Don’t be shocked by the new

Technological advances and role developments are transforming urgent care services. Jeff Solheim explains why emergency nurses should embrace these changes.

Technological advances and role developments are transforming urgent care services. Jeff Solheim explains why emergency nurses should embrace these changes.

I do not have a crystal ball and so cannot foresee what the future will bring, but I do know what happened in the past and that history tends to repeat itself. I can therefore make some educated guesses about what 2016 holds for emergency nurses in the US.

Over recent years there has been a rise in the number of nurse practitioners, from about 106,000 (Agency for Healthcare Research and Quality 2011) in 2010 to more than 200,000 (American Association of Nurse Practitioners 2014) today.

Hand-held devices have changed the way nurses work and healthcare services over the past ten years

Independent nurses provide cost-effective care and their number is likely to increase further over the coming years. It is easy, therefore, to imagine that responsibility for primary care will shift from medicine to nursing to allow clinical practitioners to focus on specialty care.

As the new millennium progresses, evidence-based practice will become increasingly important, and it has been exciting to see nurses conduct more nursing research and incorporate evidence-based practice into their care. This emphasis on high-quality, evidence-based care is set to grow, and nurses will continue to lead the development of research programmes that are specific to nursing practice.

It has been some years since the Institute of Medicine (2010) recommended that nurses become partners with physicians and other healthcare professionals in the redesign of healthcare services. Nurses have met this challenge, and have begun to seek and accept leadership roles at local, state and even federal levels.

Although there is still much to accomplish in this area, I hope nurses will continue to pursue and accept leadership roles that will help shape, not only nursing but health care as a whole.

Technological developments, such as the internet, hand-held electronic devices and telemedicine, have also changed healthcare services enormously over the past ten years.

Further developments, such as the integration of technology and the body, is advancing wound healing and prosthetics. Meanwhile, drugs are being developed or improved to reduce side effects and treat diseases more effectively.

Staff shortages

However, nursing may have to face old foes again. Not many years ago, healthcare services was threatened by staff shortages.

The situation was alleviated when the US economy took an unexpected downturn and many nurses chose to remain in their jobs for longer than they had intended due to financial concerns.

The nursing shortage was temporarily alleviated, but the underlying problem of an ageing workforce remains. As a result, the American Association of Colleges of Nursing (2014) has warned that, as the US economy improves, staff shortages will return, with an estimated shortfall of 260,000 nurses by 2025. Meanwhile, mandatory overtime and understaffing do little to improve workplace morale and patient care.

Of course, the economy is unpredictable and things could change again, but healthcare needs must be balanced with nursing supply to ensure that healthcare services have a healthy future.

Emergency nurses see a wide range of patients with varied complaints across entire lifespans. These patients, can change from hour to hour, just as emergency nursing changes from year to year.

Many emergency nurses say they were drawn to the specialty precisely because the work is characterised by change, yet in my experience they also often long for stability. This is understandable but emergency nurses should try to embrace change rather than resist it.

Find out more

Solheim J (2016) Emergency Nursing: The Profession, the Pathway, the Practice. Sigma Theta Tau International, Indianapolis IN.

About the author

Jeff Solheim is emergency nurse, and founder and executive director of the humanitarian organisation Project Helping Hands.


Agency for Healthcare Research and Quality (2011) Primary Care Workforce Facts and Stats No. 2. AHRQ, Rockville MD.

American Association of Colleges of Nursing (2014) Nursing Shortage. (Last accessed: February 4 2016.)

American Association of Nurse Practitioners (2014) NP Fact Sheet. (Last accessed: February 4 2016.)

Institute of Medicine (2010) The Future of Nursing: Leading Change, Advancing Health. (Last accessed: February 4 2016.)

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