21794834 Trends in Nursing

8/8/2019 21794834 Trends in Nursing

1/41

Trends in NursingTrends in Nursing

NN--181181

Jocelyn G.Jocelyn G. AcopAcop


2/41

Source: Laura Stokowski, 2004Source: Laura Stokowski, 2004 22

Trend 1: Where Art Thou,Trend 1: Where Art Thou,

Nurse?Nurse?

U.S. Situation:U.S. Situation:

Growing shortfall ofnursesGrowing shortfall ofnurses

since 2004 caused by asince 2004 caused by aconvergence ofmany pressuresconvergence ofmany pressures

(financial constraints, a(financial constraints, a

dissipating workforce, and andissipating workforce, and an

increasingly complicated andincreasingly complicated and

stressful work environment).stressful work environment).


3/41


Financial ConstraintsFinancial Constraints risingrisingcosts ofmedical care.costs ofmedical care.

Job Dissatisfaction and WagesJob Dissatisfaction and Wages wage growth ofRNs in thewage growth ofRNs in theU.S. is on the average isU.S. is on the average isrelatively flat.relatively flat.

Aging RN FactorAging RN Factor retirement ofretirement ofthe baby boomers (those bornthe baby boomers (those bornbetween 1946 and 1964).between 1946 and 1964).


4/41


The average age ofRNThe average age ofRNpopulation is 45.2 years (in 1983population is 45.2 years (in 1983it was 37.7)it was 37.7)

Only 9% ofRNs are undertheOnly 9% ofRNs are undertheage of30 years.age of30 years.

Only 18.3% ofRNs are underOnly 18.3% ofRNs are under

the age of35 yearsthe age of35 years Only 37.7% ofRNs are underOnly 37.7% ofRNs are underthe age of40 years.the age of40 years.


5/41


The U.S. will be needing a millionThe U.S. will be needing a million

new and replacement nurses by yearnew and replacement nurses by year

2010.2010.

It is estimated thatthe U.S. will lackIt is estimated thatthe U.S. will lack

29% or more than 434,000 nurses by29% or more than 434,000 nurses by

2020.2020.

In Canada, it is predicted thattheyIn Canada, it is predicted thattheywill be short of78,000 RNs by 2011will be short of78,000 RNs by 2011

and 113,000 RNs by 2016.and 113,000 RNs by 2016.


6/41


Fewer college students areFewer college students arechoosing nursing as achoosing nursing as aprofession. There has been aprofession. There has been a

decline of26% from 1995 todecline of26% from 1995 to2000.2000.

There are not enough nurses inThere are not enough nurses in

the educational pipeline tothe educational pipeline toreplace the one leaving thereplace the one leaving theworkforce.workforce.


7/41


Trend 1: Where are thou,Trend 1: Where are thou,

Nurse?Nurse?

Philippine ScenarioPhilippine Scenario

Nursing practice in the Philippines isNursing practice in the Philippines isguided by RA 9173 (An Actguided by RA 9173 (An Act

Providing for a More ResponsiveProviding for a More ResponsiveNursing Profession repealing RANursing Profession repealing RA7164, the Philippine Nursing Act of7164, the Philippine Nursing Act of1991)1991)

The nursing law of2002 envisionedThe nursing law of2002 envisionedto provide for a relevant nursingto provide for a relevant nursingeducation, humane workingeducation, humane workingconditions, better career prospectsconditions, better career prospectsand a dignified existence for nurses.and a dignified existence for nurses.


8/41


Geographical Distribution: Data shows thatGeographical Distribution: Data shows thatmost nurses are relocated in the urbanmost nurses are relocated in the urbanareas. NCR has the highest number ofareas. NCR has the highest number ofnurses, comprising about 33.4% from 2001nurses, comprising about 33.4% from 2001

to 2003.to 2003. Urban areas have a good number ofUrban areas have a good number of

tertiary hospitals which are used astertiary hospitals which are used asspringboards forfuture migration to otherspringboards forfuture migration to othercountries.countries.

