Evolving Practice of Nursing and Patient Care Delivery Models
Grand Canyon University
NRS 440-V Trends and Issues in Health Care
December 5, 2014
Nursing is a career that presents those in it with many opportunities. There are a variety of nurses and the field in which they choose to practice is just as varied. There are oncology nurses, school nurses, home health nurses, trauma nurses and nurse practitioners. They work in clinics, hospitals, schools, prisons, mental health hospitals, community health centers and even in law offices. The possibilities available to a nurse are endless. With the advancement of your degree the doors that open are even greater. Nurse practitioners can be found in hospitals, in the operating room, working with a physician or running their own practice or clinic. Healthcare is changing and with nurses being the largest number of healthcare providers that means the nurses role is changing as well. The focus on nursing is evolving and expanding as is the nurse’s primary role in patient’s health and wellbeing. One of the main things that will affect change nationwide is the Patient Protection and Affordable Care Act of 2010 (PPACA). It is estimated that close to 30 million people who were previously uninsured will be entering into the healthcare system over the next decade. With that increase on an already taxed system, the demand is unmanageable at the current state we are in. One way in which to combat this is with Nurse Managed Healthcare Clinics (NMHC) (Wakefield, 2010). These clinics are ran by a Nurse Practitioner and focus on providing health education, health promotion and disease prevention. These clinics serve not only the population that is most underserved (typically low income, uninsured patients) but also provide a learning environment for nursing students. The push towards public health in the nursing community has always been strong and these nurse driven clinics exploit that strength for the good of the community as well as the healthcare system in general. Many of these clinics have been tied to lower hospitalization rates and better patient outcomes (Thefutureofnursing.org, 2014). “A survey of 60 NMHCs found that provision of health maintenance services far surpassed that of chronic illness management. While data on NMHCs remains limited in terms of clients served and services provided, existing data indicate that NMHCs provide greater use of preventive services along with care that is high in quality, patient satisfaction, and cost effectiveness. One study noted that DNP nurses at a nurse managed pediatric clinic reported quality of care measures as meeting or exceeding national benchmarks” (LathropMSN, MPH, FNP-BC and Hodnicki, PhD, FNP-BC, FAAN, 2014) . Another major impact on nursing with the Affordable Care Act is the funding that has been granted towards nursing. The Health Resources and Service Administration is the primary source of funding for nursing education and their cap for funding available to advanced education for nurses has been lifted. The Nurse Faculty Loan Program enables schools to offer loans to masters or doctorate level nursing students interested in becoming teachers and that funding has grown as well. The Nursing Student Loan & Nursing Workforce Diversity programs both help to ease the nursing shortage by enabling students from disadvantaged backgrounds to receive more financial help to aid them in nursing school. “These resources include access to long-term, low-interest loans and partial loan cancellation for nurses who choose to work in parts of the country where there's a shortage of health care professionals” (Wakefield, 2010).
In discussion with my colleagues about the future of nursing, a common theme noted among all is enthusiasm. One is an Acute Care Nurse Practitioner practicing in the hospital setting, one is an RN that is working in the hospital and currently enrolled in an NP...
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