Guiding Principles

By Pamela Thompson

Even though we don't know what future patient care models will require, we have to act now

There is an old but familiar adage, "May you live in interesting times." Certainly, that applies to health care. Each day we are sculpting the shape of our future patient care delivery system, but its shape is ill-defined and we really don't know what it will look like in the end.

We do make some assumptions. By 2010, there will be inadequate numbers of health care workers to deliver care using the same models that we use today. Advances in information management, therapeutics and technology are dramatically altering the care required. Linear thinking is giving way as we embrace the science of chaos theory and complex adaptive systems.

We have many questions about what the future will require, but we cannot wait until we have all the answers. We must begin to experiment and act now. One of the most important tasks is to define the work of the future, and then we can identify the roles and competencies that we will need to do that work.

The American Organization of Nurse Executives addressed this challenge and asked the question: "What are the principles that can guide us as we define future patient care delivery models and who is the nurse that will be providing care to our patients in the future?" A task force addressed this question and created seven principles. These principles are now being disseminated with hopes that they will stimulate conversations that will help define our future.

1. The actual work of nurses will change in the future, but the core values of caring and knowledge will remain.

2. The care provided will be decided in partnership with the patient.

3. The knowledge base of the nurse will shift from "knowing" a specific body of knowledge to "knowing how to access" the ever-changing information needed to manage care.

4. Processing the information accessed will expand the nurse's use of "critical thinking" to "critical synthesis," coordinating and negotiating care across multiple levels, disciplines and settings.

5. The knowledge that is leveraged and the care provided are grounded in the relationships between the patient and the multidisciplinary team.

6. Relationships with patients will be dramatically altered by the increased application of technology, requiring that we further define the relationship context as being "virtual" or "physical" and knowing when each is required.

7. The ultimate future work of the nurse will be to partner with the patient/client to help them manage their individual journey of care.

Seven simple principles, but they will become the platform for the conversations that will guide us as we sculpt the future.

Pamela Thompson is CEO, American Organization of Nurse Executives, Washington, D.C.

Contact guest author at pthompson@aha.org

This article 1st appeared in the July 2004 issue of HHN Magazine.

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