Favorite countries ofdestinations ofFilipinoFavorite countries ofdestinations ofFilipinonurses are Saudi Arabia, United Kingdom,nurses are Saudi Arabia, United Kingdom,United Arab Emirates, Singapore, Kuwait,United Arab Emirates, Singapore, Kuwait,the United States, Ireland, Libya, andthe United States, Ireland, Libya, andQatarQatar..


9/41


Filipino nurse migrants are perceived to beFilipino nurse migrants are perceived to bepredominantly female.predominantly female.

Reasons why doctors leave as nurseReasons why doctors leave as nursemedics:medics:

1. Very low compensation and salaries1. Very low compensation and salaries

2. Feeling ofhopelessness aboutthe2. Feeling ofhopelessness aboutthecurrent Philippine situationcurrent Philippine situation

3. Political instability3. Political instability

4. Graft and corruption4. Graft and corruption5. Poor working conditions5. Poor working conditions

6. Threat ofmalpractice law6. Threat ofmalpractice law


10/41


Filipino nurses reason forFilipino nurses reason for

leaving:leaving:

Push Factors:Push Factors:1. Economic1. Economic

2. Job2. Job--relatedrelated

3. Socio3. Socio--political and economicpolitical and economicenvironmentenvironment


11/41


Pull Factors:Pull Factors:

1. Economic1. Economic

2. Job2. Job--relatedrelated3. Individual/ family related3. Individual/ family related

4. Socio4. Socio--political and economicpolitical and economic

environmentenvironment


12/41


Reasons for Returning:Reasons for Returning:

1. Personal1. Personal

2. Professional2. Professional3. Financial3. Financial

4. Social4. Social

5. Job5. Job--relatedrelated


13/41


What can be done?What can be done?

(Nursing Side)(Nursing Side)

Dr. Marilyn Lorenzo suggestedDr. Marilyn Lorenzo suggested

the following policy options:the following policy options:

1. Decrease supply ofnurses1. Decrease supply ofnurses2. Increase demand for nurses2. Increase demand for nurses

3. Improve existing policies3. Improve existing policies


14/41


To decrease supply, the followingTo decrease supply, the followingpolicy options were suggested:policy options were suggested:

1. Strict implementation ofopening1. Strict implementation ofopening

and closing ofnursing schools.and closing ofnursing schools.2. Increase public awareness of2. Increase public awareness ofnursing oversupply problems.nursing oversupply problems.

3. Create/ identify a body that will3. Create/ identify a body that will

undertake health human resourceundertake health human resourceplanning and developmentforplanning and developmentfornursing.nursing.


15/41


4. Develop nurses awareness4. Develop nurses awareness

oftheir rights for betteroftheir rights for better

compensation and workingcompensation and working

conditions.conditions.

5. Establish a nursing5. Establish a nursing

information system thatinformation system that

determines the current supply.determines the current supply.


16/41


Increase demand for nurses, the followingIncrease demand for nurses, the following

policy options were suggested:policy options were suggested:

1. Identify and fulfill local demand first.1. Identify and fulfill local demand first.

2. Encourage and facilitate independent2. Encourage and facilitate independentnursing practice.nursing practice.

3. Establish a nursing information system.3. Establish a nursing information system.

4. Improve salary and working conditions of4. Improve salary and working conditions of

nurses in private institutions.nurses in private institutions.


17/41


5. Strengthen networking with5. Strengthen networking with

government agencies andgovernment agencies and

NGOs in generatingNGOs in generating

employment.employment.

6. Develop required nursing6. Develop required nursing

pools.pools.

7. Strengthen nursing curriculum7. Strengthen nursing curriculum

to encourage role expansionsto encourage role expansions

and entrepreneurship.and entrepreneurship.


18/41


Improve existing policies by:Improve existing policies by:

1. Clarifying and delineating1. Clarifying and delineating

functions ofregulating bodies suchfunctions ofregulating bodies such

as CHED and BON.as CHED and BON.

