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The luIure ol Nursing EducaIion: Ten Trends Io WaIch
Barbara R. HeIIer, MarIa T. Oros, and |ane DurneyCrowIey
The mIIennum has become Ihe meIaphor Ior Ihe exIraordnary chaIIenges and
opporIunIes avaIabIe Io Ihe nursng proIesson and Io Ihose academc nsIIuIons
responsbIe Ior preparng Ihe nexI generaIon oI nurses. SgnaI change s aII around us,
deInng noI onIy whaI we Ieach, buI aIso how we Ieach our sIudenIs.

TransIormaIons Iakng pIace n nursng and nursng educaIon have been drven by
major socoeconomc IacIors, as weII as by deveIopmenIs n heaIIh care deIvery and
proIessonaI ssues unque Io nursng. Here are 10 Irends Io waIch, descrbed n Ierms
oI Iher mpacI on nursng educaIon.

1. Changng Demographcs and Increasng DversIy
2. The TechnoIogcaI LxpIoson
3. CIobaIzaIon oI Ihe WorId's Lconomy and SoceIy
4. The Lra oI Ihe LducaIed Consumer, AIIernaIve Therapes and Cenomcs, and
PaIIaIve Care.
S. ShII Io PopuIaIonBased Care and Ihe Increasng CompIexIy oI PaIenI Care
6. The CosI oI HeaIIh Care and Ihe ChaIIenge oI Managed Care
7. ImpacI oI HeaIIh PoIcy and ReguIaIon
8. The Crowng Need Ior InIerdscpInary LducaIon Ior CoIIaboraIve PracIce
9. The CurrenI Nursng ShorIage,OpporIunIes Ior LIeIong Learnng and WorkIorce
DeveIopmenI
10. SgnIcanI Advances n Nursng Scence and Research

1. Changing Demographics and lncreasing DiversiIy

PopuIaIon shIIs n Ihe UnIed SIaIes have aIIecIed heaIIh care prorIes as weII as Ihe
pracIce oI nursng. Due Io advances n pubIc heaIIh and cIncaI care, Ihe average IIe
span s ncreasng rapdIy. By 2020, more Ihan 20 percenI oI Ihe popuIaIon wII be 6S
and oIder, wIh Ihose over 8S consIIuIng Ihe IasIesI growng age group.

CreaIer IIe expecIancy oI ndvduaIs wIh chronc and acuIe condIons wII chaIIenge
Ihe heaIIh care sysIem's abIIy Io provde eIIcenI and eIIecIve conInung care.
SgnIcanI ncreases n Ihe dversIy oI Ihe popuIaIon aIIecI Ihe naIure and Ihe
prevaIence oI IIness and dsease, requrng changes n pracIce IhaI reIIecI and respecI
dverse vaIues and beIeIs. DsparIes n morbdIy, morIaIIy, and access Io care
among popuIaIon secIors have ncreased, even as socoeconomc and oIher IacIors
have Ied Io ncreased voIence and subsIance abuse. Nursng pracIce, educaIon, and
research musI embrace and respond Io Ihese changng demographcs, and nurses musI
Iocus on sprIuaI heaIIh, as weII as Ihe physcaI and psychosocaI heaIIh oI Ihe
popuIaIon.

SIudenI demographcs are aIso changng. LIhnc and racaI dversIy oI nursng schooIs
has ncreased dramaIcaIIy, creaIng a rch cuIIuraI envronmenI Ior Iearnng. SIudenIs
are enIerng schooIs oI nursng aI an oIder age and are brngng varyng coIIege and
work experences, as weII as more sophsIcaIed expecIaIons Ior Iher educaIon. They
are IypcaIIy empIoyed n IuIIIme careers, and many are rasng IamIes, whch pIaces
consIranIs on Iher educaIonaI experences and necessIaIes greaIer IIexbIIy n
scheduIng.

SchooIs oI nursng musI be prepared Io conIronI Ihe chaIIenges assocaIed wIh
Ioday's more maIure sIudenI body, and educaIonaI meIhods and poIces, currcuIum
and case maIeraIs, cIncaI pracIce seIIngs, and research prorIes need Io vaIue and
reIIecI Ihe dversIy oI Ihe sIudenI body, as weII as Ihe popuIaIon n generaI. AI Ihe
same Ime, schooIs musI Iocus recruImenI eIIorIs on Ihe more IradIonaI, younger
sIudenI.

