Health Care Reform in Massachusetts

Healthcare funding and coverage in the United States have been controversial issues. Massachusetts passed the nation’s first law that required residents to carry health insurance. 

· What were some of the benefits of the law, and what were some of the challenges? How could the policy have been improved? 

· Does the law take into account the population health approach to health and wellness? 

· Why or why not? 

 

You  are the evening house supervisor of a small, private, rural hospital.  In your role as house supervisor, you are responsible for staffing the  upcoming shift and for troubleshooting any and all problems that cannot  be handled at the unit level.  Tonight, you receive a call to come to the emergency department (ED) to  handle a “patient complaint.” When you arrive, you find a Hispanic woman  in her mid-20s arguing vehemently with the ED charge nurse and  physician. When you intercede, the patient introduces herself as Teresa  Garcia and states, “There is something wrong with my father, and they  won’t help him because we only have Medicaid insurance. If we had  private insurance, you would be willing to do something.” The charge  nurse intercedes by saying, “Teresa’s father began vomiting about 2  hours ago and blacked out approximately 45 minutes ago, following a  14-hour drinking binge.” The ED physician added, “Mr. Garcia’s blood  alcohol level is 0.25 [2.5 times the level required to be declared  legally intoxicated], and my baseline physical examination would  indicate nothing other than he is drunk and needs to sleep it off.  Besides, I have seen Mr. Garcia in the ED before, and it’s always for  the same thing. He does not need further treatment.”  Teresa persists in her pleas to you that “there is something different  this time” and that she believes this hospital should evaluate her  father further. She intuitively feels that something terrible will  happen to her father if he is not cared for immediately. The ED  physician becomes even angrier after this comment and states to you, “I  am not going to waste my time and energy on someone who is just drunk,  and I refuse to order any more expensive lab tests or X-rays on this  patient. I’ve met the legal requirements for care. If you want something  else done, you will have to find someone else to order it.” With that,  he walks off and returns to the examination room, where other patients  are waiting to be seen. The ED nurse turns to look at you and is waiting  for further directions.  ASSIGNMENT:     How will you handle this situation? Would your decision be any easier if  there were no limitations in resource allocation? Are your values to  act as an agent for the patient or for the agency more strongly  developed?

Prepare a PowerPoint presentation discussing Greece health care system. 

 http://international.commonwealthfund.org/countries/

16 slides. Please include the following 

Country Profile: Type of Government Demographics Population with detailed explanation.

Type of health care system currently in place. History of the health care system, including changes and recent developments. How is the delivery system organized and financed?

Who is covered and how is insurance financed? What is covered?

What is the role of government? What are the key entities for health system governance?

World Health Organization rankings in major indices of health (infant mortality, life expectancy, etc.)

Strengths and weaknesses of the system. Popularity of system among citizen

APA format references, work cited must be no older than 5 years. Five (5) reputable and current sources (within 5 years) were cited on visual presentation slides. Please include turnitin report. 

Minimum of 300 words with at least 2 peer review reference in 7th edition Apa style.

Reply to my peers

In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.

Peer 1

The top three issues I believe to be most important in my chosen role as a Family Nurse Practitioner (FNP) are increased autonomy, faculty shortages, and high job demand. The issue of increased autonomy for the nurse practitioner (NP) is very controversial. Some physicians believe nurse practitioners are allowed to do too much without being medical doctors, while others believe that NP’s don’t do enough in the medical field. These days, nurse practitioners have the ability to practice independently (without physician oversight) in twenty-one states, despite objections from the physician community (DeCapua, M., 2019). The second issue concerning my chosen role is faculty shortages. Some programs must turn down students because they don’t have enough instructors, and some student NP’s reported having to sit out a semester due to a lack of preceptors. This issue affects the NP job field tremendously. The third issue is high job demand. According to DeCapua (2019), three years ago, the NP field wasn’t in the top twenty high demand jobs; now, it is the fifth most in-demand medical specialty. This increased demand could result in people getting into the field for the wrong reasons, thus driving down the quality of care received from nurse practitioners.

The impact the role has on patient outcomes has proven to be incredibly positive. Nurse practitioners have improved health care tremendously. This field has made healthcare more accessible and affordable for many patients. Also, giving them more time-conscious options, such as being seen at an urgent care facility run by NP’s versus going to the emergency room waiting hours to be seen (Tracy & O’Grady, 2019).

Implementing my knowledge regarding values’ theory, ethics, legal and regulatory statutes, my philosophy for a career as an advanced practice nurse includes the following pillars: treat patients with respect considering their culture and ethnicity, perform my duties or scope of practice with integrity, always being honest, truthful, accountable, and dependable. Finally, continuing my education to provide quality patients care using current evidence-based practices. This philosophy reflects in some way the way I want to handle myself as an advanced nurse. It is essential to stay positive and proactive regarding knowledge, ethics, and legal practices regulations because we hold people’s lives and health in our hands as healthcare providers. Assuming a nurse practitioner’s role or any advanced practice role gives students more responsibility, it is always crucial to maintain our values and ethics all time (Tracy & O’Grady, 2019).

References

DeCapua, M. (2019). 21 Trends for Nurse Practitioners in 2016. Nurse Practitioner Schools. https://www.nursepractitionerschools.com/blog/21-trends-for-nurse-practitioners-to-monitor/

Tracy, M., & O’Grady, E. (2019). Hamric and Hanson’s Advanced Practice Nursing: An Integrative Approach, (6th ed.). St. Louis, MO: Elsevier/Saunders.

Peer 2

Going into the family nurse practitioner (FNP) specialization it is important to understand the current trends that are most important to this role. These trends include, advancing formal education, developing and acquiring leadership skills and being active in new models of leadership (Strech & Wyatt, 2013). With advanced formal education and being an active leader in the medical field you are able to improve patient care outcomes through evidenced-based practice and extensive research on the best plans of care. With the ability to assess, diagnose and prescribe medications and other treatment plans it is necessary to be aware of role regulations and requirements for this position. The American Nurses Association (ANA) provides a Code of Ethics for Nurses. The ethics and legal statutes as a healthcare provider include respecting human dignity, professional boundaries, protection of patient rights, accountability, personal health promotion, responsibility for the healthcare environment and so many others (Toney-Butler & Martin, 2020). 

The philosophy I plan to stick to in my career as an advanced practice nurse is to go above and beyond for my patients in ways of research and educating them on their plan of care. I want my patients to not only receive the best care possible but understand what is going on in their body and why the plan will be helpful. I also plan to continue my education as advancing my knowledge will only further benefit my patients. “Nurses with doctorate degrees provide the profession with a valuable leadership skill set to conduct research and analyses that promote the practice of nursing and the understanding of nursing’s effect on patient care outcomes and the health care system overall” (Strech & Wyatt, 2013). 

References 

Strech, S., & Wyatt, D. A. (2013). Partnering to lead change: Nurses’ role in the redesign of 

health care. Association of Operating Room Nurses.AORN Journal, 98(3), 260-6.  doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1016/j.aorn.2013.07.006 

Toney-Butler TJ, Martin RL. (2020). Florida Nurse Practice Act Laws and Rules. Retrieved from