BBB and the future of nursing

Published

I've been an RN for almost 34 years and currently do CVOR/General Surgery travel.  With the passage of the "Big Beautiful Bill" and the anticipated closure of numerous rural hospitals and 1 in 4 nursing homes due to lost Medicaid revenue, I'm very worried about the future of nursing in general and travel nursing in particular.  Although these Medicaid changes aren't slated to go into effect until 2026, UCSD and Sharp Healthcare (two of the biggest hospitals systems in San Diego County) have already announced preemptive layoffs, including nurses-I'm sure many more layoffs are imminent.  I also see these changes as potentially drying up the travel industry and available nursing jobs becoming very competitive and difficult to obtain.  Thoughts?

My general thought is just don't get sick. I'm not saying from a nurse side but general population. 

 

Lawmakers have every opportunity to make things better even on a state level. But also give a lot of slack.

 

I will use ny state as an example where they say a facility needs enough staff to perform duties. (Going to use long term care as an example) where each resident is to receive at least so much care from CNA and LPN or RN a tour. Then if they don't meet said requirements they get X fine. But then immediately in the next paragraph gives the facility an exemption if there is a shortage of nurses or CNA in the area (and newsflash there is a country wide shortage). So it allows these organizations to have 1 nurse for like 45+people needing to do med pass, notes, treatments, ext and 3 cnas. 

 

And no I'm not talking about in rural areas where there is a one way drive to the nearest hospital might be a 3 hour drive. But in more urban and suburban areas where your 20-30 from a hospital shouldnt be exempt in the same way. 

 

Yes this thing with Medicare and Medicaid is also giving them excuses to layoff staff and operate beyond a safe operating level for nurses and patients. You have these bigger organizations and insurance companies have people at that top making big decisions who have 0 Medical experience. 

 

 

 

2
Up Vote Up Vote ×
Specializes in OR, Nursing Professional Development.
Mrsexylegs said:

(and newsflash there is a country wide shortage)

No, there isn't. There are pockets where there are shortages and there are pockets where there is oversupply. 

0
Up Vote Up Vote ×
Specializes in Med-Surg, Geriatrics, Wound Care.

I see patients that have a hard time getting labelled as "disabled", even when they become paralyzed.  Heck, my brother took a long time after a car accident left him with back pain that limits his ability to do anything (can't sit or stand for periods of time). I've seen young able bodied persons (who may or may not be working, but are uninsured), that end up in the hospital with things like DKA (which could be prevented with routine care). I've seen people that cannot afford any medications from the pharamacy (blood pressure pills, antibiotics) and end up back in the hospital. But, some working people, especially the "gig economy" such as delivery persons, and people working in massive companies that intentionally do not give enough hours to qualify for insurance, are still working but are somehow considered unworthy of health care due to our system, and with even fewer safety nets,  our society will continue to bottom the charts for health and wellbeing.

4
Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

As a nephrology APP, many of my pts are on Medicaid. Starting in January 2027, there will be up to a $35 charge for each dialysis treatment.  When trump was in office the first time, he made a statement that he wanted 80% of all dialysis pts to be doing a form of home dialysis by 2025. Well....that didn't happen so this seems to be the next best thing from trump. Here's some info:

 

The "One Big Beautiful Bill" Healthcare Cuts and What It Means for CKD, ESKD, Dialysis & Transplant Patients | National Kidney Foundation

 

Big Beautiful Bill is Downright Ugly for K... - Kidney Dialysis

Better make sure you stay on top of your HTN and DM2....

1
Up Vote Up Vote ×
Specializes in Med-Surg, Geriatrics, Wound Care.
traumaRUs said:

As a nephrology APP, many of my pts are on Medicaid. Starting in January 2027, there will be up to a $35 charge for each dialysis treatment.  When trump was in office the first time, he made a statement that he wanted 80% of all dialysis pts to be doing a form of home dialysis by 2025. Well....that didn't happen so this seems to be the next best thing from trump. Here's some info:

 

The "One Big Beautiful Bill" Healthcare Cuts and What It Means for CKD, ESKD, Dialysis & Transplant Patients | National Kidney Foundation

 

Big Beautiful Bill is Downright Ugly for K... - Kidney Dialysis

Better make sure you stay on top of your HTN and DM2....

My coworker (a nurse) was doing home dialysis for her husband (until she injured her hand). The requirements are a machine to purify water (if your water can be used), a dialysis mahcine, a clean place to do it, a person trained to do it, and a ton of supplies that are delivered monthly (many gallons of fluid, many  more if the household water cannot be used) - so need the space to house a month's (plus "spare") worth of stuff.. Really not something most dialysis patients have if they are already living on a fixed income. It took several hours including prep, dialysis, and cleanup.

1
Up Vote Up Vote ×
+ Join the Discussion