One of the core concepts we’ve identified as essential for successful health care reform is the “rational care” solution, sometimes highlighted as:
- the right care,
- at the right time,
- from the right people.
What do we mean by this, and who are the “right people”?
Sometimes it is easiest to see the concept illustrated by what it is not. Many uninsured Americans wait long hours—sometimes days—in crowded emergency rooms for maladies that could have been diagnosed and treated by a neighborhood nurse practitioner or physician assistant if only that patient had been insured. Waiting a week as a sore throat worsens, and then 16 hours at a hospital to have a strep throat diagnosed by an emergency room team is the “wrong” care at the “wrong” time from the “wrong” people.
The rational care solution (the “right” way) would have been for the patient to visit his or her primary care clinic or office as soon as the throat became inflamed and painful. Not only is the patient accurately diagnosed and quickly treated in a low-cost efficient manner that helps the patient heal and return to full capacity, but also the emergency room is left free for true emergencies, and the patient is spared the unnecessary pain and discomfort that comes from an untreated strep infection.
Who are the right people for health care reform to succeed?
In part, they are the full spectrum of well-trained and certified nurses, including advanced practice registered nurses (APRNs), such as nurse practitioners, certified midwives, nurse anesthetists, and clinical nurse specialists. Working with teams of qualified professionals who understand our medical histories and can provide preventive care as well as diagnosis and treatment, nurses are a vital part of the rational care solution.
This week is National Nurses Week. In her recent open letter to the public, Cabinet Secretary Kathleen Sebelius of Health and Human Services noted that the Patient Protection and Affordable Care Act appropriated $1.5 billion to increase home visits from nurses and social workers to expectant mothers in high-risk communities. “Nurses making home visits,” she says, “can sharply reduce infant mortality and improve outcomes for mothers and children alike.”
In Texas, APRNs have faced unnecessary roadblocks to function at the highest capacity and greatest good both for patients and our health care system generally. Legislation currently is under consideration in Texas that would expand the scope of high quality nursing care. Whether through the pending legislation or some other means, we hope the antiquated barriers to APRNs in Texas are lifted. World-class economist and Texan Dr. Ray Perryman has advocated for the benefits of appropriately expanded nursing roles and services.
Last year, the Dallas Morning News quoted Perryman’s analysis and estimated significant savings from APRNs in rational care: “When advanced practice registered nurses are utilized within the systems of health care provision more efficiently, the economic benefits to the state are substantial,” Perryman wrote. Perryman found there would be significant savings in health care costs — about 6 percent across various industrial and economic sectors. That would set in motion economic growth in Texas that very soon could add $8 billion to the state gross product and create nearly 100,000 additional jobs, he estimated.
Without a doubt: nurses are some of the “right people” in the rational care solution for health care reform in the United States.
Marking this occasion of National Nurses Week, we salute the invaluable health care professionals who provide profound levels of care to all persons in all categories of life.