School Nurses, H1N1, Understaffing, and Public Safety

We’ve posted here, here, and here in recent days about the importance of school nurses during the H1N1 outbreak.

Now here’s strong testimony before the U.S. House Committee on Education and Labor from the California State Superintendent of Public Instruction on why school nurses were crucial during the H1N1 outbreak and why understaffing issues must be addressed for the sake of public health.

“At last count, there are approximately 2,844 nurses who serve California’s 6.3 million public school students. That translates to a ratio of 2,227 students to every one school nurse, the largest student-to-nurse ratio in the country. This in no way, shape or form provides effective healthcare for the increasing numbers of students with complex chronic and immediate health needs that require daily care on our school campuses. If we had more school nurses on our campuses, perhaps they could have played an even greater role in early detection and prevention efforts.”

2009-05-18T14:45:09-04:00May 8th, 2009|health care policy|2 Comments
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Will Sebelius ‘Walk the Talk’ on Nurses and Health Care Reform?

HSS Secretary Kathleen Sebelius. Photo by National Governors Association, via Flickr.

Reportedly, in a speech yesterday to nurses with the American Federation of State, County and Municipal Employees (AFSCME), brand new Department of Health and Human Services (HHS) Secretary Kathleen Sebelius told the group that if the Obama administration is to “make health reform a reality, we need nurses at the forefront of the effort.”

Sounds good, and it’s on point with Obama’s messages to nurses during his campaign.

So far, the Obama team has been consistent with its positions on health care reform. But as we learned from the Clintons’ efforts, talk doesn’t always translate into reality. Dare we hope that this time—with nurse Mary Wakefield as administrator of the Health Resources and Services Administration (HRSA); a Democratic-controlled Congress; data like we’ve never had before linking nurses to quality, cost-effective health outcomes; and a population at the end of its rope—maybe, just maybe Congress will get it right? Or will the powerful insurance and medical lobbyists prevail?—Shawn Kennedy, AJN editorial director

(AJN editor-in-chief Diana Mason adds this comment: Sebelius knows that nurses are key to reforming health care and reducing health care disparities. We have an infrastructure of childbirthing centers, community nursing centers, convenient care clinics, and other models of care that can be ramped up if Congress and states will remove barriers to full utilization, fair payment, and credentialling of nurses, including permitting them to head medical […]

2016-11-21T13:30:23-05:00May 6th, 2009|health care policy|1 Comment
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Pediatricians Protect Turf in Medical Homes in Bid to Deny Nurse Practitioners Role in Care Coordination

Photo by faeryboots, via Flickr.

The April issue of Pediatric News, the newspaper for pediatricians, has a front-page story on the official position of the American Academy of Pediatrics to oppose nurse practitioners (NPs) in independent practice. It doesn’t matter that in some areas of the country, the ONLY primary care provider may be an NP or a physician’s assistant (PA).

The National Association of Pediatric Nurse Practitioners (NAPNAP) has issued a statement that points out their dismay regarding this position by their physician colleagues, noting that there is abundant evidence documenting that pediatric NPs have clinical outcomes that are comparable to those of pediatricians and asserting that NAPNAP will continue to focus on reforming health care to ensure access to care for the nation’s children.

The issue is who will control and be paid for care coordination through medical homes. Physician groups have been insistent that only practices led by a physician should qualify as “medical homes.” This means that an NP or PA in a rural area who has physician backup through telemedicine must pretend that the physician “leads” the practice—and the physician will get the fee for the care coordination even if that coordination is done solely by the NP or PA. Sounds like a good way to reduce access to care coordination, drive up costs, and put frontline practitioners out of practice. Whose interests are being served?

Diana J. Mason, AJN editor-in-chief

2016-11-21T13:31:08-05:00May 4th, 2009|career, health care policy, nursing perspective|0 Comments
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Nurses Spotlighted by RWJF for Crucial Role in Health Care Reform

"Time for Change," David Reece / via Flickr.

The Robert Wood Johnson Foundation (RWJF) takes nursing very seriously. Their latest publication, “Nursing’s Prescription for a Reformed Health Care System,” makes it clear that workable health care reform in the United States is not going to happen without a major reenvisioning of the role nurses can play at every level of health care. Put another way, it’s not just about the technology and the physicians. The new RWJF brief

“combines case studies with analysis and policy recommendations, and arrives on the desks of lawmakers and health care reformers just as Congress and the President begin to piece together what promises to be the most significant overhaul of the nation’s health care system since the creation of Medicare. . . .‘Nurses have created model programs in acute care, primary care and public health settings that are improving the health status of individuals and communities,’ the brief declares. ‘These initiatives are expanding access, improving quality and driving down costs.’”

 These initiatives include
• “comprehensive, community-based care for the elderly”
• “nurse-managed health centers and retail clinics”
• initiatives such as TCAB (Transforming Care at the Bedside) aimed at supporting quality and patient safety in the workplace

-Jacob Molyneux, AJN senior editor

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2016-11-21T13:32:30-05:00April 28th, 2009|health care policy|0 Comments
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Public Health in Azerbaijan: On the Road with AJN Contributing Editor Jane Salvage

Jane Salvage in Baku, Azerbaijan

We recently received the following account of a visit to Azerbaijan from AJN contributing editor Jane Salvage, MSc, BA, RGN. At the time of writing, Salvage was a consultant for the noncommunicable diseases programme, World Health Organization (WHO) Regional Office for Europe. She now works as the policy lead in the support team for the Prime Minister’s Commission on the Future of Nursing and Midwifery in England, and fears that seeing Baku in the springtime will have to wait a year or two. This post is fairly long, but we feel the range of local detail included by Salvage gives a fascinating glimpse into what it’s really like to work in the field of international public health policy. (Note: we’ve retained some UK-style spellings.)

Did I pack the toilet rolls, diarrhoea pills, and dollar bills? These are essential survival items for my trips to Russia and other former Eastern Bloc countries. I’ve added many things to my travel checklist since my first visits in the 1980s—gadgets like the computer and phone charger—but the core kit stays the same. I never know quite where […]
2016-11-21T13:36:18-05:00April 6th, 2009|Nursing, Public health|2 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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