2. Reviewing and implementing2. Reviewing and implementing

existing policies.existing policies.

3. Decentralizing CHEDs functions.3. Decentralizing CHEDs functions.4. Coordinating with other agencies4. Coordinating with other agencies

to promote internationalto promote international

employment.employment.


19/41


5. Revising the Labor Code on5. Revising the Labor Code on

hiring ofnurses.hiring ofnurses.

6. Reviewing powers ofBON6. Reviewing powers ofBONvisvis----vis PRC.vis PRC.


20/41


What can be done?What can be done?

(MD s Side)(MD s Side)

Dr. Jimmy Galvez Tan found theDr. Jimmy Galvez Tan found the

following gaps in the health humanfollowing gaps in the health human

resource development environment:resource development environment:

1. Lack ofunified policy by the1. Lack ofunified policy by thegovernment sends contradictorygovernment sends contradictory

messages on going abroad ormessages on going abroad or

serving the country.serving the country.

2. Absence ofone government2. Absence ofone government

agency solely responsible for healthagency solely responsible for health

human resource developmenthuman resource development

planning.planning.


21/41


3. Lack ofan official database3. Lack ofan official database

that keeps information on healththat keeps information on healthhuman resources in thehuman resources in the

Philippines.Philippines.


22/41


Strategic Solutions to theStrategic Solutions to the

Current Crisis: (Dr. GalvezCurrent Crisis: (Dr. Galvez--

Tan)Tan)1. Initiation ofhigh level bilateral1. Initiation ofhigh level bilateral

talks with major Northern countriestalks with major Northern countries

importing health human resources.importing health human resources.

2. North2. North--South health facilitySouth health facilitypartnership agreements.partnership agreements.

3. Convention ofthe health human3. Convention ofthe health human

resources development agenda ofresources development agenda of

the General Agreement on Tradethe General Agreement on Trade

and Services (GATS) ofthe Worldand Services (GATS) ofthe World

Trade Organization (WTO).Trade Organization (WTO).


23/41


4. Forging ofa joint multi4. Forging ofa joint multi--countrycountryresearch agenda and action programresearch agenda and action programon health human resourceson health human resources

development between and amongdevelopment between and amongimporting countries and the exportingimporting countries and the exportingcountries.countries.

5. Creation ofa National5. Creation ofa NationalCommission on Health HumanCommission on Health HumanResource Development (NCHHRD).Resource Development (NCHHRD).

6. Enactment ofa National Health6. Enactment ofa National HealthService Act.Service Act.


24/41


7. Establishment ofHealth7. Establishment ofHealthProfessionals Registry.Professionals Registry.

8. Creation ofCivil Society8. Creation ofCivil Society

Organizations led National CouncilsOrganizations led National Councilsfor Nursing and Medical Concerns.for Nursing and Medical Concerns.

9. Development ofnew learning and9. Development ofnew learning andcareer opportunities .career opportunities .

10. Initiation ofreforms in health10. Initiation ofreforms in healthfinancing and management offinancing and management ofmedical education in the country.medical education in the country.


25/41


Other Recommendations:Other Recommendations:

(Pascual, et al 2004)(Pascual, et al 2004)

1. Creation ofa National1. Creation ofa National

Commission on Health HumanCommission on Health Human

Resources Development.Resources Development.

2. Conduct ofbilateral negotiations2. Conduct ofbilateral negotiationswith nurse receiving countries,with nurse receiving countries,

particularly Ireland, Netherlands,particularly Ireland, Netherlands,

Saudi Arabia, Singapore, UK, andSaudi Arabia, Singapore, UK, and

US.US.

3. Creation ofpartner hospital3. Creation ofpartner hospital

agreements with importing andagreements with importing and

exporting countries and a trustfundexporting countries and a trustfundfor nursin develo ment.for nursin develo ment.


