The Growing Field of Nursing

While the field of nursing has a long, rich history, nursing is a dynamic field that has experienced a great deal of growth in the past couple of decades. Nurses are increasingly finding themselves in a wider variety of settings outside the traditional hospital setting. The concept of continuity or continuum of care will be defined, and its role in the creation of new job positions in the field of nursing will be discussed. Three of these settings will be discussed in particular and the important ways nurses contribute to these fields: accountable care organizations (ACO), medical homes, and nurse-managed health clinics. Each will be defined as relevant for the nursing philosophy and its importance will be discussed.

Continuity or Continuum of Care

The College of Associated Nurses of Alberta (2008) defines continuity of care as the management of a client’s health concerns in a consistent manner. Three areas of concern for providing a continuum of healthcare for the patient are records and information management, coordination of different specialists with the primary care physician when needed, and the relational aspect of the doctor-patient rapport. The College of Associate Nurses found that if a patient’s care is consistent, where all sources of information of the patient are accessible, and an ongoing relationship with the client is maintained, health care costs decrease, and the health of the client increases. However, because of external forces, such as staff shortages, continuity of care is increasingly becoming more difficult to maintain. Positions have been created to meet the challenges the present environment presents to overcome these obstacles. Three examples of these types of positions are a nurse navigator/case manager, who help patients with multiple health care concerns, and telehealth nurses, who serve to educate the client and ensure continuity of patient information across information channels.

Accountable Care Organizations (ACO)

Expounding upon the concept of continuity of care, ACOs were created to help manage the health and well being of the patient. The Affordable Care Act (ACA), according to The Nursing Alliance for Quality Health (n. d.), rewards organizations who demonstrate the ability to improve health outcomes for clients and can simultaneously keep health care costs down, using the concept of continuity of care to help drive down healthcare costs. Within this aspect, nurses can play a variety of roles, including coordinating care across different healthcare and home settings, seek ways to improve the quality of care and drive down costs, and with extra education and certifications, nurses can become primary care specialists, such as midwives. 

Medical Homes

The Initiative on the Future of Nursing (n. d.) conveyed the importance of medical homes in the care of veterans. The U. S. Department of Veteran Affairs has an entirely new approach to patient care. A team of healthcare specialists now cares for all veterans and take a proactive approach to patient care across healthcare settings. Nurses play their part in a team of healthcare specialists. Nurses are involved directly in client care, and each team has a head nurse. There is also a qualified nurse with higher education that is in charge of leading all the healthcare teams. Another important aspect of this model is the “clinical nurse leader”, whose role “is probably one of the most transformational roles that the nursing profession has to offer the health care industry” (Initiative on the Future of Nursing, n. d., para. 6).

Nurse-Managed Health Clinics (NMHC)

NMHCs are becoming an increasingly important part of communities. They are nurse-run facilities that house a number of healthcare providers, who offer preventative health care to underserved and economically disadvantaged populations. They also fulfill a need in education, providing nurses with training opportunities that might otherwise not be present. Funding and employment opportunities will continue to grow for NMHCs.

Just because the field of nursing has a long, rich history, it doesn’t mean that it is a stagnant field. Nursing will continue to grow and adapt depending on how changes in the environment affect health care and the changing needs of clients. Nurses and the field of nursing will continue to find new and innovative ways to meet the patient’s needs. 

References

American Association of Colleges of Nursing (n. d.). Nurse-managed health clinics: Increasing access to primary care and educating the healthcare workforce. Retrieved from http://www.aacn.nche.edu/government-affairs/FY13NMHCs.pdf

College of Associated Nurses of Alberta. (2008). Registered nurse roles that facilitate continuity of care. Retrieved from http://www.nurses.ab.ca/Carna-Admin/Uploads/RN_roles_that_facilitate_continuity_of_care.pdf

Initiative on the Future of Nursing. (n. d.). The patient-centered medical home. Retrieved from http://thefutureofnursing.org/resource/detail/patient-centered-medical-home 

Nursing Alliance for Quality Care (n. d.). The role of nurses in accountable care organizations. Retrieved from http://www.naqc.org/Main/Resources/NursesRole-AccountableCareOrg.pdf