INTRODUCTION:

The research interests include a broad range of basic and applied research topics that expand the knowledge base of nursing science, influencing music and art therapy, holistic care, collaborative nursing care and spiritual nursing care.

RECENT TRENDS IN THE FIELD OF NURSING:

1. Entrepreneurs Are Building Better Nursing Homes:

The Great Recession put a strain on elderly care for both patients and healthcare practitioners alike. Entrepreneur Barry Berman took notice when his own parents entered his own nursing home under living and working conditions that left much to be desired. After marked improvements in these conditions over the past 10 years–changes that have resulted in more elderly patients choosing nursing homes that operate under Bill Thomas’s Green House Project business model–there is a demand for certified nursing assistants to work in these facilities. Both patients who currently live and nurses who currently work in Green House Project long-term care facilities report higher quality of life and higher job satisfaction, respectively [1].

2. Massive Increase in Online Training:

In 2010, the Institute of Medicine (IOM) called on all nurses to increase the percentage of workers holding a BSN from 50 to 80 percent by 2020. Universities have responded by increasing their online course offerings for nursing programs that provide RN to BSN degrees. Programs such as these often coordinate nurses’ clinicals with communities that are local to them, as well as promise higher earnings and job security for career-RNs to help them face increasingly stiff competition brought on by younger nurses with higher education’s (see trend 9). Comprehensive lists of on-campus and online nursing programs ranging from RN to BSN, RN to MSN, and Doctor of Nursing Practice (DNP) are available at all Nursing Schools.com [1].

3. Emphasis on Art Therapy:

Although hospitals (and especially pediatric and psychiatric wards) have always cultivated wide-ranging art exhibits, some hospitals have begun working with culture councils on increasing opportunities for patients, nurses, and volunteers to participate in various arts initiatives. According to research conducted by various and reputed institutions that back the American Art Therapy Association, such initiatives improve physical, mental and emotional well-being of children and adults worldwide. Institutions that back the American Art Therapy section include (but are not limited to) the University of Pennsylvania’s School of Nursing, Georgetown University’s Children’s Medical Center, and Johns Hopkins Bay view. See this list for 100 art therapy exercises that nurses can use to engage their patients during downtime [1].

4. Advocacy for Music Therapy:

Veterans, cancer patients, routine surgery patients and people with Alzheimer’s are all benefiting from nurses who are Board Certified Music Therapists (MT-BC). Studies show music therapy reduces anxiety during routine procedures, decreases the need for inoculative pharmaceuticals, lessens the likelihood of wandering or elopement. Additionally, the method is known to increase patient positivity, overall satisfaction with life-quality, and meaningful interactions with others. Nurses can find the most recent news on outcomes for music therapy and professional development at musictherapy.org [1].

5. Shortage of Experienced Nurses:

Since the year 2000, books have been published about the lack of incoming nurses. Although the Bureau of Labor Statistics recently projected 19% growth in the number of U.S. nurses between 2012 and 2022, the global number of nurses has stagnated. The Great Recession had much to do with this stunted growth, as nurses on the cusp of retirement declined to retire during the economic downturn, keeping what few jobs that workers entering the field had hoped to occupy. Compound the top-heaviness of an aging workforce with the low growth rate experienced internationally between 2000 and 2010, and you get a high demand for nurses (and nurse educators) worldwide. Nurses who are soon-to-retire will need to be replaced, new positions created to serve a growing population, and new faculty hired at nursing schools to meet such imminent demands. Additionally, more incentives are needed for experienced nurses to stay on as educators, because with practicing nurses making $20,000 to $30,000 more than teachers of nursing, the educators of our next generation are dwindling [2].

6. An Aging Nursing Workforce That is Putting Off Retirement:

Peter McMenamin, senior policy fellow and health economist at the American Nurses Association (ANA), had expected 2-3 million more patients to enter Medicare after 2009 based on the assumption that Baby Boomers would begin retiring in 2010. The problem is that most of these Boomers (i.e., nurses who got their jobs in the 1970s and early 1980s) aren’t retiring. Because of the economic crisis, they have held on to their nursing caps, subsequently slowing and endangering the flow of new blood by creating a bottleneck at the end of the pipeline. This stoppage is being relieved as a new surge of nurses enters the field, urging older nurses to exit their positions. However, these retiring nurses will soon need nurses of their own to care for them as they age, which means a higher demand for geriatric nurses will soon be in order, accompanied by higher job security for those who choose to take care of the old [2].

