Transformation of the Nursing Practice

Transformationof the Nursing Practice


Transformationof the Nursing Practice

Healthcaredelivery has been changing over a period. Different sectors haveundergone reforms with the most recent being the health reformlegislation officiated by President Obama in 2010. Some initiativesaim at reorganizing the nursing industry, its financing processes andthe modes of healthcare delivery. The American Recovery andReinvestment Act of 2009is responsible for some of the reformsexperienced today in the healthcare sector. Although some changesinvolve the provision of healthcare to the American citizen, thesechanges have a direct influence on the nursing practice. Nurses havea critical role to play in the initiation of changes in thehealthcare sector. Nurses are the key players in the delivery ofhealthcare services to the citizens and understand much better whatis to be done to create an efficient system for proper delivery ofservices.

Evolutionof Nursing and Patient Care Delivery

Thenursing practice is transforming at a high rate. There is a need forthe nurses to shift from offering acute care setting and startproviding community-based care to the patients. The healthcaredelivery systems have today shifted from treatment of a singledisease presented by the patient with emphasis on the preventionmethods and offering wellness services to the patients’ health caredelivery models have been reinvented due to the rise in health carecosts and the rising numbers of those in need of the services (Shi &ampSingh, 2014). The officiation of the Legislative Act on patientprotection and affordable care has led to the provision of affordableand equitable healthcare to over thirty million American citizens.

AccountableCare Organizations

TheAccountable Care Organizations (ACO’s), which is a partnershipbetween different players in the delivery of healthcare to patientsin a health facility, make choices on the quality and cost ofhealthcare fee and ensure that the needy are treated at a reducedcost. It ensures that the participants get a bonus and that thequality of care being offered is of the particular quality. It is aunified system that brings the nurses and the physicians together andcoordinates in the delivery of better and affordable healthcare tothe patient (Allender, Rector, &amp Warner, 2013). It is, therefore,important to us, the nurses, to work in collaboration with otherprofessions in the in the delivery of acceptable services to thepatients.


Theevolution also covers the medical homes. These are referred to as thepatient-centered medical homes (PCMH). Today, the medical homes areresponsible for offering primary care practices to the patients in aninter-professional, interdisciplinary and coordinated manner. In suchsettings, different teams have been involved in the delivery of care.The APRNs, a group of physicians and other nurses, are responsiblefor the provision of a continuum of care in the medical homes (Shi &ampSingh, 2014). In such setups, care is organized in a manner thatmeets the patient’s short-term and long-term goals. The homes arealso responsible for ensuring that the patients are followed up toassess their health progress at different stages of life. Nurses havebeen at the forefront of the delivery of care especially wheretransitions of care are required. This move has greatly improved onservice delivery in the field of nursing. The implementation of suchis expected to improve the image of nursing into one that is not onlyconcerned with delivery of care, but also quality care.

TheNurse-Managed Healthcare Clinics

Thisis established sites that offer care to the patients with no regardto their ability to pay for services provided to them. Nurses areresponsible for the delivery of care to the patients in differentcommunities. This move was initiated so as to involve the registerednurse, advanced practice nurses and other health professionalscollaborate in ensuring that the community health is improved andthat the healthcare system saves millions of shillings that would beused in acute and emergency treatment (Allender et al., 2013). Thisservice has also increased chances for employment of graduate andundergraduate students so as to reduce the shortages experienced inthe field. It has reformed the employment rate of nurses by creationof more chances for practice.

Continuityand Continuum of Care

Thisrefers to the shift from offering attention to the acute conditionsin what is known as episodic care to conducting follow ups and havinga patient-nurse relationship. Continuum of care involve interlink ofsystems to offer a patient care through their lifetime across variouslevels of intensive care. This is one of the reforms experienced inthe nursing sector. It is of great benefit to the patient andindicates the nurses’ move towards what the profession calls for.An accommodation and practice of these concepts is expected to befollowed by nurses all over the nation thus improving the image ofnurses in offering the much needed help and holistic care to thepatients.

