Abstract
D r Martha Rogers is a Canadian nurse-futurist whose research re- veals that adult responses to learning about the future can be classified 3 ways. Accord- ing to Dr Rogers, learning about the future involves patterns of the mind, heart, and soul. 1,2 Future thinking requires a keen mind that understands and appreciates the complexity of systems thinking; taken se- riously, future-oriented discussions and consequences of human action generate strong feelings; and finally, learning and wondering about the future taps existen- tial anxieties and confronts people with questions of meaning, purpose, and soul. scenarios. Dr Rogers suggests use of the fol. lowing questions 3 to aid reflection: How plausible does the scenario seem? What thoughts does it bring to mind? What feel- ings does it generate? What are the impli- cations for society, health care, and nurs- ing? If parts of the scenario are desirable, what actions need to be taken to increase the chances of the scenario happening? If parts are undesirable, what actions need to be taken to prevent them from happening? The first 2020 scenario is Technology Eclipses Care. In this story, health care is driven by technology. Hospitals become high-tech centers. Sensors, monitors, voice-activated equipment, and smart ma- chines monitor and adjust care param- eters. Genetic engineering decreases or eliminates disease development. A cast of health supporters develops, which in- cludes massage therapists, palliative care assistants, elder care assistants, health communication specialists, and child de- velopment specialists. Nursing disappears. Analysis reveals that the reason for nursing's disappearance was that nursing was defined by skills and tasks rather than by knowledge. The second 2020 scenario is Control, Manage, and Measure. In this scenario, social programs are eliminated because of debt. The business of health care is orga- nized around programs of managed care. Health activities are centralized. Genetic fingerprints result in predicted illness pat- terns. People are given personalized care maps based on genetic analysis. Compli- ance with the care maps is monitored via personal health record smart cards. Persons who do not follow the care map are re- quired to finance their own health care. Doctors choose whom to hire. i The num- ber of nurses on the teams decrease because others are cheaper to employ. A small band of nurses who believe in the power of nurs- ing continues to exist.
Published Version
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