Still Confused About Health Care Reform? Welcome to the Club

By Peggy McDaniel, BSN, RN. Peggy is an infusion practice manager who occasionally writes for this blog.

I admit that I’ve been a bit overwhelmed with the ongoing discussions around health care reform. It sounds like I’m not the only one. FierceHealthcare.com recently reported that the results of a Harris Poll suggest many Americans remain befuddled about the implications of the Affordable Care Act passed in March:

“Here are some areas [w]here a general cluelessness among those polled prevailed:

  • 82 percent think the bill will result in rationing of healthcare or that it might (it won’t);
  • 79 percent don’t know or aren’t sure if drug companies will pay an annual fee (they will);
  • 73 percent don’t know the law establishes a new tax on the sale of medical devices;
  • 66 percent don’t know or aren’t sure if the legislation will result in insurance exchanges where people can shop for insurance (it will); and
  • 63 percent either aren’t sure or don’t know if the new law will increase the number of people elibible for Medicaid (it will).

The chairman of the Harris Poll is quoted in the article: “It seems people are still reacting to the rhetoric, not the substance of what is in the bill . . .”

Considering the results of this poll, what do you think it would take to get the public up to speed on the facts? Do Americans not care, or is it too overwhelming? As a nurse, I feel I should be more informed about the law. And I’m going to spend […]

2016-11-21T13:16:17-05:00August 5th, 2010|health care policy|1 Comment
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Open Medical Records: A Question of Safety

By Christine Moffa, MS, RN, AJN clinical editor

We’ve all watched our health care provider writing or typing while we answered questions or described our symptoms. Before becoming a nurse I used to wonder what they were putting in my chart and if they got it right. And now that I am a nurse I can’t believe how often a medical assistant or nurse will take my vital signs and write them down without telling me what they are. How can it be possible that adults are kept from knowing their own or their children’s health information? Back when I worked on a pediatric floor my colleagues gasped in shock when I allowed a parent of one of my patients to look at his child’s chart. And I actually let them make me feel like I had done something wrong!

Last week this issue was the topic of a column by Dr. Pauline W. Chen in the New York Times, where two related blog posts (here and here) also received much reader commentary. The sudden flurry of interest in the subject was occasioned by an article published in the Annals of Internal Medicine detailing the preliminary findings of a study following a national project called OpenNotes, funded by the Robert Wood Johnson Foundation, in which “more than 100 primary care physicians and 25,000 of their patients will have access to personal medical records online for a 12-month period beginning in summer 2010.” Readers’ comments ranged from one extreme to the other, such […]

2016-11-21T13:16:18-05:00August 3rd, 2010|nursing perspective, patient engagement|3 Comments
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Watch Out for Dengue Fever in Travelers

By Diana J. Mason, PhD, RN, FAAN, editor-in-chief emeritus

You may have heard that in late July the Centers for Disease Control and Prevention (CDC) issued an advisory on dengue infection, which can lead to dengue fever or dengue hemorrhagic fever, noting that dengue is becoming an epidemic in tropical and subtropical areas of the world, with recent or ongoing outbreaks occurring in Puerto Rico; in Key West, Florida; and the Caribbean. It’s particularly important for nurses to be alert for symptoms of dengue fever among people who have returned from travel to tropical areas. Symptoms may include fever, eye pain, joint pain, rash, and bleeding. The greatest danger is from dengue hemorrhagic fever, which can lead to death.

For more on dengue infection (including its detection, treatment, and prevention), see the April 2008 article on the topic in AJN. And as always, please let us know here if you’ve encountered it recently yourself as a clinician—or traveler.

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2016-11-21T13:16:19-05:00August 2nd, 2010|Nursing|0 Comments
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On Difficult Truths, Anger, and Compassion: Recent Poems in ‘Art of Nursing’

By Sylvia Foley, AJN senior editor

“Why couldn’t you leave cleanly?” asks the narrator of Ann Sihler’s poem, “Leavings,” featured in the June Art of Nursing. The poem, written in response to a suicide, speaks to the emotions of those left behind. Its central image, a pair of “oxblood loafers lying there / for all to see,” is somehow both mundane and horrifying. It’s a stark poem, suffused with the narrator’s anger; yet its lack of pretension also affords us  relief.

The married man with “schoolboy cheeks” in Nancey Kinlin’s poem, “Practicing at Post Office Square,” has just heard what no one wants to hear: “the result / is positive.” The poem, featured in July’s Art of Nursing, gives us the disclosure—from the nurse’s point of view. It’s a poem about mistakes and compassion, about what it feels like to be the one delivering bad news. Kinlin’s spare, clear writing doesn’t flinch from its difficult subject.

Both poems are free online (you’ll need to click through to the PDF files). We invite you to have a look, sit with them, and tell us what they evoke for you in the comments.

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2016-11-21T13:16:20-05:00July 30th, 2010|nursing perspective|0 Comments
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Supporting Nurse Practitioners as ‘Priority Primary Care Practitioners’

By Susan McBride, PhD, RN, professor at Texas Tech University Health Science Center School of Nursing

It’s important for nurses to understand the Medicare and Medicaid incentives to implement electronic health records (EMRs) and to move to their “meaningful use,” as well as the purpose of the Regional Extension Centers created to support nurse practitioners and other “priority primary care providers” in the implementation process.

Dr. Mari Tietze, John Delaney, and I are fortunate to be involved in two of the Regional Extension Centers in Texas. We believe that nursing professionals have many contributions to make in the evolving electronic highway in the U.S. We will blog later about our roles as nursing informaticists in the Regional Extension Center program.

What are ‘Regional Extension Centers’? Under the Office of the National Coordinator (ONC) Health Information Technology Initiative to support getting providers to meaningful use on electronic health records, the ONC has established Regional Extension Centers. There are 60 Regional Extension Centers that will furnish assistance to providers in specific geographic services areas covering virtually all of the U.S. A total of $643 million is devoted to these centers.

The purpose of the Regional Extension Centers is to support priority primary care practitioners in priority settings to implement and use EMRs according to the meaningful use requirements outlined in our previous post (below is a screenshot illustrating one example of how an EMR might align with meaningful use requirements; click image to enlarge). The goal of the program is to provide federally subsidized outreach and support […]

2016-11-21T13:16:22-05:00July 29th, 2010|digital health, Nursing|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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