Nurses Must Prepare for the Future

National Nurses Week, May 6-12, was established to recognize the contributions of nurses to the field of health care. This year's theme, "Celebrate our Past, Envision our Future," provided an opportunity to examine the roles nurses play in the changing health care environment.

The focus of health care is shifting from a heavy emphasis on medical and hospital care to helping individuals prevent illness, maintain good health and reduce disability. More and more, nurses will be counseling patients on how to care for themselves. They may, for example, teach a patient newly diagnosed with diabetes how to control the disease, or they may advise a new parent on caring for a premature baby. They may provide counseling and advice to the family of a patient with psychiatric problems, or they may teach group seminars on parenting or self breast examination.

Meanwhile, employment opportunities in hospitals for nurses are declining rapidly. Until recently, 70 percent of nurses worked in hospitals. The spiraling costs of medical care have created a more cost-conscious atmosphere. To reduce costs, patients are being discharged from hospitals more quickly and in more need of continued care outside the hospital than ever before. Some hospitals are eliminating bed space, some are closing outright.

Hospital nurses are increasingly finding positions in community settings that provide care outside the hospital, such as home care, transitional hospitals, extended care facilities, clinics, specialized outpatient centers and doctors' offices. For these positions, many nurses will need retraining. The two- and three-year educational programs some students take to become licensed as registered nurses generally do not prepare their participants to work in community settings as does a four-year baccalaureate program.

To prepare themselves for the changing needs of the nursing profession, registered nurses who have not completed bachelor's degrees should consider enrolling in a program such as that offered by Tennessee Technological University's School of Nursing. A bachelor's degree curriculum ensures that its graduates have much-needed skills in community health nursing, leadership, management, research and ethics. Programs like Tennessee Tech's require students to pass a series of general education, humanities and science courses before moving in to the upper division where they focus on nursing education.

Before they graduate, bachelor's degree candidates must demonstrate competence in assessing patients' physical and emotional health status. They must be able to analyze the needs of both the patient and his or her family so they can develop a nursing care plan. In addition to having a thorough knowledge of basic nursing skills, principles, theories and research, students are expected to have effective communication, leadership and managerial skills.

In the workplace, baccalaureate nurses take on the roles of managers, health care providers, teachers and patient advocates. They assist patients and their families by providing health counseling and problem solving. They have been educated to work with patients in all age groups, with sick patients in hospitals and in the home, with healthy people in clinics and schools and with special populations in group homes.

In the new health environment, nurses are challenged as never before to do what they love best: help people. More than ever before, nurses will be helping people to help themselves.