The Nursing Practice Today and Beyond
In order to provide the most efficient methods of health care delivery, the field of nursing continues to modify itself through the years, In fact, several practices have been developed in the previous years in order to meet the necessary health care for the patients, as well as to improve its quality. There are several approaches, each of which has different specialties and provide different roles for the nurses.
Continuum of Health Care
The concept of continuity refers to the relationship that exists between the health care provider and the patients professionally and beyond (Haggerty et al., 2003). Improvement of relationship is believed to be a significant factor for efficient provision of health care in a way that this will retain more important values of responsibility and loyalty, rather than the economic considerations, specifically the income and related benefits that will be received by the nurses. What the concept emphasized is the importance of communication. The responsibilities of the nurses will be effectively delivered once a comfortable and stable communication was established (Haggerty et al., 2003). This approach is unique in a way that it reaches out the other side of nursing practice. Most of the time, people find it more important to consider income in order to provide the necessary health care. However, this is discouraged in this approach. Attention and sincerity to provide health care is more necessary, especially to those who are really in need.
Accountable Care Organizations
Accountable Care Organizations, or ACO,provide ‘bundle’ investments for health care. This will also enable customers to acquire more discounted offers without compromising the quality of health care (Mechanic, 2016). Moreover, this will avoid significant losses from the patient, because the negotiations will be able to share the investments among the more important aspects of health care. However, the main problem in this approach does not lie upon the quality or the efficiency of health care. Rather, the problem lies on the ACO itself. Their concern is that the organizations are more likely to lose on the trade-off; as such, negotiations are difficult to set (Mechanic, 2016). This only means that gains and losses are highly considered in the approach. Although losses are being avoided by the clients, it is not the case for the organizations. Because of this, the importance given to health care is reduced, and the benefits which must be highlighted by the ACOs are being overshadowed by the future worries of the same organization.
Medical Homes
This is also a kind of health care service wherein patients are no longer needed to be admitted in hospitals. Instead, the physicians and nurses go directly to their homes and provide the needed health care. However, this is not easily done, because physicians must coordinate with the people specializing in home treatment. Due to the different environment, physicians cannot directly do the same procedures like what they are doing in hospitals (Huang & Rosenthal, 2014). The explanation behind is that the specialists, or those who have studied a single or specific area in the medical field, such as gynecology or optometry, have already studied scenarios with no hospital setting. Because of this, other physicians, for example, the family physician, must consult and coordinate with these specialists in order to provide the necessary health care. Though it is a requirement, the medical home is considered to be equally efficient as in hospital confinement, with the addition that the patients are more comfortable being treated at their homes.
Nurse-managed Health Clinics
This is also an emerging solution to the lack of physicians needed for primary health care. Health clinics which are operated by nurses with advanced expertise are considered to have high quality health care service with less costs (Hansen-Turton et al., 2010). Service fees of nurses are more affordable than physicians, so this benefit the people more in terms of accessibility and capability to pay. However, the main problem is that there is a lack of public funding in these facilities. As a result, some are converted as private institutions wherein there is a limited population who are being regularly treated (Hansen-Turton et al., 2010).
Other Nursing Feedback
Sharing this information to other nurses has enlightened them that the nursing profession has several opportunities and can go beyond the hospital facilities. My nursing colleagues also did the same sharing, but it turns out that we have the same findings, but different interpretations and reflections upon learning this information. One has shown interest in medical homes. She said that the medical home gives a new opportunity for the nurses to show their potential in a specific field. She further discussed that working with a specialist will give them new ideas about that field, and might discover that they have a chance to further advance their learning. On the other hand, she considered that the medical home health care service is a starting point for all the other approaches, especially in the continuum of health care. The application of the health care continuum can be also seen in this practice, as she stated that the right attitude and values will be always required in these situations (Haggerty et al., 2003). Without them, the patients, and medical representatives will never be comfortable with one another. There will be no proper communication, efficient treatment, and the right recommendation because they will never know what will be right for the patients. As for the patients, she stated that the patients will continue to hide his or her true condition to the physicians, thus, the proper treatment and health care will never be done. For her, this is how important communication and values are in providing the healthcare. To establish a constant and healthy relationship means a more effective health care.
Another colleague expressed his interest, this time, in nurse-managed clinics. Once he learned this approach, he became more motivated in the field and now wanted to pursue advanced studies in nursing. For him, being able to establish your own clinic is like achieving his lifelong dream of becoming a doctor. However, because of the circumstances he faced in the past, he was unable to pursue his career as a doctor. As such, this opportunity will not only give him a chance to become a credible nurse, but to prove that the nurses are able to stand alone and provide the necessary health care to the patients like the physicians. In general, he added that nurse-managed health clinics will empower the nurses, as long as proper funding will be made (Hansen-Turton et al., 2010). As for the funding, he suggested that the government and if possible, other private organizations, should allocate more support to these facilities and services because this is a better solution for both the nurses and the patients. With the increasing number of nursing graduates worldwide, some of them find it difficult to find a job, so nurse-managed centers can be their starting point, not as a manager, but starting as a nurse who will provide the basic health care under the supervision of the advanced nurses. For the patients, this is an opportunity to receive a quality health care with lowered costs. At some extent, advanced nurses are able to provide the necessary health care to the patients with equal or better outcomes as in how physicians handle the same situation (Hanses-Turton et al., 2010).
As for the third colleague, he expressed equal considerations and importance to the new health care approaches. However, she specified that the accountable care organizations’ approach should be improved or modified. For her, ACOs are more inclined with improving their status rather than improving the health care system. The way ACOs provide health care is through their payment system; the more capable the patient is, the higher is the quality of health care (Mechanic 2016). As a nurse, she still wanted to be paid for her services, but for her, it does not mean that the capability of the patients to pay will be the basis of the quality of health care. No matter how hard or easy the treatment is, the payment should be fixed, or for the ACOs’ offers, stick with the discounted bundle payment. Moreover, payment should not become the priority in the first place, and for her, this is where the ACOs’ principles are misleading. The quality of health care should be the center of focus, because everyone is vulnerable to diseases and illness, fortunate or not.
Conclusion
What I learned from this experience is that the nursing and the systems of providing health care will eventually change over the course of time. Most of the time, these changes will improve the past systems and will enable to accommodate more patients in the needed times. However, there are also times when a projected improvement of the health care system was not implemented. Fortunately, there are always rooms for improvement and this is a part of the development.
In terms of priority, providing the highest quality of health care must be the first. This is what the nursing and medical field aimed for, and not to increase the income of these professionals. Yes, it is also important to suffice their efforts and expertise, but life is way more important than money. Every person should remember that. Seeing the relief in the eyes and the smiles of the patients, as well as their sincere thanks and gratitude are just the results of the efforts, as long there is a comfortable communication established during the medication period.
References
Haggerty, J., Reid, R. Freeman, G., Starfield,B. Adair, C., and McKendry, R. (2003). Continuity of Care: A Multidisciplinary Review. Education and Debate, 327, 1219-1221.
Hansen-Turton, T., Bailey, D., Torres, N., and Ritter, A. (2010). Nurse-managed Health Centers: Key to a Healthy Future. American Journal of Nursing, 110(9), 23-25.
Huang, X., and Rosenthal, M. (2014). Transforming Specialty Practice — The Patient-Centered
Medical Neighborhood. The New England Journal of Medicine, 370(15), 1376-1379.
Mechanic, R. (2016). When New Medicare Payment Systems Collide. The New England Journal of Medicine, 374(18), 1706-1709.
