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

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

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

Recalling the Why of Health Care Reform

By Jacob Molyneux, AJN senior editor ACA ruling imageIn a brief analysis of the gradual rollout and effects so far of the Affordable Care Act (ACA) at the start of this year (“The ACA Continues to Run the Gauntlet”), I reviewed a few of the issues the law was intended to address when it was passed in 2010:

* the highest per capita expenditures of any health care system in the world

* consistently worse outcomes on measures such as infant mortality rate than most other developed nations

* increasing numbers of uninsured Americans each year, to over 50 million in 2009, the year before passage of the ACA

* unsustainable annual increases in health insurance premiums and drugs costs, leading to astonishing rates of medical bankruptcy

* a Medicare reimbursement process that rewarded the volume of care provided rather than the effectiveness of that care

These worsening issues had become impossible to ignore. No one believes the ACA is a perfect law; there were too many cooks in the kitchen for that. But it’s at least a good faith attempt to address real problems, to get a framework on the table that can potentially be improved upon. […]

March 4th, 2015|health care policy, Nursing, Patients|0 Comments

AJN in January: Long-Term Complications of CHD Repair, Obesity Interventions, Nurses Planning for Retirement, More

AJN0115.Cover.OnlineAJN’s January issue is now available on our Web site. Here’s a selection of what not to miss.

Complications after cardiac repair. Nurses often encounter patients with complications that occurred years after congenital heart defect (CHD) repair. Yet many patients whose CHD was repaired in childhood have not had regular follow-up. Our CE feature, “Long-Term Outcomes After Repair of Congenital Heart Defects: Part 1,” the first in a two-part series, reviews six congenital heart defects, their repairs, and common long-term outcomes, as well as implications for nurses in both cardiac and noncardiac settings. This CE feature offers 2.5 CE credits to those who take the test that follows the article.

To further explore the topic, listen to a podcast interview with the author (this and other free podcasts are accessible via the Behind the Article podcasts page on our Web site, in our iPad app, or on iTunes). A video of an atrial septal defect device placement is also available in the iPad edition of this article.

Obesity interventions. Patients with obesity often face stigma and bias, even from the nurses who care for them. “The Obesity Epidemic, Part 2: Nursing Assessment and Intervention,” the second article in a two-part series, presents a theoretical framework to guide nursing assessment of patients with obesity and their families and reviews the most common lifestyle, pharmacologic, and surgical interventions. […]

December 29th, 2014|Nursing, nursing perspective|0 Comments