See the current issue of Scrubs Magazine

“Obamacare’s Killer Burden on Nurses” – Did you read it?

Thinkstock / Wavebreakmedia

Thinkstock / Wavebreakmedia

Love it or hate it, agree with it or not, the Affordable Care Act is likely already affecting you at work. And it will only continue to grow, as new patients made the May 31 first payment deadline and started making appointments at the hospital.

Of course, there is a lot of good that can come from previously uninsured people finally getting the treatment they need. But it also requires more of you…as if you weren’t already giving enough!

Time magazine recently broke down the “killer burden” the Affordable Care Act has placed on nurses, and we’re very interested to hear what you think. Politics aside, we’d love to hear how the new healthcare laws are affecting your job and how you think things should work going forward. What works and what doesn’t?

Here are some key excerpts from the article (which is written by an RN!):

  • We’re told the goal of the new law is to remodel healthcare in the United States into a system that promotes wellness and prevention, rather than just providing care to sick people. This seems like a great objective, but I worry that the switch may compromise the quality of the care our patients receive.
  • As a bedside RN working at an acute care hospital in Oakland, California, I care for an incredibly diverse patient population. Most of my patients have had health insurance through employer-based programs, private purchase, or Medi-Cal. Most have interacted with the health care system prior to being admitted to my hospital. Now, I will take care of patients who are new to health care. Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.

  • Executives at my hospital recently proposed reducing our inpatient nursing staff. They note that the number of patients admitted for overnight stays has decreased in the last few years. They say medical and surgical care has improved, and better primary care has kept patients healthy enough to avoid hospital admissions. The ACA permits hospitals to continue shifting patient care from the expensive inpatient setting to the cheaper—and more profitable—outpatient setting. The problem with that diagnosis? My patients are not healthier. 

  • Hospitals delaying and denying care to patients as the ACA enables more Americans to buy into this deeply flawed system. If the ACA is successful in contributing to keeping patients out of the hospital, inpatient care will be reserved for patients with acute, severe illnesses and the number of hospital nurses will drop dramatically. Meanwhile, other patients will be managed in the outpatient setting and more nurses will move into home health and advice nursing.

Read the entire story here, then tell us, which piece rings most true for you? What advice do YOU have for the government and your hospital in dealing with the new healthcare laws? Tell us your thoughts in the comments below.

SEE MORE IN:
,

Scrubs Editor

The Scrubs Staff would love to hear your ideas for stories! Please submit your articles or story ideas to us here.
By

Post a Comment

You must or register to post a comment.

10 Responses to “Obamacare’s Killer Burden on Nurses” – Did you read it?

  1. saturn567

    I work in subacute/ long term care see more sicker patients added on to my care everyday

  2. StudentRN5683

    My hospital is currently closing both of it’s inpatient units (MSU and ICU) and is converting to a free standing ER with some other services as well.

  3. Mercy RN

    I am seeing a difference. I work in an infusion center. Patients are being asked for money up front. Sometimes as much as 200 a visit, so even insured they are opting not to come. Now, even the newly insured are for the first time running into this obstacle and they also aren’t keeping their appointments. Heck, I would not be able to come up with 200 a visit, twice a day. And the people that have always had insurance are being asked to pay more, so they aren’t coming. Also insurances are requiring you to pay you OOP and deductible first. Which means people are ignoring or trying to deal with their medical issues at home until they become life threatening.

    Recently we had our own emergency. I have always carried insurance, either private or through my job. I have always been able to make payments and pay what my insurance didn’t cover. Now, from 1 broken wrist and one surgery I am being charged 5250 out of pocket and they want payment in full, not payments. So I will try to do the same as my patients, not get treated for anything I can try to fix at home.

    This bill has effected everyone but the very rich who can afford to pay out of pocket anyway. Now the middle class and the poor are not getting the care they need.

  4. UndrCvrNurse007

    I’m personally very grateful for “ObamaCare”. It has helped me and many people that I know, get quality, affordable healthcare coverage. If there is more burden placed on nurses, then it just highlights the fact that the ENTIRE medical care system needs to be overhauled.

  5. lvuv

    Inpatient hospital RN’s work to deliver excellence health care which is a challenge no matter how you slice it. I feel strongly that inpatient RN’s are in a unique position to lead that change and adapt to it. We have to power to eliminate waste, start prudent appropriate teaching immediately, to help keep patients out of our hospitals. The healthcare system is changing and always will be changing. This particular change makes sense to me and this is a big opportunity for the nursing profession to shine! The furure I see is opportunity for Nurses in advance practice outside an inpatient setting. And I think nurses know it and are answering the call, many nurses are going back to school for NP. Inpatient RN’s now who practice in outpatient advanced practice at a future time will be invaluable! I am proud to be a part of such an adaptive field. Also I am excited to take on more complex patients in the hospital today… who may have never been treated before because of the past health care system…bring then in! Let’s get them educated and back to a realistic level of health to enjoy life.

    Nelson Mandela said… “Education is the most powerful weapon which you can use to change the world.” And this is one truth every RN embraces. We are teacher, scientist, leader, advocate and friend all in one highly skilled and educated package. Go nursing!

