Nurses working in all community settings are experiencing unprecedented change. It is driven by many
factors: demographic shifts, higher rates of chronic disease, health policy, increasingly better engaged
patients, social and economic developments, and progress in medical and other technologies and in nursing
practice – to name the key factors. The interplay of these variables is dynamic and inter-dependent. Health
policy, for example, addresses the impact of changes in the demographic make-up both in the population
and in the workforce, while changing social mores and expectations demand health policies that recognise
the primacy of the patient at the heart of decision making and choice. For nurses, each of the factors is
powerful enough in its own right to prompt significant change: together, they form an irresistible force.
The demand for nurses and expectations of nursing will rise exponentially as the new world unfolds. More
nurses will be working outside of hospitals; more of them will have specialist or expert skills; many will
continue as generalists offering flexible and accessible care in a variety of settings including the home.
Nurses will practice in multi-disciplinary teams as members and as leaders; their work will cross
organisational boundaries, and will be built on partnerships – none more vital than the partnerships with
their patients and the communities they serve.