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Nursing Essay Example on Changes in Profession in the Past Ten Years

Executive Summary

The nursing profession has gone through a number of diverse modifications in the past decade. These changes have an impact on both the patients and the workers. The aim of writing this piece is to analyze the evidence concerning the effects of these changes in the health industry, particularly the nursing sector. The issues include implications of regulation on nursing, effects of trends in the nursing profession on workers’ health and safety. The paper will also deal with the trends in the labor force and the way they affect the quality of patient care.

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The study will determine the changes in the nursing profession and its effect on the quality of service in its infant stages. However, the importance of such research cannot be understated because the consumers in the industry lack clinical experience and are required to construct knowledgeable decisions. While the researches done have not directly pointed restructuring activities to specified changes in outcomes of patient’s health yet, the data found creates a link between the levels of skills of the staff, quality of the staff’s work and number of the staff or staffing. Control of health by the healthcare department is a vital component in the relationship because it specifies the required skills for the regulation of the impact of supply of workforce and costs and theories concerning public protection. Like any other trade, measurements are taken for costs to be reduced, enabling the nursing occupation becoming a cheap but reliable profession. This does not mean that the salaries of the nurses are reduced, but efficiency is increased in the sectors other than those dealing with salaries. For this to be realized, states and explorers are trying to find an understanding of the composition of a service that is cheap, while at the same time not to compromise on the quality of service.


Many institutions of health have made great strides and transformation in the last decade. These developments have resulted in a speedy rise in the theory and growth of technology. Among many changes in the nursing area are: the increase in demand for excellent hospital care, the rising stress for the reducing of operational cost, expansion of the technological knowhow with regard to nursing. The most challenging changes in the occupation is the rise in complex ailments that require special attention, decrease in the length of stay in hospital of the ageing populace and increase in the knowledge of the patients concerning the diseases they are suffering from. These changes have a connection with current moral and ethical problems, which result from the daily nurse practices.

There are several other changes predicted for the near future. The changes in technology, for example, and the development of a life-prolonging machine will compound the problem of population because it will increase the population of the old and hence cause an increase in the requirement for healthcare for the old, which has the consequence of escalating expenditure in healthcare. The research was done to aid in the comprehension of specific relationships between the changes in nursing in the last ten years and their effect on the quality of service and that of the nurses’ personal life. This piece of writing first considers the institutional trends in delivery of service in nursing. Effects of the trends on productivity, staff roles, the care quality, nurses’ security and contentment, and employment and earnings are scrutinized.

Literature Review

Health Industry Changes

Streamlining of the nursing profession, especially the training of nurse leaders is a significant range of events including organizational restructuring, delivery of services, and development of acute care systems called palliative care and the regulation of health service providers. The increase in competition, running cost concerns, technological advances, aging and other demographic issues and changes in social attitudes are the features that will keep the change in the nursing profession unstoppable.

Changes in Managerial

The main organizational change in nursing is the fact that the health care has changed from care that is hospital-based to outpatient and nursing homes. According to AHA (1996), admission of outpatients to state-owned hospitals increased by 89.3 percent while there was a decrease of 7.8 percent in the admission of the inpatients. Kleinpell, (2005) noted that the rise in the various kinds of setups and products permits the institutions of care to reduce its susceptibility to doubt in its inpatient palliative care by expanding its area of operation. This development arises due to the increase of non-hospital care systems such as physicians’ offices.

The reflection on changes of ownership and administration is seen in the increase in concentration of hospitals in the country due to the development of several hospitals that look for profit through mergers and closures. A study done in the year of 1995 revealed that investors owned about 15 percent shares of community hospitals (AHA 1996) with an increase of 14 percent in 1994. Out of ten largest hospital systems in the United States in the year of 1993, only three of them were state-owned, while the rest were for-profit organizations.

Changes in management can be used as the primary tactic in the reduction of operational costs and lessening the increased rivalry. Through corporate associations and managed care, a surplus ability is wrought out and reductions of costs are realized. In a survey done annually on hospitals by AHA, the drop in the figure of beds in hospitals was mixed in different regions (AHA 1996). When the figure of beds is reduced and time spent in hospital is lessened, the next area to seek savings will be the element of labor in the budget. At the cumulative countrywide stage, the quantity of full-time nurses have reduced in the past ten years, while in the following years, the number of full-timers was the lowest in a period of fifteen years. The reduction in beds in these institutions meant that the number of nurses would also be reduced in a particular hospital, since the hospital cannot admit more patients than it can treat. The reduction in FTEs reflects efficiencies, beds in hospital, hospital length of stay, and extra payment measures that provide some quantity of reimbursements.

