The Future of Nursing

This week I read a lot about predictions on where healthcare and nursing are headed and what the future will looked like for both.  In the article  I read it talked a lot about the future and how technology is developing greatly and as it develops more discoveries are being made especially in healthcare. People are living longer lives due to technology and living in much different ways then they did even just a few years ago.

Scientists predict that hospitals and long term care centers will become less needed as people are living healthier and longer lives. Hospital stays will become shorter with a greater emphasis on providing education on how to treat yourself and diagnose yourself at home and although hospitals will become less used, they will still be around forever because there is too much money to be made in hospitals and in many urgent situations they will forever still be needed and used. On the other hand the baby boomer generation are becoming opposed to putting their parents into long term care facilities and are more commonly providing care for family members at home which will cause less and less long term care facilities to stay in business. Doctor visits will still need to be made but in different ways. Doctor visits will happen on a screen at the comfort of your own home more frequently then at a hospital or office. Also most nursing schools still teach hospital based practices which will need to change as hospitals are becoming less used. Nursing education will focus more on technology services and educating the public which many older generation nurses are having a difficult time accepting and in a way are mourning the roles they once played with their patients. The public is taking the older generations views into account though because they don’t want to change too quickly in fear of losing these nurses and their healthcare experience. They also predict that Robots will start being used in giving care with the basics as technology continues to develop and think that Robots will be used in the OR to help with basics such as cleaning and getting supplies ready and assisting with instruments during surgery. Robots will be soon used in all areas of nursing for the basics in hopes to alleviate the workload of nurses and allow nurses to focus on other areas such as patient care and teaching.  Also they are predicting that a greater nursing shortage will arise in the near future because the role of a nurse is changing and as the population increases so does the need for nurses.

Honestly reading this article gave me anxiety. I may not be an older experienced generation nurse but I still feel that same mourning for the change in role of my career. The reason I got into nursing was because I loved the clinical base nursing and performing clinical practices. I also loved learning about the body and how to take care of it. I hope this never goes away.

It the few short years I have seen a big change though. I have seen more teaching emphasized and specific wording enforced into my practice. I have also seen a greater need for nurses and the workload increased along with a great stress in the computer part of nursing. I feel that more than 50% of my shift is spent documenting on the computer and the other 40% educating patients. I feel that I only use 10% clinical skills. I find myself delegating the clinical tasks to PCTs and others so I have enough time to properly chart and teach. It really makes me sad and I too am mourning in a way for the simplicity nursing used to be. I am starting to believe that nursing is going to become a job where all you do is chart and educated and others will be hired to do the clinical tasks. I hope this is not the cast. Although I am sad to see the changes I definitely understand why things are changing the way they are and I am excited to see what the future holds.

Nursing in the 21st Century

This week I learned that Nursing had been progressing quickly and making huge leaps in the 20th century but the job of a nurse had the biggest shift during the 21st century. Nurses no longer felt helpless and instead worked side by side physicians and were able to contribute to plans of care. Also, nursing was no longer being seen as just a “women’s” job but a job for all races and both genders. Also during the 20th century, once a women was married, they were to stop working in order to be a homemaker but times greatly changed in the 21st century and women were becoming accepted in the work filed much more. There were less stay at home mom’s then ever before.

The 21st century has been full of change but the biggest change of all was the role of a nurse. Before the 21st century (during the 20th century), nursing was considered a profession where someone would “do for” a patient who was already ill or disadvantaged. The job of a nurse consisted of caring in the late stages of illness and “doing” such as, cleaning, bathing, administering, pampering, feeding, drugging, and discharging. Today in the 21st century thanks to technology, this part of nursing has changed the most. Although nursing still consists of those same duties, so much of nursing today is focused on preventing illness rather than caring for it. The job of a nurse today is teaching/educating, linking, informing, accessing, typing, and researching. Prevention of illness is key to keeping people healthy, therefore the role of the nurse has significantly changed to accommodate our knowledge.

As the public gets more informed and health care knowledge increases along with technology, people should be getting less ill and living longer healthier lives. I can see why there was such a shift in the role of nurse because in order to keep the career of a nurse alive, nurses had to evolve. That is why our job as become so greatly focused on prevention of illness rather than treatment of illness.  Many older generation nurses are having a very difficult time accepting the new role of a nurse and want to keep with old traditions where they gave the care and there was not as great a need for documentation.

