Role of Nurses in Restructured Health Care System

Role of Nurses in Restructured Health Care System


The healthcare system has constant pressure to fulfil the needs of all the population in terms of efficient, effective, and economic care, worldwide. Moreover, an adequately funded health care system that delivers high quality of care should be supported by a workforce that meets the population’s health care needs. Nurses comprise nearly 80% of the total health workforce, hence considered as the front line in the health continuum. Moreover, the increased coverage of health insurance also increased the demand of the primary care system, which further demands the nurse practitioners and Registered Nurses that will practice in these primary care settings (Sullivan, 2013). However, despite their significant role in the health care system, they are generally not considered as equal partners in the multidisciplinary health care teams. Thus, the health reform law includes various initiatives that have the objective to redesign the organization, their financing, and the delivery of healthcare. The programs, such as ACOs and medical homes, are actually based upon the nursing scope of practice. The enactment of Affordable Care Act offers huge opportunities in the field of nursing profession to improve the health care system as well as the mechanisms of care delivery (Allan, & Aldebron, 2008).

Continuum of care

The nursing practice covers a broad continuum regarding the care of population. It includes disease prevention, health promotion, coordination of care, and cure, as well as the palliative care when cure is not possible. This continuum of care is very essential regarding the current as well as future needs of the population worldwide. The care of patient is directly affected by the nurses as they provide the majority of assessments, evaluations, and care in the nursing homes, hospitals, schools, workplaces, and ambulatory settings. They are also required to ensure that the care is delivered to the patient safely, compassionately, and effectively. Moreover, they handle the patients and their families in a holistic way that may be depend upon the social, mental, and spiritual needs of patient. Thus, by applying their knowledge, experience, and the centrality in providing care, the nurses will play a significant role regarding the transformation of the health care system (Institute of Medicine of the National Academies, 2010).

Accountable Care Organizations

The ACOs’ work as a team that coordinate the care for a group of patients, by providing high-quality; patient-centred and reduced costs care. Moreover, they also act to provide the continuous, smooth, and high-quality care to the people. Although, the clinical RNs are limited to assessments, interventions, and education, but one of their professional responsibilities is the care coordination. They need to play their role as care coordinators, quality improvement managers, communicators, and the providers of advanced levels of care. The care coordination is considered as one of the Standards of Practice for Nursing and very soon will become the important role of the RN in the community- based nursing and health care reform (Everett, 2013).

Medical Homes

The patient-centred medical homes (PCMHs) are those primary care practices that provide coordinated and interdisciplinary care to the patient. In PCMH, the care is arranged in such manner that it should fulfil the short or long-term healthcare goals of the patient in every stage of life and care levels. The nurses may play their pivotal role in the coordinating care during the transitions in care. They may take the responsibility to bring the concept of holistic care in medical home that could not be done by the physicians. This model of care delivery may prove to be beneficial as it consider the patients to be the centre of health care coordination (Sutter-Barrett, Sutter-Dalrymple, & Dickman, 2015).

Nurse-Managed Health Clinics (NMHCs)

These are the service sites delivering the community-based primary and wellness care without considering the patient’s ability to pay. The majority of care in such setting is provided by the nurses and other health care professionals along with the physicians where required. They help in providing the clinical placements for nursing students thereby increase the enrolment in education programs and also help to eliminate the shortages in the supply of nurses. The NMHCs also give the opportunity to the students so that they can integrate their classroom learning with the community-based care. The future of nursing also based on NMHC as the majority of population now focus towards the wellness care (Esperat, Hanson-Turton, Richardson, Tyree Debisette, & Rupinta, 2012).


The nurses’ work at the forefront of patient care thus can play main role in making the health care accessible, affordable, and acceptable. However, it needs to address the barriers that are preventing the nurses from responding to the rapidly changing and evolving health care system. Only by doing so can help the nurses to achieve better position that further lead the change and advance health. Such barriers may include the inability to practice in full extent, inaccessible education system for progression to higher levels, and lack of opportunity regarding the full partnership with other healthcare professionals. Hence, the nursing students should be educated enough so that they can understand their role in various healthcare settings and should be able to remove these barriers.


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