Nursing: Today and Beyond

The U.S. health care system should always overcome some issues to provide patients with a decent degree of care delivery. Since this system is a versatile phenomenon, these issues are of different levels. This information means that every hierarchical layer of the health care industry is forced to meet its peculiarities, and nursing is not an exception. Thus, representatives of the nursing profession should handle various challenges, implement some changes, and have corresponding competencies.

Three Challenges for Nurses

Nurses perform essential functions in the health care industry, delivering care to patients and completing some management tasks. Since these staff members have many responsibilities, it is clear that they face specific challenges. There are ethical, legal, financial, and social issues, and each of them can be overcome in a particular way. Thus, below are three issues that influence the nursing profession and the working performance of individual nurses significantly.

Aging of the Baby Boom Generation

This issue refers to the fact that the United States is going to meet more seniors. According to Buerhaus, Skinner, Auerbach, and Staiger (2017), it is a consequence of “the baby boom from 1946 to 1964” (p. 40). As a result, the number of aged people who are in need of medical service is going to double or even triple in a few decades (Buerhaus et al., 2017). Thus, it is a crucial issue for nurses, which increases both the intensity of the nursing care required and the demand for educated nurses. To handle the situation above, nurses should form partnerships with social workers, physicians, pharmacists, and others, rather than reckon on their education. Such a comprehensive approach only can help nurses cope with the aging of the baby boom generation.

Shortage of Physicians

Even though this issue does not seem to relate to nurses directly, it does. Buerhaus et al. (2017) state that there will be “a shortage of 24,000 primary care physicians by 2025” (p. 41). There are many reasons for this phenomenon to occur, but it is of primary significance to understand whether and how this will affect nurses. Thus, it will make nurses perform additional duties on behalf of physicians. The most effective way to overcome this issue is to have nurses prepared for future challenges, and it refers to both nurses’ skills and legislative regulations. The case is that there are some norms and laws that limit nurses’ responsibilities significantly (Buerhaus et al., 2017). If they were absent, however, nurses would get the necessary training to meet the physician shortages in the future successfully.

Retirement of Registered Nurses

In the health care industry, registered nurses perform many significant functions, and it is difficult to overestimate their role. However, (Buerhaus et al., 2017) prove that the number of working RNs decreases substantially every year. Consequently, they exit the profession with the knowledge and experience they have earned. Thus, the whole industry is left without these valuable resources, which introduces significant challenges for young nurses. This issue can be overcome when two phenomena are present. Firstly, corresponding officials should understand that this vital issue exists. In this case, they will be able to monitor the number of retiring registered nurses and develop programs to support the health care industry. Secondly, particular attention should be paid to the education of future RNs and their professional competence. The fact is that these new staff members should be skilled and experienced enough to replace the retired ones with no harm to the quality of health care.

Key Messages by the Institute of Medicine

The U.S. health care system is a complex phenomenon that consists of many elements, and nursing is one of them. Thus, the Institute of Medicine’s 2010 Future of Nursing report analyzed this element and identified some limitations that brought some problems for nurses to perform their functions properly. These limitations were articulated as four key messages that introduced the necessities to transform practice, education, leadership, and the need for better data (National Academies of Sciences, Engineering, and Medicine, 2016).

The message addressing nursing education seems to be extremely important to the nursing profession. According to the National Academies of Sciences, Engineering, and Medicine (2016), the message is that “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (p. 23). The thought is that it is necessary to change an education system to prepare nurses for future work adequately concerning sophisticated technology and information. In addition to that, Green and Schlairet (2017) support the idea of introducing qualitative changes in nurse education. Therefore, it is difficult to overestimate the meaning of education for future nurses, which makes it significant to bring corresponding changes to this system to make it useful and up-to-date.

