Bad News, Good News: Berwick, a Casualty of Politics, Succeeded at CMS Helm by a Nurse

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

When Donald Berwick steps down from his post as administrator of the Centers for Medicare and Medicaid Services (CMS) on December 2, he’ll turn the reins over to Marilyn Tavenner, MHA, BSN, RN. Tavenner is not a new face at CMS—she served as acting administrator prior to Berwick’s July 2010 appointment by President Obama and has been principal deputy administrator at CMS since February 2010.

As noted by an article in The Washington Post, Berwick is stepping down in the face of organized opposition to his nomination by Republicans in Congress, who have vowed to block the confirmation he’d need to continue after his recess appointment expires on December 31.

On November 23, President Obama announced his intent to nominate Tavenner for the top post. In her e-mail to CMS staff (carried on the Kaiser Health News site), Kathy Sebelius, secretary of  Health and Human Resources, says of Tavenner, “Her career as a nurse, hospital administrator, and Virginia Secretary of Health and Human Resources give her unique insights that position her well to serve as Administrator.”

I certainly hope so. Berwick’s reputation and track record for pinpointing problems in our health system—and more importantly, working to do something about them through the Institute for Healthcare Improvement—was stellar, and he carried this zeal into […]

2016-11-21T13:11:20-05:00November 30th, 2011|Nursing|2 Comments
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From the Blogs: Negotiating Medicare, Nurses Doing Research, Reader Comments

[youtube=http://www.youtube.com/watch?v=oOClkw1TNks&feature=player_embedded]
Medicare is confusing for providers who aren’t yet familiar with it. Here’s a Nursetopia post that draws attention to its complexity and notes the useful video above (it’s one of a series of videos on different aspects of Medicare). Those of you who know all about it already: Drop by her thoughtful (and consistently updated!) blog and let her know your own tips on handling the ins and outs of Medicare and Medicaid.

EBP matters. Terri Schmitt at Nurse Story has a frank and engaging post on evidence-based practice (EBP): “Translation of EBP: Why Creating Nurse Scientists is the Way to Improve Patient Outcomes.” Here’s what she promises to cover in it:

  • Research is sometimes far removed from bedside nurses
  • Research is COOL!
  • Research is about PATIENTS and not fame/fortune of researcher
  • Research is critical to practice and there are big gaps that nurses need to fill
  • Bedside nurses may be the most crucial link in research ideas, translation, and practice.

(Shameless plug for related AJN content: See our recent, amazingly useful step-by-step CE series on how nurses can get involved in evidence-based practice.)

Plus a brief note on reader comments: we’ve been getting a lot of great comments lately on this blog, and we’re grateful for that. So thank you. A fair number of the comments were on posts from previous months, such as this post comparing U.S. and Australian health care systems. Is somebody by chance teaching a nursing course that requires students to leave thoughtful, respectful, engaged comments in the blogosphere? If […]

2016-11-21T13:11:21-05:00November 29th, 2011|nursing research|0 Comments
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On Euphemisms and Learning to Be Present

By Alicia Marie Hinton, who is a BSN student at the College of New Rochelle School of Nursing in New Rochelle, NY. This is her first post for this blog.

My senior year preceptorship was an assignment on a palliative and acute care unit at a busy medical center. When I received the assignment, I prayed that no patient of mine would die during my time on the unit. Every nursing student is afraid of their first patient death. Simulation and course work prepare students in various ways for this experience, but nothing can really prepare you for the emotions you’ll feel. Some students experience a patient death during an undergraduate nursing program, but for others it may not happen until their first year or two working as an RN. I hoped to never endure it, but knew it was inevitable.

During report, working alongside my preceptor, I listened anxiously to the status of the various patients. Since my first day on the unit, I’d practiced my therapeutic techniques and researched different cultural needs pertaining to the death of a patient. I felt culturally competent and well informed about what a nurse should do when a patient dies, but I couldn’t shake my fear. What would I say to the family? Would they value […]

2016-12-09T11:57:13-05:00November 28th, 2011|career, students|7 Comments
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Physician-centric vs. Patient-centric?

By Shawn Kennedy, AJN editor-in-chief

Last week, we posted here a piece by AJN’s clinical managing editor Karen Roush, decrying the use of the term “physician extender.” It reminded me of a recent article from the New York Times on nurses with doctorates, which reported that if some physicians have their way and their legal strategy succeeds, they will be the only group permitted to use the honorific “doctor.”

Degrees vs. licenses. This borders on the ridiculous, as the title is an academic title that signifies achievement in a field of study; it is not a license. Doctoral degrees are awarded in just about every field of study, from astronomy to zoology. Physicians are awarded a doctor of medicine, dentists are awarded a doctor of dental science, and so it goes. In health care, there are dentists, psychologists, social workers, physical therapists, pharmacists, and yes, nurses too, with doctoral degrees. Nurses have been earning PhDs and EdDs (doctorates in education) and the DNSc (doctorate in nursing science) for years, and now there’s a new nursing doctorate degree—a DNP, doctor of nursing practice—that’s specific to nurses in clinical practice. They are still licensed as nurses, as that’s what they are.

This parochial thinking is held by those physicians (not all, but far too many) who still adhere to the […]

2016-11-21T13:11:25-05:00November 16th, 2011|career|3 Comments
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Autumn Leaves and Colorful Lives

By Julianna Paradisi, who normally blogs at JParadisi RN and has written for this blog before. Her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” was published in the February issue.

autumn leaves between sun halos and flashlight
by oedipusphinx—theJWDban via Flickr

The autumn leaves are particularly beautiful in Oregon this year. An arborist interviewed on the evening news attributed the extraordinary orange and gold to an unusually cold, wet spring, which lasted until July, followed by the intense heat and warm evenings of a brief Indian summer. According to the arborist, the combination caused a greater than normal amount of sugar in the leaves, resulting in the brilliant colors. I think about this on my morning run, as my feet scatter fallen leaves along the sidewalk.

The Season of Eating is, however, not the only messenger of the approaching holidays in a nursing unit. There is something about the holiday season that signals Death to harvest a higher than normal number of the patients we have grown to love through the course of their illnesses. Some of the deaths are expected, but not all of them. I don’t know why more people seem to lose their battles with illness around the holidays than at other times of year.

When I first began working in outpatient oncology, it took me by surprise that my coworkers […]

2016-11-21T13:11:26-05:00November 14th, 2011|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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