26/41


4. Adoption ofa National Health4. Adoption ofa National HealthService Actthat requires students toService Actthat requires students to

serve the country for a specified timeserve the country for a specified timebefore migrating abroad.before migrating abroad.

5. Establishment ofnurse registries.5. Establishment ofnurse registries.

6. Expansion ofnurse specialty6. Expansion ofnurse specialty

training programs.training programs.


27/41


7. Organization ofa Philippine7. Organization ofa Philippine

Council ofNursing Concerns.Council ofNursing Concerns.

8. Obtaining global8. Obtaining globalrepresentation ofFilipino nursesrepresentation ofFilipino nurses

concerns in WHO, WTOconcerns in WHO, WTO--GATSGATS

and lobby with the UN to declareand lobby with the UN to declare

20052005--2014 the International2014 the InternationalDecade ofNurses.Decade ofNurses.


28/41


Trend 2: The PatientSafetyTrend 2: The PatientSafety

ImperativeImperative

Greater patient safety hasGreater patient safety has

become imperative since thebecome imperative since the

Institute ofMedicines report inInstitute ofMedicines report in

1999 estimating that 44,0001999 estimating that 44,000

98,000 deaths are attributed to98,000 deaths are attributed to

medical errors.medical errors.

Nursing as a safety net.Nursing as a safety net.


29/41


Sources ofthreats to patients safety:Sources ofthreats to patients safety:

Nurses workloadsNurses workloads heavier patientheavier patientloads are associated with higherloads are associated with higherrates of infection, GI bleeding,rates of infection, GI bleeding,pneumonia, cardiac arrest and deathpneumonia, cardiac arrest and deathfrom these causes.from these causes.

Sicker patientsSicker patients

Inadequate orientationInadequate orientation

Communication failuresCommunication failures InterruptionsInterruptions

DistractionsDistractions


30/41


Trend 3: SkyrocketingTrend 3: Skyrocketing

Healthcare CostsHealthcare Costs

Healthcare is rapidly becomingHealthcare is rapidly becoming

unaffordable.unaffordable.

Prices ofmedicines,Prices ofmedicines,diagnostics, treatment,diagnostics, treatment,

professional fees ofMDs are atprofessional fees ofMDs are at

times too expensive due to thetimes too expensive due to the

flourishing sickness industry.flourishing sickness industry.


31/41


Trend 4: Born Earlier andTrend 4: Born Earlier and

Living LongerLiving Longer

Flood ofpremature babies dueFlood ofpremature babies due

to assisted reproductiveto assisted reproductive

technology (ART).technology (ART).

People are expected to livePeople are expected to live

longer (77.2 years by 2001). Welonger (77.2 years by 2001). We

will expectthis to rise as the firstwill expectthis to rise as the first

ofthe baby boomers entertheirofthe baby boomers entertheirsixties.sixties.


32/41


Trend 5: Shorter Lengths ofTrend 5: Shorter Lengths of

Hospital Stay (LOS)Hospital Stay (LOS)

Advances in technology and drug therapiesAdvances in technology and drug therapiesthat allow earlier diagnosis and treatmentthat allow earlier diagnosis and treatmentofacute conditions and safer and lessofacute conditions and safer and lessinvasive surgeries.invasive surgeries.

Greater development and coverage ofGreater development and coverage ofpostacute care alternatives.postacute care alternatives.

A shiftform Medicare costA shiftform Medicare cost--based tobased toprospective payment system for hospitals.prospective payment system for hospitals.

The growth ofutilization review programs.The growth ofutilization review programs.

Increased enrollment in managed careIncreased enrollment in managed careplans.plans.


33/41


Trend 6: HealthcareTrend 6: Healthcare

Consumerism and EConsumerism and E--HealthHealth

Consumerism is a movementConsumerism is a movement

seeking to protectthe rights ofseeking to protectthe rights of

consumers by requiring suchconsumers by requiring such

practices as honest packaging,practices as honest packaging,

labeling, and advertising, fairlabeling, and advertising, fair

pricing, and improved safetypricing, and improved safety

standards.standards. Getting more value for money.Getting more value for money.