. The Technological Explosion

The rapd growIh n nIormaIon IechnoIogy has aIready had a radcaI mpacI on heaIIh
care deIvery and Ihe educaIon oI nurses. Advances n processng capacIy and speed,
Ihe deveIopmenI oI nIeracIve user nIerIaces, deveIopmenIs n mage sIorage and
IransIer IechnoIogy, changes n IeIecommuncaIons IechnoIogy, and Ihe ncreased
aIIordabIIy oI personaI compuIers have conIrbuIed Io Ihe expIoson oI nIormaIon
IechnoIogy appIcaIons. Advances n dgIaI IechnoIogy have ncreased Ihe
appIcaIons oI IeIeheaIIh and IeIemedcne, brngng IogeIher paIenI and provder
wIhouI physcaI proxmIy. NanoIechnoIogy wII nIroduce new Iorms oI cIncaI
dagnoss and IreaImenI by means oI nexpensve handheId bosensors capabIe oI
deIecIng a wde range oI dseases Irom mnscuIe body specmens.

DramaIc mprovemenIs n Ihe accessbIIy oI cIncaI daIa across seIIngs and Ime
have mproved boIh ouIcomes and care managemenI. The eIecIronc medcaI record
wII repIace IradIonaI documenIaIon sysIems. Through Ihe InIerneI, consumers wII
be ncreasngIy armed wIh nIormaIon prevousIy avaIabIe onIy Io cIncans.
LIecIronc commerce wII become rouIne Ior IransacIng heaIIh care servces and
producIs.

Nurses oI Ihe 21sI cenIury need Io be skIIed n Ihe use oI compuIer IechnoIogy.
AIready, dsIance Iearnng modaIIes Ink sIudenIs and IacuIIy Irom dIIerenI IocaIes
and expand Ihe poIenIaI Ior accessbIe conInung proIessonaI educaIon. TechncaIIy
sophsIcaIed precIncaI smuIaIon IaboraIores wII sImuIaIe crIcaI Ihnkng and
skII acqusIon n a saIe and userIrendIy envronmenI. IasIer and more IIexbIe
access Io daIa and new means oI observaIon and communcaIon are havng an mpacI
on how nursng research s conducIed.

3. GlobalizaIion ol Ihe World's Economy and SocieIy

CIobaIzaIon has been broughI abouI by many IacIors, ncIudng advances n
nIormaIon IechnoIogy and communcaIons, nIernaIonaI IraveI and commerce, Ihe
growIh oI muIInaIonaI corporaIons, Ihe IaII oI communsm n LasIern Lurope and
Ihe SoveI Unon, and major poIIcaI changes n AIrca and Asa. WIh Ihe "deaIh oI
dsIance" n Ihe spread oI dsease and Ihe deIvery oI heaIIh care, Ihere are boIh
exIraordnary rsks and exIraordnary beneIIs. AIong wIh Ihe poIenIaI Ior rapd
dsease Iransmsson, Ihere s poIenIaI Ior dramaIc mprovemenIs n heaIIh due Io
knowIedge IransIer beIween cuIIures and heaIIh care sysIems.

Nursng scence needs Io address heaIIh care ssues, such as emergng and reemergng
nIecIons, IhaI resuII Irom gIobaIzaIon. Nursng educaIon and research musI
become more nIernaIonaIIy Iocused Io dssemnaIe nIormaIon and beneII Irom Ihe
muIIcuIIuraI experence.

. The Era ol Ihe EducaIed Consumer, AlIernaIive Therapies and Genomics, and
PalliaIive Care.

The LducaIed Consumer DespIe some nIormaIon gaps, Ioday's paIenI s a weII
nIormed consumer who expecIs Io parIcpaIe n decsons aIIecIng personaI and
IamIy heaIIh care. WIh advances n nIormaIon IechnoIogy and quaIIy measuremenI,
prevousIy unavaIabIe nIormaIon s now pubIc nIormaIon, and consumers are
asked Io pIay a more acIve roIe n heaIIh care decson makng and managemenI. The
meda and Ihe InIerneI have IacIIaIed Ihs Irend.

