Download from The Future of Nursing Meeting at the National Institute of Medicine/Science/Engineering, July 30, 2019 – Washington,D.C.

What happens when a prestigious foundation brings together nursing experts from across the United States, mixes representatives from other related fields, and invites an internationally well-known futurist to guide them through some brave and complex thinking and exploring about the future of the nursing profession? Well…I got to find out last week when I was invited to participate in exactly this opportunity in Washington, DC.

This event was part of a multi-year engagement in exploring, amplifying, strengthening and preparing the profession of nursing for the future – co-sponsored by the Robert Wood Johnson Foundation and numerous other nursing education and practice leader groups. You can read some of the national consensus panel work that preceded this gathering here.

Amy Webb is a quantitative futurist, a Professor of Strategic Foresight at the NYU Stern School of Business, and Executive Director/Founder of the Future Today Institute in NYC, who has written numerous books on complex futures topics – one of which I reviewed here in this blog (The Big Nine). Another of her notable books is called “The Signals are Talking” which was used for this meeting. This book is very much a primer on futures thinking and her method for actively preparing for it. She notes that “forecasting the future requires a certain amount of mental dexterity,” (p.34). Amy describes the futures field as one that is interdisciplinary and “combines mathematics, engineering, art, technology, economics, design, history, geography, biology, theology, physics, and philosophy,” (p. 10). If you are not familiar with her annual “Tech Trends” report – now in it’s 12th year, you will want to explore this broad and dynamic resource. It is truly fascinating how emerging technologies are most likely to impact our shared future (sometimes in unexpected ways) – and positions/challenges all of us to push for ethical and reasonable evolution in these spaces. If you’d like to watch her in action, you can do so here! “The Signals are Talking” is a textbook on her method which includes six steps: 1) Find the fringe (which are the spaces where changes are most likely initially occurring), 2) Use CIPHER to uncover patterns (contradictions, inflections, practices, hacks, extremes and rarities), 3) As the right questions, 4) Calculate the ETA, 5) Create scenarios and strategies, and 6) Pressure-test your actions. These comprise the building blocks of a facilitated group process which mapped to our day.

Of particular interest to me is Amy’s approach to organizing how to look for and begin to map trends and “signals” about change that is in the air and in motion…and how they may impact the issue you care about and/or interact with one another to create additional ripples of change. This is a handout which lays out these “disruptive sectors” – and I thought quite helpful in organizing our thinking about all the intersecting factors that drive change in the world around us.

The purpose of this gathering was to invite a broad array of key informants to widen and deepen the collective imagination and intelligence to advance and elevate the future of nursing. Our day was spent in small and large group dialogue in which we mapped out relevant signals potentially impacting the future of the nursing profession in all of these areas.

Just a few of the questions we considered included:

• What are the social determinants of health that will help decide future well-being?

• What are the new challenges to achieving equitable access to quality healthcare within the next 10-20 years?

• Who will be involved (other professions or sectors)? How will roles and expectations change (specifically nurses, physicians, and community health workers)?

We were encouraged to map out all kinds of strong and/or weak signals about possible connections and impacts to what nursing practice may look like in the future. Once we were done with this, we used these maps to identify those we thought were most compelling and then, using a method Amy shared with us (identifying axes of uncertainty related to economic shifts, technological progress, social changes and/or politics/activism), strategically create scenarios based on these insights to imagine even deeper possibilities and unexpected turns. As she said, we were trying to “see around corners” in our collective effort. Many fascinating possibilities were identified and created in our shared space. Folks were literally “all over the map” (a good thing!!!) in terms of which they thought were more and less likely to occur – and why – but that was part of the beauty of this process. We were navigating lots of uncertainty and disruption in the way we perceived what kinds of things might happen next in the nursing ecosystem – technology, politics, advances in practice – and emergence of new and more complex health challenges to name a few. We were literally building a shared sense of collective intelligence as we debated and navigated these conversations. It felt productive and definitely got to several levels deeper than typical, more superficial “conference chat.”

After spending time considering some of our scenarios, we were invited to prioritize those we most desired collectively – and used a technique called backcasting to think through what kind of strategies would most valuable to achieve this set of aspirations, being mindful of how many disruptions were likely along the way. We were attentive to the risks of the undesirable scenarios as well…and the degree to which we might have to also consider preparing to defend and/or strategize against them too.

The ideas developed from this day will be used by Amy and others involved in this effort – from RWJF and the Institute of Medicine Consensus Panel leadership – to write a follow up report to guide their ongoing work and planning.

It was a most interesting day. It was a valuable experience – and was terrific to get to see/meet/learn from Amy directly after being such a fan of her work from afar. She’s super smart and delightful!!! Grateful to have participated!! Can’t wait to share many of these lessons with my fellow social work folks!! Let’s build a better future!!

Thanks Amy and RWJF!

Bonus new term to me: Exponential Medicine. This is how futurists in medicine talk about what they are doing. They have an annual conference to share the broad range of what is happening – you can explore more about it here.