Tag Archives: babies

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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Feeding Readiness for Preemies

One of the most exciting moments for a parent of a NICU baby is when you can start feeding the baby from the bottle. Most are not able to do the breast feeding due to the difficulty latching on, but what a joy to feed your baby even if by bottle whether it is your breast milk or specialized formula.  There are different opinions in the medical community around feeding readiness.    My passion for the neonatal intensive care unit arose from having a premature infant myself.  My son was given breast milk initially via NG Tube until he was ready to try a bottle.  Initially the bottle feeding was started once per day and increased and they would leave the bottle feeding for when the parents were there to feed the baby to create that bonding experience.  One day  I arrived at the NICU on a weekend ready to spend the entire day with my son.  I was excited to feed him several times per day, but I was greeted by the shift nurse telling me that I was doing it wrong.  She took over the feeding entirely and when the rest of the feedings occurred that day, she took over stating that I was making the baby aspirate due to my inexperience.  I was only allowed to hold him.  When change of shift occurred she said okay time to go, I stated that we were in a private room and the nurses close the door so that we do not have to leave during change of shift.  We were in a private room because at one point the baby had developed a hospital borne infection called serratia and would remain in a private room until discharge.   Staying in the room was an arrangement that I made with upper management due to the fact that I worked full-time as did my husband and we did not have much visit time with him during the week.  She proceeded about her business and ripped the baby right out of my arms.

 

I cried for days until Monday came and I made a complaint to my head nurse who assured me that this was documented in my chart right on the front that I was allowed to stay whenever I needed to. She showed me the chart and stated that she would speak to the nurse about her abruptness.  The weekend nurse apologized to us a few days later, but by then my feelings were already crushed.   It was later discovered that the baby was aspirating even when he was fed via g-tube it had nothing to do with how I was holding or feeding him.  It was inevitable.  In the end, it was decided that the baby would have a Mickey G-tube inserted surgically for feedings to expedite his discharge to home.

As nursing professionals we need to be sensitive to the needs of our patients and their families.  We should always read the chart prior to walking in the baby’s room and talking with the family to see if there are any new changes since last you saw the baby. How could the nurse that  was in charge of my baby rip him right  out of my hands and ask us to leave.? When you look at how he was being fed here vs those those nurses that truly cared about bonding .

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These nurses were Kaleb’s primary day and night nurses…sheer joy to watch nurses caring about their patients….

 

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Written by Rosie Moore, RN, BSN, LNC