Tag Archives: Affordable Care Act

Nurses in the School System

Last year I explored the need for a nurse in the school, because my little boy who was born premature was entering kindergarten.  I believe that today the question of whether there is a nurse on staff at schools has become a frequent question.  I am just learning that many schools do not have nurses on staff (Florida Association of School Nurses website, n.d.).  In doing some research about Florida nurses after exploring this for my own child, it drew my attention to find out for myself  what options are available to families in school systems.  In one article by the Orlando Sentinel, it notes that not all Orange County public schools have a nurse, in fact their ratio out of 182 schools in Orange County, showed only 34 had nurses. One Orange County school mentioned that they have an RN and she helps a lot because it frees up the teacher to focus on their classroom instead of the child that is sick. The article went on to say that some tasks are delegated by the RN to non-clinical personnel, for instance an assistant principal or secretary when the nurse is not in the school (Roth, 2011).

In my opinion, although parents of children administer injections like epinephrine for allergic reactions or insulin, they are the parents that have been taught to watch for certain symptoms in their child that they see day in and day out.  They have a working knowledge of the situation should it arise. The school personnel, may be taught when to administer a medication like epinephrine or insulin, but if they have never used it, or administered it, how can they safely administer it? Will they know symptoms to look for if there is a reaction?

In the state of Delaware every school is required to have a registered nurse.  Some schools that have them receive the funding through the school system grants, or in the community (Roth, 2011).  I most recently went to a school that is private with an estimated tuition rate of $14,000 per year and service preschoolers through high school. The school has a large arts program and population of about 2000 kids, each child receives an IPad upon admission to use for homework.  They stated that they did not have a school nurse, if a child warranted medical treatment of medications or breathing treatments, this would not be the school for the child.  I found it rather sad to see that value was placed more on the material things of an IPad (which I know can help advance a student) but really the computers work just fine and having a registered nurse to help in times of kids needing treatment, or a school teacher needing treatment far outweighs the IPad.

My question then becomes to what extent is the Affordable Care Act going to benefit schools with the rise in costs of healthcare? Will every school have grants to hire a nurse?  Will they have these mini clinics on site?

 

 

References

Florida Association of School Nurses website. (n.d.). https://fasn.nursingnetwork.com/page/18381-school-nurses-save-money-

Roth, L. (2011, September 26). A nurse in every school? Not in Florida not even close. Orlando Sentinel. Retrieved from http://articles.orlandosentinel.com/2011-09-26/business/os-fewer-school-nurses-florida-20110925_1_school-nurses-practical-nurses-students-with-chronic-illnesses

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The Ever Changing Role of Healthcare

In the ever changing world of healthcare,  as new illnesses come along and as managed care gets more involved, nurses and doctors alike will be required to be on top of different ways that they can provide care to patients, DNP’s ( Doctorate of Nurse Practice)  will have to step in and provide expert clinical advice.  With health care costs on the rise, there are new and improved ways to provide care to patients both in and out of the hospitals.  Much of it involves empowering patients and their families to learn more about healthcare.  This will put more responsibility on the nurse to manage the care.  Many people use the emergency room as their primary care doctor.  This is the information that nurses can take to empower patients to have a primary care doctor or go to a less urgent facility like a walk in clinic if it is after hours to allow them to determine severity of their condition.

With the Affordable Care Act, it would be helpful for the DNP to be in an interdisciplinary team, because the nurse cannot possibly function in all the capacities and take care of multiple patients.  Nurses these days coordinate care for patients at home and even in the hospital, so that the different disciplines that need to see the patient, can help them recuperate from their illness or adjust to a new way of life due to a life changing illness.  The eight essential roles for the DNP may be interwoven, however each is a specialty in of itself and that is where the interdisciplinary team can come in to play (Fain, Asselin, & McCurry, 2008).

 

References

Fain, J., Asselin, M., & McCurry, M. (2008, July). The DNP why now. Nursing Management Springhouse, 39(7), 34-37. http://dx.doi.org/10.1097/01.NUMA.0000326565.46790.c0

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The Affordable Care Act and Nursing

Provisions that Will Afford Immediate Improvement for Health Care

The American Nurses Association for many years has been trying to get congress to pass a law affording health insurance for their nurses and everyone else.  When Congress passed the Affordable Care Act, more commonly known as Obamacare, they felt they had won the battle.  People in all walks of life were able to maintain health insurance based on what they could afford to pay and there was no longer the stigma of preexisting medical conditions denying coverage for anyone (American Nurses Association, n.d.).

Provisions that Will Fail to Address Deficiencies and Access

On the surface it appears that Obamacare would be a great service for premature babies that will require preventative treatment for a condition known as RSV (Respiratory Syncytial Virus).  The problem is that most recently the American Academy of Pediatrics lowered the amount of time that a premature baby can receive treatment for prevention of RSV.  Initially it was given to the babies under 2 yrs of age every month for a total of 5 months to get them through the season.  Due to the recommendations that the Obamacare made, this was drastically reduced to one every month for 3 months and some babies will only receive 1 dose.  This was due to the cost of this preventative treatment (Ertelt, 2013).

Challenges that affect Implementation of the Affordable Care Act

The most challenging aspect of implementing the Affordable Care Act in the United States is cost.  The insurance is based on a sliding scale and some folks may pay something and others do no pay anything.  The problem with this is the type of service that the patient receives.  If the patient does not have good insurance, they will be discharged sooner than later from the hospital.

Ethical Issues that Arise as a Result of Affordable Care Act

The ethical issues that will come up are always the issues of saving a life.  When the Affordable Care Act was signed in to law, it was noted that Americans would not be paying for plans that paid for abortions.  Yet it was discovered that it was documented in the plan that this would be covered.  Through lobbyists this was changed and if a person would like that part added to their policy, the client will pay 1.00 or so more per month to have that coverage added.

In the state of Florida people can have late term abortions up through 24 weeks.  Institutions or private physicians can refuse to do these abortions without any penalty.  According to statistics, Planned Parenthood received $528 million dollars in federal funding in 2013 (Ertlet, 2014).   It is unclear as to how much is being donated to preterm births.  In conclusion, maintaining a baby in the NICU is far more costly than providing what society calls today a simple abortion.  The costs of a NICU stay can be anywhere in the $2 million dollar range alone in the hospital, this does not include the cost after the infant is home for medications, homecare, therapy, doctor’s appointments with specialists and any other needs for equipment that the baby may have.  The cost of an abortion depending on the stage that the pregnancy is at can range from $300 to obtain the abortion pill, which also in some locations is administered free early on to an estimated cost of $2050 for later term abortions (All Women’s Clinic, n.d.).

 

References

All Women’s Clinic. (n.d.). http://allwomensclinic.com/fees.html

American Nurses Association. (n.d.). http://www.nursingworld.org/healthcarereform

Ertelt, S. (2013). Death panels for babies in Obamacare: Kids with RSV should beware. Retrieved from http://www.lifenews.com/2013/04/11/death-panels-for-babies-in-obamacare-kids-with-rsv-should-beware/

Ertlet, S. (2014). GAO report confirms Obama lied: 1,036 Obama care plans pay for abortions. Retrieved from http://www.lifenews.com/2014/09/16/gao-report-confirms-obama-lied-1036-obamacare-plans-pay-for-abortions/

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