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Clinical TopicsLegal & EthicsPatient SafetyUncategorizedWorkplace Management

To make health care better, I would…


To make health care better, I would…
…mandate every patient have a primary RN who knows the patient’s past health history, socioeconomic status, health risks, medications, and potential interactions. This nurse will follow this patient to discharge while promoting high-level wellness through early ambulation and ensuring proper nutrition. The lack of fundamentals of nursing care = poor patient outcomes.

Shirley J. Brott RN BSN MEd

To make health care better, I would…
…allow retired licensed RNs to mentor new licensed and graduate nurses. Pair us with the newly employed nurse working in the area where I practiced. They become discouraged, but are afraid to confide in the older and/or more experienced fellow staff members. Confidentiality is so important. This is one reason we lose our new grads in the direct patient care arenas, especially in the hospital clinical settings.
Joyce Boone, RN

To make health care better, I would…
…have more academic physicians and nurses in leadership roles at Medicare/Medicaid.

…force EVERY physician, nurse practitioner, physician assistant whether in private practice or in a specialty practice to take 15% of their patient population who only get reimbursed by Medicare and 10% who only get reimbursement by Medicaid to help alleviate cost burden on just a few. Not allow any of them to increase prices on others to make up the difference.

…force EVERY hospital and or health agency (like home care and hospice) to take 25% patients who could ONLY pay by their income (sliding scale) starting at lowest fee: free then $1.00 up to max of $100 for their services.

…implement the medical home idea through churches, which were the first to make formal health care available.

Natalie D. Garry, RN, MSN, GNP-BC
Mildred Wyatt & Ivor P. Wold
Center for Geriatric Care

To make health care better, I would…
…mandate completion of a an organ donation form, a durable power of attorney, an advance directives document (I like “The 5 Wishes”) and a written plan of daily care for severe debilitated individuals (for the family to review) for any insurance coverage (e.g., private insurance, Medicare, and Medicaid) in order to enhance the discussion of these difficult topics and decrease the unnecessary expenditure of funds at the end of life (adult, child, or neonate).

Rationale: Healthcare costs for severely ill individuals, with little or no hope of recovery to a meaningful state of existence (as defined by the person involved or their concerned spokesperson) are astronomical. Many who are kept alive through the use of machines and extraordinary interventions may have had a different perspective if required to ponder the issues involved. Many family members, given frank information about the effects of the interventions and the possibility of recovery, rather than the usual medical line of always providing hope, would make different choices.

Making organ donation the expectation (“presumed consent”) with exemption possible with an “opt out” document would have significant beneficial effects on long-term health for those who have single system failure (e.g., kidney, liver, vision). Having organs readily available would decrease costly maintenance procedures such as dialysis and improve the quality of life for those in need. The increased availability of organs would also lessen the suspicions by many family members that their loved one’s death was hastened to secure a valuable and badly needed organ. A better definition of “death,” a wider understanding of the post death procedure for harvesting organs, and emotional support for family members would also be beneficial.

Only by mandating these documents and moving the discussions out into the open will the awkwardness and difficulty of the conversation be dispelled.

I have worked in nursing homes and NICUs (in addition to many other areas) and find the interventions forced upon our patients at the end of their lives to be obscene. For a culture that predominantly believes in life after death, our reckless need to preserve the last gasp is ludicrous.

Katherine Chelini EdD(c), CNM, MN

1 Comment. Leave new

  • I love the idea of retired nurses mentoring the new nurses. There are too many graduates and nurses who don’t have hospital nursing experience without jobs. We want to work, but we need someone to educate us, empower us, and mold us into great nurses.


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