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Considering Nursing and Health Care Reform: What nurses could be doing

June 11, 2009

Below is just a list off the top of my head that could greatly reform health care if these changes occurred. All of them relate to nurses in some capacity.

1. Nurse practitioners be allowed to write for controlled substances, long term if needed, in classes 2-5 in all states.

2. Nurse practitioners be allowed to own clinics and have independent practice with very limited control over collaborative practice agreements.

3. Nurse practitioners be allowed to order Physical Therapy, Occupational Therapy and sign birth and death certificates in all states.

4. Registered nurses develop nurse run clinics where basic health education on issues like asthma, diabetes, weight loss, and minor health treatments ( that nurses already know how to do) such as immunizations, developmental screenings and wound care be set up. Clinics to be run without need of a physician.

5. ALL 50 states go to an interstate license compact for nursing.

6. The WHO organization look at the development of an international nursing license recognition for nurses. This could occur at a basic level such as LPN so that American and other nurses who are well trained can go in and work in countries where there is a need (many countries have some brief nursing training but then will not recognize or allow nurses with more education from other countries to come in and work.

7. Place a practicing bedside nurse on all hospital and health care committees where patient care and health care reform are being discussed in any way (Let’s be real… who knows more about what is really going on with patients and in what it takes to live their lives?)

8. Allow nurses more autonomy at the bedside. For example, if a patient has Tylenol on their order sheet for fever and percoset for pain, but the patient does not want the percoset for various reasons…. allow the nurse and patient to decide if tylenol (Ordered for FEVER and not PAIN) would be a better option. (THIS IS NOT PRESCRIBING OR PRACTICING MEDICINE….. THIS IS PRACTICALITY).

9. Support all universities and hospitals that are actually doing valid nursing research. For example, St. Lukes Hospital in KC used their Clinical Nurse Specialists to research the importance of a specific oral care protocol that was entirely nurse driven and developed to decrease their ventilator infection days. Likewise, several nurses recently researched the best design for ICU’s and patient visual contact, care, etc…. who else is going to research this but nursing? Such cheap research that makes HUGE impacts in patient care.

10. Graduate nurses with BSN degrees. If you did not know it, nursing has been fighting this battle for several decades. Nurses with associate degrees are finished faster, however their ability to continue on with education, move into management, design research and nursing protocols is quite limited. Likewise, in researched studies patient outcomes are improved and nurses stay longer in nursing if they are educated at a higher degree level.

11. Nurses and nurse practitioners be reimbursed directly for specific care they would provide in nurse run clinics. This occurs to some degree for nurse practitioners, but not with all insurances yet and not for registered nurses.

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2 Comments leave one →
  1. Melissa permalink
    June 13, 2009 1:44 am

    Well – Think you are on the right track with some of this. Maybe they should look at the DOD’s model for healthcare for the military. Makes sense and there is improved access to care.

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