The Evolving Role of Nurses in US Healthcare Delivery

This report examines the evolving role of nurses within the restructuring US healthcare delivery system. The assignment begins with an informal presentation outlining the shift towards coordinated, integrated, and continuous care, emphasizing the significance of nurses in achieving these...Read More

Assignment
US health care
Answer to Question 1
The country like the United States of America aims to remodel the health care delivery
system embracing a strategical and innovative approach of coordinated, integrated and
continuum of care for the wellbeing of people (Jenkins et al., 2015). Nurses play a significant
role as they can approach the patients in a holistic manner and undertake the detailed
assessment and follow-up care of patients. In order to set the goal of the continuum and
accountable care for the patients, with complex and chronic conditions, there should be
adequate staffing (Uijen, Schers, Schellevis & van den Bosch, 2011).
To ensure that all patients in America have access to the required healthcare services,
the unique contributions of the nurses are maximized, federal and government actions are
updated. It has also standardized the scope of the rules of practice to take advantage of the
potential and training of APRNs. Insurance companies and States has to follow certain
policies and implement financial changes that give patients the freedom to choose from a
range of providers, including APRNs. Removing policies and financial barriers to promote
patient choice and patient-focused care should be a basis for building a reformed care system
("Nursing associates’ role distinct from nurses’, says government", 2016).
Accountable care organisation consisting a group of hospitals, doctors and other
caregivers, medical homes, nurse-managed health clinics come together to deliver high-
quality care ensuring the patient is continuously getting the right care in the right time.
Clinical nurses and care givers would foster a team approach that encourages sharing health
practices and disseminate their ideas and opinions to the patients and community people.
Community health nursing concept have a good knowledge and partnership with the
community people and the care provider and also the understanding of a theoretical concept
like demography of the community is relevant. The care and healing service will be more
significant as nurses get chances to look after the vulnerable groups. Nurses would play an
important role in instilling a sense of health awareness that can improve lifestyle related
behavioural changes in the community. Clinical care which involves medical check-up,
treatment and remedies would be provided to individual and/or family through proper
screening and surveillance. The new strategic outlook taken by the government would make
the nursing profession more promising and challenging with a view to empowering the nurses
to control over the health care delivery system.
The demands for more nursing staff are increasing and their practices are expected to
grow and change. They should be properly educated with nursing management and nursing
informatics to improve their visionary attitude from a technological perspective. They can
analyze patient’s illness based on statistical data of socio-economic conditions, family history
and other aspects that can accurately sort out the causation of illness. The innovative
technological approach like telemedicine functions and remote monitoring can develop the
concept of a continuum of care (Vandyk, Graham, VanDenKerkhof, Ross-White & Harrison,
2013). Patients who suffer from chronic illness like hypertension, diabetes, stroke, heart
attack get relieved as they are continuously being cared by the disease management and
health information system (Jenkins et al., 2015). Accountable care system (ACS) (Sheingold

& Hahn, 2014) also educate nurses on case management studies. The skills that are required
in this regard are emotional intelligence, visionary attitude and commitment to the work
environment (Woods, Lanza, Dyson & Gordon, 2013).
To formulate the innovative transitional care system, the health care delivery system
would have more credential by virtue of its responsibilities (Redman, Pressler, Furspan &
Potempa, 2015).
Nursing job is a noble profession. Nurses can show their best leadership in social
transformation as they always engage themselves with diverse people. As the country
focusses on the restructuring of US health care delivery system, it initiates positive changes
in the advancement of a nursing career with the tremendous expansion of their working area
including hospital set up as well as community setup. The Government aims to provide the
integrated cost-effective continuous care for better patient outcome, decreased mortality,
higher patient’s satisfaction and shorter duration to stay in the hospital. Ensuring alignment of
nursing resources with cross-continuum health care delivery give a progressive outlook for
more professional achievement within the model context and scenario.
Answer to Question 2
As per the feedback shared by the first nurse, it sounds like with my presentation.
According to her view lack of finance and lack of partnership between health service
organisation is responsible for poor coordination that creates barriers in the American
Healthcare System. The concept of a continuum of care would encourage professional nurses
to meet the challenges of health service operation confidently. As they would be empowered
by a government organisation. The community nursing would foster a high-quality health
care service with continuous interaction with the community people (Redman, Pressler,
Furspan & Potempa, 2015). They can visit the patient’s home and approach them to improve
their lifestyle and behavioural changes. The patients having serious health issues would
continuously care in a homely atmosphere with the supervision of a team of certified
educated and experienced nurses. It helps the nurses to expand their working area and types
of working relating to health service showing their professional potentiality (Pittman, Bass,
Hargraves, Herrera & Thompson, 2015). They not only focus on the disease prevention
operation but also on the assessment of the whole community. The elderly people suffering
from degenerated diseases have been frequently neglected. Accidents that are occasionally
happened does not steadily handle. For these reasons, community nursing will be embraced
by ordinary people to get the quality of service at the right time.
As per the feedback shared by the second nurse colleague, it is revealed that the
people of the United States are overburdened with un-estimated health care expenditure. The
policy can remove these existing complexity. This innovative policy is totally a patient-
centric approach and makes the transition to sustainability in health care development
process. The nurse-managed health clinics (NHMC) (Pittman, Horton, Terry & Bass, 2014)
would have a positive implication as there would be an increase in federal and state funding.
It would encourage to reinforce their common interest and the co-operation and collaboration
on health service would multiply many times. The issues like job dissatisfaction, burnout and

