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

Open Your Mind: Brain Pickings and TED (NOT the compression stockings)

By Shawn Kennedy, AJN editor-in-chief

Twitter is a wonderful tool. This morning, as is my habit, I surfed my “favorites” column on my Tweetdeck platform to see what new and interesting things were being tweeted. And I noticed one of particular interest (I’ll get to it shortly) at the twitter page of Brain Pickings, a Web site that focuses on, in their own words,

“ . . . curating interestingness—picking culture’s collective brain for tidbits of stuff that inspires, revolutionizes, or simply makes us think. It’s about innovation and authenticity and all those other things that have become fluff phrases but don’t have to be.”

This twitter stream has alerted me to some unique and wonderful photographs, music, Web sites, charts and graphs, and books. True to its mission statement—and in service of the notion that “creativity is a combinational force”—it offers “ [c]urated bits of culture that will, at the very least, introduce you to new ideas and perspectives and, at their very best, help you think more, laugh more, create more.”

This morning, the tweet in question directed me to a video presentation by Kathryn Schulz, a self-proclaimed “wrongologist,” author of Being Wrong: Adventures in the Margin of Error. In it, she explains […]

2016-11-21T13:13:29-05:00April 20th, 2011|Nursing|0 Comments
Read More

What’s Ugly? — And Other Crucial Conversations for Nurses

By Shawn Kennedy, AJN editor-in-chief

Our monthly Art of Nursing department—often, a poem or image somehow related to health care—is a unique feature for a scholarly publication, but one we feel strongly about. We believe that in order to provide truly holistic care, nurses need to know about more than evidence-based clinical content—they also need to be aware of many other aspects of the human experience. 

One thing art teaches us is that people don’t always see things the same way. What’s beautiful, illuminating, or at least useful to one person may be ugly or offensive to another. Consider billboards with public health messages. To some, such a billboard may seem to be an eyesore blotting the landscape; to others, the image and message is a powerful tool for disseminating life-saving information. Our September 2010 Art of Nursing (click through to the PDF version) showcased billboards in Guinea-Bissau, a poor country with HIV prevalence  of epidemic proportions. The billboards, photographed by Dawn Starin (here’s a blog post she wrote about them), are used to encourage people to get tested. A blog post by AJN senior editor Sylvia Foley about the column noted concerns some had expressed about these billboards:

Are the billboards effective? Starin writes, “Although the billboards are fabulous to look at, many health professionals I spoke with thought they exemplified time and money wasted, in part because of the high nationwide illiteracy rate.” One health worker emphasized the need for more culture-specific studies on sexual practices and tradition, so that appropriate education […]

2016-11-21T13:13:30-05:00April 18th, 2011|Nursing|12 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

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