This paper examines the fundamental shifts reshaping the nursing profession in the context of an aging American population. It addresses three interconnected areas of change: the tightening of ethical and credentialing standards, the growing role of health informatics systems such as the VA's VistA platform, and the implications of these changes for accountable care organizations (ACOs), medical homes, and nurse-managed health clinics. The paper argues that stricter licensing requirements, greater use of electronic health records, and collaborative information systems will improve care quality, reduce costs through economies of scale, and position well-qualified nurses to thrive in an increasingly demanding healthcare environment.
The developed world is growing older. America's population is approaching retirement age due in large part to the baby boomer generation. Those individuals born between 1946 and 1964 will be eligible for more social security and retirement benefits as time passes. As such, pharmaceutical companies, health services, and the medical industry at large will benefit from this influx of older individuals. As competition for new patents, facilities, drugs, and more becomes more intense, companies will undoubtedly require more personnel to handle the subsequent demand. Those companies that can continually innovate and provide the products, services, and personnel that are in demand will eventually prosper as our population ages.
The nursing profession is no different in this regard. Nurses continually push the existing boundaries of science to provide better products and services to society. How they accomplish this task, however, is very distinct to each type of facility. Fundamental changes are occurring within accountable care organizations, medical homes, and nurse-managed health clinics. These changes will have a profound impact on the nursing profession as it continues to grow and shift.
The first major shift occurring within the profession concerns ethics. The ethical standards governing the industry are becoming more stringent with respect to certifications, education requirements, and overall proficiency in the field. Within the healthcare profession, safety is among the top priorities for all employees. The profession as a whole is characterized by its extreme attention to detail — one unnecessary mistake can be detrimental to both the profession and the individual who commits it. Countless lives have been lost due to malpractice or simple errors during a procedure. Safety therefore plays an integral role within the underlying operations of the healthcare industry and among the nurses who work within these facilities.
To help reduce the influence of mistakes within the industry, various licenses and degrees are used as proof of a practitioner's competence in the field. Unlicensed personnel are deemed inadequate by their peers until such certification or license is received (Dogra, 2012). The profession is becoming more stringent regarding which certifications are required, where they were obtained, and how the individual earned those credentials. Numerous ethical issues arise when unlicensed personnel are permitted to perform work on patients that only a licensed practitioner is authorized to carry out. An unlicensed individual may be incompetent in a given area of practice, which is extremely detrimental to a patient who is relying on the expertise of the hospital to restore their health. Patients rightly expect a licensed person to perform any kind of sophisticated procedure.
Upon receipt of a license, the profession as a whole acknowledges the skills and competence of the individual practitioner. This helps to establish thresholds and standards of excellence within the industry. In our current economic climate, ensuring that only qualified personnel provide care is both an ethical imperative and a practical necessity.
In our current economic environment, efficiency with both federal and private funds is absolutely essential in healthcare. The flow of excess capital and the era of arbitrary spending have given way to intense fiscal scrutiny. Many individuals question the integrity of not only the financial markets but also of the medical industry. Practices such as patient dumping and refusal of care have become as ubiquitous as they are unethical. To prevent these occurrences while helping state and federal legislatures reduce costs, information systems are becoming more prevalent within the industry. One such method of particular importance to the nursing profession is health informatics.
Informatics is the use of information systems to improve efficiencies within an organization. Since its inception in 1949, informatics has grown exponentially to encompass a broad array of clinical services designed to aid patients and providers in areas such as patient records, data processing, and more. Today, the field continues to grow, with the International Medical Informatics Association at the forefront of that expansion.
"VA's VistA demonstrates cost savings through informatics"
"Shared systems improve ACO and clinic performance"
The nursing profession is currently undergoing a fundamental shift within its respective industry. Ethics, information systems, and credentialing standards are all changing. This evolution provides ample opportunity for those who are proficient in their field to flourish and prosper. The industry overall will improve as nurses themselves develop stronger ethical frameworks, higher qualifications, and broader skillsets. Those who embrace these changes — from rigorous licensing standards to enterprise-wide health informatics platforms — will be best prepared to meet the demands of an aging population and a rapidly evolving healthcare landscape.
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