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Are you ready for a new year? A new century? A new millennium? Technically, of course, there’s a year before we have to worry about the second and third of those, but I think it’s fair to say that psychologically we’re all poised for a momentous change of date. It’s natural to wonder what else will change in the coming century. I don’t know about you, but I tend to think about technological and scientific advancements—faster computers, better diagnostic tools, more targeted medications, and a fuller understanding of genetics, for example. No doubt that kind of advance will make our current state of technology and science seem quaint and archaic by the time the world counts down to 2100. But if the past is any guide, that’s not the only kind of change the coming century is likely to bring. In this special issue of NurseWeek, we’ve taken a look back at the transformations health care has seen in the past 10 decades. It’s remarkable, to say the least. One hundred years ago, nurses weren’t even licensed. The host of allied health professions hadn’t been invented. Most nurses lived in their patients’ homes, without breaks or designated shifts, for days, weeks, and even months on end. The unpredictable shifts like these, the ones that hinge on transformations in society, politics, and economics, are at least as crucial as the discoveries and inventions we hope will save and improve lives. They also raise a lot of questions. How will health care be provided 100 years from now? Maybe hospitals will be a thing of the past, with outpatient and in-home care dominating the industry. Or perhaps hospitals will be back in favor and healthcare professionals of the next century will be laughing that we ever thought houses were a good place for health care. And who will be helping patients get well, die gracefully, or stay healthy? Nurses in the first year of this century could never have dreamed that those who followed in their footsteps would be able to draw on the expertise of physical and occupational therapists, refer a patient for a pharmacy consultation, or entrust a patient’s breathing to a respiratory therapist, to give just a few examples. There might be more professions decades from now, or there might be fewer—but we have no way of knowing one way or the other. The questions are endless: Who will pick up the tab for health care? Who will have access to it, and to what level or type of care? What will we consider the standard of good health, and how many of us will have achieved it? So what kind of changes are you ready for? What kinds of changes are you willing to make? Whatever they are, I think the lessons of the past century are that we’re in for a wild ride, and that events beyond anyone’s control will steer the course of health care. Whether it’s a war, a depression, or a radical shift in demographics, history will choose the direction that health care takes, and we’ll have to do our best to enjoy the journey. |