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Showing posts from February, 2015

The Frustrating Thing(s) About the US Health Insurance Marketplace - Part 2

This post continues from Part 1.  Click here to read it.

This is the story of my friend Eva trying to get seen in primary care and how the insurance system foils multiple attempts and delays care. We left off with Eva's first attempt to getting an appointment failing.  Eva is a friend of mine from graduate school with a PhD and a good job she was able to take because it was easier for her to buy private insurance after the Affordable Care Act and work as a consultant.

Eva still needs to be seen. She's traveling for consulting work three days later --kind of important when you need to pay your bills while waiting to hear about full time work.  She doesn't travel, she doesn't get paid.

I dive into the bag of tricks most nurses develop when they've dealt with their health system after about a year.  I email a colleague I know who runs a nurse managed clinic (staffed by nurse practitioners) to see if she can get her in.  In 5 minutes, she gets back to me and connects he…

The Frustrating Thing(s) About the US Health Insurance Marketplace - Part 1

Let's be clear: I'm all for people having insurance.  I spent enough time working in the US healthcare system to see what a lack of health insurance does to patients.  It adds to the stress of their illness and sends many into medically driven bankruptcy because of their medical bill debt --something no one should ever have to endure.  I was thrilled when the Affordable Care Act [ACA] (a.k.a Obamacare) passed. With my policy training, I knew the bill was far from perfect but what was important in the US context was to get it through and then embed it in the bureaucracy, as happened prior to and continues since implementation.

But there are flaws nonetheless.  These are driven by the business of medicine and how it is funded in the US.

This is the story of my friend Eva.

Eva and I did our PhDs together. Instead of going into academia, she ended up in the corporate world with a good paying job and excellent benefits.  After putting in her time in that sector, she decided she wan…

Neglected Non-Communicable Diseases

These diseases are already widely affecting health care and nursing practice in high income countries. The implications for low and middle income countries are scary.  They already do not not have enough health workers to care for their country's infectious disease burden (i.e. pneumonia, HIV, gastrointestinal diseases, etc.) and these diseases will increase costs because they require longer term and more treatments.  Thanks to BioMed Central for the powerful infographic.

Should you have work experience before getting your PhD in nursing?

This is a hot topic these days: Should someone be admitted to a PhD program in nursing without ever having worked as a nurse, straight from their bachelor's degree?

Good question.

A common reaction from most people is that well, of course they should! How can you know what healthcare is like from a nursing perspective if you don't have experience?

Of course, one could make the same argument about a PhD in public health where it is also common to go straight from an undergraduate bachelor's degree right into a PhD program. How can you understand the context of public health without any experience? Do we assume that bright people will be able to make reductionistic arguments about their research findings based purely on what trends in numbers show?  In many cases, it happens all the time.

Kind of like management consultants with no life or healthcare experience that make recommendations for hospitals and how they should operate. Happens more than you think it does.


Professional Conferences: Get Re-Energized About Your Nursing Career

I was reminded this morning of the value of going to travel for conferences.  Someone I had met 18 months ago at a conference in Brazil emailed me about a really interesting project with multiple benefits to my organization and career.  It's the second project to come out of that conference and a valuable network connection.

So there are lots of conferences out there for nurses and health care professionals.  Some are specific to your specialty, some are great places for general practice resources.

Most of all, what conferences can provide you is moral support for the work we do.

When you find other nurses who understand the challenges of the patients you care for and are trying to help, you realize you are not alone in the clinical practice world.

When you find other nurses who also happen to have an unsupportive manager, toxic personalities on their units, and other relationship challenges that affect the work environment, you know other people understand what you do at a deep…