As ACA Under Threat, Dawning Awareness of a Law’s Many Provisions

by matsuyuki/via Flickr

Nurses reflect the American population’s variety, and this means that many nurses support the Affordable Care Act (ACA) and many would like it repealed, whatever the replacement might be.

Like many Americans, nurses may have a broad ideological or analytical perspective on the pros and cons of the ACA or other health policy issues. Or they may choose for or against complex legislation on the basis of a single issue—like abortion funding, or insurance access for a husband or daughter with a preexisting condition, or whether they believe staffing issues can be blamed on their hospital administration or an ACA provision.

But it’s been my experience as an editor at AJN and a citizen that many people don’t really know that the ACA has multiple provisions that address quality and access issues at every level of health care.

The futures of these provisions are all in question as the Trump administration and a Republican-led Congress prepare to hack away at the ACA without a clear replacement plan.

With a kind of pre-obituary fervor, the media is beginning to pay attention to the changes the ACA brought about now that many may soon disappear—so, for seemingly the first time, are many Democratic politicians, who it’s now clear did very little to […]

January 20th, 2017|health care policy, Nursing|4 Comments

Reluctant Heroes: When Men in Nursing Cry

Reluctant Hero / graphite, charcoal, and pastel on paper / by Julianna Paradisi 2017

I first learned the effect a man’s tears have on my emotions from the parents of my young patients when I was a pediatric intensive care nurse.

I am not unaffected by the tears of a woman, but in the PICU the tears of the mothers differed in nature from the tears of the fathers.

A mother with a hospitalized child will cry, and when overwhelmed, she will break down. But in the PICU, more often than not, she took a tissue from the box I handed her, wiped her eyes, breathed deeply, and then put on a brave face to protect her child from knowing her fear and concern over his welfare.

When the father cried, it was an admission of helplessness. His problem-solving toolbox was empty. The tears represented feelings of personal failure, powerlessness to protect his child and family from disease or trauma. His criteria for being a father, or a man, was eroded.

These displays of total soul-brokenness undid me every time. […]

January 17th, 2017|career, men in nursing, Nursing|2 Comments

Will Congress Listen? Americans Don’t Want ACA Repealed Without Replacement

By Corinne McSpedon, AJN senior editor

By Daniel X. O’Neil/via Flickr

Congressional Republicans are moving quickly to repeal the Affordable Care Act (ACA), but have yet to offer a replacement plan or indicate when one might be introduced. The possibility that more than 20 million Americans who gained health insurance through the ACA may lose their coverage is a rising concern among health care providers and patients alike. The ANA detailed its Principles for Health System Transformation in a letter to President-elect Donald Trump last month, advocating for “reforms that would guarantee access to high-quality, affordable health care for all,” and the American Medical Association sent an open letter to members of Congress last week urging them to develop a replacement plan before making any changes to the existing law.

Voters—including Trump supporters who have health insurance through the ACA—are also voicing surprise and disapproval that the current law might be repealed without a replacement. The Kaiser Family Foundation conducted focus groups of working class supporters of Mr. Trump from Ohio, Michigan, and Pennsylvania who have insurance through the ACA marketplaces or Medicaid. The nonprofit organization’s president and chief executive, Drew Altman, detailed the results of the focus groups in an

January 13th, 2017|health care policy, Public health|2 Comments

Can Your Fitness Tracker Save Your Life?

Megen Duffy, RN, BSN, CEN, works in hospice case management. She occasionally writes on nursing and digital health topics for AJN.

Fitness trackers and ‘wearables’ are becoming ubiquitous.

Fitness tracker “wearables” have become mainstream, with sales projected to reach $19 billion by 2018. If you don’t have one, many of your patients probably do, particularly this time of year when fitness goals are at the forefront of many New Year’s resolution lists. Wearables can track a lot of things, and people are claiming that they save lives. Are they all that? First, here’s a brief overview of wearables types and their uses.

Popular wearable brands include Fitbit (with 79% of sales), Jawbone, Nike, Apple (Apple Watch is a smart watch that has fitness tracker functionality), Garmin, and Misfit. Prices run from about $50 to as much as you want to spend: an Apple Watch costs from $275 to more than $10,000, depending on the model.

Increased functions. Wearables have far surpassed their pedometer function. They do all count steps, but now they also track sleep and heart rate and have increasingly more bells and whistles. The newer Fitbits and the new watchOS operating system for the Apple Watch even have “breathe” functions, intended to remind the wearer to take a few minutes several times a day and breathe to promote relaxation.

Wearables (including smart watches) now have extra features such as […]

January 12th, 2017|digital health, personal health practices|0 Comments

Health Care Terms and Words To Retire and Replace?

This week, two bloggers posted lists of words or terms they felt should no longer be used when referring to health professionals or patients.

  • Harrison Reed, a physician assistant who writes for In Practice, a blog at NEJM Journal Watch, wrote “Seven Medical Terms to Ditch in 2017.” On his list was LFTs (liver function tests); regular rate and rhythm (RRR): little old lady (LOL); AAM or AAF (other potential objections aside, these are often taken to mean African-American male or female, but can just as easily mean Asian-America male or female); and nauseous when one actually means nauseated. He also would like to see an end to the use of the modifier “midlevel,” as when it’s used to refer to NPs or PAs as “midlevel providers.”
  • Over at KevinMD.com, physician Pamela Wible published “Stop saying these 7 shaming words in medicine. Right now.” Her list included phrases to abandon, along with replacements that she believes to be more accurate and/or respectful. For example, she advocates replacing “is bipolar” with “has bipolar […]