Five Challenges for Nursing in the 21st Century

David RobertshawAcademic Lead for Nursing and Healthcare

University of Derby Online LearningUniversity of Derby

D.Robertshaw@Derby.ac.uk / @d_robertshaw

Leadership Technology Specialisation

Relationships with Others The System

Leadership• A key skill for nurses at every level• “Management is doing things right, leadership is

doing the right thing” – Peter Drucker• “Visionary, equipped with strategies, a plan and

desire to direct their teams and services to a future goal” (Mahoney, 2001)

• Winning respect and trust• Competition between business goals and social

need• Personal leadership, and leading others • There are many examples of where leadership has

failed

https://www.flickr.com/photos/philozopher/17124643767/in/photolist-s6fgYK-psCxnU-tovKY-bsQDba-6xvGC3-ai7V5o-5f6gqY-Q2v1-8Q5MjM-nCPDVc-8Q5N3D-qKJVKu-5f1U5a-75mcCp-3KMcR4-qpTxZJ-5JPFC4-5AfG5X-5f6gys-fEm8vJ-sKXDzV-9EXFjs-2YY3c3-9EUKmB-fE4wVZ-bpVmwA-fEm7Th-7oKvPW-bCQiqV-4D8NUn-wKzC1B-fE4xrH-bCQgVn-qMGB8L-gscqVu-pHzms8-nNnToX-oLWD6E-priCJH-

oLZABV-7J1PPX-fEm7Z7-bCQhF4-bpVgmb-9hDbwm-bsQHBp-bCQhft-bpVj7L-bpVhwm-bpVg17

Technology

• Smart phones are now ubiquitous• The use of telemedicine has

soared• We can now use electronic patient

records• Electronic prescribing• Issues of digital literacy• Data security and transfer• Loss of data

https://s-media-cache-ak0.pinimg.com/originals/cf/d5/9a/cfd59a5225b5443538ce4a29f1a2e621.jpg

Specialisation

• Can be a good thing – Clinical Nurse Specialist roles for example

• Specialist support of specific conditions and groups, e.g. theatres

• High specialisation means development of knowledge and expertise

• But does sub-specialism prevent us from seeing the bigger picture?

• ‘Too posh to wash’?• Whatever we do needs to be evidence based

https://d1avok0lzls2w.cloudfront.net/img_uploads/Technical%20Mktg2(1).jpg

Relationships with Others

• Historical context of nursing• Parity of esteem between professions• Non-medical Prescribing and other

capabilities• Advanced practice• Challenging colleagues and practice• New roles• Blurring boundaries

The System

• Health as a political choice• Budgets and finances• Privatisation• Insurance systems• Political changes – EU, for

example• Right of access• Public health vs primary care vs

secondary care vs tertiary care• Care integration – new roles

Leadership Technology Specialisation

Relationships with Others The System

What is the answer?

• Flexibility• Adaptability• Strong voice• Unity• Focus on innovation• Knowledge • Networks• Hard work

What will the future nurse look like?

• Degree educated• Independent practitioner• Wide range of skills, with specialist areas• Clinical capability but also a strong leader• Evidence based and able to make decisions• Creator of evidence, not just consumer• Will be a digital native and thrive in a technology-enabled world• Be politically active• International

Questions