Federal Budget Battles Begin – Health Professions Education at Stake

By Shawn Kennedy, MA, RN, AJN editor-in-chief

I’m subscribed to many listservs, mailing lists, and eNews alerts that help me keep track of news that may be important to nurses. One e-mail list I’m on is the Health Professions and Nursing Education Coalition (HPNEC), from the Association of American Medical Colleges. It closely monitors funding for health professions education.

Last week, the e-mail reported on the proposed 2012 federal budget—that is, the initial draft proposed by the House Labor, Health and Human Services, and Education departments appropriations subcommittee. Among a great deal else, this includes funding for  Medicare, the National Institutes of Health, the CDC, and medical and nursing education (Title VII and Title VIII funding).

There’s already contention over the proposal, with the Democrats claiming they had nothing to do with it. According to ranking Democratic member Rep. Norm Dick, quoted in the minority party press release: “Make no mistake: this is not a committee product. This draft bill represents the ideological position of one committee member—the subcommittee chairman.”

Among other aspects, the proposal includes cuts to all monies to Planned Parenthood (as long as it continues to provide abortion services), National Public Radio, and any programs under the Affordable Health Care for America Act.

According to the HPNEC e-mail: “The bill offers a total of $87.5 million for Title VII programs, a $185 million (67.9 percent) cut, by eliminating funding for the Title VII Health Careers Opportunity Program, scholarships for disadvantaged students, primary care medicine, Area […]

2016-11-21T13:11:49-05:00October 3rd, 2011|health care policy, nursing perspective, students|1 Comment
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Military Metaphors, Unnecessary Admissions, New Blogs, Keeping Secrets

It’s a common scenario: a 90-year-old resident of a U.S. nursing home — call her Ms. B. — has moderately advanced Alzheimer’s disease, congestive heart failure with severe left-ventricular dysfunction, and chronic pain from degenerative joint disease. She develops a nonproductive cough and a fever of 100.4°F. The night nurse calls an on-call physician who is unfamiliar with Ms. B. Told that she has a cough and fever, the physician says to send her to the emergency room, where she’s found to have normal vital signs except for the low-grade fever, a normal basic-chemistry panel and white-cell count, but a possible infiltrate on chest x-ray. She is admitted to the hospital and treated with intravenous fluids and antibiotics. During her second night in the hospital, Ms. B. becomes confused and agitated, climbs out of bed, and falls, fracturing her hip. One week after admission, she is discharged back to the nursing home with coverage under the Medicare Part A benefit. The episode results in about $10,000 in Medicare expenditures, as well as discomfort and disability for Ms. B.

There is an alternative scenario, however . . .

That’s from an article in NEJM called “Reducing Unnecessary Hospitalizations of Nursing Home Residents.” In any health care system of as much complexity as ours, there’s bound to be a huge amount of waste. The article gives a good example of how the skills of NPs might be put to excellent use both saving a lot of money for Medicare and making the lives of nursing home residents a whole […]

2016-11-21T13:11:50-05:00September 29th, 2011|nursing perspective|2 Comments
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The NLN: Where Nursing Teachers Go to Learn

By Shawn Kennedy, AJN editor-in-chief

As a nursing student, I was always awestruck when an instructor could rattle off a few points that keyed me into what I should be thinking about when I approached a patient, or use questions to lead me through a thought process that ended with the discovery that I’d known the answer all along. It never dawned on me that those were teaching skills, tools of the trade that she’d learned as an educator.

Last week, I spent a few days in Orlando, Florida, attending the 2011 Education Summit of the National League for Nursing, or as most nurses know it, “the NLN.” I’d venture that if you asked most nurses (who aren’t faculty, that is) what they know about the NLN, they’d answer that it’s the body that accredits nursing schools (key information when deciding what nursing program one should attend). While that’s partially correct, that’s only one part of the NLN’s mission. […]

2016-11-21T13:11:51-05:00September 27th, 2011|Nursing|0 Comments
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Bad Economy Breeds a New Era of Discontent Among Nurses

By Shawn Kennedy, AJN editor-in-chief

Nurses are taking to the picket lines, again. On Sept 22, an estimated 23,000 nurses in California struck at Kaiser Permanente facilities and also at Sutter Health hospitals and Children’s Hospital Oakland. The one-day strike was organized by the California Nurses Association/National Nurses United (CNA/NNU) to protest what they say are unfair rollbacks to nurses’ health coverage and retirement benefits, and was also intended as a show of support for striking coworkers.

But it’s not just U.S. nurses who are engaging in job actions—for example, in the United Kingdom, the 400,000 member Royal College of Nursing is contemplating the first strike in its nearly 100-year history and is soliciting the views of its members as to what action should be taken. The issue is nurses’ pensions and job cuts—according to Nursing Standard, “almost 10,000 NHS [National Health Service] posts in England alone have been earmarked for cuts.”

The poor economy is putting pressure on hospitals and health systems everywhere to reduce costs. One way to do this, of course, is to make cuts in what is traditionally the biggest expense in running the hospital—nursing. While this is a quick fix to the bottom line, it’s also one that doesn’t solve the problem. In fact, evidence shows that inadequate nurse staffing is linked to poor outcomes, which ultimately cost more in the long term—for the patients, for the health care system, and for nurses, who […]

2016-11-21T13:11:52-05:00September 26th, 2011|career, nursing perspective|5 Comments
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The Priceless Clarity of Inexperience

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN.

Heartstudy by James P. Wells, via Flickr

I was precepting a senior nursing student last week. During an idle moment, I asked her why she’d decided to go into nursing.

She shrugged, averted her eyes, and mumbled something like “I’ve just always wanted to.”

I didn’t press it, but I’m sure there’s more to it than that. I probably shouldn’t have asked, given that I cringe when posed the same question, and usually give a faltering and inadequate “I like helping people” kind of answer . . . when “that’s too personal of a question” would be more honest.

I’ve been a nurse for years, and there are certain aspects of the profession I wouldn’t attempt to broach in casual conversation. I doubt that I could have articulated my motivations when I was a student, even if I’d wanted to. That exchange, though, calls to mind one of the most defining experiences of my nursing career.

I was a senior nursing student, doing a clinical rotation in the ICU. My preceptor and I were caring for a patient who’d been in a motorcycle accident. He’d not sustained a […]

2016-11-21T13:11:53-05:00September 22nd, 2011|career, Nursing, Patients, students|8 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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