Could Obamacare cause a shortage in nursing again

[RescueNinja123]

I would really like to know how you believe Obama care will affect the medical field and be honest. I would expect that it would create more jobs but the work would be very tiring. There would be no 3/12 but 4/12 or 3/15 with rooming/bedding at hospital.

[blondesareeasy]

Eight percent of nurses are Democrats. No one else to blame for Obamacare except for the people who voted for it.

Coincidentally, about 80% of prison inmates are ALSO democrat.

Nothing strange about those numbers either. The "takers" in the world need the providers, but we are outnumbered now. And I don't think it's going to change.

The country is in complete economic collapse.

[roser13, ASN, RN]

I hope for this too, but my gut tells me this is not likely to happen. The old days when a nurse walked into the human resources departments and they rolled out the red carpet and asked you where you wanted to work and offered nurses a sign on bonus are gone, and not likely to return. Patients were admitted a day prior to surgeries for testing. If a patient was ill, off to the hospital he would go where the testing and nursing care would begin and the mystery illness diagnosed and treated. This would require admission for several days.

Healthcare has changed. Much of the testing and diagnosing is done outside the hospitals. Only the acutely ill are hospitalized and often discharged quickly. Jobs for technical assistants to work with nurses in cardiac cath. and endoscopy are more common with the nurses being in charge of several assistants and coordinating care. I don't see a return to more nursing hands on care which is what it would take for the nursing demand to increase. I yearn for the good old days, but I don't see them returning.

Please let it be noted that all of this occurred prior to the ACA.

[mrsjeff]

I was let go promptly the first of the year by hospice due to "cuts in medicare". I realize the government no longer saw people who were not 12 hours away from death worthy of hospice care (we had a large number of patients who had been on hospice with long term chronic conditions- never to be reversed, but not imminent) also, there were a lot of patients whose families would put them on hospice for basically custodial care.

I can see in some ways why the government feels the way they do, but of course our company blamed medicare cuts and not their own greed and mismanagement.

Of course the cuts came from the bottom up- no CEO or friend of a CEO in a cushy office job got cut- just the foot soldiers- the underpaid CNA`s, LPN`s- a few RN, and anyone involved with volunteer services.

Hers the interesting thing- they still have plans for the new million dollar facility and office complex adjacent to it.

[chuckster, ADN, BSN, RN, EMT-B]

Nursing needs to take this opportunity, to finally UNITE AS A PROFESSION!!

. . .

I am violent agreement with much of what you say but I think that nearly all of it is unattainable. There are far too many powerful and monied interests to fight, ranging from big pharma to the big health care corps to the giant insurance companies. They, along with other wealthy parties, continue to mount legions of lobbyists and pour money into Washington to get what they want, most of which is diametrically opposed to what is good for the rest of us.

[danarooo, BSN, RN]

I hope this line of common sense will be applied.

I hope "been there, done that" is right as well.

I am finishing my BSN and I have no idea what direction to go precisely because of health care reform. I have so many questions, do I get a DNP? Masters? Hang out and see what happens before indebting myself further to expand my nursing education and role? How can I ensure my advanced education will get me where I want to be in ANY of the 50 states (differing requirements, military wife...).

I have been wondering the same, I know the military hospitals have no budget and things like hand sanitizer and soap are now being sequestered (in the local large military hospital where I am). Things seem to be transitioning in a way that makes it very hard for me to get a feel for what I as a nurse need to do and where I need to be!

[lamazeteacher]

There's certainly a lot of naysaying going on here!

Well, in "The Simpsons" that happens a lot, too....

With more preventive work being done, initially more patients will arrive at hospitals, as they'll have coverage. Hopefully they'll have the will to get better, and stay healthier. Since less illness will occur, eventually fewer people will be unemployed, as they'll be well enough to work and show more initiative. If they become greener, having more capacity to do more for their communities, there will be less polution in the air we breathe, so fewer advanced respiratory cases will be happening (way down the road). Healthier oeople are usually happier people, so there could be a decrease in mental illnesses......