nurse turnover may be reduced. The uninsured patients would also be benefited by this
policy.
As per the feedback shared by the third nurse colleague, it sounds alert on the safety
and security of the nurses. Due to the restructuring of the health service delivery system, the
nurses would be the primary contributor and the pattern of their health care system is going to
change. The concept of a continuum of care would enable the nursing staff treating the
patients continuously and consistently. They would not be confined to hospitals or clinics.
Their workforce will be tremendously expanded outside the hospital setting. My colleague
has opined that the regulation of appropriate government legislation should be maintained for
the safety and security of the nursing staff as they have to face different types of unfavourable
situations. The various difficulties related to demography, ageing, alcoholism, violence drug
addiction or being aloof from the accustomed environment can hinder their work spirit or
potentiality. Although education and experience can mitigate all challenges faced by them,
several safety measures like duress alarm for a staff member, hidden cameras are the key
solutions to tackle unpleasant situations. The nurses do not tolerate any abuse or aggression
towards themselves maintaining the patient’s dignity and decision simultaneously. There
should be easy access to the Health Complaints Commissioner’s Office to help the nurses
resolve all complaints (Eastman, 2016).
The safety of the nursing staff due to workplace induced injury and illnesses can also
hamper while on the job. When the nurses are found to be at risk, they can be correlated with
one another and develop the network of integrated, cohesive health service system driven by
various stakeholders. They can maintain a distant monitoring system and twenty-four hours
telephonic talk to get attached with their patients.
It is pertinent to say that the comprehensive approach taken by the Government of the
United States for the accessibility of all citizens of health care delivery is the most innovative
approach that I have ever seen.
References
Eastman, P. (2016). IOM Report Assesses Progress in Readying Nursing Workforce for
Health Care Challenges. Oncology Times, 38(1), 3-5. doi:
10.1097/01.cot.0000479754.39559.8c
Jenkins, M., Ford, J., Todd, A., Forsyth, R., Morris, J., & Roberts, C. (2015). Women׳s views
about maternity care: How do women conceptualise the process of
continuity?. Midwifery, 31(1), 25-30. doi: 10.1016/j.midw.2014.05.007
Nursing associates’ role distinct from nurses’, says government. (2016). Nursing
Management, 22(10), 6-6. doi: 10.7748/nm.22.10.6.s4
Pittman, P., Bass, E., Hargraves, J., Herrera, C., & Thompson, P. (2015). The Future of
Nursing. JONA: The Journal Of Nursing Administration, 45(2), 93-99. doi:
10.1097/nna.0000000000000167

Pittman, P., Horton, K., Terry, M., & Bass, E. (2014). Residency Programs for Home Health
and Hospice Nurses. Home Health Care Management & Practice, 26(2), 86-91. doi:
10.1177/1084822313511457
Redman, R., Pressler, S., Furspan, P., & Potempa, K. (2015). Nurses in the United States with
a practice doctorate: Implications for leading in the current context of
health care. Nursing Outlook, 63(2), 124-129. doi: 10.1016/j.outlook.2014.08.003
Sheingold, B. H., & Hahn, J. A. (2014). Medical Homes and Accountable Care
Organizations: Innovation for the Delivery System of the Future. Policy and Politics
for Nurses and Other Health Professionals, 223.
Uijen, A., Schers, H., Schellevis, F., & van den Bosch, W. (2011). How unique is continuity
of care? A review of continuity and related concepts. Family Practice, 29(3), 264-
271. doi: 10.1093/fampra/cmr104
Vandyk, A., Graham, I., VanDenKerkhof, E., Ross-White, A., & Harrison, M. (2013).
Towards a conceptual consensus of continuity in mental healthcare: focused literature
search and theory analysis. International Journal Of Evidence-Based
Healthcare, 11(2), 94-109. doi: 10.1111/1744-1609.12024
Woods, L., Lanza, A., Dyson, W., & Gordon, D. (2013). The Role of Prevention in
Promoting Continuity of Health Care in Prisoner Reentry Initiatives. American
Journal Of Public Health, 103(5), 830-838. doi: 10.2105/ajph.2012.300961