Service Delivery and Patient Care Changes

Since nursing is a part of the broader institution, i.e. the health care system, changes affecting the industry also affect it. Achievements of success in any field of practice demands new inventions that help improve the system to be made. The development of the training systems in the nursing fraternity to support the acute care system has been developed. In acute care system, patient education is provided in a variety of environs in the range of care. In the inpatient and outpatient settings, health education has shown improvement in outcomes of the patients’ health. Acute care nurses are registered nurses with advanced education and training purposed to handle specialty cases in the health care system. Hravnak, Tuite, and Baldisseri (2005) deduce that they are responsible for teaching other nurses and patients the best way to handle the disease. The service helps in the care of patients with special problems, for example, a diabetic who has a memory problem, and aid patients’ faster recovery due to paying specialized attention. The clinical nurse leader develops an overall list of patients, their families, and the caregivers and creates a strong relationship and partnerships between these three, which will enable them to provide optimal care.

There are three domains of learning in acute care; these are psychomotor, cognitive, and affective learning. Cognitive learning involves the acquisition of knowledge, while affective learning consists of internalizing values, attitudes and beliefs, and psychomotor learning involves mastery of skills.

On the other hand, Kleinpell (2005) gives a description of work models in the care system. These are care focusing on patients (PFC), operations improvement (IO), and patient-centered care (PCC). In the former years, PCC was a less frequently used system of care. This type of model uses comprehensive data to determine ways of making the health care institutions humanly. Care of patients is provided one on one, using trained and competent nurses to execute its objective. Cost focus is not a subject matter for this model. The OI and the PFC moulds involve the remodeling of the tasks of licensed practical nurses, registered nurses, and the aides of these nurses. OI in particular, focuses on cost saving affecting nurses a lot because it involves reducing their wages and responsibilities (ibid).

The shortage of nurses has affected the improvement of the healthcare sector in the US in ways more than one. For a well-developed system of health to work in a proper manner, there has to be full time surveillance of the hospital or any health care institution. The twenty-four hours and seven days a week system will help in fast diagnosing and taking action regarding the patients in the unit if a complication arises. It is, however, sad to note that in the past ten years, the management unit of hospitals put all their efforts on the reduction of hospital operational costs leading to a cut in the number of nurses. These cuts have also started at the time when the nation was lacking qualified nurses who would be well trained to handle work in various fields. These cuts have also led to the low entrance to nurse training schools because the would-be nurses claimed that they would not get jobs at the end of their schooling. Dr. Aiken says that the well-being of patients is a direct consequence of the number of staff operating in the hospital: the higher the number of nurses the better the care of the patients, since they will be receiving one on one service.

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The aim of the current research is to identify the trends in nursing in the last ten years and their impact on the quality of service offered in hospitals.


Health reforms require a system that is cost-effective, evidence-based and the one that provides the best quality of care. The new models that have been developed in the industry have to be innovative to achieve the mentioned purpose. The health workers and professionals tasked with the implementation of these models should also have a good education and be well versed with the requirements of the work since it involves peoples’ lives. This new pattern gives an exceptional chance for the nursing occupation to fill the new leadership positions created and weigh its strengths on team-based roles. The features of the new nursing system include an increase in technological innovations that will be used to help the nurses complete their work satisfactorily and ease their work. The Registered Nurses should practice fully to their abilities, training and education. They should not be limited to certain practices only. These nurses should be well educated and well trained in their field of application. They should also have aides to help them do their work satisfactorily and in a seamless way.

The government, on the other hand, is tasked to provide effective policy and workforce planning to achieve better data collection and infrastructure. The nursing profession is moving to the practice of a leader nurse who will lead the other nurses in the care of patients in a system known as acute care system. This has been achieved by the enrollment of nurses in degree programs and specialization in personalized care of patients.

The trends in the health care system can be summarized as follows:

The Go-To Person: Nurses are playing an extended role across the healthcare spectrum as hospitals expand telehealth i.e. movement of health services makes home care more realistic, and therefore, there is a continuation of shortage of primary care doctors. Nurse as an Advocate: Nurses have noticed that there is no effect on their involvement in the politics of the nation and hence more nurses are involved with the nation’s decision making themselves, therefore helping to shape the healthcare debate. This development will in turn affect the health sector and nursing fraternity in a positive way. Another trend is Smart Training: The infant years of a nurse’s career can be fragile ones, with a soaring rate of dropout cases. The intensive on-site training and mentorship, however, accompany nurse residency programs, and early turnover has been stemmed out. Decrease in the shortage of nurses: As the shortage of nurses subsides, there is a growing number of new graduates broadening training physically and medically. There are an increasing number of students joining nursing degrees, and the improved systems in these schools help.

