Nursing is a constantly evolving field. Science and society never stop mutating and developing, and the nursing profession has often been at the forefront of medical progression: delivering new methods of care based on scientific and holistic principles. The last few years have seen great leaps forwards in nursing.
Never before has the nursing profession contained so many distinct specialties. Senior nurses in all niches are expected to be innovators. Advanced nurse practitioners work in tandem with doctors and researchers to develop new care methodologies and analyses the success of existing practices. Nursing really is the cutting edge of medical care. Patients often spend far more time in contact with nurses than they do doctors. Innovations in nursing practice are absolutely crucial for improving hospitalization outcomes, social health and patient understanding of the medical system.
Here are some developments in nursing that have changed the healthcare landscape.
Public Health, The Pandemic and The Affordable Care Act
Public health nursing is absolutely crucial. Two things have bought the field of public health nursing into the limelight in the United States: The 2010 affordable care act and the current COVID-19 pandemic.
The 2010 affordable care act was an effort by the Obama presidential administration to make healthcare more affordable for all Americans. Healthcare and business have what some might call a ‘toxic’ relationship in the United States. Because healthcare provision is both extremely profitable and a (relatively) unregulated industry, some commentators have argued that the healthcare industry has no incentive to prevent illness. With the passing of the affordable care act, preventative healthcare became far more important to healthcare providers, as instead of making money from inpatients, they could theoretically lose it. It was a step in a progressive direction.
Aside from the moral and political pros and cons of semi-centralized healthcare provisions – which will not be discussed in this article – the affordable care act meant that public health nursing was thrust into the spotlight. Public health nurses specialize in preventative society-wide health education and treatment. Government funded healthcare of any sort is reliant upon preventative medical intervention: the less a health service is inundated with preventable cases, the more financial and political sense a centrally funded system will make.
62% of surveyed American public health nurses reported being involved in the activities surrounding the affordable care act. This involved increased healthcare education activities and population healthcare co-ordination between preventative and primary care systems.
The COVID-19 pandemic once again highlighted the need for public health nursing to be integrated into the nation’s healthcare system. Senior public health nurses were key advisors to the Centre for Disease Control – the governmental organization responsible for strategizing an end to the pandemic. Across the world, public health nurses are delivering vaccines, educating populations and addressing healthcare disparities that put people at risk. As a result of the pandemic, it is very likely that public health nursing will be funded and respected as a profession more than ever. During the 1918 influenza pandemic, a similar paradigm shift towards preventative medical intervention developed.
Nurses have taken on far more clinical responsibilities over the last few years. This ‘mission creep’ has occurred because of several parallel developments. Budget squeezes in many areas have meant that there are fewer doctors available to take on clinical tasks in healthcare environments. The relationship between wellbeing and health has been explored by researchers: nurses have historically been key practitioners of wellbeing healthcare provision. Nurses are also being educated to a much higher standard. Whereas nurses once got most of their training ‘on the job’, the modern American nurse is expected to have clinical skills and theory taught to them as part of a degree program or equivalent qualification.
Advances in Education
These advances in education have really changed the nursing landscape. As the US institute of medicine noted in 2011, “Major changes in the U.S. health care system and practice environments will require equally profound changes in the education of nurses”. These changes have come about. Nurses looking to specialise in a field such as paediatrics or mental health are expected to take specialist degree courses. Senior nurses are now expected to gain postgraduate qualifications, up to and including doctorates. Nursing education varies across the united states. To become a nurse in Texas, an applicant must have completed a course equivalent to a bachelor’s degree.
The result of all of this increased education? Licensed nurses are far more qualified to perform complex clinical tasks than their predecessors. This in turn has completely changed the structure of the healthcare industry, with licensed nurses finding more and more senior roles.
The Nurse Navigator
The healthcare system in the United States is complex, expensive and very localized. Patients who are in the system are often not in the best position to negotiate such a complex environment. These are often vulnerable people thrust into situations beyond their control. Nurses are now taking a leading role in helping patients navigate the healthcare system. Nurses, rather than doctors, are often the first point of contact a patient has with their healthcare provider. Nurses are the most trusted professionals in America. This patient to nurse trust is absolutely essential for guiding patients through the complexities associated with care.
This role has emerged recently because the constraints that held nurses back are being lifted away. Traditionally, nurses were women. In the medical field – as in many others – sexism prevailed. Nurses were considered to be the caregiving muscle in the healthcare industry, but not the explainers or innovators. As people realized how archaic and dreadful this worldview was, it became more acceptable to understand that nurses, regardless of gender, were the perfect guides through the world of healthcare.
The nurse navigator role is a new development. Dedicated nurse navigators help patients with chronic health conditions navigate the fragmented healthcare system and advocate for their care. This is a truly welcome development in nursing for people who found themselves confused and lost while trying to organize their own care.