Blog
Jun 30, 2009
On June 24, 2009, President Obama and ABC News hosted a White House forum on health care reform. University of Maryland School of Nursing student Hershaw Davis spoke to the President about the shortage of primary care providers and the impact on emergency departments. Davis was a featured speaker at the launch of CCNA’s Champion Nursing Coalition. During last week’s forum, he asked the President what he was "going to do to place primary care providers -- physicians and nurse practitioners -- back in the community so the E.R. is not America's source of primary care." The President called for more incentives to attract future providers into primary care medicine. Following the White House forum, CCNA asked Davis to share his thoughts.
I was humbled by the opportunity to address the President on the important issue of addressing the gap in primary care access in our health care system.
I agreed with the President's comments about the American Recovery and Reinvestment Act. The act invests "$338 million to expand services offered by Community Health Centers and enable them to serve more patients, as more Americans join the ranks of the uninsured."
I also agreed with the President's comments on educational loan forgiveness and equality in reimbursements for primary care providers because these two issues are critical to closing the primary care gap.
Had I had more time for discussion with the President, I would have asked him to discuss more specifics as to how the administration will close the gap in access, particularly in areas that are primary care deserts, the inner city and rural America. I would also ask him about the role nursing can play in expanding access to primary care. Perhaps this is an opportunity to examine private/public partnerships. An example of this is the Healthy Howard Plan in Howard County, MD that uses interdisciplinary teams, including nurses, physicians and other providers, to close the health care access gap. It also includes health lifestyle incentives for accountability by the participants, which is essential to keeping costs low and, more importantly, bringing education and prevention into our solution process.
I am again humbled to have been given the opportunity to speak on behalf of those who are a part of the primary care access gap. It is my sincere hope that my question added to the conversation about national health care reform.
Respectfully,
Hershaw Davis, Jr.
President, Maryland Association of Nursing Students
2 comments
Jun 29, 2009
It is not too often that mainstream and nursing news overlap, but recently that’s exactly what has happened. Two new television programs that feature RNs as lead characters have the entertainment and nursing worlds a buzz. The first, HawthoRNe, stars Jada Pinkett-Smith as a chief nursing officer at a hospital in Richmond, Va. Hawthorne, according to TNT’s Website, "is the kind of nurse who fights for her patients and doesn’t let them slip through the cracks. When necessary, she takes on doctors and administrators who are overworked, distracted or just unable to see the human being behind the hospital chart."
The second show, Nurse Jackie stars Edie Falco, formerly of Sopranos fame. Airing on Showtime, Falco plays an experienced, highly skilled ER nurse with a passion for her patients, but who has developed a bitter edge and a just a few bad habits (an affair with the hospital pharmacist and a not-unrelated prescription drug addiction, just two of them).
A quick review of what the nursing community is writing about and it is clear both shows receive mixed reviews. For example, some applaud Nurse Jackie’s focus on the main character’s patient care knowledge. In the series' first episode, Jackie assesses an emergency room patient, observes a significant problem and immediately alerts the doctor. This example demonstrates to the audience that nurses are educated and experienced. Critics speak up when, in the very next scene, we see Jackie abusing prescription drugs to "get her through her shift" or help her deal with severe back pain.
We at the Center will refrain from giving our review of either show in terms of entertainment value or accuracy in the portrayals of nursing. Instead, we’re wondering, do shows like Nurse Jackie and HawthoRNe really impact how health care consumers view nurses and careers in nursing? Let’s examine the evidence. According to a 2008 review of the evidence by Karen Donelan, Peter Buerhaus, and colleagues:
- Nurses rank highly (often first) in public opinion polls measuring the most trustworthy, honest and ethical professions.
- News stories about RNs working in disaster situations, such as Hurricane Katrina, generate substantial public respect for nurses (of the 66% who report seeing these stories, 75% say it positively impact their view of nurses).
- However, television shows and advertisements, as well as negative news stories about strikes, are more likely to have no impact than a positive or negative impact on the public’s respect for nurses.
- The public is significantly more likely to recommend either nursing or a career in medicine to qualified students than are either doctors or nurses. People who watch television shows (such as ER, Scrubs, Grey's Anatomy) were more likely to recommend both careers as compared with people who did not watch these programs.
So, television offers some influence. But, it is important to remember, that, according to the researchers, "the single biggest influence on conversations about nursing careers is personal experience with nurses as a patient or family members." In fact, they concluded "that while people are exposed to nurses in a variety of media, this exposure is more helpful than harmful."
There is the saying we can’t let the perfect get in the way of progress. Perhaps these RN characters are not perfect, but what’s most important is that they are lead characters in network shows, rather than supporting roles overshadowed by other providers, providing the public with more exposure to nurses. We will just have to hope that these findings hold true; in the end, these characters will do more good than harm.
Jun 19, 2009
Top researchers, nursing and health reform experts and Capitol Hill staffers met last Friday, June 12 at a forum sponsored by CCNA, Health Affairs and the Robert Wood Johnson Foundation to discuss the hottest topic in Washington: health care reform. With the President, members of Congress, and interest groups vying for the opportunity to steer legislation, nurses, doctors, insurers, hospitals—and perhaps most of all, patients—are hoping the bill that lands on President Obama’s desk will help end the current health care crisis. The forum’s key takeaway: nurses are an integral part of the solution to 21st century health care challenges.
