a human touch to their patients.
As a result of nursing shortages, healthcare facilities will be forced to use their nurses
judiciously. Nurses will spend more time at the bedside as educators and care
coordinators to refocus on the patient. With the lengths of patient stays shortening, nurses
will have to make the best use of a shrinking amount of time hospital stays. Nurses will
also spend more time in administration and supervision positions. They will need to know
how to access knowledge and transfer it to the patient and their loved ones.

Nursing’s Future Challenges

The change in health care delivery systems has also afforded nurses a wider range of
functionality. Although independence have been cultivated through expanded roles.
Trends towards downsizing and the current nursing shortage have increased the use of
non-licensed personnel in many healthcare arenas. This will continue to force the nursing
profession to identify, clarify, and communicate its scope of practice.

Advances in Technology:
The explosive growth of technology will continue to have an impact on health care
delivery. The advancements in telemedicine will link clinicians with patients across great
distances. The growth of this technology will change the way nurses function, and lead to
the development of new nursing roles. Electronic medical records are expected to replace
conventional modes of documentation. X-ray films will be a thing of the past; x-ray
images will be transmitted by computers and saved on floppy disc for retrieval and
reviewing. As consumers become more educated about health promotion, there will be an
elevated demand for alternative and complementary health care choices.
The promotion of advanced directives, organ donation, and comfort measures for the
terminally ill will lead to elevation in hospice care providers. Care modalities which
include pain management, spirituality assessment and bereavement counseling will be
incorporated into health care organizations and nursing education curriculums. Nursing
research will greatly contribute in developing and implementing these therapy options.

Work Environments:
Nursing's dissatisfaction with the workplace environment is another issue that must be
faced when considering the profession's future. This dissatisfaction was multifaceted and
included issues such as workplace violence, inability to attend continuing education
programs due to heavy workloads, exhaustion, and inability to provide safe patient care.
Mee and Robinson (2003) state that "nurses need work environments with strong
professional practice models that value their work and recognize their impact on patient

Nursing Shortage:
According to Wieck (2004), "nursing education is probably the most inflexible 'one size
fits all' environment that exists today". More campaigns such as Johnson and Johnson's
Campaign for Nursing's Future and the Oregon Center for Nursing's campaign, Are You
Man Enough to be a Nurse, will need to be launched to bring more men and minorities
into the profession. Other recruitment trends will be lower educational costs, greater
access to federal loans and grants, and new educational methods including shortening the
time required to become a registered nurse (Buerhaus, Staiger, & Auerbach, 2001).

Factors contributing to globalization include advances in information technology and
communications, international travel and commerce, the growth of multinational
corporations. Future nurses will face the challenge of maintaining a holistic approach to
client care in an environment of growing specialization. Focus on health promotion,
maintenance, and revitalization will continue to grow.

Costs control challenge:

In 1970s, 1980s, and 1990 governmental budget deficits reached all time high.
Government spends re money on health care system.
Societies poor, homeless, elderly, substance abuse, AIDS and mentally ill patients are
increased into country. The major question yet to be answered is “How can we pay for
health care for these people and the numbers are expected to be increased?
The central and state governments are seeking to answer that question. The next decades
will see hospital closing is record numbers, pressures continuing to mount from business
community forcing changes in financial health Care reforms.

Nursing and Higher education

Most professions provide a single route for the educational preparation of its
practitioners. However the development of nursing as a profession has resulted in major
educational routes that prepare graduates to write the National Council Licensure
Examination (NCLEX) for registered nurses.

Nursing Assistant: Individuals called nursing assistant provide care to the patient in
hospitals and long-term care facilities. Certified Nursing Assistant (CNA) works under
the directions of RN or licensed Practical nurse. The training course may conduct at
many settings-high schools, long term care facilities, hospitals, community colleges, and
privately operated hospitals.

Practical Nurse Education: The practical nurse or vocational nurse no new comes into
the health care delivery system. They could perform basic nursing procedure at home
itself. The general curriculum for these people to take 7 years to complete. They have
educational preparations at high schools, technical schools, hospitals, junior or
community colleges, universities or independent agencies.
Diploma Education: diploma program administered by hospitals and also referred to as
hospital based programs. The programs vary in length from 24-36 months. They are
affiliated with a college or universities.

Associate degree education: The movement toward in 1972, today associate degree
nursing program prepare more graduate for licensure as RN’s than do any other program.