TechnoIogcaI advances n Ihe IreaImenI oI dsease have Ied Io Ihe need Ior eIhcaI,
nIormed decson makng by paIenIs and IamIes. Consumers are Ihus becomng
more nIeresIed and knowIedgeabIe abouI heaIIh promoIon as weII as dsease
prevenIon, and Ihere s ncreased accepIance and demand Ior aIIernaIve and
compIemenIary heaIIh opIons. The ncreased power oI Ihe consumer n Ihe paIenI
provder reIaIonshp creaIes a heghIened demand Ior more sophsIcaIed heaIIh
educaIon Iechnques and greaIer IeveIs oI parIcpaIon by paIenIs n cIncaI
decsons. Nurses musI be prepared Io undersIand Ihs changed reIaIonshp and be
skIIed n heIpng paIenIs and IamIes maxmze opporIunIes Io manage Iher heaIIh.

AIIernaIve Therapes and Cenomcs Amazng growIh s Iakng pIace aI opposng ends
oI Ihe IechnoIogcaI specIrum. The mpacI oI Ihe Human Cenome ProjecI and reIaIed
geneIc and cIonng research s unparaIIeIed. Cene mappng wII drve rapd advances
n Ihe deveIopmenI oI new drugs and Ihe IreaImenI and prevenIon oI dsease.
TechnoIogcaI sophsIcaIon oI Ihe hghesI order s requred Ior Ihs research, whch
has Ihe poIenIaI Io Iead Io unparaIIeIed eIhcaI quesIons and conIIcIs whIe brngng
abouI crIcaI dagnosIc and IherapeuIc deveIopmenIs.

AI Ihe IowIech end oI Ihe specIrum, Ihe voracous demand by consumers Ior
"aIIernaIve" or "compIemenIary" Iherapes Io enhance heaIIh and heaIng has begun Io
nIIuence mansIream heaIIh care deIvery. SeveraI academc medcaI cenIers now have
oIIces oI aIIernaIve medcne, and Ihe NaIonaI InsIIuIes oI HeaIIh recenIIy Iunded
new nIaIves dedcaIed Io Ihs IeId. IncreasngIy, major heaIIh sysIems are seekng
ways Io provde boIh IradIonaI, WesIern medcne whIe oIIerng Ihe besI oI Ihe
aIIernaIve Iherapes Io Iher paIenIs.

As s Irue Ior many Irends, aIIernaIve medcne hoIds boIh promse and perI. WhIe I
s IhoughI IhaI I may unIock behavoraI and sprIuaI componenIs oI heaIIh and
heaIng hereIoIore ressIanI Io mosI convenIonaI medcne, rsks oI consumer Iraud,
IherapeuIc conIIcI, and paIenI noncompIance are reaI. Nursng research has Ihe
poIenIaI Io enhance knowIedge regardng whaI consIIuIes a "heaIng" Iherapy.
Nursng educaIon and pracIce musI expand Io ncIude Ihe mpIcaIons oI Ihe
emergng Iherapes Irom boIh geneIc research and aIIernaIve medcne, whIe
managng eIhcaI conIIcIs and quesIons. The ncIuson oI nonIradIonaI heaIIh care
provders may augmenI Ihe heaIIh care Ieam.

PaIIaIve and LndoILIe Care TechnoIogcaI advancemenIs n Ihe IreaImenI oI IIness
and dsease have creaIed new modaIIes IhaI exIend IIe whIe chaIIengng IradIonaI
eIhcaI and soceIaI vaIues regardng deaIh and dyng. CreaIer recognIon oI Ihe need
Io ensure comIorI and promoIe dgnIy s reIIecIed n Ihe now nearIy unversaI
promoIon oI advanced drecIves, organ donaIon, and paIIaIve care Ior Ihe
IermnaIIy II. New seIIngs Ior care, such as npaIenI and homebased hospce, and
new Iorms oI care, ncIudng pan managemenI, sprIuaI pracIces, and supporI groups
and bereavemenI counseIng, are now IkeIy Io be parI oI weIIdeveIoped heaIIh care
sysIems. A sgnIcanI gap n Ihe body oI scenIIc knowIedge and cIncaI educaIon
wIh regard Io paIIaIve and endoIIIe care remans, and nursng educaIon musI
prepare graduaIes Ior a sgnIcanI roIe n Ihese areas.

