As I sit down to write this editorial, it has been just 48 hours from the passing of the Healthcare Reform legislation. I have tried to stay up-to-date on as much information that has been available and read most anything I could, however if you are like me, I do not totally know all of the details of this legislation. Certainly with any legislation so large sweeping, the details will be very important. What I do know is that whether you were in favor of this bill passing, unsure about it or decidedly against it, the reality is that some form of healthcare reform is probably here to stay.
It has been cited that healthcare will now be available to 30 million Americans who have not been able to afford healthcare or who were ineligible for benefits in the past due to no access or pre-existing conditions. Thirty million more people trying to access healthcare via private offices and clinics will present a challenge.
Opening healthcare access to the millions of people who have not had this benefit allows these patients the opportunity and the dignity to pick up the phone, make an appointment, and walk into a healthcare facility without fear of being turned away for reasons too numerous to count. However, with these changes, comes the challenge for healthcare providers to manage this influx of patients. Some will advise that the solution might be to add more operating hours and hire more physicians and staff. However the reality is that many practices and hospitals are operating close to margin at this time. Many are just getting by, hoping to make the next payroll. The cost of providing medical care has not decreased and in fact, despite putting efficiency measures into place, costs continue to escalate. Healthcare providers and systems will need to think differently about how to provide care.
There will be many opportunities for the nursing profession as changes to the healthcare system begin to take shape. As the profession with the greatest number of professionals taking care of patients on a daily basis, we must begin to think about ways in which we will be able to provide nursing care in different and varied settings. What do we do today that we could do better tomorrow to help more patients obtain the healthcare they need and should now be able to access?
While the reform legislation does provide for a "phase in" of sorts for care, healthcare providers and institutions need to be ahead of the curve and begin to design programs that will allow patients to access providers in a timely fashion. The use of nurse practitioners to manage populations of patients would be a good solution to prevent long waits and inconsistent care that has been a problem in other countries who have adopted similar types of healthcare reform. Working collaboratively with all members of the healthcare team, these providers will be able to help manage the increasing number of patients seeking healthcare while also reducing the impending burden on current providers. Rather than being scorned or denigrated, midlevel providers should be applauded as they will bring skills that will be essential in helping to manage patients efficiently. Nurses in every specialty and practice setting should be involved in the design, implementation, evaluation, and decision making regarding the ways in which the healthcare system will need to change to meet the increasing demands that will be placed upon it. Each of us must take the initiative to become part of the team that hopefully will develop new ways to practice in the future. If not, we do run the risk of an overloaded and inefficient healthcare system. Providers must figure this out or others will do it for us. We need to take control of our future practice programs. Become involved in the process at local, state, and national levels. Nurses opinions and thoughts should and do matter. We need to be sure we are heard!!