Uninsured Population Health Nurses: A Case Study

In Nursing, there will always be instances where the patient's nurse needs to advocate for their patient. There are numerous reasons why a nurse would advocate for their patient ranging from getting the doctor to change the patient’s orders, helping the patient’s treatment team understand what it is the patient is requiring for the day, to expressing the patient’s last wishes before death. In every situation, the nurse should do what is in the patient’s best interest. Tomajan (2012), “Advocacy skills are the ability to successfully support a cause or interest on one’s own behalf or that of another. Advocacy requires a set of skills that include problem solving, communication, influence, and collaboration”(p. 2). With those skills, the

Nursing leaders promote individuals to reach their highest potential. They provide guidance and direction to reach goals and visions in healthcare. Advocacy means to support a cause as defined by Merriam-Webster (2015). An advocate supports the interest of a person or patient. A successful advocate uses skills which combine collaboration, influence, problem solving, and communication per the ANA (2015).

One way that nurses can address the current inadequacies in access to health care is by educating the public regarding the need for everyone to have equal access. The public should be advised that when citizens go without care, there can be public health implications, such as resurgences in diseases like tuberculosis (White & Atmar, 2002). Nurses should educate the public on the cost savings that can result by providing a national health insurance program for everyone because of a decrease in administrative costs. Finally, people should be made aware that

The Kentucky Coalition of Nurse Practitioners and Nurse Midwives (KCNPNM) have concerns with three major medical and political issues. One of those issues is a concern about health care to the poor and uninsured. According to the KCNPNM (2014), Kentucky alone has 20% of the population at or below 100% poverty and 41% under 200% poverty in 2007. Their focus on this is driven by the fact that those uninsured suffer negatively, including premature death and illness, due to lack of medical care (KCNPNM, 2014). As a group, they make an effort to provide the underserved community with information regarding available healthcare programs (KCNPNM, 2014). They also work to encourage legislation to aid those without health insurance by reaching out and informing local and regional lawmakers of our due diligence to promote health in all populations (KCNPNM, 2014).

I view Community/Population Nursing “As an extension of public health that includes organized health care services to the community through public and private agencies in addition to government agencies” (Nies & McEwen, 2015, p.). Community/population nursing implements the Core Functions of Public Health (assessment, assurance, and policy development) by integrating their clinical knowledge and their understanding of the entire population and its health and illnesses and communicates that knowledge to health planners and policy makers. Nurses promote public health through nursing interventions, programs, and advocacy and focus on the prevention of illness, injury or disability, the promotion of health, and maintenance of the health of populations

Also communication and involve people and reinforcing the changes are very important strategies of advocacy (Grand Canyon University, 2011). When the nurses choose to take on the role of

An article written by Robert Hanks (2012b) from The University of Texas at Health Science School of Nursing titled “Practical Approaches to Patient Advocacy Barriers” highlights the key components of the nurse’s responsibilities regarding patient advocacy. Dr. Hanks (2012b) determined that “only the patient can decide what is in the patient’s best interest and the role of the nurse is to then support the decision-making process.” A therapeutic relationship and effective communication between the nurse and the patient is essential to ensure quality of care. The nurse must support the patient in making their own decisions pertaining to their care, speak on behalf of the patient to communicate the patient’s choices for care, as well as act

To influence public policy, nurses must act as professionals with the ability and the responsibility to affect the current and future debate over the delivery of health care. This

Increased accountability and responsibility is my main fear as I enter the health care workforce as a registered nurse. Over the last three years as a student nurse on clinical placement, every shift I was supervised and overlooked by a registered nurse at all times. As well as being provided a diverse range of advice and techniques to use when applying my nursing practice. As a nursing student it gave me room for minor errors, as I always had someone to correct it and demonstrate efficient practice. Yet knowing next year I will have to carry the responsibilities of a nurse independently puts a different perspective on my year ahead. A registered nurse is accountable and responsible for their own actions and distribution of care to enrolled nurses and a number of other health care workers (Nursing Midwifery Board of Australia, 2006). According to a Nursing Times paper, accountability and responsibility is a key stressor in transitioning from a graduate nurse to a fully qualified nurse (Whitehead and Holmes 2011).

Nurses must expand the role of patient advocate to a level broader than individual patient considerations (Porter, 2010).

Nurses have an opportunity to change health care in the community in which they practice. It is of great importance for nurses to be involved in health care policy. There are many ways in which each and every nurse can become involved in legislative decisions. Whether it is writing a letter, making a proposal or actually joining a legislative group. There are bills passed daily that can have either a negative effect or a positive effect on patients. As primary care providers, we see these effects on a daily basis.

Population health as a framework for examining health is not a new concept. Historically, epidemiologist have used this to formulate etiologies of disease by measuring variations within a population and the impact of environmental factors (Radzyminski, 2007). Governments have also applied this concept to the implementation of interventions geared at improving the health of nations (Radzyminski, 2007). Although the concept is not new, the term population health has only been recently defined and differentiated from the definitions of community health, public health, and population-focused care. This paper will discuss the current definition of population health, its impact on nursing practice, its relation to evidence-based practice, and the importance of interprofessional collaboration in the delivery of population health care.

To advocate is to support publicly or to speak in favor of something. A nurse as an advocate means

The controversial notion, ‘nurses cannot advocate effectively for their patients’ will be critically analysed, utilising and synthesising a range of evidence to support fully developed discussions before concluding what the weight of evidence indicates. Advocacy is described as providing a voice, speaking out and acting on behalf of and helping another who is unable to do it unassisted, however there is not one universal definition and until there is the role of nurse as

NP’s see patient’s daily and come to know the patients they treat. This allows them the insight to know how certain bills will affect those in the community. Another way NP’s can influence legislation is by joining organizations, those that lobby on behalf of patients. “NP’s should let legislation know which organizations they are members of and how they work with patients on a daily basis. NP’s can join health policy committees within nursing organizations and work on formulating health policy priorities”, (Chilton, 2015).