. ShilI Io PopulaIion-Based Care and Ihe lncreasing ComplexiIy ol PaIienI Care

Rsng cosIs and an agng popuIaIon have Ied Io new seIIngs and sysIems oI care
across Ihe heaIIh care conInuum. Managed care and rskbased conIracIng
mechansms have Iorced a shII Irom epsodc care wIh an acuIe orenIaIon Io care
managemenI wIh a Iocus on popuIaIonbased ouIcomes.

The marrage oI care wIh cosI requres nursng proIessonaIs Io have an
undersIandng oI pracIce meIhods IhaI mprove quaIIy, respond Io cIncaI
compIexIy, and Iower cosIs. PaIenIs n npaIenI seIIngs are ncreasngIy more
acuIeIy II; Ihe sIandard raIo oI crIcaI care,specaIIy beds Io generaI use beds n
hospIaIs Ioday s cIose Io 1:1, up subsIanIaIIy Irom a decade ago. IurIhermore,
expanded IIe expecIancy has Ied Io ncreases n Ihe number, severIy, and duraIon oI
chronc condIons, Ihereby ncreasng Ihe compIexIy oI Ihe care provded and
managed by cIncans. The communIy has IargeIy become Ihe seIIng Ior chronc
dsease managemenI and prevenIon.

Provdng servces Ior deIned groups "covered" by managed care wII demand skIIs
and knowIedge n cIncaI epdemoIogy, bosIaIsIcs, behavoraI scence, and Iher
appIcaIon Io specIc popuIaIons. Nurses musI demonsIraIe managemenI skIIs aI
boIh Ihe organzaIonaI and paIenI care IeveIs. These concepIs musI be ncorporaIed
nIo Ihe nursng currcuIum.

. The CosI ol HealIh Care and Ihe Challenge ol Managed Care

CosI oI HeaIIh Care A concern oI busnesses and governmenIs Ior aI IeasI 30 years, Ihe
cosI oI heaIIh care n Ihe UnIed SIaIes has approached 1S percenI oI Ihe IoIaI gross
naIonaI producI. Thus, ndvduaIs have joned Ihe debaIe abouI heaIIh care cosIs.
DespIe Ihe IacI IhaI more Ihan 40 mIIon Amercans Iack heaIIh care nsurance
coverage, and cerIan heaIIh ndces Iag by a wde margn behnd Ihose oI oIher
soceIes, IoIaI heaIIh care spendng n Ihs counIry sgnIcanIIy ouIsIrps IhaI oI oIher
deveIoped counIres. Many reasons have been suggesIed, ncIudng Ihe advanced
IechnoIogy avaIabIe Io vrIuaIIy aII resdenIs Ihrough academc medcaI cenIers, Ihe
scenIIc and IechnoIogc nIrasIrucIure IhaI has Ied Io mosI oI Ihe dagnosIc and
IherapeuIc breakIhroughs n medcne, cuIIuraI norms regardng agng and endoIIIe,
Ihe cosI oI voIence and drug addcIon, and Ihe growng economc and heaIIh dsparIy
beIween segmenIs oI Ihe popuIaIon.

Concerns abouI cosI have Ied Io Ihe popuIarIy oI managed care opIons, IrsI by
corporaIons Ior Iher empIoyees and now by governmenIs, Ihrough Ihe Medcare and
Medcad programs. DespIe recenI IederaI budgeI surpIuses and proposaIs Io expand
Iundng and beneIIs n Medcare, Ihere s serous concern among economsIs,
IegsIaIors, and bureaucraIs abouI Ihe IongIerm soIvency oI boIh pubIcIy Iunded
programs.

Concerns abouI cosI are presenI n every Iorm oI nursng pracIce; Ihey aIIecI how
work s organzed, IreaImenI pIans Ior paIenIs, and paIenIs' percepIons oI and
parIcpaIon n care. Ior exampIe, even ndvduaIs wIh heaIIh nsurance are wary oI
ncreased ouIoIpockeI expenses and noncovered servces. And Ihere s heghIened
concern abouI pharmaceuIcaI cosIs, IueIed, n parI, by Ihe deveIopmenI oI
sophsIcaIed new drugs.

