The Patient Protection and Affordable Care Act, which has been signed is viewed by most of nurses as a day of great hopes for nursing profession, while referring to various clauses of the Act, which includes more funds availability to be spent towards nursing education, focused research taking care of safety and quality of service, increased investments towards public health, devising preventive steps required in care management.
It is further observed that the new Act shall be effective after few months or even it can take few years also. The related rules and regulation are yet to be framed. Funds need to be allocated to the pilot project, which also requires to be submitted and approval taken.
There are comments by Rebecca M. Patton “The work has not touched the finish line as yet”, who very vehemently gave support to the reform bill and now feels “Extremely important is what will be the outcome after the bill is passed”?
There are mixed feelings about the bill and there are some resentments, because some think by the passing of the bill insurance companies shall be benefited and there shall be no reformation of the industry, while protecting the consumer. Some of groups feel that the hospitals shall receive reduced repayment of Medicare and Medicaid services offered to more number of patients. The nurse related policy experts express their views that the legislation does not guarantee release of funds, because every year the congress shall be required to provide the funds.
On the whole various nursing association functionaries and policy related special commentators are of the opinion that the legislation shall open the doors to new opportunities in the fields of nurse education and practice. According to the views of Jo Ann Webb “In reality it is brilliant moment in the interest of nurses.” Due to “entire focus is on preventing the unwanted events and creating environment ensuring safe and quality service, which the nurses are famous for. ”
The Community oriented services:
The healthcare reformation legislation has provisions for multiple funds and incentives for the benefit of community oriented caring, which includes nurse operated clinics and school related health centers. The allocation of funds for the purpose is to the tune of $1.5 billion spread over duration of five years involving nurse family partnerships by virtue of which Registered Nurses shall visit first time young mothers located in lower income localities.
According to Jan Towers “There shall be addition of 32 million getting insured to the already insured persons reflecting the increase in the practice”. According to the new legislation the term “Nurse Practitioners” has been defined as primary care providers.
According to Tracy Hayens “Elimination of co-payment and deductible related to screening, vaccines, few types of preventive care inclusive of checking up of Medicare groups, The legislation provides help to ambulatory care nurses for patients, who in the earlier period who were unable to afford these service.”
According to Sheila A. Hass “There shall be necessity of Registered Nurses for managing care services at medical homes and other programs. The Registered Nurses in reality shall face increased role for care of chronically ill population arranging coordination in their care.”
There could be difficulties posed because of initial increase in the demand of primary care than the supply position resulting long waiting period for getting appointments at the clinics or at private practice front.
Affecting Hospital Environment:
Suzanne K. Stone commented that “With more number of persons having insurance cover and beginning to get primary care, there would be very few persons needing emergency care, it shall relieve the crowding taking place at emergency departments”
The law also provides for establishing a new trauma center program to strengthen ED and trauma center capacity and, starting in 2011, provides funds for emergency medicine research and to develop demonstration models for innovative emergency care systems.
Susan Hassmiller commented that “the legislation has provisions for specific granting of funds to hospitals for making available transitional care services or associate themselves with community based organizations for arranging these services. It requires for provision for establishment of pilot project with demonstration capability stressing on patient safety, educating them and quality assurance of the services. These programs shall be requiring nurses, who have acquired skills in these kinds of services, besides nurse researchers and nurse educators for helping in research and training services to be created. Further there shall be need of personnel in hospitals, who can think of improvements in quality care. Particularly the nurses are required to do all the activities they are required to for making preparation in delivering care with utmost safety in mind”
The Environment at Education Front:
The legislation provides for increased loan funds for benefit of under graduate nurses, the nursing schools and the faculty members shall enjoy the eligibility of fellowship for geriatric oriented training programs, offers of scholarships and loan waivers related to graduate students providing teaching service, expansion of work force diversity grant and increase in funds of advance practitioners providing their services in areas, where the care service is deficient.
The legislation has also provision for granting funds to schools and education centers, which have competence to make available courses related to advanced degree stressing on essentials of teamwork in relation to public health, dealing with epidemics and meeting challenges of emergency through adequate preparedness.
Suzanne Begeny has commented “Medicare demonstration program related to advanced practitioner training is destined to be set up initially in five selected hospitals, which shall induce great competition. Although there provisions of further expansion in health care and other similar places also”.
In this respect Susan Carlson states “As prevalent in the past traditions, the first place to start is hospitals, there after nursing schools are also likely to be considered”