California

UC-Davis Graduating First Class of Nurses

Posted in California, Nursing, Nursing Jobs, Nursing News, Nursing School

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Five years ago, philanthropist Betty Irene Moore donated $100 million to the University of California – Davis, moving the School of Nursing from dream to reality. This week, the first group of nurses will graduate from the program.

25 students who were recruited for their talent and whose education was fully funded by scholarships will be graduating. The hope is that they represent a new breed of well-educated nurses who will transform the health care system.

In this article in the Sacramento Bee, the School of Nursing Dean Heather Young said, “Our goals and priorities are to improve the health care system and advance the health of our communities. We realize that nurses can, and should be, the catalysts of change.”

Young called this year’s class of graduating nurses “just a beginning.” Already another 25 students are queued up for the next two years, with more than 30 percent of them coming from underrepresented ethnic communities. The school also enrolls doctoral students in a four-year program.

In a seminal 2010 report on the future of nursing, the Institute of Medicine concluded that health care reform meant “nursing education must be fundamentally improved both before and after nurses receive their licenses.”

With the population growing older and chronic diseases taking center stage, the IOM report, which Young endorses, determined that “nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.”

Young said she was drawn to the position of dean because she, too, was inspired by the vision of Betty Moore.

The story of how Moore decided to commit $100 million over 11 years to a new school of nursing is a tale of personal belief in change.

Moore had been in a hospital and experienced a medication error. A nurse had insisted she take a shot, but Moore objected. The nurse gave her the shot anyway.

It turned out the shot of insulin was meant for a neighboring patient and potentially put the health of both patients at risk.

Says nurse Johnston, “What impresses me most is that Betty Irene Moore, a person with a lot of money, didn’t go blaming the individual or the system, she did the opposite. She decided she could do something positive about the problem of medical errors, make change for the better and build a better nurse.”

Specifically, Johnston’s job, which he says is a project of the Gordon and Betty Moore Foundation, is to be an educator, a monitor and a resource to prevent patients from getting hospital-acquired infections from improper use of ventilators, intravenous tubes, catheters and the like.

In the status-quo health care system, such infections have come to be seen as somewhat of a statistical inevitability – even to the point where patients’ rights groups routinely tracked and reported their occurrence in various hospitals.

“The culture and belief that infections are a part of a hospital stay needs to change,” Johnston said.

In an interview at the UC Medical Center where he works, Johnston said his job is called “nurse champion.”

He works as part of a collaborative system for higher quality by advising and teaching medical staff on ways to curb hospital infections.

It’s a challenging and new role for Johnston, who’s worked as a nurse for 5 1/2 years.

“We are colleagues with physicians and nurses and aides,” he said. “We are change agents in the system.”

To be sure, Johnston’s gotten some push back already in his new job in the UC Davis Medical Center’s burn unit. But he’s prepared to tap into the communication and leadership skills he’s learned to overcome the skepticism.

“I was seen as an outsider, someone to audit them and get them in trouble,” Johnston said of his colleagues. “There was some question of my credibility and credentials both from nurses and the physician side. It’s a challenge. It takes time to get that buy-in.”

Nurse Practitioners: Health Care Reform’s Missing Link

Posted in California, Nursing, Nursing Jobs, Nursing News, Nursing Specialties

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Patricia Dennehy RN NP has written an Op-Ed for the Los Angeles Times explaining the role that Nurse Practitioners have as millions of people find new health care providers as part of expected Health Care reforms.

She says that about 30 million people in America will be looking for new health care providers, about 6.9 million of them in California, where she lives and works.

Unfortunately it won’t be very easy, as primary care physicians are increasingly moving to other types of practices, especially higher-paid specialties.

Dennehy argues that Nurse Practitioners, with their training and experience, are perfectly poised to fill that gap. “We’re fully prepared to provide excellent primary care,” she says.

Clinics like the one I direct in the heart of San Francisco’s Tenderloin district — GLIDE Health Services — offer a hopeful glimpse into California’s healthcare future. We are a federally funded, affordable clinic, run almost entirely by nurse practitioners. At our clinic, we nurses and talented specialists provide high-quality, comprehensive primary care to more than 3,200 patients each year.

Despite the special hardships of our clientele, who daily cope with the negative effects on health caused by poverty, unemployment and substance abuse, our results routinely compare favorably with those of mainstream physicians. Our patients with diabetes, for example, report regularly for checkups, take their meds as directed and maintain relatively low average blood-sugar levels.

This high standard of care provided by nurse practitioners has been confirmed in several studies, including a 2009 Rand Corp. report, which found that “nurse practitioners provide care of equivalent quality to physicians at a lower cost, while achieving high levels of patient satisfaction and providing more disease prevention counseling, health education and health promotion activities than physicians.”

At last count, there were more than 250 nurse-run clinics nationwide similar to GLIDE Health Services. We and about 20 others are funded by a special federal program for affordable care. In all of these projects, nurse practitioners offer both primary and preventive care, including mental health services and screening for HIV and diabetes.

Researchers have confirmed that such clinics not only improve local health but also save taxpayers money. Nurse practitioners’ salaries are generally lower than those of physicians. At the same time, the comprehensive care we provide can significantly reduce the costly emergency room visits used by all too many low-income Americans as their default healthcare.

Unfortunately, some major obstacles stand in the way of expanding our money-saving model. One big hurdle is the reluctance of leading private health plans to contract with nurse practitioners as primary care providers. Even as Medicare, Medi-Cal and pioneering local programs for the uninsured, such as “Healthy San Francisco,” now contract with nurse practitioners to provide such care, a 2009 study by the National Nursing Centers Consortium found that nearly half of the country’s major managed care organizations don’t.

Some of the holdout companies require nurses to bill for their services under a physician’s supervision. California’s insurance code only requires insurance companies to contract with nurse practitioners for primary care when it involves Medicare or Medi-Cal. If the code were expanded to include all coverage, access in the state would be greatly improved. There is room for reform on these fronts and others, and we should get started now to enact change.

In October 2010, the Institute of Medicine, an arm of the National Academy of Sciences, issued a landmark report called “The Future of Nursing,” in which it urged that nurses be “full partners, with physicians and other health care professionals, in redesigning health care in the United States.” At clinics such as GLIDE Health Services, we’re showing that we’re more than ready to answer this challenge, and take our places on the front lines of healthcare reform in America.