ANA Chart Compares Key Nursing Provisions in House and Senate Bills

By Judith Leavitt, MEd, RN, FAAN

There’s a tremendous amount of information available about the different congressional proposals on health reform. But it’s difficult to know how the proposed legislation might affect nurses and the profession. The American Nurses Association has just released an excellent chart offering side-by-side comparison of key provisions related to nursing in the two current bills, the House bill (H.R. 3962) and the Senate bill (H.R. 3590). These provisions include:

  • increased financial support for nursing recruitment and advanced education
  • increased funding for graduate education for nursing faculty
  • increased funding for education for students who will practice in underserved areas
  • establishment of a Public Health Workforce Corps
  • increased Medicare reimbursement rates for advanced practice nurses, including nurse–midwives
  • pilot programs to provide reimbursement under Medicare for nurse practitioners to create or lead “medical homes”
  • increased reimbursement to school-based health clinics under Medicaid

There’s much more to be gleaned here, and the chart format makes scanning for particular points of interest easy. Have a look!

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2016-11-21T13:20:44-05:00December 4th, 2009|career, health care policy, nursing perspective, students|1 Comment
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Ignorance May Be Bliss — But It’s Certainly Not Professional

By Christine Moffa, MS, RN, AJN clinical editor

A few weeks ago I attended an orientation provided by the New York City Department of Health for a school-based H1N1 vaccination program. Years ago I worked as a school nurse here in New York and I thought participating in the program would be a great way to keep up some clinical skills and spend time with patients. A physician from the bureau of immunization gave an informative lecture reviewing the epidemiology, signs and symptoms, prevention, and treatment of influenza.

There were about 100 nurses in attendance, many of them new graduates who were unable to find full-time work. During a break one of the new grads said to me, “why do we have to sit through this irrelevant lecture?” I couldn’t believe it. If you’re administering a medication, I told her, of course you’d want to understand how it works and why you’re giving it. In addition you need to be able to explain it to the patient or their parent. She rolled her eyes and walked away. And I thought, once again: this is why nurses are not taken seriously as professionals.

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2016-11-21T13:20:57-05:00November 25th, 2009|career, nursing perspective, students|10 Comments
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Saving SimBaby – Teaching Nurses to Speak Up

AJNReportsNov09The baby’s condition is going downhill fast. A medical team surrounds the infant, tersely exchanging instructions. The gripping scenario has the participants’ hearts beating fast, but the baby on the table is SimBaby, a manikin with sophisticated robotics that’s used in health care simulation training.

As in a real situation, “there is adrenalin in a simulation,” explains Elaine Beardsley, MN, RN, clinical nurse specialist in the pediatric simulation program at Seattle Children’s Hospital. “Even though it is a simulated environment, people get nervous. People talk more.” However, Beardsley says, the structured communication training within the simulation “cuts the chatter.”

The November AJN Reports focuses on ways that SimBaby is helping teams of nurses and physicians at Seattle’s Children’s Hospital learn to avoid the kinds of communication breakdowns that, studies have shown, can lead to errors in stressful situations. The training includes creating a safe environment in which nurses and residents are encouraged to speak up to physicians “when they perceive mistakes being made.”

“Simulation, in my mind, is about getting us to communicate better,” says Jennifer Reid, MD, assistant professor of pediatric emergency medicine at the University of Washington School of Medicine and Seattle Children’s Hospital and codirector of the hospital’s ED simulation program. “Our training is such that physicians and nurses are usually educated, trained, and practice more or less in parallel. Simulation is an opportunity-a rare one-for us to learn and train together, working consciously on our communication skills. When else do I […]

2016-11-21T13:21:09-05:00November 11th, 2009|students|1 Comment
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A Nursing Student Learns the Trick of Reassurance

NovemberReflectionsI wasn’t sure why Mary Sue was in long-term care, but I could tell she had dementia. She spent most of her time in a recliner near the nurse’s station, asking anyone who walked by why she couldn’t go back to bed.

“It isn’t time yet, Mary Sue,” the staff would reply. I asked one of the nurses why they didn’t just take her back to bed. “When we do,” she told me, “she asks to return to the chair. Out here we can keep an eye on her. She can look out the window. She smiles more often.”

But I had yet to see a smile. This was my first rotation as a nursing student, and I tried to use techniques I’d read about to distract Mary Sue: towel folding, cards, books. But she remained on target, reaching out to me and repeating her request with a distraught look on her face. . .

Read the rest of the November Reflections essay,  written by a nurse looking back on her first nursing school rotation five years ago. The basic human need for reassurance is shared by all of us, whether we are patients or providers. What do you do to stay centered during the day, to remind yourself of your own value, to focus on what really matters . . . or just to stay in the game?

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2016-11-21T13:21:27-05:00October 27th, 2009|nursing perspective, students|0 Comments
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What Do You Wish You’d Learned in Nursing School?

Dietetics class for nurses, 1918/Cornell University Library/via Flickr Dietetics class for nurses, 1918/Cornell University Library/via Flickr

By Christine Moffa, MSN, RN, clinical editor

While I was going through nursing school I imagined that our clinical rotations would prepare us for the reality of working in a hospital. I was very eager to graduate and get my first job. Had I known that I was in for the hardest year of my life, I probably would have changed majors. I was hired to work the night shift in the float pool of a children’s hospital. That is a bad idea right there and I wish someone was there to talk me out of it. But on top of that, I found it difficult to express by opinion when residents and nurses with more experience did not heed my concerns about patients who were decompensating. And calling the attending in the middle of the night did not seem like a good option. I wish I had been told in nursing school that the nurse supervisor is a great resource to go to in times like these.

We often hear stories of what a shock it is for a nurse to finally start a nursing job after finishing school. Is there anything nursing schools could do to change this? What do you wish you’d learned?

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2016-11-21T13:21:50-05:00October 8th, 2009|nursing perspective, students|10 Comments
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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.
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