FUTURISTIC NURSING

M. HEMAMALINI M.Sc(N)
SENIOR LECTURER
S.R.M. COLLEGE OF NURSING
 INTRODUCTION
During the past 15 to 20 years dramatic
societal and professional changes have
influenced nursing practice, education and
scholarship.
In future it is clear that nursing faces many
challenges, The Challenges nurses face relate
to variety of factors. Changes in demographics,
rapid changes in the health care delivery system
and unhealthy life styles.
 FUTURE SCENARIOS
Scenarios are forecasts or
assumptions for possible futures.
They rise awareness of wide
range of possible implications of
external forces, sensitize people
to potential threats and
opportunities, and allow
examination of alternative options
for action.
 SCENARIOS

• Continued growth Scenario

• Decline and stagnation Scenario
• Disciplined Society Scenario
• Transformational Scenario

BEZOLD(1985)
 Continued Growth Scenario
• Assumes Continued technological ingenuity,
sophisticated communication, high levels of
consumptions, associated with rising affluence,
cost of system continue to grow, because there
is little changes in life style, there are more
stress-related disorders & chronic and
psychosomatic illnesses are more common.
• There is only slight increase in health promotion
and the conventional medical model prevails.
• Health care is dominated by high technology
and illness oriented care in institutions for the
elderly.
• In this Scenario, which is an extension of
current environment, nursing education could be
highly individualized through the use of
computers, with little traditional face-face
instruction.
• Nurses would be employed primarily in
Institutional settings, carry for acutely ill and
long-term clients.
• Salaries would be higher but lack of work
satisfaction and low prestige would perpetuate
recruitment problems leading to intensified labor
shortages.
 Decline and stagnation Scenario
• This scenario assumes deepening
recessions, continued social unrest and difficult
resource shortages especially of food.
• Increased immigration puts a strain on
health and social systems, leading to two-tier
health care system.
• There is increased infectious disease
malnutrition and mortality among the elderly.
• There is general sense of failure and the
system becomes increasingly fragmented. The
system is less prominent, but it is still dominated
by physicians.
• Nursing care of acutely ill clients would be very
important in this scenario, but nurses would be
poorly paid and have little prestige.
• Clients who could pay would be cared for in the
home by the private duty nurses.
• Technology would be limited to reliable
established treatments, thus education
would be more shorter, more standardized
and more focused on technical
interventions and measures designed to
increase client comfort.
 DISCIPLINED SOCIETY SCENARIO
• In this Scenario, hard times have been averted
by exchanging traditional freedom for societal
controls.
• The goals of security, comfort and material
success are met through rational management
which has enforced conservation and efficiency.
• Behavioral control is maintained through
propaganda.
• Health is regulated and health system is well-
ordered. Physicians have been constrained, and
other more cost effective providers dominate the
system.
• This scenario offers real potential for nursing
to achieve greater power and influence than it
has now.
• Public health programs would be enforced and nurses
would have a major role in promoting health.

• Expensive therapies would rarely be used for the

elderly or the very young practice would be highly
regulated.

• There would be job security, especially within prevalent

Government-operated institutional with nurses paid
acceptable salaries based on job descriptions.

• All nurses would be educated in one type of

standardized program.
 Transformational Scenario
• This Scenario involves an evolution from an
industrial society into a less materialistic and
more personally fulfilling ecologically sound
society.
• License has been replaced by certification and
more equal access to practice.
• Advanced technologies have led to the
comfortable life for most people.
• Consumers are involved in decision making
regarding their health.
• There is emphasis on wellness and
development of full human potential with
rejection of anonymity, artificiality, manipulation
and unnecessary size or complexity.
• Nurses would be full partners is consumers in
this Scenario, helping people with self care and
providing information to support fully informed
decision making.
• Various information sources to support health
would be available at home through computer
networks.
• Nurses would be highly educated
professionals, whose contribution would be
valued for its effectiveness.
VISION FOR THE FUTURE OF
NURSING
RAPID CHANGES IN HEALTH
CARE TECHNOLOGY AND
THERAPIES.
The growth of
telemedicine, telenursing
and telehealth will also
change the way we
function and have great
potential and challenges
for new nursing roles.
DEMOGRAPHIC TRENDS,
EPIDEMIOLOGICAL TRENDS
AND HEALTH CARE
STATISTICS.
Help us to recognize
health care needs for
society and give
information for future
planning of cost effective
services. Nursing
research into this area
needs to be further
developed and findings
disseminated.
FLOW OF RESOURCES
Money flowing into the
health care in the
community will be the
driving force for change.
Nursing input and political
power can impact that
flow to provide effective
health care programmes
and services.
SUPPLY OF MANPOWER

