ANA’s Cipriano, AARP’s Reinhard Comment on ACA’s Undoing

President Obama signing the ACA in 2010/via Wikimedia Commons

Nurses and the Undoing of the ACA

Many in the nursing community supported the Affordable Care Act (ACA) when it was first introduced. This is understandable, given our firsthand experience of patients who didn’t seek care until they were gravely ill because they lacked health insurance. We know how disease management can change outcomes for those with chronic illness and how preventive care can make the difference between having a treatable cancer or a metastasis.

In the years since, as both supporters and detractors continued to argue over the law and its need to be improved (or scrapped, depending on your viewpoint), over 20 million people gained health insurance and access to care.

Now as Congress moves to repeal and replace the ACA with a yet-to-be-determined plan, many are concerned that major gains will be lost and once again it will be the poor and vulnerable who will suffer. (I touched on some of the concerns in my March editorial.)

To get a little more insight, I spoke with two very policy-smart nurses about what might happen and what they feel should happen.

What ANA president Pam Cipriano said:

I asked ANA president Pam Cipriano what she thought was the most critical aspect of […]

2017-03-01T10:17:14-05:00March 1st, 2017|health care policy, Nursing, nursing perspective|1 Comment
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Baby Boxes: Gifts Intended to Educate New Parents About Safe Sleeping

A Gift for Every New N.J. Parent

When I had my first child in New Jersey more than a decade ago, the hospital sent me home with a bag of product samples, including a few diapers, a package of wipes, two cans of formula, and an assortment of coupons. These items were helpful to varying extents—I was breastfeeding and unlikely to buy the products featured on the coupons, but the wipes and diapers certainly came in handy. So did the little hat a nurse put on my son’s head soon after birth. With its horizontal pink and blue stripes, this soft beanie that actually stayed in place was ever present during his first few weeks. It was the most useful and well-loved relic of our hospital stay.

The parents of infants in New Jersey are now given an even more practical item, one that also has the potential to reduce infant mortality rates: a baby box. This laminated, nontoxic cardboard box is packed with items that are essential during the early days of parenthood—including diapers, wipes, clothing, and breast pads—but it’s also a bed. The box, which includes a mattress and sheet, provides a safe place for infants to sleep during their first year. It’s free to all new and expectant parents in the state who watch a 20-minute educational video and take a quiz online. Upon completion, they receive a certificate that allows them to pick up the box at a local distribution center or order it by […]

2017-07-27T11:45:04-04:00February 24th, 2017|Nursing, Public health|1 Comment
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An Oncology Nurse’s Perspective on the Health Insurance Situation

Money Bag/ by Julianna Paradisi/ all rights reserved

Costly Care

I was an oncology infusion nurse in a hospital-based ambulatory center for a number of years, many of them before the Affordable Care Act (ACA) was signed into law in 2010. Besides administering chemotherapy and blood products, I infused medications to patients with sickle cell anemia as well as chronic autoimmune disorders such as rheumatoid arthritis, lupus, and Crohn’s disease.

The common denominator among these diseases is the high cost of the medications used to treat them, at the time ranging from $3,000 to $10,000 per treatment. I know, because patients told me, their nurse.

I also know because uninsured patients were required to fill out paperwork declaring their lack of income, prior to receiving authorization for charitable treatment. If they were sick enough, they were admitted to the hospital for initial treatment, at more expense than outpatient infusion, until the paperwork was completed and approved.

These were particularly difficult times to be an infusion nurse.

Some patients lost their jobs during cancer treatment, because the cost of their cancer care increased their employer’s insurance coverage risk pool rates.

Other patients worked night shift before arriving, sleepless, for chemotherapy as soon as we […]

2017-02-22T14:53:49-05:00February 22nd, 2017|health care policy, Nursing, Public health|1 Comment
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The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing water […]

2017-03-14T12:02:17-04:00February 15th, 2017|Nursing, Public health|0 Comments
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Culture as a Key to Health

By Beth Toner, MJ, RN, senior communications officer, Robert Wood Johnson Foundation

(Video caption: The Dakota are a horse tribe, and Charley, a retired reservation policeman, takes care of abandoned horses, connecting them to the tribe’s youth to help the young redefine themselves in relation to tribal history. Video used by permission; produced by Purple States LLC with support from the Robert Wood Johnson Foundation.)

I consider myself, and have been told by others that I am, an extraordinarily patient person—except behind the wheel of a car.

I commute 80 miles each way to work (that’s how much I love my job), so I spend a lot of time in the car. That, in turn, means I get annoyed—unreasonably so—by folks who are driving in such a way that forces me to spend a minute longer than I need to in that car. Now, it never leads to dangerous or aggressive driving, but it does lead to a lot of windows-up ranting while I’m on the road. One day, while I was in mid-rant, my 21-year-old daughter finally said, “Mom, you need to imagine other people complexly.”

I think of that conversation often as I listen to the polarizing dialogue that continues across our nation. What if, across the nation, we each imagined other people complexly, not just as their culture, their gender, their political party, their favorite television show? People, with all their joys and sorrows, their best qualities and their deepest flaws—uniquely themselves, yet with so much […]

2017-02-02T10:33:44-05:00February 1st, 2017|Nursing, Public health|1 Comment
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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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