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state health exchanges

Earlier this year, I wrote a blog post for JAMA News Forum on the role of health professionals in educating the public about state health exchanges. This week, someone asked me whether health professionals who oppose “Obamacare” should have to tell their patients and the public about the exchanges and whether they should be able to voice their opposition to the law.

My answer is: It depends.

A recent survey of physicians by LocumTenens.com, an online job site for physicians, physician assistants and advanced practice nurses revealed that the physicians are not knowledgeable about the state exchanges. In my conversations with physicians and nurses, I’ve found that both groups are woefully uninformed about what’s in the ACA. If the practitioner doesn’t know what’s in the law, then what is the opposition based upon? If someone who opposes the law is truly knowledgeable about what’s in it, how it’s being implemented and what the pros and cons are for the public’s health, then perhaps.

But first and foremost, all health professionals have an ethical responsibility to inform their uninsured patients about the opportunities for obtaining health care coverage. How could you ethically not tell an uninsured patient who has been unable to afford the surgery he needs or get an important diagnostic test that he could qualify for subsidized coverage through a state or federal exchange?

state health exchanges

Earlier this year, I wrote a blog post for JAMA News Forum on the role of health professionals in educating the public about state health exchanges. This week, someone asked me whether health professionals who oppose “Obamacare” should have to tell their patients and the public about the exchanges and whether they should be able to voice their opposition to the law.

My answer is: It depends.

A recent survey of physicians by LocumTenens.com, an online job site for physicians, physician assistants and advanced practice nurses revealed that the physicians are not knowledgeable about the state exchanges. In my conversations with physicians and nurses, I’ve found that both groups are woefully uninformed about what’s in the ACA. If the practitioner doesn’t know what’s in the law, then what is the opposition based upon? If someone who opposes the law is truly knowledgeable about what’s in it, how it’s being implemented and what the pros and cons are for the public’s health, then perhaps.

But first and foremost, all health professionals have an ethical responsibility to inform their uninsured patients about the opportunities for obtaining health care coverage. How could you ethically not tell an uninsured patient who has been unable to afford the surgery he needs or get an important diagnostic test that he could qualify for subsidized coverage through a state or federal exchange?

OfriTheresa Brown, BSN, RN, OCN, PhD, is a staff nurse, the author of Critical Care: A New Nurse Faces Death, Life and Everything in Between, an Opinion Columnist for the New York TimesBedside,” and a member of the National Advisory Council for the Center for Health Media and Policy.

Danielle Ofri’s new book What Doctors Feel: How Emotions Affect the Practice of Medicine deserves an award for pulling back the curtain on one of the most taboo topics in health care: difficult feelings. The book is honest and brave, as well as eloquent and compelling. Ofri, a physician at Bellevue Hospital in New York and a frequent contributor to the New York Times, is a talented writer and quite a smart observer of human emotional responses, including her own.

I came to the book as a staff nurse and many of the experiences discussed, as well as the emotional responses they evoked, strongly resonated with me. That’s why I’ve titled this blog post “What Nurses and Doctors Feel,” because even though Ofri’s book focuses on MD’s, nurses can learn a lot from it about our own on-the-job feelings.

 What Doctors Feel begins by exploring how hard it is for Ofri as a new physician to see the humanity in a homeless patient who is dirty, bug infested, and smells terrible. Her feeling of revulsion over the patients’ hygiene makes her unable to care for the patient. Then a nurse’s aide respectfully and gently offers to get the patient cleaned up, locating the human being underneath the patient’s dirty outer layer. Watching the exchange teaches Ofri an important lesson about the barriers to, and importance of, empathy.

OfriTheresa Brown, BSN, RN, OCN, PhD, is a staff nurse, the author of Critical Care: A New Nurse Faces Death, Life and Everything in Between, an Opinion Columnist for the New York TimesBedside,” and a member of the National Advisory Council for the Center for Health Media and Policy.

Danielle Ofri’s new book What Doctors Feel: How Emotions Affect the Practice of Medicine deserves an award for pulling back the curtain on one of the most taboo topics in health care: difficult feelings. The book is honest and brave, as well as eloquent and compelling. Ofri, a physician at Bellevue Hospital in New York and a frequent contributor to the New York Times, is a talented writer and quite a smart observer of human emotional responses, including her own.

I came to the book as a staff nurse and many of the experiences discussed, as well as the emotional responses they evoked, strongly resonated with me. That’s why I’ve titled this blog post “What Nurses and Doctors Feel,” because even though Ofri’s book focuses on MD’s, nurses can learn a lot from it about our own on-the-job feelings.

 What Doctors Feel begins by exploring how hard it is for Ofri as a new physician to see the humanity in a homeless patient who is dirty, bug infested, and smells terrible. Her feeling of revulsion over the patients’ hygiene makes her unable to care for the patient. Then a nurse’s aide respectfully and gently offers to get the patient cleaned up, locating the human being underneath the patient’s dirty outer layer. Watching the exchange teaches Ofri an important lesson about the barriers to, and importance of, empathy.

This post was written by CHMP Graduate Fellow Amanda Anderson RN, BSN, CCRN

Amanda's Bike Helmet

Recently, I posed the following question to a group of my RN friends on Facebook: “Are you nurses ashamed of being nurses? Why aren’t you telling everybody with an ‘RN’”? You see, I follow my Facebook name with the letters, “RN,” and proudly. In response, my friends told me that they kept their nurse status secret when off the job. Some spoke of liability, others, fears that neighbors would show up with weird spots and bumps on their days off.

These concerns are real, but are they valid? Is nursing something to hide, or is it a vocation that should be shared 100% of the time, in everything we do, in every situation we’re in?

My response to their responses was simply, “How is this any different than walking away from a coding person on the street?” A response, I realize, that is quite direct and some might say harsh, but wouldn’t you consider it valid, too?

This post was written by CHMP Graduate Fellow Amanda Anderson RN, BSN, CCRN

Amanda's Bike Helmet

Recently, I posed the following question to a group of my RN friends on Facebook: “Are you nurses ashamed of being nurses? Why aren’t you telling everybody with an ‘RN’”? You see, I follow my Facebook name with the letters, “RN,” and proudly. In response, my friends told me that they kept their nurse status secret when off the job. Some spoke of liability, others, fears that neighbors would show up with weird spots and bumps on their days off.

These concerns are real, but are they valid? Is nursing something to hide, or is it a vocation that should be shared 100% of the time, in everything we do, in every situation we’re in?

My response to their responses was simply, “How is this any different than walking away from a coding person on the street?” A response, I realize, that is quite direct and some might say harsh, but wouldn’t you consider it valid, too?