The Nurses Impact in Healthcare Ayva Rodriguez Felician College The Nurses Impact in Healthcare The new health care system “require U.S. citizens and legal residents to have health insurance” ("Summary of the Affordable Care Act," 2013, p. 3) that resulted in the increased insured individuals since the Affordable Care Act (ACA) implementation ("Summary of the Affordable Care Act," 2013, p. 3). Due to the new policy more people have access to health care that means more primary physicians needed to accommodate the rise of new patients ("The Physician Shortage," n.d.). Shortages of physicians not only in the primary care area but also in specialty care area are projected between 46,000-90,000 by 2025 ("The Physician Shortage," …show more content…
The policy and regulations on the nurses scope of practice in every state varies, where few states allowed their nurses to practice independently without the physicians’ supervision (Garner, 2010). But more states “…impede the full utilization of nurses” ("Issues for Nursing," 2010, p. 3). “The ACA relies heavily on the concept of the Patient Centered Medical Home (PCMH) model and free preventive care” (Anderson, 2014, p. 3), but these models need sufficient primary care providers to care for the newly insured individuals (Anderson, 2014, p. 3). With the primary care physician shortages, advanced practice registered nurses (APRNs) play an important role in attaining the goal of ACA ("Issues for Nursing," 2010, p. 3). Patient have no access to APRNs services and several health plans failed “…to include APRNs in their provider directories” ("Issues for Nursing," 2010, p. 3). This limits their choices and availability of provider ("Issues for Nursing," 2010, p. 3). Even though some state authorized the APRNs in practicing to the full extent “…without a statutory relationship with a physician” ("Issues for Nursing," 2010, p. 3), the services will not be covered unless collaboration with the physician occurred ("Issues for
The aim of the ACA is to provide affordable health care to all Americans, but it still leaves some issues unaddressed that will impact the access to health care. Covino (n.d.), “Though the intentions of the legislation are good, the Affordable Care Act does little to improve the actual health care delivery system” (para.1, page 2). According to the American Medical Association, we are facing an increasing Physician shortage. As of 2010 we faced a shortfall of 13,700 physicians, the estimate is that number will increase to 62,900 by 2015, 91,500 by 2020, and 130,600 by 2025 (Krupa, n.d.), with primary care taking the largest impact. Health Care coverage will be of no benefit if there are no doctors to treat the patients. An example of this occurred in 2002 when Thailand’s’ “30 Bhat Scheme” added (CNN n.d.) “14 million people to the country’s health care system, resulting in long waits and subpar service” (Your health is covered, but who is going to treat you?) Several factors contribute to the physician shortage. Many physicians are reaching the age of retirement, the Association of American Medical Colleges estimates nearly 15 million physicians will be eligible for Medicare in the coming years (CNN n.d.). The increasing cost of malpractice insurance also deters many from pursuing a career in medicine, and is forcing some doctors to retire. Also contributing to the physician shortage is a lack of spots in residency programs. “In 2011, more than 7,000 were left
The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.
Registered nurses are an integral part of the healthcare system, and make up the largest number of healthcare professionals. According to the Bureau of Labor Statistics (2015) “The employment rate for registered nurses is expected to grow by 16% between 2014 and 2024”. This is more than double the average rate of growth for a profession. The rapid growth rate can be attributed in part to better management of chronic diseases and the baby boomer generation. The growth in the nursing profession is paramount, however the demographics of the nursing population does not mirror the demographics of the population served.
This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component
According to Health Resources and Services Administration If the system for providing primary care in 2020 were to stay fundamentally the same as today, there will be an estimated shortage of 20,400 primary care physicians ("Projecting the Supply and Demand for Primary Care Practitioners Through 2020," n.d.). In addition this projection doesn’t include the decreasing number of people perusing the medical degree and the baby boomers retiring form this filed of science. In the hand we are experiencing a significant increase in NPs and PAs. Considering this projected shortage, which is actually a very frightening situation the increasing number of NPs and PAs, can effectively be integrated; we could reduce the number of physician shortage by over 69 percent in 2020.
