Practice Tip of the Week | Foresight and Futures Thinking for Nurse Educators and Leadership

By Cindy Zolnierek, PhD, RN, CAE

Picture yourself behind the wheel of a car. As you drive, you stay aware of what’s around you. Your focus is directed forward, at the dashboard, through the windshield, down the road, until you have to change course. Then, your awareness must expand—you use your rearview and side mirrors to check behind and beside you; stay conscious of the road before you; and keep a full range of awareness of your vehicle and your experience while driving it.

This awareness is what we talk about when we talk about foresight—awareness of the road before, behind and around you. It’s easy to assume that foresight focuses only on the future. However, an awareness of the effects of the past on the present—and the soon-to-be-past on the immediate future—makes for a more complete picture.

Foresight builds on skills that nurses already regularly employ. Nurses attend to their patients noting the patient’s history, previous responses to health challenges, current status, anticipated recovery trajectory, and risks to their condition and progress. Nurses note their patients’ responsiveness – physical, emotional, and cognitive – and project, or foresee, nursing care needs based on their assessment. Aware of many possibilities, nurses tune into any changes that may indicate shifting potentials that may require nursing intervention to minimize risk and optimize the patients’ outcomes. When nurses systemize or innovate such approaches for future patients, they are using foresight to create a preferred future.

In foresight leadership, the perspective is on a particular environmental context rather than the patient.

For educators, how does what you see and experience around you affect your understanding of the competencies future environments will require of nurses? How can you address such emerging learning needs? How can you help students develop the capacity to rapidly adapt to changing work environments and apply scientific principles in uncertain situations?

For nurse leaders, how have the tumultuous changes in health care affected your anticipation of the future? Certainly, workforce challenges are top of mind and unique from previous experiences. From the trends you see and experience, what future do you imagine? What future do you hope for? What actions can you take now to bring your preferred future forward?

Nurse vigilance is necessary to identify emerging risks to a patient’s recovery trajectory so that intervention can occur to rescue the patient from an adverse outcome. Conscious effort and vigilance is also need to apply foresight in nursing education and leadership to direct our journey toward a positive outcome. One must be attentive to what has been, what is, what is emerging, and what is possible.

“What” is plural, not singular. That is, there are many future possibilities. Nurses have the potential to steer the profession toward a preferred future, one which honors our value and optimizes our contributions to the quality, safety, and cost of health care. This can be our preferred future, but only if we can see it and are willing to intervene to make it happen.

Learn more about foresight here.