34/41


Trend 7: Complementary andTrend 7: Complementary and

Alternative Medicine (CAM)Alternative Medicine (CAM)

Nurses will need to be proactive andNurses will need to be proactive and

open dialogues with patients aboutopen dialogues with patients about

CAM.CAM.

Nurses will have a greater role inNurses will have a greater role inproviding CAM in some healthcareproviding CAM in some healthcare

settings including hospitals.settings including hospitals.

Funding for clinical trials toFunding for clinical trials to

determine safety and efficacy ofdetermine safety and efficacy of

CAM therapies.CAM therapies.


35/41


Trend 8: TechnologicalTrend 8: Technological

Wonders and WoesWonders and Woes

Imagine a wireless, disposableImagine a wireless, disposableendoscopy camera in a capsule thatendoscopy camera in a capsule thatprovides realprovides real--color images ofthe GIcolor images ofthe GItract after being swallowed andtract after being swallowed and

moved along by peristalsis.moved along by peristalsis. Picture an antibodyPicture an antibody--coated stentthatcoated stentthat

prevents restinosis ofcoronaryprevents restinosis ofcoronaryarteries.arteries.

Artificial pancreasArtificial pancreas A robotthat performs delicateA robotthat performs delicate

surgery inside an MRI chambersurgery inside an MRI chamber


36/41


Considerthe possibility ofdeliveringConsiderthe possibility ofdelivering

a baby by Ca baby by C--sectionsection halfwayhalfway soso

thatthe baby can be intubated andthatthe baby can be intubated and

resuscitated before clamping theresuscitated before clamping theumbilical cord, all because there is aumbilical cord, all because there is a

large tumor growing on the babyslarge tumor growing on the babys

trachea.trachea.

Paperless environment ofthe futurePaperless environment ofthe futurein healthcare settings.in healthcare settings.


37/41


Trend 9: WebTrend 9: Web--Based NursingBased Nursing

DegreesDegrees

Online advanced degree programs.Online advanced degree programs.

Array ofclinical and nonclinicalArray ofclinical and nonclinical

advanced practice majors.advanced practice majors.

WebWeb--Based programs make use ofBased programs make use of

online lectures, libraries, discussiononline lectures, libraries, discussion

groups, conferencing, and emailgroups, conferencing, and email

communication between instructorcommunication between instructor

and student.and student.


38/41


Trend 10: Disparities inTrend 10: Disparities in

HealthcareHealthcare

Emergence ofa diverse nationEmergence ofa diverse nation

and a more diverse patientand a more diverse patient

population.population.

Understanding ofculturalUnderstanding ofcultural

differences into the provision ofdifferences into the provision of

healthcare ofracial and ethnichealthcare ofracial and ethnic

minorities.minorities.


39/41


Trend 11: Living with ChronicTrend 11: Living with Chronic

DiseaseDisease

Increase in elderly populationIncrease in elderly population

will mean increase in chronicwill mean increase in chronic

disease management.disease management.


40/41


Trend 12: Return oftheTrend 12: Return ofthe

PlaguesPlagues

Started with AIDS during the earlyStarted with AIDS during the early1980s.1980s.

Success ofantibiotics and vaccineSuccess ofantibiotics and vaccineprograms were shook byprograms were shook byappearance ofantibioticappearance ofantibiotic--resistantresistantinfections caused by pathogens thatinfections caused by pathogens thathave flourished in the era ofhave flourished in the era ofantibiotic overdose.antibiotic overdose.

Lethal strains of influenza, West NileLethal strains of influenza, West Nilevirus, SARS, and MDR TB.virus, SARS, and MDR TB.

MadMad--cow disease has become acow disease has become adomestic menace in UK.domestic menace in UK.


41/41


THANK YOU!THANK YOU!

Documents

21794834 Trends in Nursing