I am not going to lie, the reason I love nursing so much is because I loved doing clinical work/treatments and the least favorite part of my job is the charting. I do love educating but I hate the documentation and computer side of things. I have worked in the healthcare as either a nurses aid or a registered nurse now for almost ten years and in the last ten years I have seen this change greatly. I am a little sad to see the old role of a nurse change but I understand why it does need to change and the importance that my new role takes. I think that I will always work in a hospital so I will never lose those clinical skills completely.

Nursing in the 1970’s, 80’s, & 90’s

During this time the field of medicine is continuing to grow and develop. In-fact, it really hasn’t really stopped. At times it may have had slower progression but it is still progressing. During the 1970’s, nurses were still going on strike due to poor conditions and benefits in the work place which honestly got the government and congress thinking and pushing for changes. Nursing strikes and shortages caused the field to struggle but made up for it in the long run by causing the career to have an increase in salaries and benefits. Once we had the attention of the government and as nurses were coming back to work and more jobs were becoming available, nursing became unstoppable and it allowed for new studies and focused growth in different areas of nursing to develop. 

This week I read an article about how hospice care came about. The very first hospice care program was started in 1974 by a nurse named Florence Wald. Before this time there was no such thing as “end of life care” or care for a terminally ill patient. Once a patient had been given all possible treatments by the hospital and the doctors felt that the patient was no longer treatable, they would be deemed as terminally ill and all treatments would stop because the hospitals didn’t know how to care for them anymore. The patients would simply be sent home to die. Families, caregivers, and the patients themselves had little care and help at this point. Wald felt a lot of compassion toward terminally ill patients and felt she could do more for them. She did a lot of research and put together a team of doctors and nurses who continued care for patients after hospital treatments had stopped and prior to the patients passing. She called it home care and hospice which was care given to both patients and their families prior to death with a focus on relieving the physical and emotional pain of both. Florence Wald changed how people and the healthcare viewed end-of-life. She showed people that there were very meaningful ways to cope and made death more of a reality, less scary, and a more accepting time of life. Her hospice program did so well that in 1982, congress required that Medicare pay for hospice care and today there are now 3,200 hospice programs in the US alone.

Florence Wald really impacted many lives with her contribution to the world of Hospice nursing. It makes me realize how blessed I really am. I live in a time where there are so many aspects to the medical field and I have full access to all of them. If I’m sick, having a baby, have a parent or loved one who is terminally ill, or I need surgery I have every area of researched and organized expertise right at my fingertips. What a blessing that is! Thinking back on these times also makes me think about what else there is that still needs to be further developed and studied. Infertility, Cancer, New arising diseases and prevention, and the list goes on and on. There is still so much unknown about the medical field and nursing which only allows for so much growth and I truly think that is amazing. I’m am eager to see what new discoveries and treatments as well as what the job of a nurse will look like in the next ten years or so! Grateful to be a nurse now and hopeful to see where it is going.

Nursing During the 1940’s, 50’s, & 60’s.

Nursing was really evolved during this thirty years. Technology was allowing new discoveries to be made continuously and the study of treatment and medicine was on the move. Times were greatly improving sense the 1920’s through 1930’s and people were beginning to think the great depression was behind them. The economy and health were both greatly improving. Jobs were becoming more readily available and healthcare was more affordable.  Although things seemed to be on the rise, this was still a hard time. WW2 had began and the call for nurses had greatly increased. Devastation was all around. Though the amount of jobs available were increasing, the actual labor of a nurse seemed to stay the same.

This week I read an article about one of the first great nursing shortages that occurred in the 1950s and the first nursing strikes that occurred. We all know that nursing tends to have continuing shortages due to the increased need for nurses as the population continues to grow but one of the very first nursing shortages occurred in the 1950s due to multiple reasons. During the 1920s-1930s there was not a great need for nurses as it was the time of the great depression and any job available was highly coveted. Nurses would work for little money in poor conditions with little complaint. In the 1940s and 1950s the economy had greatly improved and jobs were becoming more readily available. Nurses were becoming tired of the working conditions.

After a nurse graduated, the average salary at this time was $140 per month and some hospitals paid as little as $90 per month. This was very low income for the time and the job of a nurse was hard. The average worked hours a week for a nurse was 48 – 90 hours even though most of the public only worked an average of 38 – 40 hours.

Also many hospitals would not employ married women (this practice continued well into the 1960s in some communities). You could work in hospitals or the public until you got married. Once you were married you would be laid off and could only find work as a private-duty nurse.

