| Abstract: |
PURPOSE: To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment. DATA SOURCES: Professional journals and books, print media, and government releases. DATA SYNTHESIS: Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses. CONCLUSIONS: The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession. |
