1. Newland, Jamesetta RN, PhD, FNP-BC, FAANP, FNAP

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Every year, we celebrate nursing and nurses during National Nurses Week (May 6-May 12). This year, we may have extra reason to celebrate due to the passage of the American Recovery and Reinvestment Act of 20091 and its' implications for nursing's future. This historic piece of legislation is not without controversy and challenges, but many nurses are hopeful that healthcare reform will not be too far behind some of the changes already being discussed.

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Support for nursing education

Through the stimulus bill, funds will be directed to expand the healthcare workforce over the next few years, including support for professional nursing education through Title VII health professions programs and Title VIII Nursing Workforce Development Programs, as well as the National Health Service Corps scholarship and loan repayment programs.


Experts continue to project that the nursing shortage is only going to worsen over the next several decades. The bill includes provisions that will help NP practices and nurse-managed health clinics continue to provide high quality, cost-effective primary care to the most vulnerable in our communities.2 Additional funds are designated to pay for medical care for the uninsured and underserved through state Medicaid programs, and funds to help with the acquisition of health information technology in practices that serve Medicaid patients. The technology will facilitate the development of electronic medical records and enhanced communication within and across systems.


Community outreach

The American Nurses Association has designated the theme for this year's National Nurses Week as "Nurses: Building a Healthy America." This is very appropriate in the present climate of change and emphasis on individual and collective responsibility for one's neighbor. One example of this spirit was reported in The Philadelphia Inquirer.3 The Camden [New Jersey] Coalition of Healthcare Providers piloted a unique program last year using a "medical home without walls" model to reduce the number of hospital ED visits, lower costs, and improve care by strengthening primary care. A number of "super users" of the ED, "the worst of the worst," or individuals who had "complicated problems and lack[ed] the emotional or financial wherewithal to fill prescriptions or make doctor appointments" were identified and followed by an NP, a social worker, and a community health worker. The team found these individuals in shelters, train stations, and other places; helped them obtain social services; assisted them in securing and taking prescribed medications; and helped them get to their healthcare appointments.


Patient education was also a big component of the intervention. Dr. Brenner, the brainchild of the project, believed that if given alternatives, people would stop going to the ED. As a result of the team's intervention, ED visits for 35 patients in the pilot program dropped from a monthly average of 61 to 37 with a parallel drop in hospital costs from $1.2 million to $531,000. The Coalition plans to publish data after the first year of intervention. Similar programs have been initiated across the country.


If given the resources to implement new models of care, NPs and other health professionals can find innovative and more effective ways to improve health outcomes for many of the nation's neediest populations while reducing cost inefficiencies in the current healthcare delivery system. NPs are positioned to be among the leaders who are working to "build a healthy America."


Jamesetta Newland, RN, PhD, FNP-BC, FAANP, FNAP

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1. The American Recovery and Reinvestment Act of 2009. Pub. L. 111-5. February 17, 2009. [Context Link]


2. National Organization of Nurse Practitioner Faculties. Stimulus package signed by President includes funding for nurse education and health IT assistance for nurse practitioners. [Press Release]. February 18, 2009. [Context Link]


3. Campbell CA. An ER alternative. The Philadelphia Inquirer [Kaiser Health News]. March 9, 2009. [Context Link]