7. The Scope of Medicine that Nurses are Able to Practice is Widening:

With a shortage of Primary Care Physicians looming, healthcare facilities are beginning to rely more and more heavily on an increase in nurse practitioners (NPs) and physician assistants (PAs). Such facilities include hospitals, retail clinics, and nurse-led clinics often based in pharmacies, grocery stores and other “big box” stores. Studies conducted by members of the Institute for Health Policy Studies and the Medical Industry Leadership Institute have also shown that insurance savings could amount to $810 million if all states allowed NPs to practice independently, and $472 million if NPs were allowed to both practice and prescribe independently, all of which they are trained to do. While there are longstanding legal and conventional barriers to enacting these practices (e.g., malpractice laws and physicians who feel their territory being intruded upon), research from various medical, economic, and public health institutions supports the prospect of widening the scope of medicine that nurses are able to practice [2].

8. Steady Growth in the Number of Nurse Practitioners:

During the 1990s, nurse practitioners began migrating from hospitals to other sites in their community to answer a call for accessible care. This move led to a 20% increase in the number of U.S. nurse practitioners between 1992 and 1999 (from 48,000 to 60,000). Since 1999, the number of nurse practitioners has grown to over 205,000. That’s more than a 330% increase in the number of nurse practitioners over a 15-year period (up from a meager 20% increase over an 8-year period), which means that the field has grown at an average rate of 22% per year since 1999. Over half (54.5%) work in family practice. Approximately 19% work in adult care, 7% in acute care and 5% in pediatric care. Only 3% work in psychiatric/mental health care, 1% in neonatal care and 1% in oncology care. With so many NPs going into family practice, healthcare facilities need NPs to distribute themselves throughout other subfields that require more resources. In line with the “Mental Health Crisis” that America is said to have on its hands, there is a current shortage of psychiatrists, which means the subfield of Psychiatric/Mental Health is in more need than most [2].

9. More Nurses Are More Highly Educated:

As RNs strive to meet the Institute of Medicine’s (IOM) goal of reaching an 80% BSN-holding workforce by 2020, there has been a marked increase in the number of BSN candidates at on-campus and online universities since 2010. That same year, the IOM called for nursing programs nationwide to double the number of nurses holding doctoral degrees. In response to this demand (which appears to have started even earlier than 2010), the number of universities offering programs for a doctorate of nursing practice (DNP) has grown from twenty in 2006 to two hundred and sixty-four in 2014– that’s a 1,320% increase over 8 years. Studies have also shown that higher numbers of nurses who are more highly educated are also leading to higher quality care. The American Association of Colleges of Nursing (AACN) cites at least eleven independent studies that found nurses who have a baccalaureate degree or higher are more likely to reduce patient mortality rates and increase overall quality of care. So despite a costly national student loan debt, the higher education of American nurses appears to be paying off for American patients [3].

10. The Field is Getting More Diverse:

Of the 3.5 million employed nurses in 2011, 330,000 were men. That means roughly 1 in 10 nurses were men. Now that sounds like a very small fraction, but when compared with the ratio of male nurses to female nurses in the early 1980s, the field has made definite strides, including a 660% increase in the total number of men working as nurses since 1981. Additionally, the number of male nurses in 2011 who were ethnic minorities (i.e., Non-White) was slightly higher (~5%) than the number of female nurses who were ethnic minorities, a trend that has continued to grow uninhibited for the past 30 years. But with healthcare organizations’ continued focus on recruiting men to the field, the number of men in nursing is sure to increase at a higher rate for the foreseeable future [3].

11. Gender Pay Gap Closing Steadily:

Nursing fits the national mold of having a gender pay gap, otherwise known as the Glass Ceiling. Today, that gap is closing and that ceiling is close to shattering. According to U.S. Census data on the earnings gap in 2000, female nurses made an average of $39,670 while male nurses made an average of $88,217. That’s a $48,547 difference, which translates into female nurses making 45 cents for every dollar made by a male nurse. That gap closed by 46 cents between 2000 and 2011. According to 2011 U.S. Census data for men in nursing occupations, male nurses earned an average salary of $60,700 per year, while female nurses earned an average salary of $51,100 per year. That’s only a $9,600 difference, which is progress when compared to the almost 50,000 dollar difference only eleven years ago. This progress means that women who worked as nurses in 2011 earned an average of 91 cents for every dollar that men earned–13 cents more than the national average. And with only 9 cents to go toward achieving pay equality for women in the field of nursing, it would appear the hospital’s glass ceiling is cracking [3].

12. Increased Specialization Among Nurses:

RNs who specialize in various areas are in higher demand than generalist LPNs. This demand correlates directly with the growing number of nurses (86.3% between 2007 and 2011) who hold BSN degrees, have received field-specific training, and been certified to practice in one of several medical subfields (e.g., psychiatry, gerontology, or obstetrics). Following this trend, the number of LPNs hired at hospitals, physicians’ offices, offices of other health practitioners, and residential care facilities (i.e., higher paying employers that often require more than general care) has declined notably since the year 2000. The loss of over 10,000 LPNs from the offices of physicians between 2000 and 2010 alone is telling in this regard. Fortunately, LPN jobs are projected to grow by 25% over the next seven years (that’s 6% more than RN jobs are projected to grow), as additional educational opportunities are being made for LPNs to advance into other medical subfields. Regardless of nursing licensure, one thing is certain: nurses today are expected to specialize [3].

