Imagine the year is 2030…
Casey, a Complex Labor and Delivery nurse, notices that her patient, a young mother, rarely makes eye contact while holding her new infant son. Instead, she spends hours on Facebook rapidly swiping thru her iPhone 22. Casey punches in a text referral to the East Wing Family Unit where the family can stay for a minimum of three weeks to learn about the impact of digital media addiction on empathy, and hardwire life-long bonding skills. Gone are the days when Casey worked in the hospital labor unit asking for permission to do almost anything and spending all of her time charting. After home births became the norm in 2025, she got her master’s degree in order to return to high-risk hospital deliveries.
Seventy-five percent of nurses now work in public health! Nurses who practice in the hospital primarily care for those patients with complicated co-morbidities, provide ongoing intense education, or participate in pioneering research. Almost all of the hospital floors have transitioned to family-based educational units now because there are so few in-patients. In 2021, Americans finally realized that unless a nation spends as much on the social determinants of health than they do on actual medical costs, the economy suffers – and boy did it!
The days of 12-hour shifts ended in 2025 when charting stopped and HPHS (Health Pro High Security) cameras with scribes took over all the charting. That was Casey’s favorite year. Nurses banded together and insisted on a 5% pharma tax, specifically for nursing, and the money boosted and energized the whole profession – especially educators.
Now, in 2030, every nurse works an 8-hour clinical shift, followed by 2 hours on whatever they choose. She almost quit after the COVID-19 pandemic of 2020 when nursing was at its highest pressure point and nurses barely saw their patients. Bad as it was, at least that’s the year that everything started changing for the better because no one could ignore the disparities any longer.
All entry-level hospital nurses now have a bachelor’s degree and must have a master’s degree within five years. As per the American Pediatric Association recommendation of 2016, all schools have a clinic and a nurse who is actively engaged in teaching netiquette, relationship and resiliency skills, as well as identifying the early onset of physical and mental disease. Because of these efforts, the 36% depression rate of girls under the age of 17 finally started trending downward in 2028.
Fact or Fiction? Our call.
As Carl Sandburg once said, “Nothing happens unless first a dream.” Let’s dream of a time when the profession of nursing takes its rightful place and significantly impacts the health and well-being of all Americans. What we imagine, we become.
Adapted from: The future of Nursing. Chapter 4 by K. Bartholomew Essential operational components for high performing enterprises. 2018.
- Burroughs, J. 2018. Essential operational components for high-performing enterprises. ACHE Press. Chicago
- Institute of Medicine of the National Academies, 2010, “The Future of Nursing: Leading Change, Advancing Health Report Recommendations”.
- Tucker, A., & Spear, S. (2006) Operational failures and interruptions in hospital nursing. Health Services Research 41 (3Pt 1):643-662.
- Hendrich, Ann, et al. “A 36-hospital time and motion study: how do medical-surgical nurses spend their time?” The Permanente Journal3 (2008): 25.
- Geiger-Brown, Rogers, V., Trinkoff, A Kane, R, Bausell, R.B., Scharf, S.M.(2012). Sleep, Sleepiness, Fatigues and Performance of 12 Hour-Shift Nurses. Chronobiology International, 29(2); 211-219
- Letvak, S., Ruhm, C., McCoy, T. (2012). Depression in Hospital-Employed Nurses. Clinical Nurse Specialist: May/June 2012 – Volume 26 – Issue 3, pp. 177-182
Kathleen Bartholomew, RN, MN, is an internationally recognized patient safety and health culture expert. Kathleen has spoken on leadership, communication, patient safety, and peer relationships to hospital executives and nurse leaders for twenty years.
All of her books come from her passion to understand the stories of nurses. Her books, “Ending Nurse to Nurse Hostility” and “Speak Your Truth” illuminate our relationships with our peers and physician partners. She is also co-author of “The Dauntless Nurse” which was written as a communication confidence builder.
Kathleen is also a guest Op Ed writer to the Seattle Times and has been interviewed twice on NPR’s “People’s Pharmacy”. Her Tedx Talk calls for changing our belief system from a hierarchy to equality in order to keep our patients safe – and also explains how disaster thrust her into ‘the best profession ever’.