Futuristic

{ Nursing
By:- Firoz Qureshi
Dept. Psychiatric
Nursing
INTRODUCTION:-

 Nursing is a profession with good career opportunities

that change and reflect the society in which nurses live.
 Patricia Benner (2000) predicted that in the new

millennium nurses will be doing more in the community

but also will continue to be even more integral to the
provision of intensive care that will increasingly be the
focus of hospital care. Nursing has a chance to grow and
develop its vision for practice and education. The rapid
changes in the health care delivery and changing
population demographics have affected supply and
demand of nurses. The future will require effective
identification and planning for personnel needs.
 We are in a new place, we are not on the edge of old
place. We are not pushing the envelope, we are in
totally a new envelope. So the rules have changed.
Ever fundamental premise of the old way of
thinking is no longer applies.

Sister Elizabeth Davis

 According to occupational outlook guide, the

nursing profession is one of the fastest growing of
all career paths.
Nursing in starting :
 ‘Lady with the Lamp’
 Selflessness and Service
Vision for the future of nursing:-

 Addition new diseases and

the threat of bio-terrorism.
 New treatments and technologies.

 Patients are moved out of hospital rapidly, those

that remain are more acutely ill.
 Those discharged patients need more assistance at
home.
NURSING IN THE 21ST CENTURY:-

 For the nursing graduate, the future holds

numerous social, political and
technological changes.

 During the 21st century, societies will continue to move

towards globalization, with an increased sharing of products,
attitudes and financial investments. The clients may be more
likely to combine conventional therapies with complementary
healing techniques, such as homeopathy, neuropathy,
therapeutic touch, reflexology, acupressure, aromatherapy,
and nutritional therapy.
Sibbold and other experts on nursing and health care
also predict the following:-
 Neighborhood will employ nurses who will work in 24 hour
nurse managed clinics.
 Nurse Practitioners will cross medical threshold to provide

services usually provided by physicians.

 Nurse therapists will provide numerous services to the clients

and their families.

 Hospital stays will be exceedingly short and early discharge

will become more important.

 Nurses will be strong and autonomous practitioners whose

practice and care delivery focuses much more on health than

illness.
 FUTURE TRENDS IN NURSING:-
 Nursing is not a static, unchanging profession but is
continuously growing and changing as society
changes, as health care emphasis and methods
change, as lifestyles change and as nurses themselves
changes.
 The current philosophies and definitions of nursing

demonstrates the holistic trends in nursing- to

address the whole person in all dimension in health
and illness, and in interaction with the family and
community.
TRENDS IN FUTURISTIC NURSING
 Service(practice) education
 Practice (nursing care) Research Administration

1. Clinical nurse specialist {C.N.S}

2. Nurse practitioner {N.P} academic administration
3. Adult nurse practitioner
4. Family nurse practitioner Master’s education
5. Acute care nurse practitioner
6. Doctoral programs in nursing
7. Geriatric nurse practitioner
8. Bachelor of Science in management/ Pediatric nurse
practitioner health care.
9. Women’s health nurse practitioner Certificate in Forensic
Nursing
10. Certificate in legal nurse consulting
 Certified nurse midwife (C.N.M.)
 Certified registered nurse anesthetist
(C.R.N.A.) administration
 Other areas for practice in service

1. Mobile nursing / Health care Education

2. Space nursing Certified nurse practitioner

3. Licensed practical nurse

4. Arrow nursing

5. Master’s of science in nursing/ Master’s of

health administration
SERVICE {PRACTICE} EDUCATION :-

Innovations in health care, expanding health care systems and

practice settings, and the increasing needs of clients have been a
stimulus for new nursing roles are specific employment
positions or paths. Because of increasing educational
opportunities for nurses, the growth of nursing as a profession,
and a greater concern for job enrichment.
 It includes three broader areas:-

o Practice (nursing care)

o Research
o Administration
PRACTICE (NURSING CARE):-
Graduate education prepares nurses for
advanced practice in a variety of
specialized roles in primary, secondary
and tertiary settings. This covers four
principle types of APN’s.