Feedbackfrom Colleagues on Reforms in Nursing

SarahWhite, a registered nurse for eight years, indicates that she hasgathered more experience in her field and is familiar with the moderndevelopments in the field. She also expressed her willingness inexcelling as a nurse. She believes that in the nursing field, theprofessional should be ready to offer quality care to the patientswith no room for errors. Her primary concern in the area was onmedical records. She suggested that although the current reforms arepleasing, more should be done in ensuring that patients’ recordsare available in electronic form and that a central database isestablished for easy retrieval of patient data when needed. She,however, expresses high hopes for the evolution of nursing andpraised the nurse-managed healthcare clinics.

StephanieJones, a passionate nursing profession, who apparently admitted thatthe reforms being experienced today are of great help not only to thepatient but the whole community. She primarily praised theestablishment of medical homes indicating that such a move wouldcreate more jobs for the young nursing students and that it willincrease the efficacy of service delivery.

EmmieJohnson, a registered nurse with two years of experience in thepractice, noted that she wanted to learn more on Accountable CareOrganization. She projected some questions about it and seemed muchinterested towards a better understanding of the concept. From thedifferent strategies on the evolving trend in nursing, Emmieexpressed concerns of involving in service delivery to the vulnerablerural populations. Emmie suggested that for any reforms to takeplace, the nurses must be ready to take responsibility for initiatingit. She suggested that changes cannot be brought about by merelegislative guides but a collaborative action by the nurses. Sheclearly outlined that nursing is a call and that every nurse shoulddevelop strategies that will help in making the profession morehelpful to large populations. One way that she suggested was bysuggesting on the policies to be amended to favor the transformationsin the nursing field. On the last note, she expressed her remarks inthe interactive session and indicated that she was willing to getassociated with the Accountable Care Organization.

Discussionon the Interaction with the Three Nurses

Interactionswith the three nurses were successful and saw the generation ofproper feedback from all of them. Major areas that were mentioned bythese colleagues included the Accountable Care Organization, medicalhomes, and the nurse-managed healthcare clinics. These are part ofthe major reforms in the nursing and healthcare sector. In the ACO’sfor example, the community is focused on much more than an individualin the delivery of healthcare. Such is facilitated by the strategy bythe Accountable Care Organizations in offering health services to theless fortunate in the community at a subsidized fee. With such amove, the whole community can access health services, therefore,improving the health status of the general population. From both myresearch and what was gained from the feedback, the medical homeshave been of great benefit to the community. It is in this homes thatholistic care is offered to the patient. Such a reform has thereforebeen of much interest and impact in transforming nursing practice.The Patient Aligned Care Systems have also been incorporated in thisfor the provision of quality health care.

Sarahalso mentioned of the nurse-managed health care clinics which shetermed as a major reform towards a wholesome delivery of healthcareservice. These clinics focus on the community in the provision ofservices. They offer free health services to the much vulnerablecommunities. The hospitals provide the communities with an extensiveprincipal care and wellness services for little or no fee at all(Hamrick et al., 2014). The clinics also provide employmentopportunities to graduate and undergraduate students and, therefore,enable them to practice what they are taught in their nursingclasses. It also offers the students with an opportunity to interactwith the community and, therefore, have experience in the fieldbefore they start their profession. This will ensure the graduateshave much experience and become more resourceful even when they getto the actual nursing field.


Reformsin nursing show significant benefits in the delivery of healthcareservices to the patients regardless of their location or socialclass. Legislature partly provides such improvements through therelevant bodies, but the nurses are the key players in theirimplementation.


Allender,J. A., Rector, C. L., &amp Warner, K. D. (2013). Publichealth nursing: Promoting the public`s health.

Hamric,A. B., Hanson, C. M., Tracy, M. F., &amp O`Grady, E. T. (2014).Advancedpractice nursing: An integrative approach.St. Louis, MO: Elsevier/Saunders.

Shi,L., &amp Singh, D. A. (2014). Deliveringhealth care in America: A systems approach.Boston: Jones and Bartlett.