As the nurse executive takes on many more departments, the nurse executive function has become more broadly defined into that of patient care management. Other managers, in turn, also have responsibilities outside of nursing. Providing preparation for the assumption of these added responsibilities is always a concern. The tremendous variability in skill levels of UAP across the country, the many models of delivery, and the confusing roles of the nurse all contribute to consumers' continually eroding confidence in our health care system. These issues must be addressed to regain the confidence of the public.
Some trends bear watching in the future.
Disease management models utilize the nurse in the outpatient setting to drive the care that is delivered in the hospital. The RN's role continues to take on complexity usually associated with the MD's role. As these people take on more fiscal and managerial responsibility, managers need greater preparation in the field of business. The challenge for health care is to provide the educational programs to support care delivery in the new models. There is a lag between the innovation of new services and the integration into the educational programs of the necessary skills to support them.