2. aNursing has been called the oldest of the art, and the youngest of the profession. As such, it
hasgone through many stages and has been an integral part of social movements. Nursing has
beeninvolved in the existing culture, shaped by it and yet being to develop it. The trend
analysis andfuture scenarios provide a basis for sound decision making through mapping of
possible futuresand aiming to create preferred futures.The future will see great advantages in
prevention, diagnosis and treatment of illness anddiseases with increasing demand for heath
care and health information. As large hospital arereplaced by high tech and small hospitals,
health care will be provided in homes and out reachfacilities and the focus will be on provider
skill, out comes and user preference and satisfaction.Nurses will be the preferred care
providers and entry points for diverse services.On the other hand there will be challenges
related to ethics, rising costs, access to care andquality of care. Nurses will have an essential
public health role and patients will become moredemanding. Healthier life styles, continuum
of care, health environments and evidence basedpractice will be emphasized and in the
forefront of nursing agenda. Globalization will enhancefree movement, standardization, and
wider opportunities and challenges. The changing
nursing is wellpositioned.The multifaceted components in this unfolding will be; the
revolutionary advances that wecontinue to witness in modern medical practice as a
result of technological advances from thefields of physics, electronics,
instrumentation, chemical and material sciences. The advent ofmolecular medicine,
with work at the frontiers of modern biology particularly on the humangenome, and
its relevance to the generic basis of disease; the importance of recent advancesrelating
to the human brain the wide range of opportunities becoming available through
advancesin information technology; the great importance of community and social
medicine, of hygieneand epidemiological studies in understanding and preventing
disease.Philosophy of life, elements of human nature, Religious factors, political
ideologies,socioeconomic factors, cultural factors and expiration of knowledge are the
factorsReligious factors, political ideologies,socioeconomic factors, cultural factors
and expiration of knowledge are the factors determiningeducational aims.Vocation,
knowledge, complete living, Harmonious development, mental and
emotionaldevelopment, physical development, moral development, character
development, self –realization, cultural development, ideal citizenship and education
for leisure are the general aimsof education. 1
Progress in transportation, communication and other technological areas: e.g.
automobile likeaids e. g. telephone, motion pictures, radio, television, computer email
and internet services, useof ultrasound, CT Scan, MRI imaging machines, electronic
microscope radio active isotopes formedical research, artificial respirator ventilator,
discovery of third generation antibiotics,findings of new drugs e.g.; vitamins,
penicillin, insulin, chemotherapy and invention of othermedical supplies like cool air
machine, refrigeration, air and water mattress, electric beds etc.Nursing has a
tremendous capacity to change people. The demands associated with nursingpractice
require a broad knowledge base and critical thinking abilities along with
competentskills. The focus of nursing is shifting towards viewing patients as
collaborative beneficiariesrather than passive recipients of care. Nursing requires
psychological, social and physical skillsand certain attitudes, which are rooted in
3. knowledge. The demands associated with nursingpractice require a broad knowledge
base for decision-making. Critical thinking abilities andskills in the technological
aspects of care.The function of the professional nurse in the hospital is more
comprehensive. She will beactively involved in direct nursing care, health teaching,
planning for care in home, rehabilitationand service to the outpatients. She may have
to teach the students also.The world health organization (WHO) has been considering
the future and predicts that by 2000the world experiences: Major growth in the elderly
population, Decline in birthrate, especially inwestern countries, Increases in chronic
illness, Continuing social unrest, AIDS a major
problem,Many infectious diseases under control, Mental health a key issue and
Poverty continuing toplague mach of the world.Exposure to human ill, sick child and
baby, dying patients, cancer patients, renal failure patients,still birth etc., closer nurse
patient relationship, Helplessness, Felling of incompetence inemergency situation,
Lack of support system, Lack of resources, Often high unrealisticexpectations, High
technology equipments, Communication breakdown, and Heavy workload arethe
causes of stress among nurses.Nurses are responsible for public anger because: Nurses
stay 24 hours with client, Nurses have togive answers fault made by professionals of
other discipline, Work load very high, Less time forcounseling and guidance to
patients, Unable to explain their own role in clients care and Poororientation to clients
and relativesProfessional judgment, Defining "Care", Information system or effective
communication,Electronic network or computer link, Problem based learning,
Marketing or privatization,Nursing standard, Nursing audit, Nursing research,
Multidisciplinary health team, Independentarea of practice, Community based
nursing, Holistic care approach, Specialized services(dialysis, Psychiatric etc.),
Problem based learning, Distance learning (open university system),Self – directed
learning, Continuing education, Use of advanced technology, Consumerprotection act
