Contemporary Nursing and Healthcare Issues

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Nurses in a group photo

Nurses are on the front lines of change within the healthcare system, and change is happening quickly. New regulations that boost access to care and improve outcomes without compromising quality have expanded nursing roles. A paradigm shift in nursing education has encouraged greater critical-thinking and problem-solving skills. The increased use of technology and informatics has changed how nurses function on a clinical level.

As the environment around nursing has evolved, registered nurses (RNs) have adapted. As a whole, the profession has been working to partner with patients and families to administer culturally competent care and optimize the continuum of care. Researchers in Orthopedic Nursing said nurses must be full partners in the continuing efforts to improve patient outcomes.

“There are transformative changes occurring in healthcare for which nurses, because of their role, their education, and the respect they have earned, are well positioned to contribute to and lead,” Susan W. Salmond and Mercedes Echevarria said in “Healthcare Transformation and Changing Roles for Nursing.”

Here are some ways that nursing is changing in response to new technologies and regulations, and some of the opportunities that the field is seeing as a result.

As the Nursing Shortage Continues, New Opportunities Emerge

The nursing shortage is increasing as the population ages and as states enforce stringent new nurse-to-patient requirements. The U.S. Bureau of Labor Statistics estimates that the industry will need an additional 203,700 new RNs each year as healthcare access expands, the population ages, and retiring nurses rotate out of the workforce.

This expansion will be tilted slightly to the west. According to a recent workforce report by the American Nurses Association, “The fastest growth for RNs’ employment is projected in the West and Mountain states and the slowest growth is anticipated in the Northeast and Midwest. But in every state, growth is projected at 11% or more annually through 2022.”

A Physician Shortage Increases the Demand for Highly Specialized Nurses

Nurses aren’t the only healthcare professionals in short supply. In 2018, the Association of American Medical Colleges (AAMC) reported an anticipated shortage of 120,000 physicians overall, including a shortfall of between 14,800 and 49,300 primary care practitioners, by 2030.

The situation opens up opportunities for nurse practitioners.

“Patients may increasingly see nurse practitioners and physicians’ assistants as a substitute for primary care physicians, especially in areas with PCP shortages where scheduling an office visit to a PCP is more difficult,” John Hargreaves, a senior researcher at the Health Care Cost Institute tells U.S. News.

Nurse-to-Patient Regulations Mean Fewer Patients for Some

New staffing laws such as those in California and Massachusetts are setting new healthcare for the country. Since 2015, Massachusetts has required that nurses working in ICUs, burn units, and children’s units, including the NICU, only be assigned up to two patients at a time.

California’s law is more far-reaching. It places RN-to-patient limits on all hospital units, including one-to-one ratios for trauma patients in the ER and for all patients in the OR.

The law has “improved patient care in a variety of domains” and has reduced nursing injuries by more than 30 percent, according to J. Paul Leigh at the Economic Policy Institute.

Similar standards could become federal law. Two laws are under consideration, one in the House of Representatives and one in the Senate. These laws, Amy Blitchok reports for, are “closely modeled after California’s law and are the most promising development in the fight for safe staff-to-patient ratios.”

Patient-Centered Care Creates Opportunities – and Demands

For decades, healthcare professionals worked within a fee-for-service model to deliver care within a provider-based system that lacked accountability and didn’t always produce the best outcomes. Today, in an effort to control costs and deliver high-quality care, healthcare teams are working collaboratively to provide evidence-based care across the entire healthcare system.

For nurses, this trend means:

  • Accurately charting patient care using standard medical terminology.
  • Working across inter-professional teams to properly communicate successes and deficiencies within the system.
  • Taking a holistic approach to care that treats the whole person as opposed to a specific ailment or symptom.
  • Working with patients to guide them toward self-management of their ailments and provide information about the behavioral changes necessary to improve their outcomes.
  • Helping maintain a culture of safety and efficiency at all times.

Technology Will Change Everything – Including Nursing

Informatics, or leveraging technology to improve patient care goals, is touching nursing at every level of care.

As healthcare technology vendor Tiger Connect notes, “clinicians have more access than ever to electronic health records [EHRs], diagnostics, and treatment plans. Clinical communication and collaboration platforms are making it easier to manage healthcare workflows, improve coordination, and enhance patient outcomes.”

Technological, regulatory, and other changes in healthcare will bring both opportunities and challenges. Nurses who earn online nursing degrees can develop the skills and competencies necessary to succeed in this fast-changing environment.

About Duquesne University’s Online MSN program

Duquesne University’s MSN degree program prepares RNs for careers in leadership and to set new standards of care. The university’s online MSN and Post-Master’s Certificate degree programs allow nurses to continue their careers and personal lives while earning an advanced education. The school offers programs in Family (Individual Across a Life Span) Nurse Practitioner, Forensic Nursing and Nursing Education and Faculty Role.

For more information, contact Duquesne University today.




Workforce: American Nurses Association

New Research Shows Increasing Physician Shortages in Both Primary and Specialty Care: AAMC News

Can Nurse Practitioners Help Ease the Growing Physician Shortage?: US News & World Report

In ICU, 2 Patients Per Nurse: Boston Globe

California RN Staffing Ratio Law: Connecticut General Assembly

California’s Nurse-to-Patient Ratio Law Reduced Nurse Injuries by More Than 30 Percent: Economic Policy Institute

Proposed Federal RN Ratios – What You Can Do About It:

Healthcare Transformation and Changing Roles for Nursing: National Center for Biotechnology Information

How Nursing Informatics Improves Patient Care?: TigerConnect

A History of EHRs: Becker’s Hospital Review