A Summary of the December 2009 Forum on the Future of Nursing Care in the Community (2010) / Chapter Skim
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6 Testimony
6 Testimony
Pages 41-58
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From page 41... ...
Like the presentations of the speakers, the testimony, observations, and opinions in this chapter should not be interpreted as positions or recommendations of the committee, the Robert Wood Johnson Foundation, or the Institute of Medicine. Dana Egreczky, Vice President of Workforce Development New Jersey Chamber of Commerce For the past decade, the cost of health care has been among the top three concerns of business leaders, along with increasing taxes and fees and the lack of a qualified workforce, said Dana Egreczky, vice president 41
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From page 42... ...
A partnership between the Robert Wood Johnson Foundation and the New Jersey Chamber of Commerce Foundation led to the New Jersey Nursing Initiative (NJNI) , which is working to ensure that New Jersey has the well-prepared, diverse nursing workforce it needs to meet the demand for nursing in the twenty-first century.
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From page 43... ...
Though their role is often taken for granted, nurses are "touch points in nearly every interaction between the patient and the provision of care." AARP works with policy leaders, states, and the nursing community to increase awareness of the role that nurses play and the dire situation that the health care system must face unless the supply of highly skilled nurses is increased. Voluntad described himself as a 79-year-old diabetic male with kidney failure.
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From page 44... ...
Certification, which requires specialized skills and knowledge, is based on field research and a test. Nurse case managers work in a variety of settings, but they perform care coordination and case management in community health to a greater extent than in any other arena, said Albrecht.
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From page 45... ...
Its goal is to provide primary care services through advanced practice nurses in an interdisciplinary setting to patients who are uninsured. The services provided by the mobile clinic include diagnosis, management, and treatment for a variety of ambulatory care sensitive conditions.
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From page 46... ...
"Their work as advanced practice nurses has made a vital contribution to addressing health disparities and managing chronic care in the local community," noted Tagliareni. This is a relatively small example, Tagliareni said, "but it packs a powerful message." Through faculty support, funding at the point of entry into nursing, and subsequent collaborative relationships throughout all levels of nursing, students from minority backgrounds can gain a new vision of what they can do and return to local communities as advanced practice nurses ready to give culturally sensitive care to vulnerable populations.
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From page 47... ...
They promote health, prevent injury and illness, provide 40 percent of child mental health services in the United States, and connect families and children to health insurance and a medical home. School nurses provide the only access to health care for many children who are homeless, immigrants, refugees, and underserved in both rural and urban areas.
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From page 48... ...
Yet states are experiencing serious declines in public health nursing positions, Moffatt said. A prominent role for public health nurses in community health teams would be an excellent way to link clinical health care with public health and should be considered by the committee as it develops its recommendations.
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From page 49... ...
A variety of factors are contributing to the current public health nursing shortage, including the aging population of nurses, poorly funded public health systems, limited advocacy for public health, a growing shortage of faculty who understand how to teach public health nursing, curricula that do not adequately cover public health or community nursing, and the overall invisibility of public health nurses. To counter these trends, Garrett said that public health nurse leadership development needs to be nurtured, resources are required to rebuild the public health nursing infrastructure, and a new infrastructure is needed to provide interventions to vulnerable and at-risk populations that represent the weakest link in the health care system.
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From page 50... ...
The group has not been able to convince the hospital administration to grant admitting privileges for certified nurse midwives, nor can they practice to the full scope of their licensure. For example, in the State of Maryland and many others, certified nurse midwives must have a signed collaborative agreement on file with the Board of Nursing to get a license.
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From page 51... ...
"It is imperative that barriers to collaborative community care models such as these across the country be removed once and for all so that improved access to high-value primary care is available to everyone," Johnson concluded. Susan Apold, President New York State Association of Nurse Practitioners "The nation's nurse practitioners stand ready to participate in the solution to the looming primary care crisis," said Susan Apold, president of the New York State Association of Nurse Practitioners.
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From page 52... ...
In addition, much more needs to be done to work closer with mental health consumer organizations to reduce all barriers to the full integration of mental health and substance abuse services into primary care, concluded Ford-Roegner. Andrew Rosenzweig, Assistant Clinical Professor Brown University Medical School and Medical Director, MedOptions Some of the most challenging patients in long-term care are those with dementia, mental health disorders, and other behavioral health problems, said Andrew Rosenzweig, assistant clinical professor at Brown University Medical School and medical director for MedOptions.
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From page 53... ...
and a recent book titled The Forensic Case Studies: Diagnosing and Treating the Pathologies of the American Health System (Smith, 2009) both point out that the long-term care system now faces its most serious crisis of the past century, observed David Smith, research professor at the Drexel University School of Public Health's Center for Health and Quality.
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From page 54... ...
In one long-term care facility where the effects of innovative technology were documented, skin breakdowns in high-risk patients decreased by 75 percent, nursing turnover decreased by 74 percent, and nursing assistant turnover decreased by 40 percent, said Wolf. The TIGER (Technology Informatics Guiding Education Reform)
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From page 55... ...
Nurse practitioners took the lead in home programs organized as health parties, where nurses in people's home gave them the skills and motivation to change. Beyond prevention, nurses need to teach people to take personal responsibility for their health.
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From page 56... ...
The majority of residents in these facilities are experiencing an absence of professional nursing care; there are not enough nurses employed in nursing homes, so the average resident receives just a half an hour a day of care from a regis tered nurse. The federal and state governments generally require limited coverage of nursing homes by registered nurses, and these nurses are paid significantly less than their colleagues in
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From page 57... ...
• For nurses and other health care professionals to deliver the best possible care, they need access to information about evidence based interventions, said a member of the audience. Nurses therefore need to be prepared to use information technologies to access the information that will drive health care in the future.
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From page 58... ...
58 FORUM ON THE FUTURE OF NURSING: CARE IN THE COMMUNITY • Many physicians are frustrated because they lack the skills to be effective in the community, said one forum participant. Nurses could forge a partnership with physicians around the need for a common set of training experiences that will permit both groups of professions to meet the challenges of community based medicine.
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