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When I was 25 I got pregnant with my first child. I worked in a medical office and my husband was a construction worker. Needless to say, we didn’t have insurance that would pay for the delivery of my baby—so we decided to go on Medicaid. I felt justified in the decision and continued to work throughout my pregnancy.
That’s just a little background for what I want to discuss. You see, I never dreamed back when I was 25 and on Medicaid that I would receive any different care or be seen any differently than any other pregnant woman when going to the doctor. And frankly, I don’t believe my amazing doctor at that time, or the hospital where I delivered, treated me in a biased manner.

Fast forward to what I see today on the other side of the bed: clinic patients, i.e. those on Medicaid or without insurance, sure DO receive a different standard of care. Not from me, or my nursing coworkers, but from SOME of the attending doctors. I am mortified and absolutely ashamed.

I can’t really go into specifics. Let’s just say docs really drag their feet, pass the buck, etc. with clinic patients because the money isn’t there. For example, a clinic/Medicaid delivery pays a fraction of what an insurance delivery pays, so docs don’t feel doing deliveries for the clinic is “worth it.”

But I can say, that with the economy the way it is, and insurance being so hard to obtain, it is hard for me to understand why there would be a bias against those people who have to resort to using government programs (legitimately) or have no options at all. And why in the world would that make a difference in the care they receive? It blows my mind.

In fact, it puts patients in real danger when this behavior occurs. And it puts my career in danger. I end up teetering on going beyond my scope of practice in some cases just to protect and care for my patients. And though I can’t detail the situations I find myself in, it would not be exaggerating to say that I get nervous for my license. I am constantly put on the spot!

Yes, there are laws, and the state supposedly watches over things and bla, bla, bla. But the reality is that there is a HUGE problem. I am seeing it and it disgusts me. Besides reporting it, I am at a loss.

This is where patient advocation plays a huge part in our jobs—but I’ll be honest and tell you my advocating does little to nothing. The healthcare machine itself is broken, and until it’s fixed, advocation is just a band aid that hardly covers a gaping wound.

Amy Bozeman
Amy is many things: a blogger, a nurse, a wife, a mom, a childbirth educator. She started her journey towards a career in nursing when she got pregnant with her first child. After nursing school and studying "like she has never studied before" she entered the nursing profession eager to get her feet wet. The first years provided her with much exposure to sadness, joy and other complex human emotions. She feels that blogging is a wonderful outlet and a way for nurse bloggers to further build their community. Traditionally, midwives have handed down their skill set from midwife to apprentice midwife. She believes nurses have this same opportunity: to pass from nurse to new nurse the rich traditions of this profession.

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