1) Clinical Nurse Specialist:-

The C.N.S is an Advanced Practice Nurse with nursing
expertise in a specialized area of practice and may work in
any practice setting. The C.N.S. may also assume
administrative and management roles. The C.N.S. functions
as an expert clinician, educator, case manager, consultant and
researcher to plan and improve quality of care provided to
the client and family.
 The C.N.S. should have following
eight characteristics:-
• Clinical judgment
• Clinical enquiry
• Facilitator of learning
• Collaboration
• Systems thinking
• Advocacy or moral agency
• Caring practices
• Response to diversity
2) Nurse Practitioner :-
Nurse Practitioner provides health care to clients usually in an
outpatient, ambulatory care, or community based setting.
Nurse Practitioner provides care to the clients with complex
problems and provide a more holistic approach, attending to
symptoms of non-pathologic conditions, comfort and
comprehensiveness of care. Nurse Practitioner have legal
authority to implement patient management by ordering
diagnostic tests and treatments and prescribing medications.
a) Adult nurse practitioner (A.N.P.):- provides
primary, ambulatory care to adults with a non-
emergent acute or chronic illness and in some
settings tertiary care. The role includes case
management, consultation, leadership,
education, research and health policy
development.

b) Family Nurse Practitioner (F.N.P):- provides

primary ambulatory care for families, usually in
collaboration with a family care physician. The
F.N.P. meets the families health care needs, manages
some illness by providing direct care, and guides or
counsels the family as needed.
c) Acute Care Nurse Practitioner (A.C.N.P):- is a registered
nurse with a graduate degree in nursing who is prepared for
advanced practice using a collaborative model to provide direct
services to adult patients who are acutely or critically ill in a
variety of setting such as hospital or speciality clinic. The
A.C.N.P. is a generalist, usually based in internal medicine,
focusing on the care of the hospitalized patient.

d) Geriatric Nurse Practitioner(G.N.P.):- G.N.P’s are trained in

the specialized needs of the ageing adults, with emphasis on
health promotion, health maintenance and functional status.
Age of the client is usually 65 and older.
e) Pediatric Nurse Practitioner(P.N.P.):- P.N.P.
provides specialty care for children from birth to
21 years of age. P.N.P’s practice in hospital
ambulatory care, emergency care and physicians
offices.

f) Women’s Health Nurse Practitioner

(W.H.N.P.):- provides ambulatory care to women
seeking obstetrical and gynecological health
care.
3) Certified Nurse Midwife(C.N.M) :-

C.N.M. is a registered nurse who has advanced educational

preparation in midwifery which includes theory and extensive
supervised clinical experiences in prenatal care, management of
labor and delivery, postpartum care of the mother and the infant,
family planning, pap smears and treatment for vaginal
infections.
C.N.M. practices with a health care agency that provides medical
consultation, collaborative management and referral. C.N.M.
practices in all 50 states in the United States, Great Britain,
Canada in hospitals and in birthing centers and in the home, but
it has not yet started in India.
4) Certified Registered Nurse Anesthetist (C.R.N.A) :-
C.R.N.A. is a registered nurse who has advanced educational preparation,
including classroom and Laboratory instruction and supervised clinical
practice in the delivery of anesthesia to client in a variety of practice
settings, including hospitals, ambulatory surgical centers, birthing centers
and clinics.

C.R.N.A. takes care of patient’s anesthesia needs before, during and after
surgery. The role includes:-
• Performing physical assessment
• Participating in pre-operative teaching
• Preparing for anesthetic management
• Maintaining anesthesia intra operatively
• Overseeing recovery from anesthesia
• Following the patient’s post-operative course from recovery room to
patient care unit.
OTHER AREAS FOR PRACTICE IN SERVICE

MOBILE NURSING :-
Mobile nursing is a service agency that provides
home teaching and care for patients with varied
needs and health problems.

BENEFICIARIES OF MOBILE NURSING:-

o Patients discharged early from hospitals.

o Patients suffering from chronic and acute medical problems.

o Surgical patients.

o Patients requiring I.V. therapy.

o The elderly Respiratory patients.

o The seriously ill. Patients in need of medication management

o Hospice concept

o Ventilator dependent

o Assistance with bathing, dressing, meals, transportation, light

housekeeping
SPACE NURSING :-
 Space Nursing Society (SNS)
 Founded in 1991, over 400 members from around the world.
 Space Nursing provides a forum for the discussion and exploration of
issues related to nursing in space and its impact upon the
understanding of earth bound nursing through conference
participation.
 Cardiac monitors originated with space program.
 Ultrasound studies assessing bone loss in astronauts abroad the space
station could help nurses better care for patients with osteoporosis.

