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Nursing shortage issue
Improving nursing communication with patients
Nurses role in the affordable care act
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Health care reform has been a major issue over the past decade. The Nursing industry has in particular experienced a period of unpredictable change. On Dec 24, 2009, a landmark measure was passed in the senate by a vote of 60 to 39. This decision to pass the health care reform will change America forever. Nurses will constitute the largest single group of health care professionals. They will have a huge impact on quality and effectiveness in health care. The nursing industry will help hold this new program together by acting as the glue (The nursing industry will be the glue holding the new health care in tact.) It is estimated that by 2015 the number of nurses will need to increase to over 4 million. Nurses are the backbone of the health care industry thus creating better polices for this profession will help ease the workload and high demand. A nurse’s main concern is always to insure quality care and the safety of their patients. Under the new health care reform several new measures have been set into place to ease the transition and improve the quality of care for all patients. One program is designed to fund scholarships and loan programs to offset the high costs of education. Nursing shortages and the high turnover has become a serious epidemic. Health care reform is supposed going to solve many of these problems.
Furthermore, health care reform will provide 47 million Americans with health care. Many of the 3 million nurses see their jobs as constantly changing. Their positions as primary advocates for their patients can be compromised when adequate healthcare is not provided.
“Eighty three percent of Americans believe nurses are honest and have high ethical standards” (American Nurses p4). Nurses are in high demand; patient overload and large shortages of qualified nurses makes their jobs even harder. Health care reform would like to help ease the work load as well as increase the number of nurses coming into this field. These reforms are about delivering care that is more effective in the community. This includes improving out of hospital services to make sure that people are able to access the care they need. Many people go to hospital for a minor cold or a sore throat because they are unable to pay for high costs.(unable to see a physician, who usually requires a patient to have medical insurance.
The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.
For decades, one of the many externalities that the government is trying to solve is the rising costs of healthcare. "Rising healthcare costs have hurt American competitiveness, forced too many families into bankruptcy to get their families the care they need, and driven up our nation's long-term deficit" ("Deficit-Reducing Healthcare Reform," 2014). The United States national government plays a major role in organizing, overseeing, financing, and more so than ever delivering health care (Jaffe, 2009). Though the government does not provide healthcare directly, it serves as a financing agent for publicly funded healthcare programs through the taxation of citizens. The total share of the national publicly funded health spending by various governments amounts to 4 percent of the nation's gross domestic product, GDP (Jaffe, 2009). By 2019, government spending on Medicare and Medicaid is expected to rise to 6 percent and 12 percent by 2050 (Jaffe, 2009). The percentages, documented from the Health Policy Brief (2009) by Jaffe, are from Medicare and Medicaid alone. The rapid rates are not due to increase of enrollment but growth in per capita costs for providing healthcare, especially via Medicare.
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
The article I chose discusses the continual change in the roles of nurses. The article also poses a concept that nursing now is not based on caring, but medicine. “By accepting continual changes to the role of the nurse, the core function of nursing has become obscured and, despite assuming medical tasks, the occupation continues to be seen in terms of a role that is subordinate to and dependent on medicine.” (Iley 2004) Nurses are taking a more professional role, and more tasks are being delegated to assertive personnel. Therefore, with all these changes occurring, the role of the enrolled nurse is unclear. “Previously, having two levels of qualified nurse in the United Kingdom had been seen as problematic for health service managers and nurses themselves, and the ending of enrolled nurse programs in 1992 helped to solve this problem.” (2004) The study in this article gathered the characteristics of enrolled nurses and differentiated the groups converting to registered nurses, groups in the process of conversion, and groups interested or not interested in conversion. This study reveals the situation of enrolled nurses in context of continuing towards the professionalization of nursing. “The data from this study support the possibility that the role of nurses as direct caregivers is seen as a positive dimension of the work they undertake.” (2004) The findings imply that nurses need to get back to being caregivers, instead of concentrating on obtaining professional status in medicine.
