Fundamentals of Nursing Collaborating for Optimal Health

Preface A new millenium inspires hope that humankind at last will meet one of its major challenges--that of assuring access to affordable health care for every individual. As reforms emerge, nursing's role will be a central one in shaping the policies, structures, and practices to advance access as a national objective. Indeed, nursing's participation in the policy initiatives of the 1990s, grounded on its own national reform agenda, amply demonstrates the profession's commitment to health care as a human right, and calls attention to nursing's readiness to provide cost-effective services to a diverse population seeking health information and choice. Looking forward, the theme of this text--collaboration for optimal health--is as relevant as when the first edition appeared. The rapid expansion of managed care, to date the major trend in health care reform, makes it so. Managed care, while on the one hand fostering interdisciplinary professional collaboration with its pressures for cost-containment, also brings economic constraints to bear on patient-provider collaboration, often with controversial results. Although the years ahead will determine whether managed care will curtail health care costs over the long term, public concern is now growing over the role of third-party insurers, and how seriously their intervention will erode the foundation on which patient-provider collaboration is based. As the issues in this dilemma are sorted out, consumerism in health care, which manifests the popular demand for choice and participation in decision making, will continue as a powerful movement and an important societal trend. Approach The collaborative philosophy, which provides a necessary foundation for nursing practice, remains a key feature of our approach and the theme of this edition. Nurses' ability to initiate and influence reforms will to a large extent depend on the strength and quality of their transactions in an increasingly complex and volatile environment. Those transactions will be enhanced by collaboration, which emphasizes the importance of working together with others, using persuasion based on knowledge and reason to attain mutually beneficial, socially important goals. A philosophy of collaboration is valuable, because it provides an action-oriented framework within which nurses can realize their professional values. Nursing has long recognized that our multicultural society, characterized by population diversity and subgroup value differences, embraces a variety of paradigms on health and illness, paradigms which may have critical implications for care. A philosophy of collaboration is uniquely sensitive to human differences. It assumes that patients will bring their divergent points of view to the encounters they have with health care professionals, which are important points to address in the context of the helping relationship. Indeed, doing so fosters patient dignity and self-determination, hallmarks of caring and central values of the nursing profession. The environment of health care continues to grow more challenging day by day which means that nursing education will be under constant pressure to align its curricula with the driving forces of change. As a new era opens, the fast-paced scientific advances and ever-changing technology of the 20th Century will persist as important characteristics of the health care environment, as will the provider specialization they promote, delivery system reforms notwithstanding. Although this triad is responsible for much of the service quality improvement of the past, it is also a factor in the spiraling cost increases that make access a problem for so many citizens. Thus, continued pressure for economy is a certainty as the nation's population grows and ages, and its demand for expensive services increases. In light of that reality, it is important to initiate today's fundamentals students toBerger, Karen J. is the author of 'Fundamentals of Nursing Collaborating for Optimal Health' with ISBN 9780130549471 and ISBN 0130549479.