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Key messages about Advanced Practice Nursing November 23, 2011

Posted by mariemanthey in Leadership, Professional Practice, Thought for today.
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During this time of system reform, nursing needs to be positioned to maximize -our strengths.    Legislative restrictions on advanced practice nursing need to be eliminated.   Here are some key messages.     Talk it up!

  • APNs are trusted professionals who are well tested in the community with a long track record of quality & safety. 


  • When APNs are allowed to practice fully, they can provide care that is more economical and better than our current health care system allows and this savings can be passed on to the state and to consumers.


  • Government is in the way, and the legislature needs to act to remove regulatory barriers which prevent APNs from fully practicing to meet the needs of the public.


Follow the Money November 13, 2011

Posted by mariemanthey in Leadership, Professional Practice, Thought for today.
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Follow the money.   As health care reform initiates evolve, the control exerted by reimbursement decisions becomes abundantly clear.    Equally clear is the reality that if an idea is not reimbursed, no matter how beneficial it is for health, it will not be sustained.   While it has taken nursing a long time to accept this reality, we ‘get it’ now.

I think the long delay in our ‘getting it’ is the direct result of the concentration of nurses working in hospitals where, within the umbrella of our revenue being inextricably tied to room rates and days of care, we have had freedom to maneuver many reforms/improvements in care delivery without following the money.

No longer.   Recent legislation has stimulated many initiatives to change the system .   Nurse leaders are now clear about the importance of influencing legislation and clarifying the metrics supporting nurse-led health and health care improvements.   We all need to commit to being informed and taking action to support legislation that will improve health and the health care system.

For example, reimbursement influenced by patient satisfaction scores is but one of the upcoming changes that will profoundly impact the way nursing departments are managed and led.   Withholding reimbursement for conditions caused by errors, is another.  What is and is not being paid for will drive both the system and the nation’s health as never before.

At the very least, every nurse needs to know the following:

  1. content, implications and local response to the IOM report on nursing
  2. local developments of ACO’s and Health (or medicine) Care Homes

We need to stop being the victim profession and start being the leaders society needs us to be.  Nightingale would be out in front with both metrics and the ability to powerfully influence the decision makers.   How can we be less?

I’d love to have a lively discussion about these issues.