FCRP Policy Statement

The dynamic scope of nursing practice will continue to change and evolve as the health care system continues to change and evolve. Nursing practice must be flexible and responsive to the changing needs of society, to transformations in health care delivery, and to the expanding professional and scientific knowledge base. Nurses must be educated and prepared to meet the changes and demands in health care delivery which the future will undoubtedly bring.

Who is the nurse of the 21st century? What roles will the nurse assume? What skills will be required? As we near the next century, nurses will continue to assume a central role within the health care system and to provide cost-effective quality services based on patient and family outcomes. A restructuring or, in the current language, reengineering is needed so that graduates of nursing programs will be prepared to meet the expectations and needs of our changing society.

Skills of the Nurse of the Future

The Pew Health Professions Commission (1991) identifies seven capabilities that are essential for all future practitioners. These include: 1) caring for the community's health, 2) providing state-of-the-art care, 3) functioning in emerging systems (new health care settings in which health care practitioners function in interdisciplinary teams with greater personal accountability), 4) providing cost effective and appropriate care, 5) supporting prevention and health promotion, 6) empowering patients and families in decision-making processes, and 7) managing information.

Nursing practice of the future will focus on prevention and new and interesting ways to promote health and well-being. New methods of motivating and stimulating patients and families to engage in preventive practices; to prepare themselves for behavioral, emotional, and physical changes due to an illness, and; to adopt health behaviors to prevent relapse or continued deterioration will be needed. The success of the system will be measured by how cost-effectively consumer mental, social, and physical function is maintained.

Roles of the Nurse of the Future

Nurses will assist families to anticipate the needs that will occur in the future given the illness, stage, age, and other patient and family risk factors. The nurse of the future will work in settings across the continuum - working in homes, clinics, day care centers, geriatric living communities, meal delivery sites, and foster care environments with the well and the chronically ill. Nurses will need to familiarize and legitimize community and resource services to patients and families. Nurses can have an active role in advocating for patients and empowering family members to care in a health care setting where family members must interact, coordinate, and negotiate with the healthcare system to obtain information, services, and equipment. The next generation of nurses will need to be independent, flexible, decision-makers skilled in computer usage, education and information provision, and systems approach tactics. Nurses will require the ability to communicate effectively, to be self-aware, and to have an understanding of the effect of the self on others, to be able to solve problems, and to be able to reflect on life experiences.

Policy Implications

• Accreditation policies that demand involvement by academic institutions in developing, measuring, and promoting excellence in nursing education and professional practice should be encouraged by the federal government.
• Educational institutions must be supported in the structural and curricular changes they implement and in the competencies they require of nurses for the next century.
• Policy-guiding individuals and institutions should work closely with the nursing profession, as nurses will be key players in the health care of the future and will be patient and family advocates.
• Health care reform must take into consideration the role of the nurse in maintaining health care standards while engaging in cost-effective strategies.
• Local, state, and federal funds should be dedicated to the initial and continuing education of nurses, especially for the outreach and distance learning required to meet the informational and educational needs of nurses in rural or under served communities.

Source: Shugars, D. A., O'Neil, E. H., & Bader, J. D. (eds). (1991). Healthy America: Practitioners for 2005, an agenda for action for U. S. Health professional schools. Durham, NC: The Pew Health Professions Commission.