In the United States, reform modalities and the extent of reorganization have varied
greatly. Health care reform and the intensity of changes has varied, and been the driving
of change. In relationship to nursing practice, nurses report their practice has been influenced
by altered personnel mixes or decreases in the nursing workforce,
stricter reimbursement mechanisms, health service restraints brought on by
economic limitations, new organizational structures, and a changing demographic
and health profile for the populations served. The nurses describe
doing more work in less time with fewer ...
Changes within the health care system over the past 10-15 years are summarized. References are also provided to justify the assertions.