Future Persepective Of Nursing Education.

FUTURE PERSPECTIVE OF NURSING EDUCATION Mr. Upendra Yadav (M.Sc.) Department of Child Health Nursing COLLEGE OF NURSING BPKIHS, Dharan, Sunsari, Nepal. 1

INTRODUCTION 

At the dawn of the 21st century and the long-awaited new millennium, nurse educators face a rapidly changing to health care landscape, shifting student and patient demographics, an explosion of technology, and the globalization of health care, in addition to a myriad of everyday challenging. 2

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As we position ourselves to meet today’s a challenged and tomorrow’s, we must understand the drivers affecting nursing. Education is one of the main priorities of a truly democratic society. Pattern of education in nursing is more or less similar to that of the allied professional. 3

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The role of nursing has taken a new meaning with the launch of HFA 2000 Ad. After a decade of unprecedented change in both health care higher education and predictions of more to come in the future, we are now here. 4

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We lead to new millennium with a lock at nursing and nursing education if the midst of this revolution Carol Lindeman (Dean, Emeritus of Oregon Health Sciences University School of Nursing) examines the market driven economy of health care and layout a clear agenda for nursing education. 5

MAJOR DEFICIENCIES IN NURSING EDUCATION AND TRAINING. 

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Lack of good standard training schools and colleges. Lack of in-service, refresher, correspondence courses. Limited facilities for undergoing higher education in nursing.

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Variation in nursing training course syllabi within the state as well as among different state of Nepal. Facility for undergoing specialty training in different areas such as cardio-thoracic nursing, emergency nursing, Paediatric nursing, etc. at present the opportunities and facilities are very limited.

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There is a great need to prepare nurse educators. At present there is insufficient number of trainers. Rigid curriculum and lack of teaching material in terms of books and journals, etc. 8

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Lack of or limited opportunities for continuing education in nursing and in-service education. Lack of separate directorate. No nurse leader in parliament

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FACTORS AFFECTING NURSING EDUCATION 

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During 20th century, society examined tremendous change nursing as a part of that society has also experience enormous change. A number of factors influenced nursing education are given below; 10

Societal Challenges   

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Demographic changes Environmental deterioration Unhealthy lifestyle and resulting illnesses Continuing need for cost containment. Regulation of health care 11

Emerging Health Care System Characteristic of the Emerging health care system are as follows:  Orientation toward health: Greater emphasis on Prevention and wellness; greater expectation for individual responsibility for healthy behavior. 12

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Population Perspective: New attention to risk factors affecting substantial segments of the community, including issue of access and the physical and social environment. Intensive unit of Information: Reliance on information system to provide complete, easily assimilated

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Knowledge of Treatment Outcomes: Emphasis on the determination of the most effective treatment under different conditions and the dissemination of this information to those involved in treatment decision. Constrained Resources: A pervasive concern over increasing costs, coupled with expanded use of mechanisms to 14

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Coordination of services: Increased integration of providers with a concomitant emphasis on terms to improve efficiency and effectiveness across all settings. Expectations of Accountability: Growing security by a larger variety of payers, consumers and regulators, coupled with more formally defined 15

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Growing Interdependence: Further integration of domestic issues of health, education and public safety, combined with a growing awareness of the importance of community health care in global context.

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Competencies of Health Professional for Future   

Care for the community’s health Provide contemporary clinical care Participate in the emerging systems and accommodate expanded accountability.

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Ensure cost-effective care and use technology, appropriately. Practice prevention and promote health lifestyles. Involve patients and families in decision making process Manage information and continue to learn. 18

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National Accreditation of Nursing Programme: The accreditation of programme has a noticeable effect on standards of nursing education. As a result of accreditation activities, schools were forced to look at the education preparation of faculty the work load of faculty and students, the structure of clinical team withdrawal rates and the state board 19

Continued… Changes in nursing services:  The advancement in medical technology and health related fields changed in expected of nurse professional in the practice setting.  The nurse professional need for competent a efficient to meet these expectations. 20

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The demands of health care consumers also changed due to the increased awareness related to health. As a result today, the nurse professional assume more responsibilities in health care ever before. She works as direct care provider, change agent, educator,

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VISION FOR THE FUTURE “Today’s Nursing Education: Vision for the Future” highlighted the major issues using a phenomenic word- “IMPOSSIBLE”.

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I - Infrastructure- poor classroom. Labs and hostel. M - Manpower Shortage in quality and quantity, hierarchy. P - Poor practical training fieldclinical field, equipments, community, staff. 0 - over weighted curriculum- In no. of courses and hours. 23

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S -Selected of students-external pressure to sacrifice merit. S - Student status- External pressure to sacrifice merit. I -Improvement of faculty- lack of opportunities for deputation for conferences and workshop 24

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B - Budgetary limitation L -Library Facilities- books, journals, Internet access. E - Educational freedom- Lack of autonomy, Rigidity

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IN SHORT, THE MAJOR CHALLENGES FOR NURSING EDUCATION WILL BE 

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To respond to societal changes rapidly with appropriate curricular modification. To provide a steady supply of well prepared graduates in the face of an aged faculty. Rapidly changing technology, increasing cultural diversity of students and patients and lack of health and 26

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Nursing theories continue the influence nursing and nursing education, nursing theories assists to building a body of nursing knowledge and describing a defining nursing practice.

