Some questions for nurses

jesskidding, LPN · Sep 23, 2011

Can you find an nurse to interview in person? I think that's always better.

What is MPH?

systoly · Sep 23, 2011

Can you find an nurse to interview in person? I think that's always better.
What is MPH?

masters in public health ( I believe)

jesskidding, LPN · Sep 23, 2011

Ah. Okay. That makes sense.

Thanks. :)

Isabelle49 · Sep 23, 2011

Your first question probably needs to be answered by a doctor. Now if you asked what the biggest problem in nursing was, then a nurse would be appropriate.

tyvin, BSN, RN · Sep 23, 2011

1. Access

2. The Democrats

3. Vote Obama out

4. Repeal Obamacare

BSN babyboomer and look above for specialties.

brandy1017, ASN, RN · Sep 23, 2011

I think the greatest problem in medicine today is the lack of national health care! We have a patchwork system that leaves millions of people without coverage and many millions more with inadequate coverage!

Health care reform is certainly needed but the Obama plan simply doesn't go far enough! The problem is the private health insurance companies have pretty much simply refused to insure anyone with any real health problems. They only want to cherry pick young and healthy clients and want to leave all the rest to someone else, preferably the govt! Just like the govt flood insurance program, they want the govt to take responsibility and provide coverage to all the people who are unhealthy and not profitable. This is also one of the reasons for the rising state and federal deficits because they are covering the sickest people.

Most large employers now self-insure to save money, and don't use the private insurance except to administer their plans. Small employers have a much more difficult time getting insurance because as soon as someone in their small group plan has a serious health problem the insurance company either cancels the group plan or raises the premiums so high to force their hand to leave and go elsewhere.

Add the general inflation in medical care, second only to college inflation and you have a toxic mix. The employers that offer insurance keep cost shifting with larger deductibles, etc onto their employees or stop offering coverage at all. I know some give a stipend of money and then require their employees to get private insurance and again anyone older and or health problem can be completely excluded from the market if not simply priced out!

The rising cost of health care also encourages age discrimination in companies as they realize health costs of older employees tend to be higher. On top of that older employees tend to be more experienced and at a higher pay and benefits (ie pensions) so there is even more added incentive for companies to lay off their older workers. This is very commonplace in America unless you have union protections.

For the poor folks who fall thru the gaps and qualify for state Medicaid programs they have substandard and inadequate insurance and there is no universal insurance coverage. States pick and choose what benefits to cover and what to exclude re treatments, medications, etc.

What I find particularly ironic is that the Republicans were quick to claim Obama was creating death panels to save money on medicare; but the real truth is the republicans in many states are creating their own death panels and no one is talking about that or bringing it to the nation's attention! Arizona stands out as the main death panel where to save money they have refused to cover organ transplants claiming they are experimental! So if you have the misfortune to be sick, poor and in need of a transplant in AZ prepare to die! People have already died! Why this isn't brought up in the news media is beyond me! Other states have made other changes to save money and push people off the govt insurance. Wisconsin under infamous Gov Walker and his buddies have decimated the health programs and have total control of administration, indept of any oversight now! Another state was going to refuse to pay for HIV meds, but I can't remember for sure which state that was!

So if you don't have insurance and can't get it or afford it your only choice is to beg for care from a doctor and beg for samples of meds, try to get the $4 generics at Walmart, and last resort turn up at the ER!

Solution would be national health care and the govt already provides for a lot of American's anyway (ie federal and state employees, military, retired and disabled thru medicare and medicaid and some high risk state pools). Why not cover everyone, get the young healthy people under the plan which would help the govt save money, pool risk the way insurance was meant to work. Not the upside down system we have in America today where the private insurance say we'll take all the young, healthy profitible people and cover them and you (the govt) can insure everybody else!

Also we should have a national universal plan where benefits would be equal across the board for everyone. Not the current system where the Republicans can create their very own death panels in their states like AZ did to save money! It is unconscionable!

That is another reason we need national, universal coverage so everyone has fair benefits and to stop this nickel and diming people literally to death state by state to save a buck! What is so amazing to me is that many times in the past an insurance company would deny coverage say for cancer treatment or transplant under the "experimental" excuse and the national media would be all over them and pressure them to pay for treatment when the real reason for the denial was profit and obvious to everyone. How can it be that the republicans throughout the individual states like AZ are able to do the same thing and get away with it! No one is speaking up and no one has stopped it! AARP had an article about AZ and I heard about it on NPR but that's it. As far as I know they are still getting away with letting people die just to save a buck, and this would not happen if it was a private company involved because the media and the public attention would pressure the company to give in and treat the person. This has happened many times, but sometimes the delay leads to the death of the person.

Wendell Potter, former CIGNA PR exec, has become a whistle blower about the insurance industry's tricks for profit and has a book out "Deadly Spin". He left CIGNA after a young teen girl died when her treatment was first denied but then belated approved. He talks first hand about the need for health care reform and the problems in the private insurance market.

How to pay for it use a taxing program like unemployment where people (workers) pay in a % of wage and employers do likewise! Then if the private companies want to compete to help administer it or to sell supplemental policies like they already do with medicare, go for it! It is well known that medicare is run more efficently than private companies, albeit fraud has been a problem. But medicare doesn't pay outrageous salaries and bonuses to the CEO's that waste a lot of health care dollars. You definitely can't say that about private companies!

Fly Guy JB, MSN, RN, EMT-P · Sep 24, 2011

1. what is the most important problem or problems facing medicine as a profession today? lack of access to primary care (the emergency room is not your pcp)

2. what do you think is the cause of the problem? lack of $$ for family medicine, fewer md/dos entering this specialty, lack of nps/pas being added to this specialty, lack of independent practice option for nps other than in federally designated under-served area.

3. what can be done to remedy the problem? incentivize md/dos entering this specialty, increase the number of nps/pas being added to this specialty, remove barriers to independent practice option for nps other than in federally designated under-served area.

4. what do you think of health care reform, and how will it affect you and your profession? (for those of you practicing in the us) this is going to increase ed volumes d/t lack of pcps

if you're comfortable with it, i'd also like to know your general age range (45-55), your degree(s) (dipl professional nursing, bs and ma in unrelated fields) and specialties (certified emergency nurse), work experience (pre-hospital and emergency), and current practice setting (how many people you work with 400, how long you've been working there,4 yrs, level 2 trauma ctr with 120k visits/yr etc).

nursej22, MSN, RN · Sep 24, 2011

As per a PP, my answers are about the problems with healthcare, not medicine.

1. Biggest problem is that people want the best possible treatment and to live forever, without having to pay for it.

2. The cause is societal attitudes. Individuals feel they are entitled to want every they want, but have no concept of the cost involved. And "I got mine, too bad for you."

3. Only major crises are going to change this and I think it is starting to happen with the lack of primary care. I foresee hospitals having to close for lack of funding and epidemics because people do not get vaccines and do not (cannot) get treatment before infections become septic. I think nursing homes will have to close and the elderly will die starving and alone.

4. I think a single payor system would help but it will never pass.

I have >20 years experience in acute care, currently in cardiac telemetry and work in a 220 bed not for profit community hospital. I have an MN.