Continuum of Care
The current nursing practice involves providing care to patients. Patients suffering from chronic illnesses receive treatment only when they visit a healthcare facility seeking medical attention. This system is harmful to the patients, the health practitioners, and the medical insurance companies. This form of care leads to the severity of a disease, posing a great risk to the patient, and increasing the work of the healthcare providers (Longman, 2010).
The health insurance firms suffer huge costs from the emergency treatment of the patients. Under the continuum of care, nurses will offer health care and follow-up services to ensure that those suffering from chronic illnesses are monitored from their homes. The role of nurses under the continuum of care might change from that providing primary care to that of the provision of acute care, ambulatory care, home care, extended care, and wellness programs, among others (Carver & Jessie, 2011).
Accountable care Organizations (ACOs)
ACOs refer to groups made up of providers and suppliers of healthcare services, which work together to facilitate the provision of medical care to the Medicare beneficiaries that they serve. The groups are usually made up of hospitals, nurses, physicians, and other stakeholders responsible for facilitating the provision of healthcare services (Longman, 2010). ACOs are gradually changing the face of healthcare by insisting on patient-centered services as opposed to the traditional fee-for-service care.
Therefore, the role of nurses is expected to change from that of providing basic care to managerial roles whereby nurses shall be empowered to manage a group of healthcare professionals. Nurses may be required to embrace research to facilitate evidence-based practices. Under ACOs, nurses are tasked to ensure that the cost of health goes down to achieve savings owing to the requirement that they bear some financial risks for their patients.
Medical homes
The medical home healthcare model is a type of medical care that involves the creation of a patient-physician long-term relationship to facilitate lasting health. It seeks to replace the episodic care that is currently in place in most healthcare facilities in the US (Larson & Reid, 2010). The adoption of the model follows the view that there might be a shortfall of healthcare providers in the future against the backdrop of the aging population and the increasing number of patients suffering from chronic illnesses. Based on the concept of medical homes, nurses might have their roles changed from the traditional episodic care to managerial roles, whereby they shall be charged with the responsibility of managing the healthcare for a group of patients. They shall act as the intermediaries between the patients and the physicians.
Nurse-managed health clinics
A nurse-managed health center refers to clinics established by nurses to offer medical care in underserved areas. The clinics’ chief aim is to bridge the gap in the provision of care for the uninsured and underinsured persons in the US (Arvantes, 2011). In most cases, the nurses work independently while in some clinics, they collaborate with physicians to facilitate the provision of quality care services to the patients. The concept of nurse-managed health clinics promotes the independence of nurses in the backdrop of the increasing number of patients. The role of nurses may be altered from that of junior members in the healthcare industry to that of certified healthcare providers.
Reflection from nurse colleagues
Respondent 1
When asked about the possible changes in the roles of future nurses, the first respondent identified the evolution of the new technology and the Internet at large as one of the driving forces to changes in the nurses’ roles. This argument was informed by the view that patients can now manage their health matters using the Internet. The Internet contains important tips regarding health; hence, patients may use it where necessary.
The respondent cited the availability of information about the management of diabetes and other chronic diseases as among the important resources for the management of the listed illnesses. The information regarding healthy feeding may be helpful in the management of most chronic illnesses (Duke, Frankel, & Reis, 2013). Thus, the Internet presents a good opportunity for patients to manage their health at home, given the ever-increasing number of victims of chronic illnesses. Additionally, the respondent claimed that future nurses would use the Internet to conduct research and facilitate evidence-based care.
The respondent also cited teamwork as a possible change in the future. Currently, nurses work individually when providing care. The need to provide patient-centered services may challenge nurses to work in teams for better patient outcomes. The evolution of ACOs may facilitate teamwork among nurses as they strive to offer quality services while at the same time reducing the involved costs.
Respondent 2
Just like the first respondent, this nurse colleague cited the effect of the new technology on future nursing roles. The respondent noted that the new technology would facilitate research, thus, promoting evidence-based practices. The incorporation of research in treatment would facilitate the provision of patient-centered services, which improves healthcare outcomes. The respondent believed that through the provision of high-quality education to nurses, such research is possible.
Carver and Jessie (2011) argue that nurses today are engaging in qualitative and quantitative researches to add to the currently available medical knowledge and promote evidence-based practice. Such endeavors have resulted in better patient outcomes due to certainty in treatment. The role of the Internet is not restricted to the management of health by the patients, and it may change the nursing practice. As it stands now, most hospitals have embraced the use of electronic patient records to minimize errors in medication. Care in the online context comes in the form of the advice offered by the healthcare provider to a patient through the Internet. The respondent cited that nurses would be compelled to utilize computers to store the patients’ data to improve the quality of care.
This respondent also cited the evolution of medical homes as a key source of change to the nursing roles and practices in the future. He claimed that future nurses would seek to establish a healthy patient-nurse relationship to facilitate the provision of quality care services. The current nursing curriculum empowers nurses to pursue medical specializations. Hence, a nurse may specialize in a field of his/her choice, such as diabetes, obesity, and pharmacology, among others. This specialization would facilitate the evolution of the nurses’ roles from that of a junior health care provider to managers in their area of specialization. Dossey and Keegan (2012) argue that the role of nurses is gradually evolving to that of management, as it is the case of ACOs.
Respondent 3
The third respondent asserted that the role of nurses would change from that of the provision of medical care at a hospital setting to that of delivering such care at the convenience of the patient. This respondent cited the rising cost of care and the increased number of patients suffering from the chronic illnesses as some of the drivers of the change. Currently, nurses are compelled to provide continuous care especially the victims of terminal diseases.
Larson and Reid (2010) posit that the problem of high costs of care is largely attributable to the reluctance by the healthcare providers to embrace the concept of continuum care. The lack of close monitoring of the sick persons after the initial treatment at the hospital may lead to the severity of the condition; hence, high treatment costs. The respondent also cited the modern healthcare tools that call for close monitoring of the patients after treatment. For instance, new bandages for cardiac patients have built-in sensors to measure important signs, and they require nurses to monitor the patient closely to assess such changes.
The creation of knowledge other than acquiring it could also be a major change in the nursing practice according to this respondent. Currently, the Internet offers platforms in which nurses can communicate with their colleagues and the patients. This aspect facilitates problem solving and the advancement of medical knowledge since a nurse may enquire from a colleague on the best nursing practices. This aspect promotes learning for the inexperienced nurses. Besides, it facilitates the acquisition of knowledge by the patients regarding the management of certain conditions without visiting the clinic.
References
Arvantes, J. (2011). CMS innovation center expects to play major role in forging new payment, care delivery models. American Academy of Family Physicians News. Web.
Carver, C., & Jessie, A. (2011). Patient centered care in a medical home. The Online Journal of Issues in Nursing, 16(2). Web.
Dossey, M., & Keegan, L. (2012). Holistic nursing. Burlington, MA: Jones & Bartlett.
Duke, P., Frankel, R., & Reis, S. (2013). How to integrate the electronic health record and patient-centered communication into the medical visit: a skills-based approach. Teaching and learning in medicine, 25(4), 358-365.
Larson, E. B., & Reid, R. (2010). The patient-centered medical home movement: why now? JAMA, 303(16), 1644-1645.
Longman, P. (2010). Best care anywhere. San Francisco, CA: Berrett-Koehler.