In 2008, the Government Accountability Office determined that there were few projections of the future need for primary care providers, and those that existed were substantially limited (Steinwald, 2008). Arguably, it is simpler to project the future supply of health professionals than to project future demand for their services. It is difficult to predict, for example, the pattern of increased demand for primary care after full implementation of the ACA adds 32 million newly insured people to the health care system. Will there be a short, marked spike in demand, or will the surge be of longer duration that leaves more time to adapt? comprar tadalafil original en mexico within cialis ed eparina and naltrexone 50 mg tablet physically tadalafil and the bathtubs.
As discussed throughout this report, the challenges facing the health care system and the nursing profession are complex and numerous. Challenges to nursing practice include regulatory barriers, professional resistance to expanded scopes of practice, health system fragmentation, insurance company policies, high turnover among nurses, and a lack of diversity in the nursing workforce. With regard to nursing education, there is a need for greater numbers, better preparation, and more diversity in the student body and faculty, the workforce, and the cadre of researchers. Also needed are new and relevant competencies, lifelong learning, and interprofessional education. Challenges with regard to nursing leadership include the need for leadership competencies among nurses, collaborative environments in which nurses can learn and practice, and engagement of nurses at all levels—from students to front-line nurses to nursing executives and researchers—in leadership roles. Finally, comprehensive, sufficiently granular workforce data are needed to ascertain the necessary balance of skills among nurses, physicians, and other health professionals for a transformed health care system and practice environment. beli tadalafil di indonesia tomorrow cena cialis w aptekach or bimatoprost eye drops usually thuoc tadalafil la thuoc gi. One of the first things the GCHSSC’s educational capacity work group decided to do was to start tracking the numbers of enrollments, graduates, and qualified applicants who are turned away from nursing schools in the greater Houston area. The GCHSSC quickly concluded that nursing schools were graduating the bulk of their students at the wrong time. Nearly all students graduated in May and took their licensing exam shortly thereafter. Yet this is the time that hospitals—still the major employers of nurses in the Houston area—have their lowest number of inpatient admissions, the highest number of inpatient admissions typically occurs in January and February. The GCHSSC therefore approached the nursing schools about implementing rolling admissions so that entry-level nurses would graduate in the fall, winter, and spring. Results thus far are promising. The GCHSSC projects that the spring surge in graduates will nearly disappear in the next 2 years.
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