13. Increased Focus on Preventive Medicine (otherwise known as Holistic Care):

Health care reform initiatives begun by the Affordable Care Act in 2010 and instituted worldwide before then have resulted in growing demand for nurses who provide preventive and holistic services. Nurses’ clinical skill-sets, bedside manner, and training in patient instruction make them ideal candidates for providing the level of care and leadership necessary to manage these procedures. With the shortage of PCPs and psychiatrists (see trends 7 and 8), healthcare organizations will be relying more and more heavily on nurse practitioners (NPs) for both chronic and family care. Once NPs become empowered to prescribe, conduct screenings, and educate patients, it won’t be long before “an apple a day keeps the doctor away,” gives way to the nurse [4].

14. Increased Focus on “Collaborative Healthcare”:

Collaborative healthcare rose to popularity after the Affordable Care Act made way for Medicaid health homes. Its holistic method combines primary, acute, behavioral, and long-term services for a comprehensive approach to providing for the whole person in one place as opposed to treating special conditions at multiple locations. These entrepreneurs need nurses of all qualifications to staff homes at all levels of their collaborative care teams. 70 such teams have been studied over the past 15 years. Across all fronts– primary, acute, behavioral, and long-term–collaborative care has consistently demonstrated higher effectiveness than usual care [4].

15. Nurses Need Technological Expertise More than Ever:

Numerous Studies, reports, and surveys attest that information technology has increased patient satisfaction, reduced clinical errors, and decreased the amount of paperwork for nurses to perform outside the room. Today, nurses use a variety of data-driven approaches to perform their job in the room, including Electronic Health Records (EHR) for tracking patient and family health histories, Smart Beds for obtaining patients’ vitals, and Point-Of-Care Technology to access patient case records before conducting special procedures such as X-rays. This new focus on data-gathering with the patient has been called Nursing Informatics or NI, and it is quickly growing into its own, as nurses interested in data science and communication technology are in high demand for new jobs that will help develop this new field for nursing worldwide. One such job is called Nursing Informaticist, which, according to a ExploreHealthCareers.org, has a “Very Good” outlook for the forseeable future [4].

16. Nurses Taking Charge of Patient Education:

Nurses have taken on the role of patient-educator since the profession’s infancy. Dorothea Orem, the nurse famous for having developed Self-Care Theory over the course of the twentieth century, instructs her peers that the goal of nursing is to render the patient capable of caring for him or herself. Nurses today follow this model by informing patients about procedures, their prescriptions, and symptom-management often without even knowing they are doing so. However, more and more recently, nurses have been noticing that the incorporation of patient education and health literacy leads to more optimal patient outcomes. Such outcomes have inspired a spike in the number of resources available for teaching health literacy, allowing nurses to arm their patients with knowledge today so that they can care for themselves tomorrow [4].

17. Spiritual Care and Nursing:

The principles of spiritual care are based on compassion, the root of which means “to suffer for.” Arising out of a feeling that the cure-driven, technological advances made over the course of the 20th century needed to be balanced with a desire to care for the individual, spiritual care’s role in health care is to tend to the whole person: mind, body, and soul. Nurses have often filled this role in their capacity as caregivers at privately run, religiously affiliated hospitals. Studies have shown that such approaches are successful in bringing hopefulness to patients, as well as improving their relations with other patients, family members, and their caregivers. Hospital religious affiliation notwithstanding, nurses continue to fill this role today by recognizing and practicing respect for the diversity of religious and spiritual worldviews their patients are likely to maintain. Indeed, nursing leaders recently have seen success in the implementation of spiritual principles by practicing mindfulness meditation with their patients to both manage and relieve stress [4].

CONCLUSION:

This article presents a review on the recent trends in the field of Nursing.

REFERENCES:

1. Walsh F (2015). Trends in Nursing Care. 48(4):462–480.

2. Kongable L. G., Buckwalter K. C., Stolley J. M (2015). Nursing care topics. 3(4):191–198.

3. Richeson N. E (2016). Topics of Nursing Care. 18(6):353–358.

4. Moretti F., De Ronchi D., Bernabei V., Marchetti L., Ferrari B., Forlani C., Negretti F., Sacchetti C., Atti A. R (2018). Trending Nursing Care Topics of 2018. 11(2):125–129.

Received on 19.03.2019 Modified on 10.05.2019

Int. J. Nur. Edu. and Research. 2019; 7(3):421-424.

DOI: 10.5958/2454-2660.2019.00096.6