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Changes in the Practice of Nursing Featured

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The nursing profession has evolved over time. Traditionally, nurses were tasked with duty of taking care of patients.  However, changes in nursing practice, as well as the restructuring of the US healthcare delivery system have seen the role of nurses become pronounced. Nurses are now exposed to non-traditional experienced of practicing. These practices include exposure to direct and indirect care experiences. Nurses get to learn, within the healthcare environment they are expected to work. Nurses will keep playing a vital role as their jobs become increasingly available in communities. Nurses will widen the continuum of care. Nurses will also be active players in Accountable Care Organization, medical homes and nurse-managed health clinics. Nursing practice is thus bound to become an increasingly valuable profession.


The role of nurses has changed dramatically with the nurse’s role evolving to cover a wider range of healthcare responsibilities. The society is grappling with a diversity of health complications such as diabetes and obesity. These complications have increased due to the changing lifestyle of individuals, as well as increasing numbers of the aging population. According to Tiffin (2012) nurses are no longer confined to taking care of the sick. They are becoming involved in research; there are also active players in the progress of mobile medical applications. Additionally, nurses are engage in active collaboration with professionals in social services, administrations, as well as physicians, in determining the ideal strategies to enhance the delivery of quality healthcare services. The nursing profession is becoming increasingly broad and deep as nurses have the opportunity to specialize in their preferred nursing fields e.g. oncology, pediatrics, or pharmacology. Nurses will also be involved in analyzing the health of surrounding communities. Nurses will conduct research and analysis of surrounding communities. The data collected will be utilized to establish ideal health strategies to prevent diseases and ascertain a healthy population. The role of nurses is expected to keep evolving over the years, with the practicing nurse performing tasks that go beyond the traditional role of taking care of the sick.

Nurses will also be involved in the continuity of care. The concept of continuity of care refers to the provision of healthcare services over time. Additionally, it refers to focus on a client’s health needs. There are three main types of continuity: informational continuity focuses on effective sharing of information so as to enhance healthcare delivery. The second type is management continuity that ascertains multiple providers remain connected (Scudder, 2011). The third type is interpersonal continuity, which focuses on the formation of a therapeutic relationship between the client and provider. The ability to provide continuity of care will be possible through the provision of holistic nursing practice. Holistic nursing care focuses on the patient, his family, community and populations.

The nursing profession is also expected to grow with the emergence of Accountable Care Organization (ACO). ACO will focus on bring the services of doctors, hospitals and other ancillary providers together, to take responsibility in the provision of healthcare services, to patients. ACO will provide expanded opportunities for nurses who will become managers of care, rather than mere providers. The overall purpose of ACO is to improve the standard of patient care given to patients (Maslen, 2011). With ACO, nurses will enjoy care coordination as they will access a broad continuum of information. ACO will also minimize the risk of medical and medication errors, which may jeopardize the patient’s health. Nurses will also be exposed to broad options of preventive health. Nurses will also have the capability to investigate and determine at-risk populations and assist them with healthcare provisions (Graham, 2011).

Nurses are also expected to establish medical homes in an effort to extend the provision of healthcare services to the public. A medical home is a model to care that uses primary care providers to ascertain the provision of coordinated and comprehensive care. Nurses and nurse mid-wives are expected to take the role of primary care providers.  Traditionally, pediatricians and family physicians were considered as the ideal primary care providers. Nurses are receiving advanced education, which is gradually preparing them to provide initial, continuous and comprehensive care. In future, nurses in medical homes will be involved in the process of gathering patient’s medical histories, performing physician’s examinations, ordering and interpreting laboratory tests, as well as prescribing medication. This is a nursing role that will be highly appreciated considering there are hardly adequate physicians to handle all patients.

The inclusion of qualified nurses in the medical homes model will ascertain that patients receive prompt and quality services. Nurses will be assigned to healthcare communities. These are healthcare facilities that are situated within the locality of certain communities.  Traditionally, nurses have been the most dominant body in these community centers (Tiffin, 2012).  The inclusion of nurses in the medical home concept will ascertain that nurse’s take a leadership role, and that participate in the delivery of healthcare services. The restrictions on the scope of practice that undermined nursing profession will be eliminated, with the establishment of medical homes. Nurses will undertake active roles in the medical homes. Their participation in the provision of quality care will be based on the extent of their education and training. Currently, the government is engaging in efforts to improve the training and educational standards of nurses. Nurses will be trained to be caregivers, managers, leaders and researchers.  With this training, nurses, in the future, will take leadership positions with regard to the provision of quality care (Scudder, 2011).

 Advancement in education and training of nurses will also increase the number of nurse managed clinics. Nurse managed health clinics (NMHCs) is a model which could enhance access to quality healthcare services. NMHC is a community based healthcare services that operate under the leadership of advanced practice nurse. The establishments of these clinics would boost the provision of healthcare services. Additionally, the strain of physicians due to overcrowding in major hospitals will be minimized. The clinics will emphasize on health education. Nurses will be involved in the education and creation of awareness on disease prevention and methods of leading a healthy lifestyle. These clinics will be located at the vicinity of the local community hence ease of access to vital information related to healthcare management (Tiffin, 2012). My nurse colleagues agree that the NMCH that exists today are providing patients with exceptional healthcare services. In the future, expectations are that the number of NMCH will increase from the current 200. Currently there are 200 clinics across 37 states across America. These clinics serve approximately 2 million patients every year.  It is anticipated that clinics will increased. The clinics will be available in all states. The ease of use and access of the clinics will ascertain that many patients will access quality healthcare services. Currently, most people never visit healthcare facilities unless they are unwell. The presence of NMCH will ascertain that the public get informed on the need for regular testing and wellness check-ups. Some of the services that nurses will provide at the clinic will include physical examinations, cardiovascular analysis, smoking cessation program and immunization.  The clinics will provide treatment, as well as preventive measures that will ascertain a healthy community.


My sentiments on health reform tally with my nurse colleagues.  Nursing practice is becoming a valuable profession in the healthcare sectors. With adequate training and experience, nurses are becoming managers who are taking the leadership role in the management of medical homes and nurse-managed health clinics.   These health facilities are largely located around communities and strive to provide patients with prompt and easy to access treatment and preventive services. Nurse-managed health clinics will be essential providers of primary care, as mainstream health facilities grapple with a large number of patients. The increasing role of nurses is likely to lead to a rise in job opportunities for nurses, especially at the community level.


Graham, M. (2011). Accountable care organizations: the future of healthcare? The nurse practitioner. Vol. 36(8)

Maslen, L. (2011). Accountable Care organization: the future of quality healthcare. Washington healthcare news

Scudder, L. (2011). Nurse-led medical homes: Current status and Future plans. Medscape nurses

Tiffin, C. 2012). Beyond the bedside: changing role of today’s nurses. Huffington post

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