on action, Change in uniform and dress code, Utilization of married
nurses,Specialization, Leadership of nursing in 21st century, Human relation in
nursing , Disastermanagement, Marketing strategies for nursing, Computer
application in nursing, Space nursing , 2
Nurse patient relationship and Provision for nursing consultant or specialist are the
emergingtrends in Nursing.Transitions taking place in health care are: Curative to
Preventive approaches, Specializedcare to Primary health care, Medical diagnosis to
Patient emphasis, Discipline stovepipes toProgramme stovepipes, Professional
identity to Team identity, Trial and error to Evidence basedpractice, Self – regulation
to Questioning of professions, and Focus on quality to Focus oncosts.In the workplace
the transitions taking place are: High tech to Humanistic, Competition
toCooperation, Need to supervise to Coaching, mentoring, and Hierarchies to
Decentralizedapproach.Transitions taking place in nursing are: Continued
competencies to Competencies a condition,Hospital environment to Community
environment, Quality as excellence to Quality as safe, andClear role to blurring
rolesThe Major issues in nursing education are: Selection of students: Lack of valid
tool to selectproper students, Gap between theory and practice: There is vast gap
between actual theory taughtin classroom and the actual practice in clinical setting,
Student status: In most of institutionsstudents are vitalized for patient services,
Nursing Competencies: To develop nursingcompetencies knowledge, under standing
skill and attitudes are essential factors, Underutilization of clinical facilities in
government colleges / schools, In adequate library facilities,Poor transport facilities,
Less stipend for nursing students, Poor supply of AV aids, LessPromotional
4. opportunities for teachers of both schools and colleges, Very few M. Sc. courses
isavailable, Few Ph. D. Courses in Nursing colleges, and In private Institutions: there
is Lack ofqualified teachers, Hired building, Most institutes has not own hospital for
clinical practice, Veryexpensive, In adequate hostel facilities for students and Poor
provision of library.The Issues in nursing service are: Poor working condition,
Staffing level not based on standardnorms, Inadequate quality In-service education
programme, Less wages, Lacking in formalpractice guidelines, Work activities roles
not well defined, Deficiencies in Team work, Lackingadvanced extended nursing
practice, Professional relationship with doctors decreasing day byday, Inadequate use
of modern technologies, Inadequate availability of equipment and supplies,Poor team
spirit among colleague, Very few professional representations in higher
authorities,Poor exposure of nurses in National conferences workshop and forums,
Inadequate availabilityof scientific research findings, As the education raises the gap
between nurses and patients alsoraises, Nurses are more busy in administrative and
paper works in compression to bed side care,Nurses are not research oriented, Use of
non professional manpower to deliver nursing service,Monitoring, supervision,
recording, deporting and evaluation system are poor in nursing service,Expert senior
nurses are usually not involved in planning nursing manpower in an institution,There
is not a system for scheduling planned annual leave for nurses, Lack of
autonomyandempowerment for nursing leaders, Lack of understanding of nursing
professional roles andresponsibilities in general, and Gap in the latest managerial
knowledge and skills among seniornursing leadersCommon problems of nursing
administration are: Poor involvement of nursingadministrators in planning and
decision making in the government hospital administration, No 3
specific power has been assigned to nursing Incharges but she has been made
Incharges of allinventories and linen of hospital, In many institutions nursing
superintendent will have noauthority to sanction leave to their subordinates, Lack of
knowledge of management of nursingadministration among nursing administrators,
Administrators most of the time depends on theadvice of clerical staff in all matters
including technical aspects, Prevalence of role ambiguityamong administration
administrators, Unnecessary interferences of non nursing personnel innursing
administration, No clear cut written nursing policies and manuals, Poor job
descriptionfor various nursing cadres, Poor organized staff development programme,
which includesorientation, in-service education, continuing education etc,. Poor
provision of incentives like:awards, visits, praise, conferences etc. Inefficiency of
nursing councils to maintain standards,and inadequate efforts at higher level for
implementation of separate directorate of nursing.Less educational preparation,
Refuse to accept new role, Adhere to tradition, Failure to unityamong nurses, Failure
to work with consumers or public, and Failure to delivery nursing care tomeet
(satisfy) public needs are the common professional limitations in Nursing
Profession.Conclusion: Transition generally occurs or takes place in each and every
individual of thisworld. Nurses as an individual, involved in caring profession, also
faces this transition arenothing but the passages or changes from one situation or state
to another that occurs over time.There are often wide ranges of emotions experienced
during the transition process that can affectthe emotional and physical well
being.Some ways to Prepare for transition process are: Positing thinking, flexible to
adjust invarious situations, organized personal life, practice healthy life style, find an
ideal mentorhavesome fun and able to know what is expected to learn to rules of road
early
