Change is upon us. According 2008 data from the U.S. Dept of Labor (DOL) Bureau of Labor Statistics, most of the 2.8 million employed nurses are working in hospitals. While the DOL projects that the demand for nurses will require over a half million new positions by 2018, nurses are more likely to be hired in non-acute care settings including primary care offices, home care, and long-term care facilities. There are a number of factors contributing to this trend including: the aging population, increased access to healthcare, and advances in healthcare technology. As more people are living longer, there is a greater need for continuing care beyond hospital discharge and services to manage chronic conditions and disabilities. Healthcare reform is going to provide more individuals with access to primary care and preventive care who couldn’t afford it in the past. As the science and technology of healthcare advances, more patients are opting for less invasive diagnostics and surgeries that reduce length of stay in hospitals or eliminate the need for an admission. 

   Instead of mourning the loss of hospital jobs, nurses should retool their careers for the new and expanded opportunities. The following are examples of education and skills that may prepare nurses for the future.

• Return to graduate school and become a nurse practitioner to fill the demand for primary care providers.

   
• Earn wound ostomy and continence nursing certification to fill the need for WOCNs in wound care clinics and in home care.

   
• Obtain certification in infusion nursing or insertion or peripherally inserted central catheters (PICC) to meet the requirements of home infusion services or clinics that provide  blood components, chemotherapy and other I.V. medications.

   Of course there are many more skills and certifications that nurses could acquire that will position them well in the future job market. Regardless of nurses’ current roles or work settings, they should stay in tune with the trends and embrace change by continually developing contemporary skills and credentials. 

By Karen Innocent, MS, RN, CRNP, ANP-BC, CMSRN