The Other Changes in the Nursing Area Include


Registered nurses normally receive their training through four essential paths: Diploma in Nursing where one graduates has a three-year certificate from a hospital-based school of nursing. Few of these programs are still there in the U.S., while the fraction of nurses working with a diploma is increasing. Another one is Associate of Science in Nursing where one graduates from a degree-granting nursing program is awarded a degree in nursing. This incorporates two to three years of college level training with a strong emphasis on medical knowledge and skills. A third is Bachelor of Science in Nursing where one studies in a university for four to five years offering a degree with prominence given to research and leadership as well as medically driven courses.

The final course offered is the Generic-entry Master of Science in Nursing where a student graduates from a university after one to three years of study. The university should offer programs leading to the conferment of an MS/MSN degree. This course is offered to students who hold a bachelor's degree or an equivalent in an academic field different from nursing. There are also other special programs called baccalaureate programs that take a shorter time to complete. They are designed for people with undergraduate degrees in fields other than nursing. A normal nursing course at any level includes disciplines such as pharmacology, epidemiology, medication administration, physiology and anatomy, ethics, legal issues in nursing and finally nursing theory. The requirement for the start of practice in the nursing profession is the license delivered after successfully completing the course training in nursing. The courses generally undergone in nursing include Adult medical-surgical nursing, Maternal-child nursing, Geriatric nursing, and Psychiatric nursing.

Legal Regulation

In the past ten years, the government has moved in and started controlling the activities of this profession. The work of the government is to make sure that nurses and their aides do a quality job so that the public is protected. In the US in particular, each state has its own set of rules that regulate nursing, and these laws are known as state laws and regulations and are overseen by State Nursing Boards. Several states have implemented two laws made by the board that regulates nursing. These are Model Nursing Administrative Rules and the Model Nursing Practice Act. Moreover, many nursing boards mould their license requirements known as Uniform Core Licensure Requirements that set aptitude development and assessment ideologies.


In the first quarter of 2013, the stakeholders in the health sector released a report jointly termed as “U.S. Nursing Workforce: Trends in Supply and Education”. The report showed a growth in the salaries paid to full-time (FTE) nurses. In mid 2012, the expected average yearly earnings for a registered nurse in the U.S. was $65,500 and the average wages hourly was $32.70. Compared to Licensed Practical Nurses and being higher for Advanced Practice Nurses, salary ranges are lower for Licensed Practical Nurses, while Advanced Practice Nurses have a higher pay, although this has a wide variation with respect to geography and specialty. According to the report, the salary of a full-time registered nurse was $43,910.16 in 2001 and $63,950.22 in the year of 2011, which showed an increase of about $20,000. A year’s income for a FTE LPN was $27,809.77 in the year of 2001 and climbed to about $12000 in the year of 2011, which was an increase of about $11,500 (HRSA, 2013).

High Demand for Nurses

There has been an increased demand for nurses in US hospitals in the past ten years. This can be attributed to the change from overall care of patients to personalized care. The ailments brought by various changes in climate, pollution and exposure to harmful substances have also increased the number of admittances in hospitals. These factors give an indication that the requirement for nurses will continue rising in the future with an increase of about 23 percent between the years 2006 and 2017. This is a report given by the Department of Labor in the US. Contenders for nursing jobs in highest demand include certified medical assistants, registered nurses, certified nurse assistants, and licensed practical nurses.


In conclusion, the health care sector has changed a lot in the past years owing many factors already defined above. Nursing has become a pillar in this industry supporting many changes that have occurred. Nursing as a profession has also become friendly due to many changes in the sector both in practice and in learning. Many institutions of health have made great strides and transformation in the last decade. These developments have resulted in a speedy rise in theory and growth of technology. Among many changes faced by nursing are, the increase in demand for excellent hospital care, the rising stress for the reduction of operational costs, and expansion of the technological knowhow with regard to nursing.

The most challenging changes in the occupation is the rise in complex ailments that require special attention, decrease in the length of stay in hospital, an ageing populace and improvement of the knowledge of the patients. An increased regulation in the profession has been witnessed owing to various researches done. Management of the health industry is a vital constituent in the relationship because it identifies costs and the theories, and controls the effect of labor supply and the required skills regarding the protection of the public. These issues are a part in any thriving profession. Another change that has arisen is the regulation in nursing. Control of health occupations and professions is a vital component in the relationship because it specifies the required skills, regulates the impact of labor supply and costs and provides assumptions regarding public protection. Like any other industry, there are measurements taken so that costs can be reduced enabling the nursing occupation to become a cheap but reliable profession.

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