Baccalaureate Education: This program that occur in 4.5 years in colleges or

universities. The program existed as a quasi autonomous branch of the university’s
school of medicine. In recent years the nature of baccalaureate education has changed
they permit a degree of specialization at the same level .

Masters program: After baccalaureate degree students are granted Masters Degree in
nursing after completion of 2 years program .The research-based Master of Science in
Nursing (MScN) program provides the basis for leadership in professional Nursing and
the foundation for doctoral studies.

M.Phil: This program is of 1 year (full time) or 2 years (part time) after the completion of
M.Sc. nursing.

Doctoral programs: Nurses with doctoral degrees are expected to have tremendous job
demand over the next ten years. These programs prepare nurses for careers in health
administration (a PhD is the preferred degree for nursing executives), clinical research,
and advanced clinical practice. The programs take from four to six years to complete, so
they represent a significant commitment on your part. In a doctoral program everyone
receives training in research methods (including statistics and data analysis), the history
and philosophy of nursing science, and in leadership skills.
Changing roles and functions of the nurse as perceived in the globe.
The nurses in India are also prepared and more privileged to face the changes and ready
to accept the challenging roles and functions of the nurse as perceived in the globe
because of the development in the education and training system. The following
roles and positions perceived as in the globe are given below.

a. Nurse educator works in schools of nursing, staff development departments. They

provide the educational programme for student’s nurses and nurses, teach clients
about the self-care and home care.
b. Clinical nurse specialist specializes in managing specific diseases and they function
as clinicians, educators, managers, consultants and researchers.
c. Nurse practitioners are certified to provide health care to clients in out-patient or
community settings.
d. Certified nurse-midwife are certified by the American College of Nurse-Midwives to
provide independent care for women during normal pregnancy, labor and delivery.
e. Nurse anesthetist, having advance training in anesthesiology, provides surgical
anesthesia to the client under the supervision of an anesthesiologist during minor surgery
with baccalaureate degrees or master’s degree.
f. Nurse administrators manage client care within the healthcare agencies in a middle
level or upper level management position.
g. Nurse researcher with Doctoral degree investigate nursing problem to improve care
and to define and expand the scope of nursing practice. Advancements in science increase
health needs of the society and thereby expect changes in the role of nurses and thus

Nursing in the 21st century

With the focus of clinical practice on evidence-based medicine, the relationship between
nursing and the patient has become treatment-centered. Amidst the organizations and
policy initiatives, the ever-changing technology, and the focus on healthcare costs, the
nurse practitioner is faced with the need to find faster, simpler ways to provide care.
Furthermore, many nurse practitioners practice in settings driven exclusively by the
medical model and leave little room for creative, caring approaches to practice.
Healthcare systems suffer from a lack of access and fragmented, costly care; there is also
an overemphasis on technologic approaches to treatment. Not enough time is spent on
health maintenance and disease prevention. In addition, there is little to no attention paid
to the patient's emotional and social needs, nor to their particular pain and struggle.
Troubled by this emerging paradigm for practice, nurse practitioners are challenged to
envision how holistic, caring practices can change both the way that care is provided and
the relationship between the patient and nurse practitioner -- creating a partnership. The
call is out to advanced practice nurses to imagine the possibilities for enhancing their
caring practices in the 21st century.

Future directions for nursing Research

Nursing research continue to develop at a rapid pace and will undoubtedly flourish in the
21st century .The priority of nursing research in the future will be promotion of excellence
in the nursing science. Towards this end nurse researchers and practicing nurses will be
sharpening their research skills and using the skills those skills to address emerging
issues of importance to profession and its client.

High focus on EBP: Concerted efforts to use research findings in practice are sure to
continue and nurses at all levels are encouraged to engage in evidence-based patient care.
In turn improvements will be needed both in quality of nursing studies and in nurses
skills in locating,understanding,critiquing and using relevant study results.

Development of stronger Evidence base through rigorous methods and multiple,

confirmatory strategies: Practicing nurses are unlikely to adopt an innovation based on
weakly designed or isolated studies. Strong designs are essential and confirmation is
usually needed through replication (i.e. intentional repeating) of studies with different
clients in different clinical settings and at different times to ensure that findings are
Expanded local Research in health care settings: In current evidence based environment
there is likely to be an increase of small and localized research designed to solve
immediate problems. It ensures that evidence from these small projects become available
to other with similar problems.