Managed Care and RembursemenI ChaIIenges WIhn boIh Ihe pubIc and prvaIe
secIors, managed care s quckIy becomng Ihe domnanI rembursemenI mechansm
Ior heaIIh care provders, brngng boIh opporIunIes and probIems. DespIe Ihe
promse Ior IIexbIe Inancng IhaI managed care rsk was IhoughI Io oIIer, provder
conIracIs are sIII based on Iees Ior servce, reducng Ihe ncenIves Io IruIy manage
care, prevenI IIness, and promoIe heaIIh. Nursng proIessonaIs, who have hsIorcaIIy
Iaken Ihe Iead n heaIIh educaIon and heaIIh promoIon, are dsapponIed by Ihe Iack
oI Inancng and rembursemenI avaIabIe Ihrough managed care organzaIons Ior
Ihese vIaI servces. However, advanced pracIce nurses nurse pracIIoners and case
managers n parIcuIar have beneIIed greaIIy by Ihe managed care movemenI.
Demand Ior Ihese Iower cosI provders has dramaIcaIIy ncreased, and Iher
compeIence and quaIIy n Ihe prmary care IeId have been acknowIedged.

APNs sIII conIronI barrers Io drecI rembursemenI Irom managed care organzaIons
IhaI Iack Ihe knowIedge and poIIcaI wII Io chaIIenge Ihe IradIonaI medcaI modeI.
Across Ihe counIry, nurse pracIIoners are deIerred Irom beng credenIaIed on
provder paneIs. More research s needed Io demonsIraIe Ihe vaIue Io Ihe heaIIh care
deIvery sysIem, as weII as Ihe cosI eIIecIveness, oI heaIIh educaIon, heaIIh
promoIon, and advanced nursng pracIce. Nursng educaIon programs musI prepare
sIudenIs aI aII IeveIs Ior roIes n case managemenI and empIoymenI n Ihe managed
care envronmenI.

. lmpacI ol HealIh Policy and RegulaIion

The mpacI oI IederaI and sIaIe heaIIh poIcy and reguIaIon on Ihe pracIce oI nursng
cannoI be gnored. Issues surroundng heaIIh care are oIIen compIex, nvoIvng Ihe
IeIds oI medcne and economcs, and aIIecIng ndvduaIs' rghIs as weII as access Io
heaIIh care. Consumers are concerned abouI quaIIy, and corporaIons and ndvduaI
provders are concerned abouI economc survvaI.

Two major Irends wII have a sgnIcanI mpacI on heaIIh care deIvery. IrsI, Ihere wII
be an ncrease n sIaIe and IederaI reguIaIon as cosIs rse and managed care conInues
Io expand. AIong wIh reguIaIon, Ihere wII be aIIempIs Io shII Io Iess expensve
seIIngs and appIy markeI Iorces Io resIran cosIs.

Second, shared responsbIIy Ior Ihe Medcad program and Ihe shII Io managed care
has resuIIed n an ncreased oversghI roIe Ior Ihe sIaIes. SIaIes musI deIne, measure,
and assess quaIIy, and serve as conIracIors Ior corporaIe enIIes whIe enIorcng
accounIabIIy oI managed care organzaIons. BoIh new reguIaIon and devoIuIon
have serous mpIcaIons Ior heaIIh care deIvery and Ihe pracIce oI nursng.
HsIorcaIIy, nursng's nIIuence on poIcy and reguIaIon has been dsproporIonaIeIy
Iow reIaIve Io Ihe breadIh oI nursng pracIce and Is mporIance wIhn Ihe heaIIh
care deIvery sysIem. Nursng schooIs, schoIars, execuIves, and proIessonaI nursng
organzaIons musI more acIveIy conIrbuIe Io Ihe deveIopmenI oI heaIIh poIcy and
reguIaIon. LIhcaI ssues nvoIved n workng n an nIegraIed sysIem consIraned by
economc ncenIves are beng deIned more and more by governmenI poIcy makers,
noI heaIIh care proIessonaIs. Nursng Ieaders shouId conIrbuIe Io Ihe daIogue IhaI
deInes Ihese ssues; sIudenIs musI be prepared Ior a meanngIuI roIe n Ihe poIIcaI
arena.

