So republican or democrat, Christian or Muslim, etc. or etc. I think there is a message in Dove Chocolate once again. Do we walk in ways that we would be positively remembered? Are we paving roads before and after us that demonstrate our purpose and that carryout our great commission? I think we all need to sit and ponder this.
I feel the pressure of being an Advanced Practice Nurse (APN) and the pressure involved with leaving positive footprints for nurses that come after me. The pressure of being an APN in today's healthcare society is such a challenging role to fulfill. Key drivers for change are developing and being pursued right now, and my generation is the generation that will research, investigate, and determine best evidence based practice for the future care of our patients. And yet, we are so controlled by the government and politics, that really have little contribution to what should and shouldn't be in healthcare--yet they are deciding what is best for our patients. WHAT?!?! Last time I checked I have the license to practice nursing, not our politicians.
Let's look at some big issues. Demand without accountability. Porter-O'Grady & Malloch (2011) state,
"Citizens of the United States believe there are no limits to treatment access. Healthcare is believed to be an inherent right for every individual to have access to every available treatment. Further the healthcare system has yet to create expectations or boundaries for those receiving care. There is no accountability for healthy behaviors as the requirement for receiving healthcare service funding. Funding continues to be provided to both individuals who actively engage in healthy behaviors and those who repetitively engage in unhealthy behaviors that exacerbate existing conditions. Healthcare funding is based on a one-way model: presence of illness or disease. There is no expectation that healthcare prescriptions will be attended to or followed" (p. 83).
I hope that whatever candidate is elected tomorrow, that they will take this issue with healthcare seriously and as top priority within the healthcare debate. Forcing someone to pay for healthcare or to pay a tax and decline healthcare is not going to fix the problem of repetitive treatment for patients that purposefully choose to disengage themselves from healthy behaviors, that would prevent exacerbation of their conditions. I do find people that consistently use the Emergency Department as their primary care providers absolutely inexcusable, regardless of their reason, and hope that this too can be changed. Requiring healthcare to be purchased by all will fix the money issue now, but patients will continue to abuse the healthcare system as well, unless there are some boundaries created for those that engage in healthy behaviors and those that do not. The one-way healthcare model needs to change and needs to be fixed. If it's not changed, look at healthcare costs to continue to sky rocket....
These are the issues that are never discussed and were never discussed in any of the presidential debates. If we want to discuss the deficit, look at healthcare costs. As an APN, can we work to guarantee a level of basic services? Will changing our expectations become the best first step to reform? Should every available healthcare service be available to every citizen regardless of the cost? Feeling overwhelmed with the rules and regulations, and it is becoming harder and harder to leave positive footsteps in an environment where we, as APN's, are to fix all the problems that are completely out of our control.
For tomorrow's election, I choose to vote for the candidate that has shown the first steps towards healthcare reform. Though I don't agree with every decision he has made, I feel that he is the only person in years to take steps towards healthcare reform. There is a lot of change ahead of us in this arena, and it's not going to be easy or pretty. Yes, I choose Obama. I choose him and hope for progression and moving forward in this critical time for healthcare.
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