Man power shortages

or surpluses in health
care professions
impact the utilization
of nurses and
advanced practice
nurses.
ROLE DELINEATION AND
ROLE CONFUSION
Are the jobs keeping
up the expectations of
nurses and with
advanced practice
nursing. How do
professional
standards interact
with reality.
GLOBAL TRENDS
Global economy and
health care services
face similar problems
internationally. Nurse
educators need to
incorporate disaster
training and stress
counseling into the
curriculum.
NURSING PRACTICE AND
THEORY
Nursing research and
theory have the potential
to contribute to the body
of knowledge of other
discipline. Nurses are
now able to provide
medical expertise in
diagnosing and treating
specific conditions .
FUTURE NURSING SERVICE
 FUTURE NURSING SERVICE
• Involve reflective practice
• Apply deliberate rationality
• Nurses will have skilled knowledge
• Greater integration of theory and practice
• Nurses will be responsible for morally right
• Greater consistency in applying professional
values
• Sound ethical principles applied in practice
• Nurses will apply distributive justice
• Greater application of anti-oppressive
theory
• Nurses will have greater power as gate
keepers to resources
• Nursing practice will have diversified field
for practice,extended,expanded roles
areas for practice
• Focus on outcome oriented approach
FUTURE NURSING
ADMINISTRATION
 FUTURE NURSING
ADMINISTRATION
• Quality and equality will be the dictum
• Nursing will reflectively use expertise and
experience
• Greater recognition of interdependence
with other team members
• Being collectively accountable for practice
.
 FUTURE NURSING
ADMINISTRATION
• Will adopt public administration model of welfare delivery
The characteristics of welfare delivery will be as
• defined bureaucratic structure
• professional domination
• accountable to public
• equity treatment
• self sufficient
• welfare policies
• connect theory , values, and practice
• greater application of theory into practice
• Nurses will undertake statutory training
• Nurses will have greater values and standards
• Nurse administrators will collaborate shifting
boundaries and changing practice
• Greater clarity of purpose and structure
• Administration will be characterized by
communication based on need rather than
position
• Will have team work interventions.
FUTURE NURSING EDUCATION
 FUTURE NURSING EDUCATION
• Nursing education will focus on value education
• Evenly distributed nursing institutions in the
country
• Educational system will be learner driven
• Educational system will be standardized
• Will have greater coordination with research and
service component
• Nursing profession in future will clearly develop
tools to evaluate regulatory effectiveness
• There will be greater reforms toward
professional disciplinary process
• There will standardization for ENTRY FOR
PRACTICE requirements
• Nurses will need a broad based education,
assertive skills, technical competence and ability
to deal with rapid changes.
FUTURE NURSING RESEARCH
 FUTURE NURSING RESEARCH

FOCUS WILL BE ON
• Greater researchable areas
• Research education and training
• Dissemination and implementation of
research findings
• Career opportunities for research
eg;nurse scientist and nurse
epidemiologist
• Greater coordination of research bodies
eg;coordination with medical research council ,
economic and social research council
• Established structure for research dissemination
• A finely developed strategy for research training
and career structure
• Greater clinical and practical oriented research
• Practice based on research (EBP)
 NURSING PROFESSIONAL
TRANSITION
CURRENT FUTURE
ROLE ROLE
Dependant Interdependent
Illness fixed Health based
Delegated Assumed
Narrowly defined Flexible application
RESPONSIBILITY RESPONSIBILITY
Care and safety Health prescription
Institutionally defined Community defined
prescribed self client determined
CURRENT FUTURE
FUNCTION FUNCTION
• Physician • Multidisciplinary
dominated
• Preventive and
• Interruptive maintenance
correction
• Policy based • Standards defined
 TRENDS IN HEALTH CARE
DELIVERY
FROM TO
Illness emphasis Preventive emphasis
Acute care Preventive, home care
Hospital or institution based Non institution based
Physician directed Diverse decision makers
Independent decision Protocols/ guidelines
Local perspective Global perspective
Paper records/medical Information
charts systems/computer
records
 FUTURE CHALLENGES
• Demographic challenges
• Environmental challenges
• Lifestyle challenges
• Cost containment challenges
• Regulatory challenges
• Autonomy and accountability
• Maintaining a healthy work environment
• Challenges of outcome based education
• Challenges of technology and collaboration
• Reforms in health care and higher education
 HOW TO CREATE THE FUTURE
The role of nursing leaders/educators in creating
the future is a four (4) step continuous
loop/process: each step is ongoing
simultaneously expanding and contracting in
scope as needed. The four (4) steps are:
• 1) Monitor and analyze trends,
• 2) Open discussion on the trends; identify all
possible, probable and preferable futures,
• 3) Develop a strategic pathway for the futures,
remember futuring is not about predicting the
future but about not being surprised,
• 4) Head to the future; implement the strategic
plan.
FUTURE ROLES OF NURSES
HOSPITAL
OPPORUNITIES
Staff nurses, surgical
nurses, midwives,
lactation specialists,
rehab nurses, nurse
anesthetists, IV
specialists, staff
educators,
supervisors, clinical
specialists, clinical
managers, quality and
utilization specialists,
nursing directors, and
administrators.
 OUTSIDE THE HOSPITAL
Clinic nurses, office nurses,
school nurses, forensic nurses,
industrial nurses, case
managers for insurance
companies and worker's
compensation, sales reps for
drugs and medical supplies,
clinical research nurses,
diabetic educators, wound
ostomy nurses, legal nurse
consultants, flight nurses,
childbirth educators, dialysis
nurses, home health nurses,
hospice nurses, and private
duty nurses. There are
managers and health care
administrators and many,
many more.
NURSE ENTREPRENEURS
Nurse entrepreneurs
are building a huge
variety of independent
businesses ranging
from consultants in
many diverse areas of
health care to
aestheticians to foot
care specialists.
EMPIRICAL OUTCOMES
 CONCLUSION
In the future , more than ever, nurses will need a
broad based education, assertive skills,
technical competence and the ability to deal with
rapid change. However, research and
technology may provide the instruments nurses
require for defining professional nursing,
demonstrating that professional nursing care
affects client care outcomes and marketing
professional nursing into the public. Nurses
should be actively prepared to take an active
role in shaping future practice.