Nurses address health care concerns at UF conference

Published: Saturday, January 19, 2008 at 6:01 a.m.
Last Modified: Friday, January 18, 2008 at 11:27 p.m.

As the U.S. population continues to age, so grow the worries of many who lack faith in the quality and safety of the country's health care system.

By the year 2020, will that system be irretrievably broken, or can changes be made today to prepare us for the challenges ahead?

Some 200 nurses and nursing educators gathered at the University of Florida this week to consider just that issue as part of the Dorothy M. Smith Nursing Leadership Conference.

Their "2020 vision" of the future of health care was not all gloom and doom.

Joanne Disch has spent more than 40 years in nursing. As director of the Densford International Center for Nursing Leadership at the University of Minnesota, she offered the conference's keynote address Thursday.

"Things are getting a little different out there," Disch told the group, saying that trends, "are moving us inexorably toward a whole new health care system."

Her examples ranged from the recognition that women are now outpacing men in income growth (although not necessarily in income), mini-clinics now offer "mall medicine" in many parts of the country, and some states offer compensation to relatives who serve as caregivers for a family member.

Disch, who chairs the national board of AARP, said health care and financial security are the most pressing domestic issues facing the nation.

Unless consumers make their wishes known, she warned, health care reforms that presidential candidates are touting in an election year will "go to the bottom of the pile after the election."

She urged audience members to make their desire for adequate, affordable, accessible health care known by going to the AARP Web site

Turning specifically to changes in the field of nursing, Disch warned that the numbers of people being turned away from nursing programs is going up, despite a continuing shortage of nurses.

"There's no room at the inn: fewer faculty members to teach, less classroom space and fewer practice sites for learning," she said.

UF's College of Nursing Dean Kathy Long said there are new options to embrace in a time of shortage, including more education for every nurse, expansion of interdisciplinary practices and teams for patient safety.

Change will demand strong nursing leaders, Long said, who are willing to speak out about the need for new models of health care delivery.

Dr. Bruce Kone, dean of the College of Medicine, echoed Long's call for more collaboration and teamwork to shape health care in 2020.

"Education systems in general breed the creativity out of us," Kone said. "Standardization does not raise standards."

Under the current system of medical education, Kone added, "We don't teach collaboration well, or communication about problem solving."

He points to a world in 2020 where the top 10 jobs of 2008 will no longer exist. According to Forbes magazine, he said, they'll be replaced by positions such as gene screener, quarantine manager and drowned city coordinator.

"We'll be looking at a flat world where you can touch anybody (electronically) anytime, and yet we'll still have access issues," Kone warned.

Bobbi Kimball, a San Francisco-based health care management consultant, said the key to resolve health care issues lies in innovative approaches to delivering care.

"Today's patient-care delivery model has not kept up with reality," she said, "and expanding the supply of workers is not sufficient to address changing health care needs."

Among the changes in health care Kimball foresees are an elevated role for nurses, who will serve to integrate care, a team approach to that care, and care that will continue from the hospital to the home.

Successful strategies will target the growing number of elderly, who will be "high users" of health care.

Disch said consumers now want more choice and control over their health care, including financing options, support for family caregivers and more livable communities.

"It's not just about how we pay for health care, such as universal coverage, but how it is delivered," Disch said.

"Do any of us really want better access to our current system?"

Diane Chun can be reached at 352-374-5041 or

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