“We all know that the health care system is broken and isn’t meeting the needs of our current population—especially the older population,” David Sloane, AARP’s senior vice president for government relations and advocacy, told a packed audience at the Columbus Club in Washington, DC.
Several of the panelists authored studies released on Friday in Health Affairs on various aspects of the nursing workforce, including the temporary easing of the shortage, the increasing need for qualified faculty, and patient quality. The studies are available here. Susan Reinhard, senior vice president and director of AARP’s Public Policy Institute and CCNA’s chief strategist, served as the moderator of the first panel and described it as an opportunity to connect issues like health care reform, the cyclical nature of nursing shortages, and the lack of faculty and educational policy. During the panel, Elaine Ryan, vice president for government relations at AARP told the crowd, “Congress would be kidding the American public if we spent a trillion dollars on health care reform and didn’t have the professionals at the frontlines who can realize the promise of that kind change.” Nurses, she noted, are at the forefront of all aspects of health care delivery, which is why the nursing workforce is one focus of the Senate Health Education Labor and Pension Committee’s bill.
The second round of panelists examined strategies to increase the ranks of nurse educators and noted their importance to preparing the next generation of nurses. In a year when over 50,000 qualified nursing school applicants were turned away, Linda H. Aiken, a professor of nursing at the University of Pennsylvania, said that without solving the faculty shortage, “it is a mathematic improbability that we will ever solve the nursing shortage.” Aiken recommends modernizing the way Medicare reimburses for nursing education to build, prepare and deploy a nursing workforce of advanced practice nurses who can become faculty. According to Aiken, these nurses can also enter practice and provide the kind of highly skilled care our changing health care system will demand. [Read more about Aiken’s recommendations.]
To solve the faculty shortage, CCNA director Brenda Cleary told the audience it’s time to redesign nursing education programs. Far from “reinventing the wheel in every school of nursing,” she said that new models like shared regional simulation labs that can be used by multiple nursing schools represent the “education of the future.”
The final panel focused on the politics of health reform and included policy experts like AARP’s Sloan, Wendell Primus, Health Counsel to House Speaker Nancy Pelosi, and others, who discussed current legislation and the challenges ahead. Mr. Sloan, who moderated the panel, said that we must reform our health care system to meet the needs of our changing population. “Nurses are not only key to health care quality, access and cost, but to providing the kind of care that will be required in a reformed system,” he said. As nurses approach Congress with suggestions, it’s important for them to speak with a unified voice, he added. “If different nursing communities are asking for different things, it will be harder to achieve what is wanted.”
Jun 10, 2009
Over the past year, we’ve watched a major overhaul of health care debated, and the next months will bring us much more debate. Each day new developments on Capitol Hill take shape, proposals are offered, options discussed. We are on the verge of what most analysts deem a historic shift in how health care is delivered in this country.
At the Center to Champion Nursing in America, we know that nurses are central to high quality, accessible and cost effective health care delivery. And we also know that this care cannot be delivered without a nursing workforce that is right in both numbers and skills. That’s what makes all this change so fascinating. I’ve watched with interest as Congress, the Obama administration and state governments across the country have become more aware of and demonstrated their support for nursing education.
The Center, through our work to educate key stakeholders in this debate, is proud to have contributed to the shifting landscape for nursing education and practice. And we hope that our new, enhanced Website will continue to contribute to the discussion.
We are indebted to the Robert Wood Johnson Foundation for their continued support of our efforts and making available the services of Forum One Communications, our Website development partners. Please take some time to explore the site. You’ll find continued conversation on this blog, nursing and health care news, and resources to help you connect your work to nursing workforce solutions.
Ultimately, our goal is to ensure that every American has a nurse with the right skills, when and where they need one. This site is just one tool we will use help us reach that goal.
Susan Reinhard
Senior Vice President and Director, AARP Public Policy Institute
Chief Strategist, Center to Champion Nursing in America
Jun 4, 2009
Register now and join CCNA, Health Affairs, the Robert Wood Johnson Foundation and AARP for a June 12 forum, Nursing Workforce Solutions for 21st Century Health Care: How Do We Get There?
At the forum, moderated by Susan Dentzer of Health Affairs, panelists will examine the impact of the nursing workforce on health care delivery, access and quality. This event also marks the publication of several papers in Health Affairs focusing on the nursing workforce and health care quality. Featured speakers include Congresswoman Allyson Schwartz (D-Penn), AARP’s John Rother and Susan Reinhard, CCNA Director Brenda Cleary, Health Policy Advisor for Speaker Pelosi Wendell Primus, Peter Buerhaus, Linda Aiken, Peter Buerhaus, and Oregon’s Chris Tanner, among others.
Event Details (PDF)
Jun 3, 2009
Strategic alliances and partnerships are key to the success of our state teams' efforts to increase nursing education capacity across the country. Team Florida offers one recent example of how these partnerships can provide useful venues for change. This week the team convened the Florida Center for Nursing, the AARP Florida State Office, Emply Florida, Workforce Florida Inc., BlueCross/BlueShield of Florida, Generation RN, the Florida Hospital Association, and the University of Central Florida to rally the state to take action on the looming shortage of nurses.
In an article in Chiropractic Economics , AARP Florida State Director Lori Parham noted that in 2008 more than 12,000 qualified nursing applicants were turned away from Florida nursing schools.
Check back for information on the outcomes of this meeting and the work of all our state teams. And congratulations to Team Florida for a successful event!
