Nurse Roles: Changing & Expanding
By Dana Sperle, RN
Content: The idea, formatting, and question content for this post was stimulated by Sara M. Ahten's (DNP, RN, Associate Professor at Boise State University) NURS 422 Care Coordination and Resource Management course.
Context: As nurses take on the challenge of leading change in healthcare reform, their roles are also changing and evolving.
How this relates to the nursing profession: This post is a little overview of how the nurse's role has changed over the recent past a well as the outlook of role changes in the future.
What are some role changes nurses have recently experienced or are currently experiencing (Ahten, 2013)?
Over the recent past, the nurses role has expanded and emphasized clinical specialists, educator, entrepreneur, administrators, midwifery, anesthetist, research consultants, and nurse practitioners as independent prescribers and primary care providers (Admin, 2008; Jokiniemi, Pietila, Kylma, & Haatainen, 2012; Robeznieks, 2011). The role I would like to focus on is nurse entrepreneur. According to Johnson & Johnson (Nurse Entrepreneur, n.d.): “Nurse entrepreneurs can use their nursing education to start ventures within the healthcare industry—establishing, promoting and running their own companies. Some develop medical devices, computerized systems, or home health products. Others provide patient care, education, and/or consulting.”
Because of these role changes, what has the nurse been required to learn or do
differently to meet the new standards/expectations of the role (Ahten, 2013)?
Stepping out independently (versus working for in hospital or medical group), a nurse entrepreneur needs to make sure she has the business savvy, credible certifications (and licensure), and experience necessary to market herself as a qualified and appealing healthcare provider. One nurse, who started her own diabetes education center, made sure she acquired her nurse practitioner degree and is board certified by the American Nurses Credentialing Center. She is also maintains membership in appropriate associations (i.e. American Association of Diabetes Educators) which keeps her personal continuing education and credibility up to date (Casey, 2011; Hieronymus & Geil, n.d.). Also, if the nurse does not have a background in business, it would behoove her to take a course in business management, finances, and/or accounting. In my opinion, acquiring as many certifications, having adequate experience in the given specialty, and any additional training acquired above and beyond set requirements will assist the nurse in her entrepreneurial efforts.
Looking to the future what examples of a nursing role changes
are likely to be seen within the next decade (Ahten, 2013)?
I believe the major role nurses will morph into is already under way. Advanced practice nurses, namely family and midwifery nurse practitioners, are being groomed to fill the gaps of primary care providers. One state, North Dakota, passed legislation freeing nurse practitioners from collaborating with physicians when prescribing medications (Robeznieks, 2011). Also, with the passing of the Affordable Care Act, nurses are realizing the expectation of filling the primary care provider gap.
As for my current position (telemetry) and the role changes I foresee, I wonder if nurses, even at the associates or bachelor’s prepared levels are going to be expected to take on higher patient ratios (1:8-10 versus 1:4), increased certifications, and increased responsibilities with the task of delegating more to certified nursing assistants or licensed practices nurses while ensuring the patients safety. As healthcare reform roles out, I believe the evolved role of nurse navigator (NN) as care coordinator within the hospital or facility setting is ingenious. Many times patients just need a little personalized guidance (attention, education, and support) which is not always given by the busy bedside nurse. While NN can focus on education, support, advocacy, and guidance, the bedside nurse can focus on the medical and physical needs of the patient, ensuring all needs are met (Bosely, 2013).
Nurse Navigators: Championing the Sick and Poor Improves Outcomes and Saves Lives by Christine Bosley BSN, RN, OCN (March 5, 2013)
Care Coordination — RNs Work Wonders by Robyn DeSantis Ringler, RN, JD (April 25, 2005)
Become a Nurse Entrepreneur by Laura Hieronymus, RN, MSEd, CDE, and Patti Geil, MS, RD, CDE (n.d.)
Admin. (April 19, 2008). Roles & responsibilities of a nurse. Nursingcrib.com. Retrieved July 8, 2014 from http://nursingcrib.com/nursing-notes-reviewer/roles-responsibilities-of-a-nurse/
Ahten, S. M. (2013). NURS 422 care coordination and resource management: assignment #4 nursing roles in care coordination and care transition. [Class handout]. Retrieved from https://blackboard.boisestate.edu
Bosely, C. (March 5, 2013). Nurse navigators: championing the sick and poor improves outcomes and saves lives. Retrieved July 8, 2014 from http://connect.ons.org/issue/march-2013/up-front/nurse-navigators
Casey, P. (2011). APRN entrepreneur focuses on diabetes. Connecticut Nursing News, 84(1), 19.
Jokiniemi, K., Pietilä, A., Kylmä, J., & Haatainen, K. (2012). Advanced nursing roles: A systematic review. Nursing & Health Sciences, 14(3), 421-431. doi:10.1111/j.1442-2018.2012.00704.x
Nurse Entrepreneur. (n.d.) Management: ASN or BSN. Discovernursing.com. Retrieved July 8, 2014 from http://www.discovernursing.com/specialty/nurse-entrepreneur
Robeznieks, A. (2011). Helping hands: Roles and responsibilities are expanding for nurse practitioners and physician assistants--but not without some resistance. Modern Healthcare, 41(21), 26-29.
Hieronymus. L. & Geil, P. (n.d). Become a nurse entrepreneur. Honor Society of Nursing, Sigma Theta Tau International.
Retrieved July 8, 2014 http://nursinglink.monster.com/education/articles/3426-become-a-nurse-entrepreneur
Random blurbs and discussions on topics, issues, and personal sentiments related to the current climate of the nursing profession.