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GLOBALLY CHANGING HEALTH CARE SCENARIO AND THE FUTURE OF NURSING EDUCATION: Implications For Nursing Education In 28

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The challenge in nursing education today is to design curricula that will address the health care needs of the future. Designing such curricula is difficult role of the rapidly changing health care environment in which we live. 29

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Nurse educators face a change: restructuring nursing education to prepare graduates to work in the 21st century.

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BREAK THROUGHS IN NURSING EDUCATION: LOOKING BACK, LOOKING FORWARD

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If we look at the changes in nursing education in the last quarter century, notes some of the trends currently shaping health care delivery and academia, and discusses some issues likely to grow in importance in next quarter century. 32

TOP 10 CHANGES: LAST QUARTER CENTURY 

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Growth in various technologies has changed in nature of both cares giving and teaching/learning, particularly with regard to how place-bound services must be. Advanced practice nursing has become established at the masters’ level, with existing acceptance by the public of nurse practitioners and growth of 33

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Taxonomies that define nursing diagnoses (NANDA), Nursing interventions (NIC), and nursing outcomes (NOC) now provide the foundation for the art and science of nursing. Students have become increasingly diverse in terms of age, race, gender, learning styles, etc. 34

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Doctoral education in nursing has become established. The research base of nursing has become visible nationally and regionally with the establishment of the National Institute of Nursing Research and the development of regional research societies. 35

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The link between nursing education and nursing service has been revitalized as nursing schools increasingly provided community based services. Articulation across levels of nursing (LPN, ASN, LPN, BSN, RN-BSN, RNMSN) is increasingly possible and user friendly 36

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Accreditation criteria have moved away from a focus on processes to a focus on outcomes. Nursing’s literature/ infrastructure has greatly expanded with new journals, annual reviews, standards and policy statements (e.g. ANA’s 1980 Nursing, A social Policy Statement) 37

FUTURE DIRECTIONS FOR NURSING EDUCATION 

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In 1943, three major organization issued statements and reports about nursing education for the twenty first century. Their report addressed the new directional nursing education needed to take in the future. 38

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Although the three organizations had somewhat different approaches and strategies common emphases included the following eight points.

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Schools should recruit diverse students and facilities that reflect the multicultural of society Curricula and learning activities should develop student’s critical thinking skills. Curricula should emphasize student’s abilities to communicate, form interpersonal relationships and make decisions collaboratively with patients, 40 their families, interdisciplinary

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The number of advanced practice nurse should be increased and curricula should emphasize health promotion and maintenance skills for all nurses. Emphasis should be placed on community based care, increased accountability, state the art clinical skills and increased information 41

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Cost effectiveness of care should be a focus in nursing curricula. Faculty should develop programmes that facilitate articulation and career mobility. Continuing faculty development activities should support excellence in practice, teaching and research. 42

FUTURE DIRECTION IN NURSING FROM

Sick individual Curative model Cure for few Primarily hospital setting Nursing Intervention Through task

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Total population Care model. High risk & vulnerable. Home, school, industry, institution setting. Intervention through43

From Intervention through individual to family Objective of Nursing practice as secondary and tertiary prevention Health care provider role

To Group community, family, individual Objective as primary prevention Health care facilitator role, self care concept people participation. 44

Continued. Institutional health care. Evaluation of care in the basis of cure.

Primary health care for All. Evaluation of care on the basis of changes in behavior and coverage 45 of population.

CRUCIAL ISSUES IN PLANNING NURSING EDUCATION INCLUDES 

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An understanding of the nature of nursing, which has consequences for the value placed on different subjects in the curriculum and how they are taught and assessed. What constitutes nursing knowledge, whether it comes from a unique discipline, via the nursing process and models of nursing or whether it is combination of knowledge from several disciplines. An understanding of how best to foster the

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CONCLUSION 

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It is clear that nursing education is about to see the greatest challenge to both the form and process of preparing future nurses. The nurse educators and nursing service personnel must be prepared to change the total configuration of nursing education to act as agents in health care. 47

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The future of nursing education has brought with it many challenges and opportunities for the nursing profession

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The present health care environment requires creative change. The students in the future are to be encouraged to explore the meaning of “care” for themselves as nurses and the meaning of “caring” for the clients who are experiencing health care. 49

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It is time to refine nursing education, so that one can ensure that nurses are adequately and appropriately prepared for potential diversity in nursing. The nurse educators must be prepared to change the total configuration of nursing education to act as change agents in health 50

BIBLIOGRAPHY 

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Katherine W. Vestal, Management concepts for the New Nurse, 19th edit.1987, J.B.Lippincott Company Philadelphia, pp 349. Janice Rider Ellis,& Celia Love Hartlay, Nursing in today’s world, challenges, Issues, and Trends, 7th edit., Lippincott Philadelphia, NewYork, Baltimore, publication.pp 230-

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