Continuing education for 21st century

One need only scan a newspaper or read a weekly magazine to be astounded by the
number of stories about new medical breakthroughs, disease processes, emerging threats
of disease, or innovations in medical and health care technology. The World Health
Organization warns us to prepare for a potential worldwide Bird Flu epidemic, terrorists
threaten us with chemical, biological and nuclear weapons, and new protocols for ACLS
are released. How is a working nurse to keep up?
Nursing educationprovides the basic building blocks of medical, scientific, and nursing
knowledge, but competence in the nursing profession requires an ongoing process of
continuing education. Continuing education for nurses is necessary for the nurse to
remain up to date with the latest practice issues and it is necessary for patient’s safety as
well. Some states have made continuing education for nurses mandatory and require a
certain number of course credit hours be attained before license renewal, or require certain
mandatory course subjects, while other states leave it to the nursing professional
themselves to accept a personal responsibility for their own continued learning.
Regardless of whether nursing continuing education, or Nursing

Methods of obtaining nursing continuing education hours and the pros and cons of

1. Professional Journals: Most professional nursing journals offer an article for

continuing education credit. Some offer a partial credit hour or one credit hour to readers
who fill out a post test after reading the article and mail it in. While some journals offer
the credit for free, others charge 10 or more and in addition to the inconvenience of
needing to tear out a post test form and mail it in the nurse has no official record of
having taken and passed the course. Obtaining continuing education hours through
professional journals is costly and inefficient in that the cost of the journal itself must be
taken into consideration along with the cost of the course if there is one, and the time and
expense of mailing in addition to the lack of official record of completion and lack of
central maintenance of all credits accumulated by the nurse.

2. Seminars: Professional development programs and seminars that offer accredited

continuing education hours for nurses are frequently offered at various locations in every
state, in some foreign countries, and even on cruises. Employers frequently pay the
registration fees for nurses to attend local seminars of short duration such as one day, but
nurses still have to sacrifice their precious day off to attend them or lose time from work
to do so. In addition nurses who attend seminars away from home have to pay their own
travel expenses, hotel bills, and costs of meals. Needless to say cruises and foreign travel
are an appealing avenue, but obtaining one's continuing education by that method is not
something every working nurse can afford to do.

3. Online Nursing : The internet provides nurses access to extremely affordable and high
quality accredited continuing education courses covering a plethora of professional
nursing topics. Online nursing courses are the gateway to nursing continuing education
for the 21st century! Nurses who take advantage of online courses are not restricted by
geographical barriers, financial hardships, or the inconvenience of taking time from work
or family in order to attend courses. Online nursing continuing education courses are
readily available for both mandatory state required subjects, courses in one's own nursing
specialty, and courses that all nurses regardless of practice specialty need to be
familiarized with so nurses have access to a much broader choice of subject matters than
they ever had before when restricted primarily to journals or seminars. In addition to
those benefits, substantial as they are, online nursing courses are inexpensive, up to date
with changing trends, can be taken from the comfort of ones own home, generally allow
nurses who take them to keep an official record of courses completed and credit hours
earned online with the course provider, and allow nurses who complete a course to print
the course certificate immediately upon completion.

In order to stay professional and to safeguard the wellbeing of the public nurses need to
continue their education over the course of their career through a variety of means
including taking continuing education courses. The most convenient and most cost
effective method of nursing continuing education is by taking online Nursing courses.


Nursing as it exists today has come a long way, withstanding the ups and downs that
social, political, economic religious, cultural, technological changes have put forward.
These factors such as religion, economy & culture have a major impact on the entrant.
“The only thing that is constant is change” Lord Krishna in the “Geetha”
Futuristic nursing can be classified in terms of nursing education, nursing Practice,
nursing Research, nursing administration and an amalgamation of all the four
components which might occur in years to come.
Nursing Research SNRC Other groups
Individual Renewal of licensure Institutional Alumni
Institutional Blog groups nursing
Collaborative groups
oriented &
Nsg Administration holistic Nursing Education
Placement health care Upgrding Nsg schools
Position to colleges.
Promotion Program
Pay scales Nursing services M.Sc nsg
Committees 1.Institutional specialization
involvement in Ph D
primary health care.
2.Job description &
job specification

• Potter and Perry, Fundamentals of Nursing,6th edition,Mosby publishers,Pp 22-23

• Lowenstein.pdf