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 opened in the morning. They couldn’t afford to lose their health […]

February 22nd, 2017|health care policy, Nursing, Public health|1 Comment

This is What Democracy Looks Like, Nurses Included

Photos by Karen Roush.

“Nursing leaders have called upon all nurses to be heard, from bedside to boardroom and beyond. Not all of us share the same political views, and that is how it should be.”

By Karen Roush, PhD, RN, assistant professor of nursing at Lehman College in the Bronx, New York, and founder of the Scholar’s Voice, which works to strengthen the voice of nursing through writing mentorship for nurses.

On Saturday, I marched with over a million others in Washington, D.C., to protest the policies and rhetoric of the incoming Trump administration, along with millions more who marched in sister protests throughout the world. It was a day marked by exhilarating solidarity, determination, and hopefulness.

People of every age, race, ethnicity, religion, sexual orientation—all the ways you can try to divide people—stood together. Many carried signs and banners: some funny or clever plays on words, many serious messages of inclusiveness or demands for rights and action. Throughout the day strangers exchanged smiles and nods, silently saying to each other yes, look what we’re a part […]

January 24th, 2017|Nursing|1 Comment

Top Nursing, Policy, Clinical Stories of 2016

Crowd members hold candles during a vigil for the victims of a mass shooting at the Pulse nightclub in Orlando, Florida. Photo © Associated Press

Late last year, we asked our editorial board members and contributing editors to tell us what they thought were the most important health news stories of 2016. In our January article “The Year in Review 2016,” we take a closer look at three of their most-mentioned topics: the Affordable Care Act (ACA), opioid misuse, and Zika virus.

What other issues stood out last year in specific areas of health care? We compiled top news story roundups for several categories—here’s an overview (click the links below to read the full articles):

Health Care Policy

  • Gun violence
  • Access to care: LGBT health, migrants, mental health care, medication costs, rural health care

Nursing

  • Workplace stress: 12-hour shifts, EHRs, evidence-based practice, staffing
  • Nursing education: increased access, faculty shortage, expanded simulation, improved employment prospects
  • Care delivery barriers: care for veterans, nurses’ practice authority

Clinical News

  • Sepsis awareness
  • Maternal mortality
  • Patient engagement
  • Population health trends

Finally, see “Stories to Watch in 2017” for a discussion of a few health topics, aside from the fate of the ACA, that we expect to hear more about this year.

January 23rd, 2017|Nursing, Public health|0 Comments

As ACA Under Threat, Dawning Awareness of a Law’s Many Provisions

by matsuyuki/via Flickr

Nurses reflect the American population’s variety, and this means that many nurses support the Affordable Care Act (ACA) and many would like it repealed, whatever the replacement might be.

Like many Americans, nurses may have a broad ideological or analytical perspective on the pros and cons of the ACA or other health policy issues. Or they may choose for or against complex legislation on the basis of a single issue—like abortion funding, or insurance access for a husband or daughter with a preexisting condition, or whether they believe staffing issues can be blamed on their hospital administration or an ACA provision.

But it’s been my experience as an editor at AJN and a citizen that many people don’t really know that the ACA has multiple provisions that address quality and access issues at every level of health care.

The futures of these provisions are all in question as the Trump administration and a Republican-led Congress prepare to hack away at the ACA without a clear replacement plan.

With a kind of pre-obituary fervor, the media is beginning to pay attention to the changes the ACA brought about now that many may soon disappear—so, for seemingly the first time, are many Democratic politicians, who it’s now clear did very little to sell the ACA to their constituents. With that in mind, might […]

January 20th, 2017|health care policy, Nursing|5 Comments

AJN in January: Triglycerides, HPV–Related Oral Cancers, Year in Review, More

The January issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Triglycerides: Do They Matter?

In light of the increasing incidences of obesity, insulin resistance, and type 2 diabetes, lowering triglyceride levels has been getting renewed interest. In addition to the focus on lowering low-density lipoprotein cholesterol levels in cardiovascular disease (CVD) prevention, clinicians need to be aware of the role of triglycerides—their contribution to CVD, and the causes and treatment of hypertriglyceridemia. In this article, the authors discuss the importance of lowering triglyceride levels and review the lifestyle changes and pharmacologic treatments that can help achieve this goal.

CE Feature: “Human Papillomavirus-Related Oral Cancers: The Nurse’s Role in Mitigating Stigma and Dispelling Myths

The prevalence of human papillomavirus (HPV)–related oral cancers has been rising, with the cancers occurring in adults at a younger age than HPV-negative oral cancers typically do and in men more often than women. Because HPV is sexually transmitted, diagnosis with an HPV-related oral cancer may prompt feelings of shame and guilt. It’s essential for nurses to educate patients on HPV transmission and HPV-related oral cancer, thus helping to mitigate the stigma and dispel myths, and to promote vaccination in at-risk populations, including children and young adults.

In the News: “Top […]

December 30th, 2016|Nursing|0 Comments