Might Health Care Reform Happen? And What Will It Mean for Nurses?

By Shawn Kennedy, AJN editorial director/interim editor-in-chief

Sometime in the next few days, Congress may bring the health care reform issue to a final vote and even a resolution of sorts, though one never knows what new twists may occur before then. I can’t even imagine what will occupy the news if it really does pass. (Philandering professional athletes and pilfering politicians better beware as newspapers seek new headlines.) 

Many Americans are calling their legislators to tell them what they want and don’t want. At the same time, many remain confused by the complexity of the legislative process as well as the particulars of the legislation. The final push received a boost this week from projections by the Congressional Budget Office that the bill would cut the budget deficit by $1.2 trillion over the next two decades. 

As nurses, we need to be knowledgeable and concerned with how health care will shape up—we’ll be delivering it. For information on the current bills under consideration, here’s two accessible sources: the Washington Post has a comparison of what the already passed Senate bill and the reconciliation version under consideration by the House include; the New York Times provides a pdf of the House bill.

Here’s a short list of provisions related to nursing likely to be in a final bill (as we noted in a post back in December about a useful ANA chart comparing House and Senate bills at the time):

2016-11-21T13:18:42-05:00March 19th, 2010|health care policy, nursing perspective|4 Comments
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Word Games? ANA Says We’ve Already Got a National Nurse; Others Disagree

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

On a new post at Homeland Voice, author Fiona Regina, MSN, RN, presents a rather critical discussion of the American Nurses Association’s opposition to the National Nurse initiative. She writes, “For heaven’s sake, it’s time for the ANA to get on board. The entire ANA organization would be better served by embracing motivated, politically active nurses willing to improve the health of our nation.” 

Regina offers several theories as to why the ANA might be taking the position (that is, aside from their stated reasons, one of which is that the U.S. Public Health Service already has a Chief Nursing Officer); what’s lacking in her piece, though, is any comment from the ANA to refute her charges or further elucidate their position. 

The ANA stance aside, the notion of a National Nurse keeps coming up and has support from many sectors. Diana Mason, AJN‘s editor-in-chief emeritus, argued for it here last September. More nurses should join the debate so that this issue can either move forward or be put to rest. What’s your opinion?
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2016-11-21T13:18:44-05:00March 18th, 2010|career, nursing perspective|28 Comments
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Workplace Violence Against Nurses — Neither Inevitable Nor Acceptable

I’ve read about hospital nurses dealing with violence at work, but I always told myself that was something that happened in the emergency room or the psych ward. In oncology, I reasoned, we have relationships with our patients, and I have always felt safe with them.

So begins a harrowing—and remarkably nonjudgmental— story of a really bad day at work, written by Theresa Brown, a nurse who blogs regularly for the NY Times. (AJN will be featuring a profile of Brown in the May issue.)

Unhappy coincidence: It so happens that AJN published a Viewpoint essay on workplace violence in the March issue. Here’s how it starts:

I was working in the ED one day when a patient looked up and threatened to kill me. Grabbing my hand, he squeezed it until I thought it would break. It took several staff members to restrain him and force him to let go. I’ll never forget how he looked into my eyes and smiled as I screamed in pain.

Some of my colleagues said I should file a police report; others told me to get used to this type of behavior and toughen up. I called the police, and although they took my statement, they wouldn’t arrest the patient because he hadn’t inflicted “serious bodily injury.”

The author, Jessica Leigh, offers advice to those who have faced workplace violence as nurses, and makes several recommendations for influencing policies at your hospital or facility, as well as […]

2016-11-21T13:18:45-05:00March 17th, 2010|nursing perspective|4 Comments
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When Devices Do the Thinking for RNs, What Training Still Matters?

By Sheena Jones. (Sheena is an LPN in training to be an RN at Dutchess Community College, Poughkeepsie, NY.)

So I’m sitting at home on a rare day off and I get a phone call. It’s the supervisor trying to locate one of the many devices each staff member has to sign in and out at the beginning and end of each shift. The hospital I work for uses bar code scanners, wireless computers, PDAs, and Vocera badges. These things are supposed to reduce errors and in general make the jobs of staff members easier. Once I get to work I feel like I have to put on a utility belt to carry all of these devices.

With all of these machines to think for me, I wonder if all of the schooling I’m enduring to go from my LPN to RN is obsolete. Yes, compassion and empathy can’t be taught or replaced by technology. But sometimes it seems to me that a technology-savvy teenager could do much of this job, as long as she could stomach the visuals at the bedside. I remember studying night and day for an exam about calculating medication dosages, only to discover that the computers give the exact dosage and that drugs come from the pharmacy just as they should be given.

Maybe we are a little bit dependent on technology. You should see the mass panic when there is an electrical surge. Nurses often waste time finding computers on wheels (affectionately known as […]

2016-11-21T13:18:47-05:00March 15th, 2010|career, students|5 Comments
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Advanced Practice Nurses: Pushed Forward by Health Reform Advocates, Pushed Back by Physicians over Turf – Enough Already!

By Shawn Kennedy, MA, RN, AJN editor-in-chief

As we’ve noted in past posts on this blog and in AJN editorials in August 2006 and August 2008, organized medicine does not want to acknowledge that nurses can practice independently.  And now the turf war between advanced practice nurses (APRNs, which include nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists) and physicians is heating up.

In California, physicians are suing the state for allowing nurse anesthetists to practice without supervision, using patient safety as a reason. In Kentucky, physicians are opposing legislation to expand the scope of practice for NPs—at issue is whether NPs should need a signed collaborative arrangement with a physician (even though the physician does not supervise the NP). According to an article by a Louisville, Kentucky, newspaper, the Courier-Journal, the physicians charge high fees for their signature or demand a percentage of the practice.  The bill, though, passed the state House committee on March 4, with several members questioning the ethics of physicians’ requiring fees.

Nurses have been and continue to fight for the right to practice, and during this period where the government is seeking solutions to health reform, this is a battle that shouldn’t have to happen—a view shared by Stephen Ferrara, NP, at A Nurse Practitioner’s Place (“I have tried to refrain from taking the bait from some recent negative opinions regarding nurse practitioner delivered care”). […]

2016-11-21T13:18:48-05:00March 12th, 2010|health care policy, nursing perspective|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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