The biggest complaints of nurses during this time were, long hours, low salaries, poor living conditions, too few holidays/days off, and job instability. In the late 1950s nurses had had enough and many nurses around the US went on strike. It was reported that in 1957, every nurse at the Virden District Hospital in the Canadian Province, left on strike for three months in hopes to negotiate a pay increase. The hospital fired all of them and in their place hired the former nurses who had to leave the profession due to be married.

Because of this, nobody took the nursing shortage seriously. To add to this, nursing at the time was considered to be: “a natural extension of a woman’s caring and nurturing role as mother, wife, and daughter, and was devalued as such.” The nursing shortage was getting so severe that the government announced that new hospital funding would not be given to hospital boards unless they cold guarantee they had found nurses to staff them, and would not be raiding other facilities to find nurses. The government also recommended that hospitals create pension plans for nurses as a way to encourage woman to work in their facilities. This was not common for woman to have such a privilege and it caught many nurses attention.

A look back at nurses in 1950

Nursing during this time was hard, you either served in war with your life in danger or in a hospital with long growling hours and little pay, or due to being married had to work as a privet nurse which very few people could afford so privet nursing jobs were scarce. I feel that these nurses were extremely strong willed and tough. They had to fight for nursing to be more appreciated and many gave up their jobs in strikes or even lives in war with little recognition to do so.  I am so grateful for what they did. Although at times I still feel that the flexibility and benefits of a nurse still struggle and need improvement, I know that it is much better today because of what these nurses did and how they changed the public view on nursing.  Very grateful for them and all they did.

Nursing in the 1920’s through 1930’s

This week I have come to think that nursing is become much more organized and technology is making a big difference. Nursing at this time doesn’t seem so foreign anymore as it is becoming more similar to what nursing is today which is more diverse, organized, and focused.

In the 1920’s through the 1930’s WW1 is coming to an end and it seems like it is a new era for growth and refinement that is until the wall street stock market crashed and lead to the the great depression in 1929. Up until this time, most nurses were hired by a household to be a private in-house nurse meaning, they were privately employed by the patient or the patient’s family themselves and the nurse would provide care for the entire length of illness or injury and would work around the clock. These nurses were paid by the patient or patients families themselves but when the great depression occurred people stopped being able to afford private nursing care and stopped hiring private nurses. This caused a huge shortage of jobs and caused most nurses to look for work in hospitals. At the time, working in a hospital as a graduate nurse was looked down upon because it meant you had failed as a public duty nurse. Most nurses who worked in a hospital setting were student nurses and not actually graduate nurses.

The overall health of the public took a major decrease during the great depression because nobody sought treatment due to not being able to afford healthcare. The public was suffering from situations which were detrimental to overall health such as malnutrition, overcrowding and extremely poor sanitation. Hospitals were struggling with increased illness but decreased patient counts and empty beds. Hospitals were loosing funding and many had to close. Nurses who were lucky enough to get a job had a large workload with little pay and restricted hours. To provide more job opportunities, hospitals changed shifts from two twelve hour shifts per day to three eight hour shifts to allow three nurses to work in each day instead of just two. It became common for many hospitals to restrict nurses to work a maximum of forty-eight hours per week.  On average, a nurse only made 15$ a month and in some cases had to resort to working for only room & board without salary. Hospitals favored student nurses because they could get away with paying them less.

In a hospital, the common nursing duties included scrubbing floors, washing screens, serving meals, caring for patients, cleaning equipment such as (needles, bed pans, bandages), stoking the furnace, and even painting the hospital rooms. The workload was heavy but nurses maintained a positive attitude as they were just grateful for the chance of employment.

The Great Depression immensely impacted nursing working conditions today. It’s what lead to the shift of nurses working as private duty nurses to working in a hospital setting. It changed the way hospital employed nurses were viewed and it impacted the workflow for nurses as supplies were scares causing a demand for creativity and a greater study in the art of nursing.

The Great Depression was such a hard, stressful, and even scary time but really shifted the direction of nursing. I love working in a hospital and I’m glad that the view of a hospital nurse changed so greatly during this era. I would say that it flipped completely and hospital nursing is now a huge focus and is amazing today because of this time period. I feel so grateful that I didn’t have to work during the great depression. It would be so hard to wake up everyday knowing it could be your last of employment when you so greatly needed income. I feel glad that I chose a profession that seems to always have a need. Even during a time so devastating as the great depression, there was still a high need for nurses. Nursing definitely has a sense of job security because there will always be sick people who need medical attention in any situation. I’m very grateful times are better today and hope and pray that they always stay that way!