Theoretical knowledge is something that flows through our brain. Practice is what flows through our heart. Studying nursing and trends in healthcare, in general, is the process of absorbing vital information, whereas practicing nursing is the process of applying this precious knowledge to reality in order to become an active participant in these trends, changing healthcare for better. Nursing practice is, thus, a conscious application of theory accompanied and warmed by a highly personal, devoted and caring attitude.
The health care is expected to grow and shift from a costly, highly fragmented system with a vivid segregation of duties towards a cost-efficient, affordable, unified system of care based on enhanced responsibilities of its actors functioning within a highly coordinated, interoperable environment. The revolutionized health care delivery system, and nursing in particular, will be centered around such concepts as accountable care organizations, continuity of care, medical homes, and nurse-managed health clinics. Programs like primary care medical homes or ACOs will rely, I quote: "...on interventions that fall squarely within the scope of practice of nurses" (Sochalski & Weiner, 2010, p. 1).
According to the source, "ACOs are envisioned as locally integrated groups of hospitals, physicians, and other providers that are responsible for the health service needs of a defined population of patients" (Sochalski & Weiner, 2010, p. 5). ACOs will incorporate fully-integrated electronic health records (EHR) as a means ensuring timely and meaningful information sharing. ACOs' care management and coordination strategies will require nurses to be linked to the patient. This link presupposes that nurses are ready for changes of setting which may include hospital to home, home to hospital transitions or shifts from ongoing primary care to out-patient secondary care. Thus, a nurse will have to perform the adjacent functions of the healthcare provider and manager at the same time, being accountable for complexly ill patients' health condition, as well as their coordinated care transitions (Sochalski & Weiner, 2010). This cross-setting transition is the manifestation of care continuity which comprises informational, management and relational continuity (Registered, 2008). The concept of continuity is nothing but the antonym or the fractured care we witness now. To ensure care continuity, a nurse must involve and address patients' families - the indivisible parts of the home site - widening health care from simply physical to psychosocial care (Prevost et al., 2011, p. 22).
As for patient-centered medical homes, they will represent an enhanced model of primary care where special care teams meet the variety of patients' needs providing "whole person comprehensive and coordinated patient-centered care" (Sochalski & Weiner, 2010, p. 3) Another excerpt from the report says: "...the creation of medical homes will demand the production of RNs who can provide and direct interdisciplinary teams in the provision of primary care services" (Sochalski & Weiner, 2010, p. 13). It means that nurses will have to be good team players and team leaders focused on the goal of providing multi-faceted care to their patients.
Nurse-managed health clinics traditionally help the underserved populations. The initiative was put forward to recognize NMHCs as sources of primary care and to expand the coverage of such care to meet the rising demand for it. NMHCs are proved to be "a well-established model that could be expanded" (Kovner & Walani, n.d., p. 1), which means the reformed healthcare can benefit from them. Within NMHCs, nurses will keep performing the wide range of roles of primary care providers, community outreach workers, RNs, health educators, behavioral specialists and collaborating physicians (Montalvo et al., 2011, p. 26).
Nurses are important and indivisible parts of the health care mechanism which means their contribution is just as important as that of doctors or decision makers. In the nearest future, nurses will literally become both of the latter, thus, performing multi-faceted roles of nurses with high technology proficiency as well as extended responsibilities and managerial duties within the highly interoperable and coordinated healthcare environment. In other terms, soon we will get the "nurse-lead and nurse-managed health care" (Norlander, 2011, p. 2). Donna Wilk Cardillo once said: "Nurses are the heart of healthcare" (Quotations, n.d.). Within the framework of the ongoing and planned changes, this claim is quite true. So let us provide health care with a strong heart which beats passionately and beats the leftovers of the old healthcare system on the way of health care to its better future and new form.
Kovner, C. & Walani, S. (n.d.). Nurse-managed health centers. Robert Wood Johnson Foundation: Nursing Research Network. Retrieved from http://thefutureofnursing.org/sites/default/files/Research%20Brief-%20Nurse%20Managed%20Health%20Centers.pdf
Montalvo, W., Torrisi, D., Hansen-Turton, T., & Birch, S. (2011). Nurses close the gap in community health. The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf
Norlander, L. (2011). Transformational models of nursing across different care settings. The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf
Prevost, S., Rushton, C. H., Chrastek, J., & Kirschling, J. (2011). Palliative and end-of-life care transformational models of nursing across settings. The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.thefutureofnursing.org/sites/default/files/Future%20of%20Nursing%20Report_0.pdf
Quotations about nurses. (n.d.). Quotegarden.com. Retrieved from http://www.quotegarden.com/nurses.html
Registered nurse roles that facilitate continuity of care. (2008, September). CARNA. Retrieved from http://www.nurses.ab.ca/Carna-Admin/Uploads/RN_Roles_that_Facilitate_Continuity_Care.pdf
Sochalski, J. & Weiner, J. (2010). Health care system reform and the nursing workforce: Matching nursing practice and skills to future needs, not past demands. The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.nap.edu/catalog/12956.html