{"id":37,"date":"2019-09-23T13:25:15","date_gmt":"2019-09-23T13:25:15","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-delhi-professionalnursing\/chapter\/healthcare-in-the-21st-century\/"},"modified":"2025-08-13T14:00:33","modified_gmt":"2025-08-13T14:00:33","slug":"healthcare-in-the-21st-century","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-delhi-professionalnursing\/chapter\/healthcare-in-the-21st-century\/","title":{"raw":"Healthcare in the 21st Century","rendered":"Healthcare in the 21st Century"},"content":{"raw":"
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The need for a highly educated nursing workforce is in high demand due to the changing healthcare environment and the demographics of the U.S. population. Nurses require specialized knowledge and competencies to navigate the healthcare delivery system, such as leadership, research, integration of innovative technology and working in expanded roles and settings. These and other essential skill sets are vital for providing safe, high quality care. Nursing education and practice needs to move towards a patient-centered philosophy, higher standards for safe, quality care, with a stronger emphasis on information technology, scientific research, evidence-based practice, and interprofessional collaboration (Institute of Medicine [IOM], 2011).<\/p>\r\n

The structure of America\u2019s healthcare environment is continually evolving. Changing demographics brings about new cultures and practices. These cultural changes have brought about many questions about nursing\u2019s ability to adapt yet maintain core values. How can essential nursing values hold up in the rapidly changing 21st century? In order to better understand the need for adaptation, it is important to understand certain changes that occurred since the 1960s.<\/p>\r\n\"diverse\r\n

<\/a>Immigration and Globalization<\/strong><\/h2>\r\n

In the 20th and 21st century, immigrants from Europe, Africa, Central America and Asia continued to settle in the U.S. to escape war, poverty, and oppression. America gave them the chance to live free and practice their cultural and religious beliefs without fear of outright persecution. People have always come to America to seek out a better life for themselves and their children.<\/p>\r\n\"migrant\r\n

One effect of globalization is increased mobility and the advent of international aid programs to facilitate movement throughout the world (Bruce, 2018). Modern America\u2019s recent history was influenced by an immigration characterized by a mixture of religions, cultures, ethnicities, and races. Immigration from non-European areas has led to a wider variety of cultural integration becoming more pronounced in the U.S. (Bruce, 2018).<\/p>\r\n

As a result of immigration and globalization, nurses must be committed to practice in a culturally congruent manner. According to the American Nurses Association (ANA, 2021) Standards of Professional Performance, Standard 9, Respectful and Equitable Practice, is fundamental to cultural humility and inclusiveness.<\/p>\r\n

Providing culturally congruent care begins with creating a personal inventory of one\u2019s values, beliefs, and cultural heritage. Knowing oneself helps nurses understand themselves better, they may find more similarities than differences when reflecting on one\u2019s values and beliefs. Understanding the impact of social injustice and oppression on health helps nurses better understand their patients\u2019 needs, leading to a more accurate assessment and plan of care.<\/p>\r\n\r\n

<\/a>Changing Demographics of the U.S.<\/strong><\/h2>\r\n

As a result of immigration and globalization, the U.S. population has become more racially and culturally diverse. People are living longer with more chronic and complex illnesses as a result of technology and innovation. The following U.S. Census data (Colby & Ortman, 2015) projects an aging and more diverse U.S. population over the next 40 years:<\/p>\r\n\r\n