It was the mid 1990s. The highly regarded nurse speaker, Tim Porter-O’Grady, DM, EdD, ScD (h), APRN, FAAN, FACCWS, came to our hospital to speak to the nursing leadership group about change, the future, innovation, and the role of nursing within this paradigm. He made a point of saying that nurses need to be more proactive than reactive within healthcare. This was around the time that technology was making its way into the daily lives of staff practicing in the acute care setting. Computers and electronic medical records were the focus. Porter-O’Grady addressed the more mature nurses in the audience. To paraphrase his remarks, he said something like the following.
Computers are coming whether you like it or not. They will be a huge part of your life at work, and their arrival is only the tip of the iceberg. The changes ahead of us are formidable mostly due to advances in health care technology. So, you have a choice. You can dig your heels in and keep your reactive way of being or you can proactively embrace what’s coming and get ready for a much different nursing future.
This statement was made over two decades ago. His remarks and predictions certainly have proven to be accurate. So, based on what we currently are seeing now in our workplaces, what can we envision in the next decades?
Here is what I think.
Wearable technology (many prototypes of such have already been created by the military) will prevail. This will facilitate communication of vital signs and other physiological parameters such as oxygen saturation remotely into centralized databases for monitoring and decision making. Genetic advances will continue to impact cancer treatment with the possibility that genetic discoveries will be able to stop cancer’s evolution in its’ tracks.
Choices about the ideal treatment regimen for a patient may be made by computers, not physicians. Drugs will increasingly be administered via non-invasive routes, with topical, intranasal, mucosal, and oral administration being the norm. This will require fewer infusion nurses and more staff to oversee adherence not only to medications but also to screening and follow up. With this, we can expect in the future that nurses will be paid for what they know, not for what they do. The ability to motivate and promote positive health-related behaviors will hopefully be compensated. Evidence-based algorithms generated by computers will dictate optimum interventions rather than physician-derived prescriptions. Those who chose not to adhere to wellness guidelines may pay higher insurance premiums.
What do you think about these crystal ball projections? The one thing I can be certain about is this: Just as we look back two decades and see enormous change between how we practiced in 1995 and how we practice in 2020, we must expect comparable change in the coming decades.