Why nurses deserve a place in primary care

I’m feeling pretty good about myself today. My patient, recently admitted to home health care, was just not herself, low O2 sats, irregular heart rate with pain on inspiration and feeling a little clammy. While her recent surgery was a neck fusion, it still didn’t completely eliminate the possibility of a pulmonary embolism. Instead of spending 15 to 30 torturous minutes in her primary doctor’s voice mail hell, I made the call to go to the emergency room for evaluation; she was ultimately admitted. While I do not know her admitting diagnosis, I think I nailed it. Policy wonks and health system bean counters will cringe at the thought, but it’s time to bring up another personnel conundrum: Why can’t we see the advantages to the patient, and the primary care system as a whole, of putting RNs back into primary care and specialty care offices? We’re all in cost-saving mode with primary care doctors receiving fewer reimbursement dollars. Let’s look at the long term health impact to patients instead of the short term cost. First, what qualifies me to comment on this? I am a home health RN case manager. The majority of time, I receive your patient from the hospital because of a recent admission, usually a result of an exacerbation of a chronic disease, heart failure, COPD, uncontrolled diabetes, pneumonia. I get to see the ugly underside of a patient’s home life which directly impacts their health. And as a result, I’m there to get them over the hump when they get ...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Policy Primary care Source Type: blogs