The future of nursing in primary care. An interview with Virginia P. Tilden, PhD RN FAAN

This is a repost from Primary Care Progress and the first of our celebrating Nurses Week 2013.

photocredit: Primary Care Progress

The future of nursing in primary care
An interview with Virginia P. Tilden, Ph.D., R.N., F.A.A.N.
By Sonya Collins

Thank you for giving us an interview for National Nurses Week.

I’m very pleased to know that PCP is honoring National Nurses Week.  And I hope in the future that it’s joined by a Team-Based Care Week that is all about doing the right thing for patients.

I love that idea.  And how do you see the role of nurses in primary care evolving in the coming years? How do you see this role in ten years?

I see nurses in both staff and provider positions having a vital and expanding role and a responsibility for reinventing primary care now and in the years ahead.

In the staff role in traditional primary care practices, the RN typically does patient triage, telephone advice, and prescription management, sometimes including case management and chronic care management. Overall job satisfaction in this role typically is low, and burnout and turnover are high, such that medical assistants have tended to step into this staff role.

However, important reinvention of the RN staff role is happening now with exciting results. A recent ABIM Foundation study of innovative primary care practices found many RNs playing a different role. Care in these practices is typically team-based with RNs working at the top of their licenses as care coordinators, case managers, and systems specialists, resulting in much better patient care and higher morale for everyone, including physicians.

This is a repost from Primary Care Progress and the first of our celebrating Nurses Week 2013.

photocredit: Primary Care Progress

The future of nursing in primary care
An interview with Virginia P. Tilden, Ph.D., R.N., F.A.A.N.
By Sonya Collins

Thank you for giving us an interview for National Nurses Week.

I’m very pleased to know that PCP is honoring National Nurses Week.  And I hope in the future that it’s joined by a Team-Based Care Week that is all about doing the right thing for patients.

I love that idea.  And how do you see the role of nurses in primary care evolving in the coming years? How do you see this role in ten years?

I see nurses in both staff and provider positions having a vital and expanding role and a responsibility for reinventing primary care now and in the years ahead.

In the staff role in traditional primary care practices, the RN typically does patient triage, telephone advice, and prescription management, sometimes including case management and chronic care management. Overall job satisfaction in this role typically is low, and burnout and turnover are high, such that medical assistants have tended to step into this staff role.

However, important reinvention of the RN staff role is happening now with exciting results. A recent ABIM Foundation study of innovative primary care practices found many RNs playing a different role. Care in these practices is typically team-based with RNs working at the top of their licenses as care coordinators, case managers, and systems specialists, resulting in much better patient care and higher morale for everyone, including physicians.

Nurses Week: When the Nurse is Underinsured

Sharlinee Sritharan, RN, BSN

This blog post was written by Sharlinee Sritharan, BSN, RN, a graduate nursing student at Hunter -Bellevue College of Nursing, City University of New York.

On Christmas Day, 2010, I was taken to the emergency room at Queens Hospital Center for severe palpitations and endocarditis. I spent the next six days on an inpatient unit for close monitoring and intravenous antibiotics. I was a full time student back then with an income below poverty line and student health insurance that covered 95% of the medical expenses.
Two and a half years have passed and my out-of-pocket expenses for health insurance have sky rocketed from less than $40 to a few hundred dollars per month–a mere reflection of the change in my economic status from a full-time student to a full-time working, middle-class nurse. When I started working two years ago, my employer paid $4000 of an $8,000 premium for my health insurance. Currently, the same employer pays $4500 of an $11,000 premium for the same insurance. The problem here is that the paycheck hasn’t grown as much as the premiums and copayments did, adding to my financial stress as I try to live and work in New York City.

This makes me wonder how many middle-class, working families are struggling to pay for their medical expenses. You are not poor enough to qualify for government assistance, nor rich enough to pay for expenses out of pocket. The Kaiser Family Foundation reports that a quarter of 45 million uninsured Americans in 2009 were middle class. AARP, in Middle Class Security Project, states that the “steep increases in the cost of premiums have led more workers to move to plans with lower premiums and less comprehensive coverage—trends that have increased the number of people at risk of being uninsured”–or underinsured. When the middle class experiences the risk of being uninsured or underinsured, there is a serious problem with our healthcare system. The Affordable Care Act will expand the number of people with health insurance by 2014 and will eliminate the co-payments for preventive services. But if the premiums stay high and the employers’ share of the premiums does not reflect the rising costs, then the working class, including myself, are at high risk of being uninsured or significantly underinsured.

[caption id="attachment_6205" align="alignleft" width="225"] Sharlinee Sritharan, RN,