I'm a supreme optimist (obviously), and I have the will to see those things as possibilities! Having attained many years of life, I've seen many changes happen in healthcare and in people. Advances that weren't even dreamed, have happened! It wasn't easy and the future still holds stressors that lead to disease. I'm convinced that better understanding and stratigizing will bring about great changes.

Think not of dire consequences, but of doors opening that challenge and amaze, bringing peoples' potential to bear.

[danarooo, BSN, RN]

I am violent agreement with much of what you say but I think that nearly all of it is unattainable. There are far too many powerful and monied interests to fight, ranging from big pharma to the big health care corps to the giant insurance companies. They, along with other wealthy parties, continue to mount legions of lobbyists and pour money into Washington to get what they want, most of which is diametrically opposed to what is good for the rest of us.

100 % agree. Where I am (few hours from DC), I see the results of just this. I moved to this area from a state with great practice acts, clear delineation of practice and high use of nurses to do things that those with less education should not be doing. Moved here and was shell shocked at unclear delineation of practice, horrible regulations which put healthcare delivery in the hands of those who DO NOT have enough education to support their ability to do certain things (in certain settings). To top it off, the BON is NOT a source of advocacy for nurses and there are no built in protections AT ALL in regulations for us. All MONEY RELATED.

[lub dub]

There are plenty of people without insurance right now who are being hospitalized. Once the ACA kicks in, there will be more people with insurance, so they may be seeing their primary healthcare provider (MD or ARNP) on a regular basis. In this scenario, there may be fewer hospital admissions, since problems that were left alone, only to get worse, will now be dealt with sooner.

I believe that the big winner in all of this will be nurse practitioners. There will be a need for more primary healthcare providers.

[BostonFNP, APRN]

There are plenty of people without insurance right now who are being hospitalized. Once the ACA kicks in, there will be more people with insurance, so they may be seeing their primary healthcare provider (MD or ARNP) on a regular basis. In this scenario, there may be fewer hospital admissions, since problems that were left alone, only to get worse, will now be dealt with sooner.

I believe that the big winner in all of this will be nurse practitioners. There will be a need for more primary healthcare providers.

I agree with you about NPs being in a good position.

I think the biggest "winner" is the general public with a shift from tertiary care to primary care.

[FranEMTnurse, CNA, LPN, EMT-I]

I believe a lot of the doctors as well as the nurses will be overworked decreasing the quality of healthcare with extra long waiting periods due to the increase in the patient load.

[GM2RN]

I hope for this too, but my gut tells me this is not likely to happen. The old days when a nurse walked into the human resources departments and they rolled out the red carpet and asked you where you wanted to work and offered nurses a sign on bonus are gone, and not likely to return. Patients were admitted a day prior to surgeries for testing. If a patient was ill, off to the hospital he would go where the testing and nursing care would begin and the mystery illness diagnosed and treated. This would require admission for several days.

Healthcare has changed. Much of the testing and diagnosing is done outside the hospitals. Only the acutely ill are hospitalized and often discharged quickly. Jobs for technical assistants to work with nurses in cardiac cath. and endoscopy are more common with the nurses being in charge of several assistants and coordinating care. I don't see a return to more nursing hands on care which is what it would take for the nursing demand to increase. I yearn for the good old days, but I don't see them returning.

I have to disagree with this just a bit. I work in the ED and see patients admitted all the time for things that shouldn't require hospitalization. Patients have some obscure complaint that the ED doc can't find a reason for so they admit for "TIA." Or patients sometimes demand to be admitted when it isn't necessary but they get their way. Just two examples of admissions where people are not acutely ill.

[Kooky Korky, BSN, RN]

Common sense dictates : more consumers ..covered under government MANDATED health care.

equals... we need a boatload more of nurses.

Sink that boat. There are too many nurses already. New grads and even experienced nurses can't find work. There are already way too many nurses, just too few decent employers, employers who offer good pay and benefits, who respect their staff. One example: giving only 25 days PTO per a whole YEAR and making staff use it to cover ALL time off, including sick, vacation, emergency, & holidays. Fooey on that. I repeat - sink the boat, just make the Captain Bligh's out there treat the crew right.