Chapter 1: Nursing in Today's Evolving HC Environment Flashcards
Where do most nurses practice?
Hospitals: 63.2%
Ambulatory Care: 10.5%
Public and Community Health: 7.8%
Home Health: 6.4%
Extended Care Facilities: 5.3%
Others: 6.8%
Nursing in Hospitals:
Last 150 years — shift from home/community setting to hospitals. Ex: health care providers come to your home to provide care.
Medical center (a hospital designation)
Community-based hospitals. ex: Shelby county tax payers pay for regional one hospital. Evidence based survival rate increased at city hospitals with several nurses.
Hospital Roles: advanced degree
Nurse managers
Direct patient care
APRNs/CNS
Research and Education: ex: LCON professors, medication research, health care education (pt edu.)
Case Managers: organize, discharging patients, chronic ill patient, coordinate management of patients. (ex: insurance nurses)
Other places nurses can be found working:
Schools
End of life care: make connections and explaining
Dialysis and Kidney care
Telehealth and Insurance/Triage: blue cross/blue shield professional advice 24/7 when need to hear medication advice.
Parish nursing: community nurses, religious, cultural perspective regarding health. Make decisions via belief.
Businesses
What are factors impacting nursing in the next several years?
Government (abortion, overworked, laws), patient overload, long hours, etc.
Affordable Care Act (ACA): 2 laws
The patient protection and affordable care act
The health care and education affordability reconciliation act
Inflation reduction act:
gives Medicare ability to negotiate drug policies
Medicare = elder population (baby boomers)
Medicaid Eligibility and expansion:
federal pays 75%, different in every state.
Free health care comes out of peoples tax $$
Ethical issue: ex: insulin prices; people are dying because they are rationing insulin
Health insurance helps to lower medical cost so health insurance is something that is highly important to have
Nursing in the U.S,:
RNs are the largest group of health care providers
Over 4 million licensed RNs
Average age of nurses in 2018 was 43.69
91% of nurses younger than 50 are employed in nursing
12.7% of nurses are men
31.0% are of ethnic minorities
Nursing migration and push/pull factors: ex: travel nurses; migration from rural areas to urban areas
(looked at public health concerns) and the Henry Street Settlement in New York City in 1895. Broad field of community health nursing:
Care settings
Government and private agencies
Home health and cost-effectiveness
Knowledge and skills of the home health nurse
Helped with: clean water supply, clean/healthy pregnancies, etc.
Lilian Wald (1867-1940)
Occupational and environmental health nurses:
“Good employee health reduces absenteeism, insurance cost, and worker errors, thereby improving company profitability.”
employee health nurse
nurse in place of work (ex: Fedex employee nurses; help with coordination of safe lifting and taking care of body)
Nursing in the Armed Services:
Peacetime and wartime settings
Military nurses have broader responsibilities and scope for practice than do civilian nurses
A major benefit of military nursing is the opportunity for advanced education
Travel and change and need for flexibility
Nurses with Advanced Degrees:
Nurse educators
Clinical nurse leaders
Advanced practice nurses:
Nurse Practitioner
Clinical nurse specialist
Certified nurse midwife
Certified RN anesthetist
Researchers
Employment Outlook in Nursing:
Growing opportunities for nurses
-Technological advancements
-Increasing emphasis on primary care
-Aging population
Hospital care to cost-effective home care
Long-term care
Nursing salaries including advanced practice nurses
-Wage compression: flattening of salaries for experienced nurses
