Challenges for Nursing in the 21st Century

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Executive SummaryNursing has and continues to face significant challenges to its identity and sustainability due to prevailing forces of economics and demographics and due to the professional and political response of the profession to date.While the 1990's Pew Commission report on nursing missed the mark by predicting an oversupply of nurses, it did call for increasing accessibility and affordability of education, developing integrated education and practice models, strengthening clinical ladders, and increasing the points of entry into the profession.Despite this prophecy, nursing education remains hospital-centric when the majority of health care is delivered outside the acute care setting.Future educational models should emphasize more sophisticated methods of problem solving and analytical skills rather than attempting to teach an increasingly complex body of knowledge.Similarly, care delivery models should emphasize radical redesign instead of incremental layering of tasks that are quickly becoming unmanageable.The interdependency of constructs driving nursing education and practice need to be radically redefined, not just retro-fitted, to keep pace with the uniquely different challenges apparent in health care today.

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