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Trends in Nursing: Q&A with Healthcare Leaders

The founder of modern nursing, Florence Nightingale, earned the nickname “The Lady with the Lamp” from this report in The Times:

She is a ‘ministering angel’ without any exaggeration in these hospitals, and as her slender form glides quietly along each corridor, every poor fellow’s face softens with gratitude at the sight of her. When all the medical officers have retired for the night and silence and darkness have settled down upon those miles of prostrate sick, she may be observed alone, with a little lamp in her hand, making her solitary rounds. (Cited in Cook, E. T. The Life of Florence Nightingale)

Reading this account, I instantly recognize the nobility of nursing. The tireless efforts and commitment to patient care remain the same.

But beyond its focus on patients, nursing is a dynamic profession – always innovating.

In honor of National Nurses Week  (May 6-12), I talked about trends in the field with Marcia Ferrero, vice president and CNO at Heritage Valley Health System, and Patricia P. Sengstack , deputy CIO and chief of clinical informatics at NIH Clinical Center. Here are some of the highlights:

Q. How is nursing today different than it was two years ago?

Marcia Ferrero: The rapid influx of various types of technology — not only bedside direct patient care equipment, but also for medical record documentation — has impacted former nursing work flows immensely.  Although the patient must remain the focus of safe nursing practice, the application of the various technologies has forced work flow analysis and revisions to occur often resulting in process improvements along the way.

Patricia Sengstack: Over the last two years and certainly over the last 5 years, the pervasiveness of technology would constitute one of the greatest changes to nursing and patient care. It’s now difficult to find any segment of healthcare that hasn’t implemented several types of new technology, whether it’s a clinical information system, bedside diagnostic testing device, electronic patient bed, or a new method to communicate with co-workers or patients. The list goes on …

Another significant change is a trend we’ve seen taking place over the last 5 – 10 years, and that’s the shift toward ambulatory care leaving only the very sickest and most complex patients in hospitals. And then of course there’s the pharmaceutical industry that continues to develop new drugs and treatments for various illnesses to the point that it’s almost impossible to keep up. Add these together and you’ll understand why nurses must continue their education to keep up to date on new treatment modalities, medications, and the latest technologies – including access to the latest evidence in online knowledge bases.

Q. How do you expect nursing to change over the next two years, and how can nurses prepare for those changes?

Marcia Ferrero: Less acute care focus and more towards population management – the hospital will take the back seat to the outpatient world of healthcare delivery. Maintain flexibility and never lose sight of the patient!

Q. What aspects of healthcare technology are the most challenging for nurses?

Patricia Sengstack: Even with the pervasiveness of technology within an organization, a major challenge remains:  many of the electronic systems that are implemented do not talk to one another. I’d be willing to bet that if we asked healthcare organizations to provide a list of every clinical system in use and then ask how many of them are truly interoperable with one another, that we’d find a very small percentage. And those that are actually talking to one another may share very limited information.

This is challenging to the nurse as he/she is required to log in to multiple systems and often enter duplicate data. I’d also be willing to bet that the average nurse will log-on to at least 5 -6 different systems multiple times throughout the course of the day in order to provide and manage patient care. Additionally, I’ve observed technology implemented at a rate that outpaces the ability to develop strong processes, policies and procedures to support efficient patient care and can lead to frustration. It’s sometimes hard to keep up.

Q. What aspects of healthcare technology are the most beneficial to nurses?

Marcia Ferrero: The interdisciplinary flow of information to multiple caregivers AND that it is all legible!

Q. What can nurses do to help lead technology efforts and build a more Connected Community of Health?                                                                      

Marcia Ferrero: Constantly ask yourself if this is meeting the goal to provide the safest and most efficient story of a patient’s stay or experience.  Think positive and offer suggestions to improve processes for all involved.

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We’ve come a long way since Florence Nightingale. In what other ways do you see nurses delivering quality and innovation in patient care through healthcare technology? Please share in the comments below.

Editor’s Note – “Save one life, you’re a hero. Save 100 lives, you’re a nurse.” If you’d like to thank a nurse who made a difference in your life, join us on Twitter and share your example. (Click to tweet this idea

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