The new federal health-care law has raised the stakes for hospitals and schools already struggling to train more doctors. Evidence suggests there won’t be enough number of doctors to treat the newly insured millions under the ACA. At current graduation and training rates, America faces a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The greatest demand will be for primary-care physicians. Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more with longer wait times under the new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER
Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.
With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting
Primary care access is a growing concern for all Americans and the reason behind this concern is an imbalance between demand for care and capacity to provide care. Demand is growing as the population expands, ages, and faces chronic illnesses and the capacity is shrinking as the ration of primary care clinicians to population drops (Ghorob & Bodenheimer, 2012). A primary goal of the Affordable Care Act (ACA) was to improve access to quality health care for uninsured Americans, largely through public and private insurance expansions (Polsky et al, 2015). At the same time, the architects of the law recognized the need to increase the availability of primary care providers to meet the increased demand for health care (Pg. 538, 2015).
Moreover, insurers are mandated to cover and provide certain preventive services such as vaccinations without additional charge. The ACA is projected to provide an estimated 32 million uninsured Americans access to health care insurance resulting in more people seeking medical care. As a result of this policy, the demand for nurses is projected to grow at a higher rate (Spetz, 2014). In addition, nurses are confronted with critical changes in health care such as providing efficient and high quality care while keeping the cost affordable. According to Vincent & Reed (2014), the policy plans to enhance the role and expand opportunities in nursing. The law provides funding to expand the number of advance practice nurses and providers. Some experts claim that the growing number of people seeking medical care will not become an issue with the projected nursing workforce due to the many opportunities for expansion as part of the ACA’s provision. In another view, the shortage of Registered Nurses (RN) is projected to intensify as the Baby Boomers age and the need for health care rises in addition to the increasing number of uninsured people that have access to health insurance. Therefore, the increase of patient load due to the extension of health care coverages to millions of previously uninsured people as a result of the ACA will be unmanageable for nurses.
As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).
The Affordable Care Act set forth millions of dollars to address the problems and concerns that are associated with existing physicians shortages. The Affordable Care Act also has provisions that are aimed to improve the education, ongoing training as well as to help with the recruitment of nursing, physicians, doctors as well as other health care personnel. In addition, there are provisions in place that help to increase workforces’ cultural competency, enhance faculty training of healthcare professionals, and diversity. The provisions also play a vital role because of the fact they are put into place to examine innovative reimbursement and care delivery models that highlight primary care services value and offer in improvement in the patient care coordination.
The overall health care industry has undergone fundamental change over the last decade. Most of the changes have occurred within the underlying business operation of the healthcare industry. Legislation in particular has had a profound impact on the health care industry. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. The U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation, the need for primary car overall is shifting and will be needed heavily in the future. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more individuals are now insured. As such, the need for primary care will also increase over subsequent years, particular within the minority population. This patient centric approach will require more care predicated on specific communities in a seamless manner. Furthermore, primary care physicians will be in high demand over the coming years.
The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and
Nurses are known as the heart of health care. Being a nurse is a demanding job that requires commitment, but does not lack rewards. A fact stated by the American Association of Colleges of Nurses claims that “Nurses comprise the largest single component of hospital staff, are the primary providers of hospital patient care, and deliver most of the nation 's long-term care” (“Nursing Fact Sheet”). With many roles throughout the healthcare system as a whole, nurses are a large, very important role that interacts with every other part of the health care system. They have great qualities that not everyone has. They are highly compassionate, caring, professional, diligent and understanding individuals. A nurse experiences people at their worst and still care for patients in a way that no one else would. All these honest points prove that nurses are the most important members of the health care system because, nurses spend the most time with patients, nurses are the managers of patient care; they are teachers and are great with conflict resolution.