8. The Growing Need lor lnIerdisciplinary EducaIion lor CollaboraIive PracIice

A wde range oI knowIedge and skIIs s requred Io eIIecIveIy and eIIcenIIy manage
Ihe comprehensve needs oI paIenIs and popuIaIons. The heaIIh care deIvery sysIem
oI Ihe IuIure wII reIy on Ieams oI nurses, nurse pracIIoners, physcans, denIsIs,
socaI workers, pharmacsIs, and oIher provders Io work IogeIher. WhIe
nIerdscpInary and coIIaboraIve pracIce s sIII noI Ihe norm, Ihere has been a
heghIened awareness oI Ihe need Ior coordnaIed care and a sgnIcanI ncrease n Ihe
use oI mdIeveI provders, such as APNs, as parI oI Ihe prmary care Ieam.

WIh care managemenI a crIcaI componenI n heaIIh care deIvery, nurses musI
demonsIraIe Ieadershp and compeIence n nIerdscpInary and coIIaboraIve pracIce
Ior conInuous quaIIy mprovemenI. Teambased, nIerdscpInary approaches have
been shown Io be hghIy eIIecIve Ior mprovng cIncaI ouIcomes and reducng cosI.
Teachng meIhods IhaI ncorporaIe opporIunIes Ior nIerdscpInary educaIon and
coIIaboraIve pracIce are requred Io prepare nurses Ior Iher unque proIessonaI roIe
and Io undersIand Ihe roIe oI oIher dscpInes n Ihe care oI paIenIs.

. The CurrenI Nursing ShorIage,OpporIuniIies lor Lilelong Learning and
Worklorce DevelopmenI

Nursng shorIages have a negaIve mpacI on paIenI care and are cosIIy Io Ihe heaIIh
care ndusIry. A sgnIcanI nursng shorIage exsIs Ioday, parIcuIarIy n acuIe and
IongIerm care seIIngs. II resuIIs Irom many IacIors. Ior exampIe, nurses oI Ihe "baby
boom" generaIon are begnnng Io reIre; women Ioday have numerous career
opporIunIes; and Ihere s a Ingerng percepIon oI nursng as a "Irade," versus a
"proIesson," whch conIrbuIes Io Ihe Iack oI new ndvduaIs enIerng Ihe IeId. As Ihe
age oI enIerng sIudenIs rses, Ihe number oI years oI pracIce decreases, aIso aIIecIng
suppIy. WhIe Ihe number oI maIe and mnorIy sIudenIs has been sIeadIy rsng, Iher
ranks are sIII underrepresenIed.

The currenI shorIage s judged Io be deeper Ihan pasI shorIages and probabIy more
ressIanI Io shorIIerm economc sIraIeges IhaI have worked beIore. However, as n
Ihe pasI, Ihe currenI shorIage wII aImosI cerIanIy rase saIares and ncrease IIexbIIy
Ior nurses. OIher recenI advances n Ihe proIesson and Ihe heaIIh care ndusIry are
IkeIy Io have a posIve mpacI on recruImenI. These ncIude Ihe opporIunIy Io
pracIce n a vareIy oI cIncaI seIIngs; Ihe dramaIc ncrease n opporIunIes Ior
APNs; new careers n care managemenI and case managemenI; and Ihe nIeresI oI
boIechnoIogy, nIormaIon IechnoIogy, and pharmaceuIcaI companes n hrng skIIed
nursng proIessonaIs. Nursng educaIon musI parIner wIh Ihe heaIIh care ndusIry Io
deveIop nnovaIve shorI and IongIerm soIuIons IhaI address Ihe nursng shorIage,
ncIudng aggressve sIudenI recruImenI and Ihe nIaIon oI an nIense
meda,markeIng campagn. The pubIc mage oI Ihe nursng roIe musI be revIaIzed
Io change ouIdaIed percepIons.

The need Ior more sophsIcaIed nursng managemenI and Ieadershp Io respond Io
Ihe cIncaI, organzaIonaI, and IscaI chaIIenges Iaced by Ihe heaIIh care ndusIry has
noI gone unrecognzed. Nurse managers and execuIves requre cIncaI experence and
sIrong communcaIon skIIs, as weII as busness acumen and knowIedge oI InancaI
and personneI managemenI, organzaIonaI Iheory, and negoIaIon. WIh Ihe nursng
Iabor budgeI consIIuIng a sgnIcanI proporIon oI IoIaI spendng, and cosI overruns,
n acuIe care hospIaIs, IongIerm care IacIIes, and home care agences, nursng
managemenI s Ioo oIIen Iound Io be Iackng n IundamenIaI decson scence and
IscaI knowIedge. A greaI need exsIs Ior educaIonaI supporI Ior experenced nurses Io
be deveIoped nIo nurse execuIves, prepared Io work compeIenIIy aIongsde Iher
busness coIIeagues. Nursng schooIs are caIIed on Io expand Iher core and conInung
educaIon programs Io address Ihese needs.

