This past year has been remarkable in terms of change for our nation with the election of our first African American President. Although his first year has not been without challenges and struggles, it is exciting to see his passion and dedication to healthcare reform. Many of us may not agree on what that reform should look like (indeed, our lawmakers in Washington, DC give evidence to this), but most of us agree reform has been too long in coming. Access to care is limited for some and nonexistent for others. Cost of care is astronomical, even for those with employer-provided insurance coverage. Often, insurance coverage changes from year to year as those very employers seek to provide employee coverage while scrambling to keep costs down. Some of those insured end up moving from provider to provider as their insurance coverage changes and their previous provider is no longer a provider for the new insurance company. Continuity in care and a relationship with one's provider are no longer the norm.
The discussions surrounding healthcare reform are often confusing and frustrating at best. Despite efforts to bring together leaders from healthcare and industry to participate in staging healthcare reform, I do not see evidence that there is one voice emerging nor am I convinced there should be. Healthcare in American is a complex system-when you make a change in one aspect of that system, there is a ripple effect with untoward changes occurring, often unintentional, over and over again.
One important aspect of healthcare reform that nurses must not miss is the opportunity to work collaboratively with other healthcare providers to improve access to care and drive costs down. Some of our colleagues in healthcare are not so motivated to work collaboratively. Nursing, I hope, will continue to be the voice of the patient, advocating not for increased dollars in our pockets but for safe, quality care for all citizens.
Journalists Bernice Buresh and Suzanne Gordon have provided nurses with some sound advice regarding the importance of communicating with the public. In their book, From Silence to Voice: What Nurses Know and Must Communicate to the Public,Buresh and Gordon (2006) emphasize the importance of nurses communicating "the richness and diversity of nursing" (p. 4), so that the public and those in positions of influence will give ear to what nurses believe, need, and want. As journalists, Buresh and Gordon (2006) encourage nurses to be much more visible in the media:
Nursing perspectives expressed in letters, opinion pieces, and on the Internet would expand the knowledge and point of view of journalists and the public. Articles and essays by nursing in various media would include personal and ethical reflections, anecdotal accounts of their care of the sick and vulnerable, descriptions of innovations in clinical practice, analyses of major health care issues, and recommendation addressing treatment, preventive practices, and health care system issues (p. 12).
Now is the time for us to act on Buresh and Gordon's (2006) advice. Nurses should be part of the discussion on healthcare reform, educating the public and lawmakers on the day-to-day issues our patients face as well as the challenges we confront in providing safe, quality care. It is critical for nurses to articulate credible, reasonable solutions to the challenges of our complex system, not protecting our own turf but advocating for what is valuable and necessary to care for the citizens of our country.
I challenge you, colleagues, to capitalize on nursing's opportunity to be involved in healthcare reform. No one knows more about the challenges patients face than nurses. No one is more passionate about advocating for wellness and health of the American people than nurses. Take time to study and understand the proposals for healthcare reform (http://www.whitehouse.gov/issues/health_care/). Be a voice in the community, talking with your patients, friends, family, politicians, and nursing organization(s) about your experiences and perspectives on healthcare reform in America.
Although we may not all embrace the same political party or hold the same discrete views about healthcare issues, nurses can come together in agreeing to be an active voice in pushing for healthcare reform. The voice of nursing cannot be silent at such a crucial time for change. Study the issues, be clear about your beliefs, and advocate on behalf of the patients you care for every day-and those who may not yet have access to your care. Be a voice of nursing.
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