4) Education and Retraining:

A) Preparation for New Nursing Roles

While hospitals continue to employ two-thirds of the practicing nurses, and will probably continue to be the largest employment setting for nurses for some time to come, new opportunities exist in managed care and in alternate settings, such as nursing homes, community/home/public agencies, and schools. As more nurses find themselves employed in a managed care work setting, adequate preparation for the unique elements of such an environment must be addressed. To appropriately prepare and retrain acute care nurses for new roles in community care, continuing education and undergraduate nursing programs need to develop curricula that include the essential skills necessary to function competently and effectively in new managed care roles and settings.

ANA has developed a Managed Care Curriculum for Baccalaureate Nursing Programs, funded by a grant from the American Nurses Foundation and Aetna Life and Casualty (Hart, 1995). Copies of the curriculum were distributed to all university schools of nursing and the State Nurses Associations. This six semester-hour course is designed to prepare nurses to function effectively and efficiently in beginning leadership roles in a managed care environment.

Didactic content includes community-based nursing practice, the philosophy of managed care, technology and managed care practice, prevention, health promotion strategies, client and provider accountability, risk management, sensitivity to health costs, quality improvement, risk management, marketing and interdisciplinary collaboration. Practicum includes computer knowledge and skill development, clinical practice, mentoring by experts, performance assessments, quality assessment and analysis, cost accounting and analysis, interdisciplinary team activities, and generation of and participation in staff development programs.