Core Competencies Explained

The question of how it is possible to achieve the highest quality of health care delivery has always been crucial. The Institute of Medicine decided to explore this topic, and they developed five core competencies every medical worker should meet. Thus, these competencies are patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics (Turner, Eliot, Kent, Rusnak, & Landers, 2017). According to Roberts (2016), these competencies are utilized by those organizations that want to provide their patients with exemplary care. Furthermore, each of them introduces some recommendations for nurses to follow.

Proving Patient-Centered Care

This competence means that a patient, rather than a medical professional, should be placed in the center of a health care system. It denotes that nurses should respect their patients, communicate with them, and care for them. Thus, it is of crucial significance to provide patients with treatment recommendations concerning their preferences, beliefs, and lifestyles (Turner et al., 2017). Implementing this idea is a complex task because there are very different patients, and everyone should obtain enough attention. However, patients’ individualities represent a possible obstacle; nurses do not have enough time sometimes, which makes them neglect this competency. The issue can be overcome if experienced and attentive nurses work in well-staffed teams where it is possible to allot enough time to every patient.

Working in Interprofessional Teams

The fact is that any team consists of many professionals who represent various spheres of expertise. They have different knowledge, experience, and even views of life. That is why this competence refers to the fact that every member of such a team should both share their own expertise and learn that of others (Turner et al., 2017). Thus, nurses should have perfect communication skills and be able to cooperate with others. However, this positive phenomenon is the main disadvantage simultaneously. The fact is that diverse teams are subject to conflicts. As a result, team leaders and all members should utilize effective conflict resolution strategies to minimize their harm.

Employing Evidence-Based Practice

It directs attention to the case that there is an ever-expanding evidence base that contains the information for health professionals to identify necessary volumes of care needed (Turner et al., 2017). Thus, mastering this competence consists of the following steps: articulating clinical questions; searching for an answer among the existing evidence; integrating findings into practice. Some problems can appear even in the first step when a nurse fails to formulate a question clearly; the search will not achieve successful results in this case. Experience and assistance of senior colleagues can help cope with this task.

Applying Quality Improvement

It seems to be one of the most crucial competencies because it relates directly to health outcomes. The fact is that nurses should minimize the number of errors and contribute to the higher efficiency of the health care provided (Turner et al., 2017). This competence is achieved thanks to education, expertise, and experience. Various problems can appear if a nurse lacks professional knowledge. The possible solution is to improve the three phenomena above through life-long training and education.

Utilizing Informatics

With respect to the health care industry, this competence means more than just information technology. Thus, medical professionals should use existing information systems that have been developed specifically to meet nursing needs (Turner et al., 2017). Such applications make it possible for nurses to avoid mistakes, manage information correctly, make decisions, and even communicate with patients. Thus, a potential obstacle can arise if a nurse lacks expertise in using particular applications. It can be easily overcome by gaining relevant experience and attending specialized training.


The nursing profession is a significant component of the health care industry since its representatives perform crucial functions. Nurses are forced to deal with particular challenges that can be overcome with the help of corresponding competencies. Furthermore, nursing should respond to the developing world, which means that some changes are required. Thus, it is of crucial significance to improve nursing education to prepare students for future work properly.


  1. Buerhaus, P. I., Skinner, L. E., Auerbach, D. I., & Staiger, D. O. (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation, 8(2), 40-46.
  2. Green, R. D., & Schlairet, M. C. (2017). Moving toward heutagogical learning: Illuminating undergraduate students’ experiences in a flipped classroom. Nurse Education Today, 49, 122-128.
  3. National Academies of Sciences, Engineering, and Medicine. (2016). Assessing progress on the Institute of Medicine report The Future of Nursing. Washington, DC: The National Academies Press.
  4. Roberts, B. (2016). Relationship-based care: The Institute of Medicine’s core competencies in action. Creative Nursing, 22(2), 92-96.
  5. Turner, P., Eliot, K., Kent, S., Rusnak, S., & Landers, P. (2017). Level of implementation of the Institute of Medicine core competencies among dietetics education programs. Journal of the Academy of Nutrition and Dietetics, 117(11), 1709-1716.
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