48 Years of Medicare (and Counting)

By Shawn Kennedy, AJN editor-in-chief, and Jacob Molyneux, senior editor

Next week marks Medicare’s 48th anniversary. President Lyndon Johnson signed the legislation creating Medicare on July 30, 1965, guaranteeing health coverage for the elderly. With the gradual implementation of the Affordable Care Act (ACA; 2010), Medicare, along with other government and private forms of health insurance, is undergoing changes, with efforts being made to rein in rising costs, combat fraud, tie quality of care to reimbursement, and so on.

PPresident Lyndon B. Johnson signing the Medicare Bill at the Harry S. Truman Library in Independence, Missouri. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration. President Lyndon B. Johnson signing the Medicare Bill. Former President Harry S. Truman is seated at the table with President Johnson. Photo: National Archives and Records Administration.

With the ACA’s date for mandated purchase of health insurance fast approaching, some states are setting up state-run health insurance exchanges to provide consumers with a standardized menu of health […]

2016-11-21T13:06:55-05:00July 26th, 2013|health care policy|0 Comments
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A Hurricane Sandy Bed Bath

Amanda Anderson, BSN, RN, CCRN, works as an intensive care nurse in New York City and is pursuing a master’s in administration from Hunter-Bellevue School of Nursing at Hunter College.

Hurricane Sandy/NASA Goddard photo Hurricane Sandy/NASA Goddard photo

When Hurricane Sandy hit, the bloated feeling from snack and rom-com binging proved my deepest suffering. Safe, dry, and bored on Manhattan’s Upper West Side, I was little harmed by the storm. My commute across the park proved adventuresome, but I slept in my own bed; I had a bed.

As the city calmed in the weeks following, I watched my fellow New Yorkers erupt in volunteer revolutions. Feeling guilty about my idle skills, I signed up with New York City Department of Health’s Medical Reserve Corps, the organization staffing emergency shelters.

On my scheduled morning, I arrived to find the clinic behind an old door marked with a handwritten sign that said “Medical.” Inside, a crowded group of older professionals—MDs, NPs, social workers—listened as a frazzled and tired pediatrician gave shift report.

Few medical needs plagued the shelter, but one reported client stuck out—a feisty octogenarian evacuee, Ms. E. Her lengthy medication list suggested cardiac problems, and her arthritic frame limited her mobility. Stairs were out of the question.

Report dragged on. I left to find some work to […]

2016-11-21T13:06:56-05:00July 24th, 2013|Nursing|3 Comments
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Something Like Grace

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

ViewFromPlaneWindowMark was in town to be the best man in an old friend’s wedding—on a vacation, of sorts—when the unthinkable happened and he was involved in a horrendous traffic accident. He was ejected from his rental car. His injuries were severe and life threatening.

Mark’s family was halfway across the country. Getting to Mark quickly seemed impossible. But this is where the story takes a turn:

Mark’s family found a flight leaving that morning from their local airport, with the exact number of available seats that they needed. As they bought the tickets, they explained the nature of their emergency. They got to the airport in the nick of time. While checking in, they were approached by an airline employee who asked if they’d already arranged a rental car. They told him that they hadn’t—they hadn’t even stopped to get their clothes.

They didn’t know it at the time, but the employee who’d approached them was the pilot of the plane. He’d learned of the family emergency and held the plane for them. He knew how serious Mark’s accident had been, as he’d happened to drive right past the accident scene on his way to the airport before the first leg of the flight.

When the plane landed, the pilot requested that Mark’s family […]

2016-11-21T13:06:57-05:00July 22nd, 2013|nursing perspective, Patients|4 Comments
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A Fine Line Between Patient and Provider, and a Mother’s Plea for More Epilepsy Research

by Eric Collins, ecol-arts.com by Eric Collins, ecol-arts.com

Thomas is a frequent flier in our ER, a bespeckled 40-something with coke-bottle glasses, a man who seems to run, like a dog out for a joyride, right into the arms of the dogcatcher. The police bring him in, one man on each arm, his legs limp. Thomas has schizoaffective disorder, dives into the fountain at the mall, screams at strangers at the YMCA, paces outside the grocery store. In a way, I understand—sometimes behaving according to convention can be a little dull.

That’s the start of “Thomas,” the July Reflections essay in AJN by Emily Maloney. It’s about the fine, but still absolute, line that can exist between paid provider and patient at moments when life feels overwhelming to both. Or something like that—it’s hard to summarize a nuanced, lightly ironic account like this in a few words. Like all Reflections essays, it’s short, free, and worth a full read.

The July Viewpoint essay, “A Son’s Seizures,” is written from the perspective of a mother, Linda Breneman, who looked beyond her own experience to become an advocate for all those with epilepsy, particularly those with the intractable sort that doesn’t respond to most treatments. While most people with epilepsy respond to medications and can eventually live more or less normal lives, it’s the author’s well-argued conviction that more research needs to be done to help the subset of those with […]

2016-11-21T13:06:58-05:00July 19th, 2013|Nursing|1 Comment
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Who Will Watch the Watchers? Consider Nurses

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Sometimes my surgical mask feels like a gag/by Julianna Paradisi Sometimes my surgical mask feels like a gag/by Julianna Paradisi

Does anyone else find it ironic that, while the National Security Agency (NSA) is seeking to extradite and prosecute the contractor who revealed the agency’s alleged widespread spying on ordinary Americans and visitors from other countries, nurses can get fired for far more local breaches of privacy?

When the government gives 500,000 private contractors access to data hoards compiled from the electronic and phone conversations of U.S. citizens, is HIPAA still relevant?

Two years ago, the nurse blogosphere raged over the expulsion of three nursing students for posting the photo of a placenta on Facebook. Today, in light of the NSA’s potentially far-reaching privacy violations, the decidedly insensitive exploits of those students seem a bit less newsworthy.

More famously, the ordeal of Vickilyn Galle and Anne Mitchell, nurses who were fired after they blew the whistle on medical malpractice while exposing a conflict of interest affecting patient safety within the hospital, illustrates the high accountability placed upon nurses to protect patient privacy. […]

2016-11-21T13:06:59-05:00July 17th, 2013|Ethics, Nursing, Patients|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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