Nursing is changing ... and so should family care giving

Healthcare is a growing concern as population density increases stress, food production affects nutrition, and science is beginning to recognize that lifestyle choices mean as much or more than heredity...

Nurses stand beside family caregivers in the hospital, in home healthcare and at doctors offices as a bridge between everyday reality and the urgent care provided by specialists.   And its time that nurses are recognized in the health care system for this critical and powerful "supply chain" role in health care.

With three million nurses in the United States, nursing professionals “hold the power and influence to make those numbers speak” in the new era of health care, said Donna Shalala, president of the University of Miami and former U.S. Secretary of Health and Human Services, at the 124th commencement of the University of Pennsylvania School of Nursing in 2011.

Health Care Transformation

With the implementation of the Affordable Health Care Act of 2010, which provides health insurance coverage for all Americans, “health care providers -- and especially nurses -- have a unique opportunity to transform the way health care is delivered in the United States,” said Shalala. Under health care reform, 32 million more Americans will have access to health care, requiring more health care providers to meet the need.

Shalala sees nurses as the leaders in a reformed health care system.

Shalala, who chaired the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine, told the Penn Nursing graduates that their expanded role under the Affordable Health Care Act should “elevate nursing to its proper leadership place in the health care pantheon.”

Nurse Practitioners' Scope of Practice Transformation Needed Nationally

However, to be truly successful, nursing will require “a coherent national practice policy,” said Shalala. Current policy varies by state, for example giving nurse practitioners prescriptive privileges in one state but not in another. “We must remove scope-of-practice barriers as fast as we can,” said Shalala. “They are so yesterday. Preventing nurse practitioners from providing the care they are trained to give is inexcusable and, I should point out, a waste of money and lives.”

Shalala called on the graduates to claim a leadership role in health care reform: to ensure that their voices are heard “on rounds and on the record,” to demand “full partnership with physicians,” and to “give the profession a little swagger.” Today’s nursing graduates, she said, are entering the “Golden Age of Nursing” and should lead the way in the re-design of the health care system in the U.S.

Family Caregivers

Our family has been immersed in the health care system for three months now... and continuing.  My husband had brain surgery and a shoulder replacement.  That meant 19 days in the hospital, radiation and chemo for 6 weeks... and chemo that will continue into the foreseeable future.   This experience has given us an inside view of the healthcare system and a good feel for how valuable nurses and nurse practitioners are -- and the practicality of their care and intelligence.  Nursing is grounded in the daily grind that makes a surgical solution heal and be therapeutically restored to function.  Doctors provide emergency care.  Nurses provide problem solving.  And FAMILY provides the nutrition, exercise, stress reduction, emotional support and transportation required to implement the recovery process over the long term.

Just as nurses need more respect and managerial role in healthcare solutions ... so do family caregivers and the patients themselves.  Without follow-through, there is no successful scenario for patients.   But we don't hear much about the consumer's role in heath care affordability.  Or in emergency preparedness or first response.  Or therapy.  Or long term care.   Family members also need a better managerial seat at the table if we are going to bring practical solutions to our healthcare system.