This is a question I am frequently asked.  My answer: ‘IF we are prepared to change to meet changing health care needs’. 

Since about 1999 I have been arguing that nurses must do things differently if we are to remain relevant.  I have also argued that other health professionals must do likewise, but here I am interested in nursing.  Some of you will possibly remember when nurses dusted, served meals in the middle of the ward, cooked the evening meal and eggs for breakfast; didn’t take bloods, manage dialysis and so on.  As needs changed, so too did our practice. 

So why are we so afraid of ENs administering medications, giving injections and generally extending their scope of practice?  Why do we even imagine we may not be needed? Maybe it is because some of us do not want to put in the effort to enhance our own scope of practice.  Maybe we are threatened and feel comfortable with the pill trolley? 

Well in my view the nurse of the future will be the equivalent of today’s Nurse Practioner – there will be relatively fewer of them and they will provide more of a consulting service.  The day-to-day nursing management of teams will fall to ENs (or their equivalent if we resist the movement) with enhanced skills and much of the direct care will be provided by multi-skilled health practitioners.  A team of professionals will work with older people and their families where relevant – the team could consist of a Nutritionist, Geriatrician, Pharmacist, Psychologist, Physiotherapist, OT, SW, GP and NP.  The health practitioners will have broad skills in these areas but be guided by protocols and led by the EN, who would liaise between the Expert Team and health practice team depending on the circumstance. 

Importantly, the staffing model would be driven by the clients’ needs and other factors such as environment, available skills, access to experts, technology and so on.  We can take the initiative and be part of driving this change; we can be led by others and left with the practice they do not want or we can resist and become redundant.  I am all for leading change and being strategic. Who’s with me?