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
According to the Bureau of Labor Statistic’s Employment Projections 2012-2022 released in January 2014, the Registered Nursing workforce is the top occupation in terms of job growth through 2022. It is expected that the number of employed nurses will grow from 2.71 million in 2012 to 3.24 million in 2022, an increase of 526,800 or 19 percent. Growth will take place for a number of reasons: demand for health care services due to increasing life expectancy; chronic conditions, such as arthritis, dementia, diabetes, and obesity; and the number of individuals who have access to health services.
The 2010 Institute of Medicine (IOM) Report- The Future of Nursing described the role that nurses have in the current and future US health care environment (IOM, 2011). This report was completed at a time when the Affordable Care Act had been passed and a new emphasis was being put on interdisciplinary healthcare teams, care coordination, value-based payment systems, and preventative care (IOM, 2011). Nursing is the largest profession in health care and with an aging baby boomer populace, the expanded role of nurses will be critical in meeting the growing healthcare burdens (Sisko et al., 2014).
The nursing shortage most likely does not mean a great deal to people until they are in the care of a nurse. The United States is in a severe nursing shortage with no relief in sight due to many factors compounding the problem and resulting in compromised patient care and nurse burnout. Nursing shortages have been experienced in the past by the United States and have been overcome with team effort. However, the current shortage is proving to be the most complex and great strides are being made to defeat the crisis before it becomes too difficult to change. Researchers anticipate that by 2010, the United States will need almost one million more registered nurses than will be available (Cherry & Jacob, 2005, p. 30).
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
About 32 million people will represent the newly insured, affecting the health care system and nurses are the fundamental in health system. Health care reform is positive for nurses. The health care bill provides money for advance practice and general nurse education. The law also creates a grant program for innovative safety net programs, such as nurse-managed health clinics. Due to the shortage of family Physicians, nurse practitioner programs are going strong. The health care reform is a good opportunity for nurses; the law will permit different approaches to deliver primary care and with the decreasing number of physicians going in to primary care, Nurses represent the best way to provide primary care to the millions of new insured people. (Satowski, 2010)
Retrieved November 3, 2009, from http://abcnews.go.com/images/pollingunit/1091a2Healthcarereform.pdf Pardis, M., Wood, J., & Cramer, M. (2009, September-October). A policy analysis of health care . Nursing economic$ the journal for health care leaders, 27(no 5 2009 r). Retrieved from http://www.nursingeconomics.net/cgi-bin/WebObjects?NECJournal.woa/wa/viewSection?s_id=1073744460.
Since the 1990’s, the interest in nursing and the profession as a whole has decreased dramatically and is still expected to do so over the next 10-15 years according to some researchers. With this nursing shortage, many factors are affected. Organizations have to face challenges of low staffing, higher costs for resources, recruiting and reserving of registered nurses, among liability issues as well. Some of the main issues arising from this nurse shortage are the impact of quality and continuity of care, organizational costs, the effect it has on nursing staff, and etc. However, this not only affects an organization and community, but affects the nurses the same. Nurses are becoming overwhelmed and are questioning the quality of care that each patient deserves. This shortage is not an issue that is to be taken lightly. The repercussions that are faced by both nurses and the organization are critical. Therefore, state funding should be implemented to private hospitals in order to resolve the shortage of nurses. State funds will therefore, relieve the overwhelming burdens on the staff, provide a safe and stress free environment for the patient, and allow appropriate funds needed to keep the facility and organization operational.
That saying, everything they do has a lasting and major effect. They participate directly, indirectly, and behind the scenes with the patient, family, hospital staff, and community. Going along with Gardner, nurses have the “intelligence to observe, validate, and network to articulate messages advocating for health care reform values that resonate with Republican, Democratic, and Independent Congressional members” (Gardner, 2014). With large size in numbers, nurses can effectively participate in health related politics to improve the healthcare system. Regardless, at the end of the day the patient is what matters most, meaning the nurse needs to ensure care for everyone – people below the poverty line, immigrants, and other minorities
Reforming the health care delivery system to progress the quality and value of care is indispensable to addressing the ever-increasing costs, poor quality, and increasing numbers of Americans without health insurance coverage. What is more, reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, preventable impediments of illnesses to the greatest extent possible. Thoughtfully assembled reforms would support greater access to health-improving care, in contrast to the current system, which encourages more tests, procedures, and treatments that are either
Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.