Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Health Care Reform Works—If You Work It

Medical Bills

By Gail M. Pfeifer, MA, RN, AJN news director

My husband and I both recently had preventive screening colonoscopies, which are now covered under the Affordable Care Act (ACA) as preventive care for adults over 50. That coverage, if you purchased a new health insurance plan on or after September 23, 2010, which we did, means you do not have to pay a copayment or coinsurance or meet a deductible if you use an in-network provider (here’s a full list of preventive services covered under the new law). You would think that medical office billers and insurance companies would know that by now.

Although some plans have clauses that let them off the hook on this rule, ours does not—these tests should have been covered. Lucky for us, we knew it when the bills came in. To make a long story short, I was billed for the “surgery” and for the anesthesia. So I first called the billing department of the GI specialist’s office and asked them to rebill the procedure correctly, as preventive screening. No further bills from them, for me, but shortly afterward, my husband was billed by the same office for “surgery” occurring months later—same doc, same procedure, same billing office. He’s following up with phone calls as I write.

I next called the anesthesia billing office, which said our insurance company had denied the claim. I called the insurance company, which looked at our plan […]

2016-11-21T13:13:25-05:00April 22nd, 2011|health care policy, nursing perspective, patient engagement|2 Comments
Read More

When Good Nurses Make Mistakes

The next day, as I prepared my medication tray with shaking hands, two physicians sat at the nurses’ station, talking too loudly as they discussed the medication error and wondered which nurse had made it. Overhearing them, I turned to confess, feeling like a marked woman. They muttered something in my direction, shook their heads, and quickly returned to their charting.

That’s an excerpt from fairly late in “Roger’s Angst,” the Reflections essay in the April issue of AJN. It explores the crippling shame, anxiety, and self-doubt that good nurses can feel when they make mistakes. And it suggests that no one, however conscientious they may be, is free from error in a long career—though few ever reveal their little secrets, even if we might all gain from the knowledge. A touchy subject, to say the least; we hope you’ll read the entire essay and consider weighing in with your own experience. Anonymous comments are, as always, fine.—JM, senior editor/blog editor

2016-11-21T13:13:31-05:00April 15th, 2011|career, nursing perspective|3 Comments
Read More

Bearing Witness: April’s ‘Art of Nursing’ and Cover Art

By Sylvia Foley, AJN senior editor

In “Palm Sunday,” the poem featured in this month’s Art of Nursing, nurse and poet Rachel Betesh evokes the prolonged anguish of those who tend the dying. A man lies “sick and stained” in a bed, leaves his food untouched, and “hardly speaks anymore.” His wife and sons lament “the sin of the too-long moment”; time does not heal, but gapes like an “open wound between sickness and dying.”

A lesser poem might have slipped into sentimentality. But Betesh’s characters are a lively, indomitable bunch. “Pop!” the man’s sons say, visiting; you can feel their vigor. His wife remembers a baked potato he’d once given her, and her response: “You gonna marry me or what?” Indeed, it’s through witnessing, hearing the family’s stories, that the nurses can offer some comfort. They cannot heal the man, but they can “pack the wound, and listen.” (Art of Nursing is always free online—just click through to the PDF file.)

This month’s cover art, a work of embroidery by nurse and fiber artist Paula Giovanini-Morris, explores the concept of memory and illustrates its mechanisms, the neurons and synapses through which the brain registers, encodes, and retrieves events. The piece, titled “Windows and Doors,” was prompted by another kind of witnessing: the artist’s visits to her mother, who was suffering from the early stages of dementia.

AJN senior editorial coordinator Alison Bulman spoke with […]

2016-11-21T13:13:33-05:00April 14th, 2011|nursing perspective, patient engagement, Patients|1 Comment
Read More

Same Boat, Different Ocean

By Shawn Kennedy, AJN editor-in-chief

Since the Robert Wood Johnson Foundation/Institute of Medicine Future of Nursing report was released six months ago, we’ve heard a lot about how nurses need to have more representation on boards of health care institutions and be more active participants in decisions about redesigning health care delivery systems. (See our online resource page for a variety of information about the report.)

To me, it’s a recommendation that’s so intuitive and simple that it’s almost embarrassing—and the need for it only drives home how absurd our health care system can be. It’s mind-boggling to me that organizations feel they can plan effective health care without the input of nurses. Imagine aircraft manufacturers designing a plane without input from the primary group—pilots—who will be responsible for flying it safely.

I suppose many health care entities and boards  feel that they have this input from physicians—but really, in most hospitals physicians aren’t involved in the nitty-gritty operations details that either make or break workflow processes or can impede the delivery of safe, cost-effective care.  How many times have hospitals planned patient care units or purchased equipment without nursing, input only to find that the systems aren’t workable or create more work? […]

2016-11-21T13:13:34-05:00April 12th, 2011|health care policy, nursing perspective|12 Comments
Read More

Feeling Just Beachy

By Shawn Kennedy, AJN editor-in-chief

Last week I wrote a post here about the feeling of well-being—what it is, how it’s measured, and whether or not nurses often experience it. I guess writing the post struck a chord with me. I sometimes (often) feel overwhelmed with responsibilities at work and home and wish there was more time for fun, rejuvenating activities, and relaxing with friends. With this in mind, I decided to accept an invitation from friends to come for a visit.

My husband and I took a leisurely two-hour drive on Saturday down to see old friends at their new home on a New Jersey barrier island, one block from the ocean. Although it was a very cold day, the sun was shining in a bright, blue, cloudless sky. We decided to brave the wind and bundled up and headed out for a walk on the beach. 

The air had that salty-sun smell and the wind was blowing enough to make the water choppy and full of whitecaps—it was gorgeous and exhilarating, and we tramped about for an hour. Later, we headed out again, this time to wander around the point at the south end of the island, where migratory birds and turtle nests were protected. Nothing like an ocean wind to clear your head!

A good meal, some catch-up conversations and laughs—it was a fabulous day. At times, I could still hear that nagging part of my brain saying, “What about those e-mails you need to get out?” and “You have to […]

2016-11-21T13:13:40-05:00March 28th, 2011|nursing perspective|2 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
Go to Top