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Healthcare Reform

House Healthcare Reform Bill: What’s In It for Nurses?

Published November 4, 2009 10:19 AM by Stacey Miller

Like all political propositions, healthcare reform has left nurses wondering what's in it for them. Why should they support a bill? What could it do to their roles?

The American Nurses Association examined the Affordable Health Care for America Act, introduced in late October by the U.S. House of Representatives, finding there's a lot in it pertaining to nurses. For instance, the bill would create programs aimed at building the workforce and reimbursing more for services provided by nurse practitioners.

To give just an overview, the bill would:

  • pour a lot of money into educating nurses  —  an additional $638 million over the next 5 years for various nursing programs to be appropriated from the Public Health Investment Fund. Currently the fund is worth $171 million.
  • increase loan repayment benefits for students and faculty.
  • increase Medicare payment rate by 5 percent for primary care services of primary care practitioners  —  including nurse practitioners. Eligible practitioners practicing in health professions shortage areas receive an additional 5 percent.
  • establish a demonstration program to reduce the student-to-school nurse ratio in public elementary and secondary schools.
  • authorize nurse practitioners to lead various new models of coordinated care, including the "medical home" and Independence at Home pilot program.
  • create transparency in nursing homes by detailing its staffing ratios, patient census and staff turnover rates on Centers for Medicare & Medicaid's Nursing Home Compare Web site. The bill would also include whistleblower protection for employees who complain in good faith about the quality of care or services at a skilled nursing facility.

There's a lot more in the bill aimed at strengthening the role of nurses. After you read ANA's full synopsis of the bill here, let your Representative know what you think and share your opinions with other nurses.

9 comments

I have been a nurse for 31 years. I worked as an LPN for 10 years and RN for 21 years. I have worked rotating shifts, 16 hr. shifts, holidays and weekends, and double shifts when no one came to relieve me. I have seen many changes, and it seems that some new changes are necessary: such as incentive and reward for longevity in this career.

With all the discussion about the nursing shortage, why not allow nurses to take challenge tests to earn a title, based on testing for knowledge and experience: such as LPN to RN, or RN to BSN?

I have seen so many nurses with excellent diversified experience, professional bedside manner and critical decision making skills not advance due to inability to go back to school.

In this economy, doesn't it make sense to keep our nurses who are experienced?

Madgie Kaiser, Case Mgmt. - RN, Govt. November 21, 2009 8:55 AM
Baltimore MD

Looks like the plan is....  More spending....  Who in turn will end up paying the taxes for all the increased spending in the long run?

I want to know if we will be government employees if the government wants to run all the health care.

Julie, EHS - RN November 18, 2009 2:53 PM
NC

I keep reading, that everyone is harping about help for the RNs. What about LPNs who want to go back to school.   It just seems that those of us who are LPNs seem to get forgotten alot of the time.  I remember a time when I first started in nursing that there would be 1 RN who was in charge of the floor, and LPN passing meds, and 3 or 4 Nurse's Aides doing all the hands on care!!  And I know from doing this kind of work that patients felt much better taken care of with this model.  AND IT WAS CHEAPER!!!!!!!!   Maybe "primary care" really does not work after all?

Mark , LPN November 18, 2009 1:13 PM
MI

Bedside nurses are the backbone of the hospital, we go without lunches, breaks and support.  Many hospital are not using agency, travelers for call outs or increased volumes in the busy months in the ER.  Nurses are burning out, to give you must be given to, no time for teaching, etc., the bare essential is all we have time to do at times.  The ER nurse is triaging her pt's at bedside, managing ICU pt's and being pushed to get less sick people out of the ER, you have to be extremely energetic, able to run on hard floors, sneak food, pee quickly and prioritize but let everyone including the Dr's feel what they ask is your priority.  It is a jungling act to make everyone happy.  It's impossible to do that everytime you work, You're human and if you're not personally having a great day, there is no one to lean on, everyone is just trying to please someone to survive.

erin muscarella, ER - RN November 16, 2009 12:30 PM
Phila PA

all that money for nurse education is contingent upon belonging to a union!!!!   Why have the strings attached if the purpose is to help nursing....all nurses%0d%0aSAlly

Sally Campbell, ER - RN, Baptist November 16, 2009 12:21 PM
Pensacola FL

We have been cutting costs again and again for several years at the hospital where I am employed.  There is not much that can still be reduced while maintaining the quality of supplies, equipment and food.  The push to further reduce Medicare and Medicaid reimbursement while systematically forcing private health insurers out of business by or before 2013 (when this partially passed health reform bill is likely to be enforced) will force hospitals to cut nursing salaries (as well as salaries of other hospital employees).  What a reform!

Sharon November 12, 2009 10:58 PM

This all looks good on paper.  The average graduating seniors are not interested in shift work, long hours and gruellling education to obtain a nursing degree.   With glamourous jobs available who would want to change adult briefs, assist with wound care and do all the various necessary jobs related to health care.   I do not believe that adding additional money for education is going to increase the working healthcare force, namely Nurses.    There has to be an incentive and benefits to entice the young to go into nursing.  Technical and Pharmaceutical positions are where they are going.   Several nurses have left their profession to become doctors stating, I am already in debt why stop here.   Nurses need to help recruit and change the present attitudes about the healthcare work force.

Sharon Duva, Med Surg - BSN,RN,MHA, Methodist November 12, 2009 4:24 PM
Dallas TX

Michelle you are so right.

I'm in debt for pursuing a higher degree and get paid less than when I worked at the bedside. How can nurse educators continue to build nursing's future as well as establish and maintain excellence if we can not pay our bills? WE do not want to be rich; we want to be able to pay our bills; ok I really want to go visit Disney World again before I die; no hope in sight.

Thanks for introducing the topic.

Rox

Roxana, nursing - nurse educator November 12, 2009 4:14 PM
NJ

Does any bill support and increase in salary for RNs and teachers?  Educators spend a lot of money to obtain a higher degree but is not compensated.  Their salaries are too low.

Michele, Mental Health - RNC, Spring Grove November 10, 2009 10:58 PM
Catonsville MD

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