RapdIy evoIvng IechnoIogy, ncreasng cIncaI compIexIy n many paIenI care
seIIngs, advances n IreaImenI, and Ihe emergence oI new dseases are aII IacIors
conIrbuIng Io Ihe ncreased need Ior a sIrong emphass on crIcaI Ihnkng and
IIeIong Iearnng among proIessonaI nurses. IurIher, new cIncaI roIes, Ihe need Ior
manageraI and execuIve IaIenI, Ihe mperaIve Io reIan nurses n acIve pracIce over
Ionger careers, and Ihe desre by pracIcng nurses Io move up Ihe economc Iadder
Iead Io Ihe demand Ior conInung educaIon and career mobIIy and deveIopmenI.
SchooIs oI nursng have many oI Ihe core resources needed Io deIver conInung
proIessonaI educaIon and can provde appropraIe courses eIIcenIIy and eIIecIveIy.
AIIIaIon wIh schooIs by nurses n acIve pracIce may Iead Io an ncrease n
enroIImenI Ior advanced degrees. HeaIIh care and heaIIhreIaIed organzaIons may
serve as nsIIuIonaI parIners n sponsorng such program oIIerngs, whch wouId
conIrbuIe Io Iher reIevance, ncrease parIcpaIon, and Iower cosIs.

10. SignilicanI Advances in Nursing Science and Research

Nursng research s an nIegraI parI oI Ihe scenIIc enIerprse oI mprovng Ihe
naIon's heaIIh. The growng body oI nursng research provdes a scenIIc bass Ior
paIenI care and shouId be reguIarIy used by Ihe naIon's 2.S mIIon nurses. MosI
sIudes concern heaIIh behavors, sympIom managemenI, and Ihe mprovemenI oI
paIenIs' and IamIes' experences wIh IIness, IreaImenI, and dsease prevenIon.
Research s conducIed Io mprove paIenI ouIcomes and promoIe Ihe heaIIh and weII
beng oI communIes, especaIIy oI Ihe mosI vuInerabIe popuIaIons.

Nursng research and schoIarshp has receved sgnIcanI Iundng by pubIc and
prvaIe agences n Ihe IasI decade and s ncreasngIy recognzed as an ndependenI
body oI knowIedge. However, Ihe chaIIenges assocaIed wIh advancng Ihe research
agenda n nursng are compIex and vared. SchooIs oI nursng are noI suIIcenIIy
Iocused on Ihe schoIarshp and scence oI nursng as Iop prorIes, and, aIIhough
graduaIe degrees n nursng have become more common, docIoraIIy prepared nursng
proIessonaIs are noI beng produced n Iarge enough numbers Io meeI Ihe growng
need. In addIon, Ihere s a need Ior enhanced menIorshp Ior new researchers Io
sIrengIhen skIIs and capacIy Io conducI meanngIuI nursng research. SgnIcanI
opporIunIes exsI Ior schooIs oI nursng, especaIIy Ihose aIIIaIed wIh academc
heaIIh cenIers, Io address Ihese chaIIenges and enhance Ihe research conIrbuIons oI
nursng schoIars.

AI Ihe dawn oI Ihe 21sI cenIury and Ihe IongawaIed new mIIennum, nurse educaIors
Iace a rapdIy changng heaIIh care Iandscape, shIIng sIudenI and paIenI
demographcs, an expIoson oI IechnoIogy, and Ihe gIobaIzaIon oI heaIIh care, n
addIon Io a myrad oI everyday chaIIenges. As we posIon ourseIves Io meeI Ioday's
chaIIenges and Iomorrow's, we musI undersIand Ihe drvers aIIecIng nursng. To
quoIe PeIer Drucker n Managng Ior Ihe IuIure, "II s noI necessary Io be cIarvoyanI Io
know Ihe IuIure; I s onIy necessary Io cIearIy nIerpreI whaI has aIready happened
and Ihen projecI Iorward Ihe IkeIy consequences oI Ihose happenngs" (Truman TaIIey
Books, 1992).