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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AJN February Issue News: Linking RN Perception of Workplace Safety and Patient Care, Aid for Family Caregivers, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here are some of the stories you’ll find in our current issue:

A hospital nurse prepares toxic medication using a biological safety cabinet. Photo © Horizon International Images Limited / Alamy Stock Photo.

How Does RN Perception of Workplace Safety Relate to Patient Care?

A new report by health care consulting firm Press Ganey found that higher nurse-rated scores for workplace safety and surveillance capacity were associated with higher nurse ratings of quality of care, lower rates of missed-care events, and lower rates of pressure ulcers and patient falls.

Bipartisan Bills Propose Assistance for Caregivers

Two bills currently before Congress would reduce burdens of care for family members, if passed: one would establish a national strategy […]

2017-02-21T10:16:42-05:00February 21st, 2017|Nursing|0 Comments
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Nurses and Patient Safety: Parallel Histories

Photo from AJN archives.

I’m especially pleased that one of the CE articles in the February issue focuses on nursing’s role in creating a safe environment for patients: “Nursing’s Evolving Role in Patient Safety.” And in full disclosure, I was excited to see that the authors used the AJN archives to chronicle how nursing addressed (or didn’t address) safety issues around patient care.

From the earliest days of nursing through to the current complex systems in which we practice, nurses have been the health professionals responsible for ensuring safe passage of patients through the health care system. From Nightingale’s criteria for creating a healing environment to the “5 rights of medication administration,” patients rely on nurses to act as sentinels.

The authors reviewed 1,086 AJN articles from 1900 to 2015 and conducted a content analysis to identify patient safety themes. Aside from uncovering many fascinating (and sometimes alarming!) details of former health care practices, the authors drew this general conclusion:

“Emphasis on patient safety increased as patient care became more complex. As nurses developed a professional identity, they often put a spotlight on safety concerns and solutions.”

Here’s a quote from a nurse who wrote in 1908 about nurses’ duties: […]

2017-02-15T15:46:47-05:00February 15th, 2017|Nursing, nursing history, nursing research, patient safety|0 Comments
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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 and needed […]

2017-03-14T12:02:17-04:00February 15th, 2017|Nursing, Public health|0 Comments
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Ann Burgess: Forensic Nursing Pioneer

Ann Wolbert Burgess, DNSc, RN, APRN-BC, FAAN. Photo courtesy of Caitlin Cunningham Photography.

Last fall, Ann Wolbert Burgess was named a Living Legend by the American Academy of Nursing. It’s a fitting honor for a nurse who has spent decades studying victims of trauma and abuse and the perpetrators of those crimes, in addition to working alongside the FBI and testifying as an expert in the courtroom. She has also written numerous articles and books and currently teaches forensics at Boston College.

Burgess earned her doctorate in psychiatric nursing from Boston University, and thought she’d ultimately be a nurse psychotherapist—but her career path took a different turn than she expected. In the early 1970s, motivated by the feminist movement, Burgess and her colleague Lynda Lytle Holmstrom started one of the first hospital-based crisis counseling programs for rape victims, at Boston City Hospital.

The program enabled nurses to provide counseling to rape victims, and allowed Burgess and Holmstrom to conduct research on rape victimology. Their research led […]

2017-02-14T13:06:24-05:00February 13th, 2017|career, Nursing|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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