For the past 10 years or so I have shared my views as to how nursing can save healthcare. This article is by no means to discredit other disciplines in the healthcare field, rather draw light to how nursing, if given the autonomy it needs, can greatly improve the overall conditions needed for a healthy nation.
Variable # 1 - Healthcare Spending
In 2011, the Unites States averaged $8,508 per person on healthcare, while the United Kingdom only spent $3,406 (The Common Wealth Fund, 2011).
On average, American's receive more testing such as X-Rays and MRI when compared to other first-world countries. Alarmingly Americans have fewer hospital visits per year, averaging 126 visits per 1,000 people compared to 252 visits in Germany (The Common Wealth Fund, 2011).
This data suggests that Americans pay much more for healthcare costs than people in other countries. Fewer visits, yet more diagnostics and prescription drug use. Americans struggle with primary care availability, which in turns can help prevent and reduce illness and chronic conditions.
So How Can Nursing Save Health Care in terms of cost?
The solution lies in a simple thing called autonomy. If nurses in all scopes of practice are allowed to practice to the fullest scope of their license and education, healthcare costs could be dramatically reduced
Principles of economics can help explain why healthcare costs are so high in this country. To start, people need to give up something in order to get something. We call this a trade-off. In simple language, we pay for healthcare insurance to have coverage in case we get ill or injured. Unfortunately, the costs of this trade-off come at a high price. When a person enters a hospital, they are charged for services. One of these services "bundles" the cost of nursing care. Unfortunately this bundled charge is far less than the fancy diagnostics and physical assessments performed by physicians. This drives the cost up, while nursing care is what gets people better. Think about it! I am not preaching that nursing care should cost more, rather some of the other price tags associated to healthcare in our country need to go down!
Nurses in the community can bring care to the person, bypassing the expensive hospital setting and help reduce costs. This is a great concept, yet many communities lack funding and resources. Nurses need to be deployed around this country in order to care the care, education, and help to those in need. I am not going to ramble on much more here, however if you would like to read more on the workforce commission tat was set up to help such an initiative but was never funded, please Read More Here
Did you know that half of the money spent on healthcare goes towards just 5% of the population?
This is because some people use and use and use, while others do not. If we could deploy nurses to this 5% of the population and begin reducing this figure, this could create a huge savings overall. Many of this 5% belongs to chronic diseases such as CODP, CHF, and Diabetes. Nurse Practitioners need to have the autonomy and recognition nationwide to practice to the fullest of their license. We must encourage and promote more NP's to get the care to this population. And, by the way NP's make a fraction of what their physician counterparts make. So why pay physician rates for chronic illness? Why not get more people to have access to this money as we slowly chip away at this 5%?
Variable #2 - Dangerous Care!
Whether you follow the IOM reports or others, it can easily, sadly, be said: Healthcare is dangerous in the United States. Some reports have hospital deaths due to error as high as 210,000 to 440,000 people!
Where does the good old RN fit into this equation you may ask?
I was fortunate to meet John Nance, a national leader in both aviation and patient safety. In his 19th and latest book, Why Hospitals Should Fly, John Nance compares healthcare systems to aviation. The aviation industry has some of the best safety systems in place today. Think about every time you fly, regardless of the airline, you still hear the same standard safety messages. This is one example portrayed in the book. Now think of different hospitals you have been too. Have you experienced these same standards of care? For example does the nurse ask you for your name and date of birth every time a procedure is going to be done? Does the nurse stop the doctor and demand a time out be performed before surgery? This list could go on and on and needs to. The dangers of healthcare errors is huge. One death related to a wrong medication is one too many in my book.
Nurses must follow safe care and encourage the same safe care they provide by all other members of the healthcare team. The nurse has the power to speak up and stop something about to happen that is unsafe. The nurse can remind the team of the correct way to start a procedure regardless if it is already 15 minutes behind schedule. Nurses must speak up and ensure safe care reaches the patient.
Nurses love to look for simple, effective, efficient, and safe ways to deliver care. Complexity can cause problems. The fewer the steps the better I say! To learn more about Why Hospitals Should Fly and how nurses can improve these horrible statistics, click below and take a look at this book now!
Why Hospitals Should Fly: The Ultimate Flight Plan to Patient Safety and Quality Care
Healthcare spending and safety, in my opinion, are the leading causes for poor healthcare outcomes in the country. We seem to charge enormous rates, provide the bulk of care for the same people, yet make mistakes that can be tragic. Think about this: Would you spend thousands of dollars on a new addition to your home if you knew the contractor cut corners and the risk of the roof falling in was 50%? Hell No!
So why do we cut corners in healthcare?
I have a little theory on this: We simply don't have enough people working in healthcare. I see it everyday as a manager. When my staffing is great, care improves and my results show it. As staffing falls, well so can the patients (Knocking on wood right now!!)
The Unites States needs to place more emphasis and resources into our healthcare system. We need to draw people into this profession for the right reasons and help them feel satisfy so they will remain. We must break some of the hierarchy that has existed for hundreds of years and lower rates, while recognizing nursing care for what it is - Care that saves people's lives!
Nurses have the voice to speak up, follow systems, improve systems, educate, and encourage others to do the same. Nursing is a science! We can fix anything, because well that's what we do. We are fixers! I say give a nurse a chance to fix healthcare! After all, we really know what goes on behind closed doors. We are the ones with the patient at 1AM ensuring they get the right treatment or responding to the critical blood pressure. We are the ones helping a person understand why they need to take their medications while helping them figure out how they will even get them in the first place. We are the ones moving them through the system, reaching out to other disciplines for guidance. Nurses must be pulled to new heights in this country and seen as the true hero's they are. After all, there is a reason nurses are the #1 trusted profession in this country!