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Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Today, Diane Rehm’s radio program included an hour-long discussion on the role of nurse practitioners with Reid Blackwelder, MD, family physician and president-elect of the American Academy of Family Physicians; Mary Agnes Carey, senior correspondent for Kaiser Health News; Ken Miller, PhD, RN, CFNP, nurse practitioner and associate dean of The Catholic University of America School of Nursing; and Sandra Nettina, MS, ANP, nurse practitioner at Columbia Medical Practice in Columbia, Md., and past president of Nurse Practitioner Association of Maryland.

There was one thing missing from this otherwise great discussion of the issues related to nurse practitioners being able to practice with full authority (without legally mandated physician collaboration or supervision). Nurse practitioners bring additional knowledge and skills to their practice that are just what primary care needs. They understand patient-centered care, listening carefully and responding to what patients and families say they need and want. They are experts in health education and counseling, as well as care coordination. These skills matter when we’re trying to transform our health care system into one that emphasizes health promotion, wellness, and chronic care management.

Most discussion of nurse practitioners’ roles center around their ability to diagnose and treat disease. They are prepared to do so with common acute and chronic conditions, and they know when to refer patient with symptoms of uncommon diseases to physicians–and without a legal mandate to do so, as has been shown in about a third of the states in the U.S. But we need a primary care system that can focus more on preventing diseases, promoting health, and helping patients to be knowledgale about and capable of promoting their health.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

[caption id="attachment_6044" align="aligncenter" width="480"] Source: Vanderbilt University

Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Source: Vanderbilt University School of Nursing; www.nursing.vanderbilt.edu

Today, Diane Rehm’s radio program included an hour-long discussion on the role of nurse practitioners with Reid Blackwelder, MD, family physician and president-elect of the American Academy of Family Physicians; Mary Agnes Carey, senior correspondent for Kaiser Health News; Ken Miller, PhD, RN, CFNP, nurse practitioner and associate dean of The Catholic University of America School of Nursing; and Sandra Nettina, MS, ANP, nurse practitioner at Columbia Medical Practice in Columbia, Md., and past president of Nurse Practitioner Association of Maryland.

There was one thing missing from this otherwise great discussion of the issues related to nurse practitioners being able to practice with full authority (without legally mandated physician collaboration or supervision). Nurse practitioners bring additional knowledge and skills to their practice that are just what primary care needs. They understand patient-centered care, listening carefully and responding to what patients and families say they need and want. They are experts in health education and counseling, as well as care coordination. These skills matter when we’re trying to transform our health care system into one that emphasizes health promotion, wellness, and chronic care management.

Most discussion of nurse practitioners’ roles center around their ability to diagnose and treat disease. They are prepared to do so with common acute and chronic conditions, and they know when to refer patient with symptoms of uncommon diseases to physicians–and without a legal mandate to do so, as has been shown in about a third of the states in the U.S. But we need a primary care system that can focus more on preventing diseases, promoting health, and helping patients to be knowledgale about and capable of promoting their health.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

[caption id="attachment_6044" align="aligncenter" width="480"] Source: Vanderbilt University

Source: www.MaddowBlog.msnbc.com

Source: www.MaddowBlog.msnbc.com

This week, the U.S. Supreme Court will hear oral argument in two cases on marriage equality.  Hollingsworth v. Perry is a challenge to California’s Proposition 8, a 2008 ballot initiative that amended the state constitution to prohibit recognition of same-sex marriage. U.S. v. Windsor challenges Section 3 of the Defense of Marriage Act (DOMA), a federal law declaring that “‘marriage’ means only a legal union between one man and one woman as husband and wife, and the word ‘spouse’ refers only to a person of the opposite sex who is a husband or a wife.” The law thus bars same-sex couples, even those who are married in states that recognize their union, from rights or benefits available to other married couples. Lower courts in both cases ruled against these laws as violations of  the U.S. Constitution’s guarantees of equal protection under the 5th Amendment (DOMA) and the 14th Amendment (Proposition 8).

Public sentiment on marriage equality has evolved rapidly in recent years. In a March ABC-Washington Post poll 58% responded that it should be legal for same-sex couples to marry. (A 2003 ABC-Post poll found support for same-sex marriage among only 37% of respondents). Especially among younger Americans, support for marriage equality is consistently strong, reaching across racial, ethnic, party and religious lines.

Dire predictions about the consequences of allowing same-sex marriage have , not surprisingly, simply not been borne out in those states (or the growing list of countries) that currently recognize it. Many people who previously opposed same-sex marriage have shifted their opinions, in some cases because their concerns for sons, daughters, other loved ones or close friends who themselves are Lesbians or gay men has made the issue more personally compelling for them.  The recent announcement by Sen. Rob Portman (R-OH) that he now supports marriage equality is one example. Other prominent political figures have declared their support as well, citing marriage equality as a matter of fairness, including President Obama as well as both Hillary and Bill Clinton (who, as President,  had signed DOMA into law in 1996). Over 100 prominent Republicans signed on to an amicus curiae (friend of the court) brief filed by Ken Mehlman, a former Chair of the Republican National Committee and George W. Bush’s 2004 campaign manager, supporting marriage equality.

Source: www.MaddowBlog.msnbc.com

Source: www.MaddowBlog.msnbc.com

This week, the U.S. Supreme Court will hear oral argument in two cases on marriage equality.  Hollingsworth v. Perry is a challenge to California’s Proposition 8, a 2008 ballot initiative that amended the state constitution to prohibit recognition of same-sex marriage. U.S. v. Windsor challenges Section 3 of the Defense of Marriage Act (DOMA), a federal law declaring that “‘marriage’ means only a legal union between one man and one woman as husband and wife, and the word ‘spouse’ refers only to a person of the opposite sex who is a husband or a wife.” The law thus bars same-sex couples, even those who are married in states that recognize their union, from rights or benefits available to other married couples. Lower courts in both cases ruled against these laws as violations of  the U.S. Constitution’s guarantees of equal protection under the 5th Amendment (DOMA) and the 14th Amendment (Proposition 8).

Public sentiment on marriage equality has evolved rapidly in recent years. In a March ABC-Washington Post poll 58% responded that it should be legal for same-sex couples to marry. (A 2003 ABC-Post poll found support for same-sex marriage among only 37% of respondents). Especially among younger Americans, support for marriage equality is consistently strong, reaching across racial, ethnic, party and religious lines.

Dire predictions about the consequences of allowing same-sex marriage have , not surprisingly, simply not been borne out in those states (or the growing list of countries) that currently recognize it. Many people who previously opposed same-sex marriage have shifted their opinions, in some cases because their concerns for sons, daughters, other loved ones or close friends who themselves are Lesbians or gay men has made the issue more personally compelling for them.  The recent announcement by Sen. Rob Portman (R-OH) that he now supports marriage equality is one example. Other prominent political figures have declared their support as well, citing marriage equality as a matter of fairness, including President Obama as well as both Hillary and Bill Clinton (who, as President,  had signed DOMA into law in 1996). Over 100 prominent Republicans signed on to an amicus curiae (friend of the court) brief filed by Ken Mehlman, a former Chair of the Republican National Committee and George W. Bush’s 2004 campaign manager, supporting marriage equality.