Guiding Principles for the Role of the Nurse in Future Health Care Delivery Toolkit

AONE is holding the question, “What are the principles that can guide us as we define future patient care delivery models and the nurse who will be providing care to our patients and populations in the future?” That work to date has resulted in the following set of guiding principles that will provide a framework for these continuing conversations.

The principles are grounded in the following assumptions:

  1. In 2010, we will not have enough healthcare workers to deliver care using the same models that we use today.
  2. We must first define the work of the future, then the roles needed to do that work, and then the education that is required to create the role to do the work.
  3. We will be dependent on technology to assist us in achieving safe patient care that is provided with measurable quality.
  4. We cannot wait until we have all the answers. We must begin to experiment and act now.
  5. We ground our planning in the science of complex adaptive systems, with an emphasis on systems thinking.
  6. Dramatic change and revolutionary thinking are imperative.
  7. The delivery models for the future will require that we work collaboratively in multidisciplinary teams.
  8. We are committed to evidence-based practice and the research that supports it.

The Guiding Principles

  1. The Core of Nursing is Knowledge and Caring. The actual work that nurses do will change, but core values will remain.
  2. Care is User-Based. Care will be directed in partnership with the patient/client or population needs and will be respectful of the diversity of the health belief models of all users.
  3. Knowledge is Access-Based. The knowledge base of the nurse will shift from “knowing” a specific body of knowledge to “knowing how to access” the evolving knowledge base to support the needs of those for whom care is managed.
  4. Knowledge is Synthesized. The processing of accessed knowledge will shift the work of the nurse from critical thinking to “critical synthesis”. Synthesis occurs as care is coordinated across multiple levels/disciplines/settings.
  5. Relationships of Care. Our knowledge and the care provided are grounded in the relationships with our patients/clients/populations. The relationship will be multidisciplinary and include the full societal scope of generations, diversity, and interdependency.
  6. The “Virtual” and the “Presence” Relationship of Care. Relationships will be dramatically changed by the increased application of technology, causing us to further define the relationship context as being “virtual” or “physical presence” and knowing when each is required.
  7. Managing the Journey. The work of the nurse in the future will be to partner with the patient/client to manage their journey in accordance with their needs and desires and available resources.

The following resources can be used to conduct dialogues on the Guiding Principles within healthcare organizations. Questions and feedback should be directed to

Guiding Principles presentation (.ppt) Members Onlylock
Guiding Principles Talking Points (.doc) (.pdf) Members Onlylock
“Guiding Principles” (Hospitals & Health Networks, July 2004)
Nursing Organizations Alliance Principles and Elements

AONE Guiding Principles for the Role of the Nurse in Future Care Delivery Toolkitlock

The Core of Nursing is Knowledge and Caring
Care is User-Based
Knowledge is Access-Based
Knowledge is Synthesized
Relationships of Care
Managing the Journey