  6. eastcoastnurse

    Changes are on the horizon with nursing, but you should have had some notion that changes were coming. Most of us are afraid of change, but instead of fighting it, we should be embracing it. Every one of us should have the RIGHT to healthcare. How sad for our citizens who, unable to afford healthcare in the past, died of an ailment or illness that could have easily been handled by a family physician or acute care setting. All of us knows or is related to someone who passed away far before their time.
    To respond to some of the author’s points, the quality of care your patients receive can only be affected by you. I spend the same amount of time with each of my patients as I did 10-15 years ago. If time is an issue, then be sure to make your key points with each patient and with each continued interaction reinforce those points. True, in general, the amount of time patients are admitted is on the decline, this has been for the past 20 years. I am a cardiac nurse and 20 or more years ago a patient was admitted for 6 weeks with an MI. When I started in the late 90’s, the length of stay was 5 days and now with cardiac interventions, that LOS can be as little as 3 days. That happened before Obamacare, so NOT placing the blame there.
    To say that you will now see patients who were refused coverage in the past because of pre-existing conditions should make you shout,”Hooray”! No longer can these money grubbing companies continue to profit by insuring those of us with little or no healthcare needs! Hard working citizens (and hard working non-citizens) can stop using our cramped/overused Emergency Rooms for toothaches and Tylenol and perhaps our ER’s can return to focusing on… Emergencies.
    If the focus will now be to guide people to the “more profitable” outpatient setting, then a shift of nursing will therefore ensue. Hospitals have far too long overcharged for services and overused services, ordered far too many tests and allowed family members to use acute care settings as a “babysitting” service. They will now be held accountable for this misspending of taxpayer dollars. How can you argue this?
    And to close, I am a nurse on the Eastcoast and this author is a nurse on the Westcoast, so I cannot speak for her/him, but I do know that on this side of the country, we are not “delaying” and/or “denying” care to patients. This RN is ecstatic about Obamacare, I am proud that we have finally caught up to Canada and most of Europe with regard to the importance of Healthcare Rights to all of us, not just the wealthy.

    • qaqueen RN

      Thank you!

      I agree that the ACA has created change that we all have to deal with. At the end of the day, I would much rather have a patient admitted to the hospital for early intervention of illness than have them wait until they are at death’s door. I have seen too many patients who have waited to come in because they did not have insurance. Instead of treating out of control blood sugars, or intervening early with wounds, (because of delays in care) we ended up with patients in DKA spending time in ICU, and/or requiring amputations that could have been avoided. If these patients were uninsured, often the hospital did not get paid.

      You make two great points!

      ” Hard working citizens (and hard working non-citizens) can stop using our cramped/overused Emergency Rooms for toothaches and Tylenol and perhaps our ER’s can return to focusing on… Emergencies.”

      People complain about the wait times in ER, but if the doctors and nurses were allowed to treat EMERGENCIES, this would not be such a significant issue. How many times have people come into the ER for dyspnea or a headache that has been going on for three or more days?

      “Hospitals have far too long overcharged for services and overused services, ordered far too many tests and allowed family members to use acute care settings as a “babysitting” service. They will now be held accountable for this misspending of taxpayer dollars. How can you argue this?”

      This also happens far too often!

      As for east coast/west coast differences, I am in Arizona, so much closer to the author. I believe that if the ACA is appropriately supported, we can have “a system that promotes wellness and prevention”. That is a longterm goal. There will always be a need for qualified healthcare professionals, especially the ones that can adapt.

  7. htarceno RN

    All I can say is – I now have a steady full time job, after the past few years of dealing with layoffs, downsizing, facilities closing, etc. I’m not complaining

  8. catlvr4395

    I am a hospice RN. As of May 1st, thanks to the new laws, any medications previously covered by Medicare Part D are denied. All meds need a prior authorization which can be up to 22 pages long with NO appeal process. So, if a patient is on hospice for COPD but also has Diabetes and glaucoma, hospice will cover the COPD meds but Medicare won’t cover the Diabetes or glaucoma meds. So, while our reimbursements are being cut, we are faced with higher expenses of covering all of a patient’s meds or telling the patient they have to do without. The humane, compassionate thing to do is cover their meds but at what cost? As reimbursements go down, the care we can provide suffers. Anyone remember the accusations of death panels? Guess what, they’re here. Yes, patients on hospice have a terminal illness but does that mean we deny them meds and try to speed up the process? That is just wrong

  9. jcox

    “As a bedside RN working at an acute care hospital in Oakland, California, I care for an incredibly diverse patient population. Most of my patients have had health insurance through employer-based programs, private purchase, or Medi-Cal. Most have interacted with the health care system prior to being admitted to my hospital. Now, I will take care of patients who are new to health care. Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.”

    This is ridiculous. You became a nurse so that you could care for all patients, not a select few. Yes, the new flow of patients could potentially possess more complicated conditions. However, if you can only provide nursing care to acute illness, how and why did you even become a nurse? I for one am thankful for obamacare. There are many people in my community that have now been able to seek the care that the need. I know this has made prior auth’s more strenuous, but we became nurses to help no matter how steep the hill is. Get over it, or stay home.

shares