FUNCTIONS OF SPACE NURSING :-

• Evaluate emergency plans.

• Use of medications in space.

• Telemedicine opportunities.

• Performing surgery in space.

• Developing a condition database to evaluate the risk of certain accidents

or illness during a flight.

FORENSIC NURSING :-
 Specialized training in forensic evidence collection, criminal
procedures, legal testimony expertise.
 Liason between the medical profession and that of the
criminal justice system.
 Came about in 1992 during the first ever national convention
of sexual assault nurses.
ARROW NURSING :-
Services provided by arrow nursing are :-
 Administration and stoppage of blood services.

 Clinical laboratory services.

 Activities services

 Dental services

 House keeping services

 Mental health services

 Nursing services

 Occupational therapy services

 Pharmacy services

 Physical therapy

 Physician services

 Social work services

 Speech/ language pathology services

 Diagnostic X-ray services

DISASTER NURSING
 Readiness and preparedness in responding to immediate
community needs during and after a catastrophic event.
 Medical history and physical assessment, psychosocial
assessment and referral to mental health services.
HOSPICE NURSING
 observing, assessing, and recording symptoms for
terminally ill patients.
 patient’s social worker, home-care aide and physical,

occupational, or speech therapist.

RESEARCH:-
Research is directed towards building a body of nursing knowledge
about “human responses to actual or potential health problems”.
The vision for nursing in the 21st century is the development of scientific
knowledge base that enables nurses to implement on evidence based
practice.
Evidence Based Practice incorporates critical thinking and research
utilization competencies. It stresses the use of research findings, and as
appropriate, quality improvement data and affirmed experiences to
support a specific practice.

AIM OF RESEARCH IN FUTURE:-

 To create a research culture.
 Provide high quality educational programme to prepare a workforce of
nurse scientist.
 Develop a sound research infrastructure.
 Obtain sufficient funding for essential research
Evidence Based Practice:-
 Goal is to achieve cost-effective, high quality patient care
based on scientific inquiry
 Nurses need to understand research process involved
 Nursing care should not be based on opinions, past
practices, but on the results of scientific research
Future of nursing career:

 Many nursing functions will be automated.

 Result of nursing shortages, healthcare facilities will be forced
to use their nurses judiciously.
 Changes in technology will possibly attract more men and
minorities into the profession.
 The number of outpatient care will increase, as will the need
for home health care nurses.
 community health care.
 focus more on preventing the illnesses rather than treatment.
Changing roles of Nurse

Educator

Administrator NURSE Practitioner

Researcher
Client Advocate
 Nurse protects the clients human and legal rights
 Providing information to assist in decision making

 Patient Bill of Rights

Comforter Role
 Caring for client as a human being
 Role is traditional to nursing

 Care is directed to whole person,

not just a body part
 Demonstration of care and

concern
Rehabilitator Role
 Assist client to return to optimal level of
functioning
 Nurse helps client to adapt physically and

emotionally to changes in lifestyle, body

image
Communicator Role
 Role is central to all other roles
 Involves communication with client, family,

healthcare team members, resource people, and

the community
 Without clear, concise

communication it will
be difficult to give
effective care
Teacher/Educator Role
 Explains concepts and facts about health,
demonstrates procedures, reinforces learning,
determines understanding, and evaluates progress
of learning
 Unplanned or informal education

 Planned or formal education

ROBORTIC NURSING
 Staff shortages and technical challenges (such as patient lifting and
moving) means there is a present and growing incentive to design,
develop and implement robotic technology in the delivery of health
care. The reliance on robotic technology in surgical fields has been a
reality for decades, but recent trends and developments indicate that
the emergence of technology and even robotic technology in the
delivery of primary healthcare is a growing phenomenon.
 Lifting Robot – is intended to assist nurses particularly in the aged care
setting to lift or move patients. The obvious benefit being that there is no
need for nurses to compromise their own back-health in the process of
assisting their patients
 The use of a robot, as opposed to a mini-lifting machine is intended to
make the process a bit less intimidating for the patient.
 ‘Stan the Man’ – which is used to train nurses and health
professionals. The robot is designed to respond to various treatments
applied by the trainee nurse.