Essay on Reforms in the Nursing Practice

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1781 words
Carnegie Mellon University
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The evolution of healthcare system in the United States is expected to institute some changes in the strategies used by healthcare professionals in the delivery of care to the patients. Due to the expected changes, there will be the expansion of the current roles played by nurses while uncovering new opportunities. According to forecasts, these changes should improve the health sector in addition to enhancing nursing education and the relevant leadership activities. The expected changes will bring positive impacts and shortcoming as well. Nurses should take a role in the implementation of the changes due to their critical part they play in the healthcare sector. The fundamental objective of the reforms is to ensure there is the diversion of healthcare to communities instead of having an acute care program (Aoughsten et al., 2015). Despite this, there are many healthcare professionals who are not enlightened on the implications of the reforms on their practice. The paper will explain the implications of the changes in the healthcare system to the nursing practice and also include the summary of feedback from nurses. There will be an evaluation of whether the impressions conform to the research concerning the reforms in the healthcare system.

The idea of continuity of care deals with the delivery of services which are of the required quality over a specified period. Previously, the concept was used to outline the experience of the patients concerning the continuous care relationship as facilitated by the healthcare professional (Adler et al., 2010). The changes in the nursing practice, it will be critical to consider the feedback of the healthcare providers in addition to that of the patient. The framework provided by the continuity of care ensure proper decision-making activities every day and the provision of quality care services to clients. When the reforms in the healthcare sector are well implemented, there will be the provision of continuity of care. The process should be consistent through the various stages of illness and quality of attention should be maintained. Despite the requirement of different professionals in the different care settings, the healthcare system will work to harmonize various care activities to avoid disruptions. It is the role of the nurses to be prepared for the various changes in the healthcare system and be flexible.

Another aspect is Accountable Care Organization (ACO) which include a group of healthcare providers collaborating in the provision of care to patients. Their aim is the provision of care which is patient-centered in addition to being of high quality and cost effective. The organization is formulated in such as it way it promotes cultural diversity. By doing this, it is possible to achieve better community health, better quality care and minimized cost (Barnes et al., 2014). The reforms involving ACOs will help in coordinating and in the management of care to the Medicare beneficiaries. According to forecasts, the ACOs are projected to serve around 5,000 clients and having the provision of enough healthcare providers. The nurses' role in the ACOs is to coordinate care, management of care improvements, facilitate communication and the provision of care in various areas (Barnes et al., 2014). There will be the need for the provision of care different from the one assured under Medicare by ensuring care which is continuous, smooth, of reducing cost and high quality.

There is the Medical Homes which are fundamentally primary care practices and after reforms are set to become patient-centered medical homes. After the reforms, there will be the provision of care that is coordinated, interdisciplinary and inter-professional (Auerbach et al., 2013). According to this type of models, the patient is the center of attention in the provision of primary care. The changes will see the expansion of medical homes with the objective of enhancing the continuum of care. This especially will help in availing healthcare services to patients suffering from chronic ailments. The reforms will also be important to the marginalized communities since the provision of patient-centered care will be in setups. One of the primary objectives of this model is the provision of care services to all communities and at reducing cost.

Another anticipated reform is Nurse Managed Clinics which entail the location of the provision of community-based primary care irrespective of the capability of the clients to settle their bills. One of the aims of this model is the provision of education, promotion, and preventions concerning health especially to the populations that are not adequately served. It ensures that nurses can control their practices as they provide care to patients (Auerbach et al., 2013). The changes in the health care system are expected to expand and provide more funds. The leadership responsibilities will be provided to the nurses.

Feedback from Colleague Nurses

The goal of implementing the reforms in the United States healthcare system is to enhance the nursing practice. One of the changes will be the expansion of roles played by nurses and provision of opportunities for the nurses to contribute to the changes (Sutton et al., 2016). Irrespective of the implications of the reforms, nurses have their opinions. After sharing the presentation with some of the nurses, they were able to provide some feedback.

The feedback from the first nurse was in support of the reforms in that they will lead to changes in nurses' roles. The nurse understood that the changes would shift the healthcare system from traditional task-oriented model to outcome-oriented. Instead of the current setting were nurses' work in isolation, after the implementation of the reforms there be the need for collaboration with other healthcare professionals such as physicians. The nurse also pointed out how continuity of care would help in the promotion of the delivery of care and the effective utilization of the health programs already in place (Adler et al., 2010). Another idea that the nurse supported was the Accountable Care Organization since it was the best platform on which nurses could be exposed to the wide experience in practice. The response corresponds with the research concerning the changes in the healthcare system such as ACOs. This framework helps in the reduction of the national deficit and helped in the avoidance of unwarranted procedures and therefore reducing the cost of care.

The second nurses pointed out the benefits of the reforms such as the nurses will have an opportunity to be part of various changes in the healthcare system without being isolated. By introducing and expanding the Accountable Care Organizations, medical homes and clinics managed by nurses will be critical in the provision of preventive services and also create a system of delivery, especially when dealing with chronic ailments (Aoughsten et al., 2015). There will also be the advancement of the roles played by nurses after the reforms are adopted into the healthcare system. This is because the development of nurse-managed clinics will improve the extent to which nurses' practice. The reduction of the cost of care will increase the number of clients increasing the job opportunities for healthcare professionals such as physicians, nurses and social workers among others. The reforms are quite significant in the healthcare system, and therefore the nurses play a critical role in their implementation (Sutton et al., 2016). Another place nurses can provide their expertise is hospitals and community programs in which they can work with physicians to address the issue of shortage. This is a situation nurses can work with and also get the learning experience from it. The feedback provided by the nurse was in line with the research on the healthcare reforms.

The third colleague was skeptical of the negative implications of the reforms in the nursing practice. Due to the increase in patients as a result of increased accessibility and low cost of care, the nurse pointed that issue of shortage of healthcare professionals (Sullivan, 2013). The worry by the nurses is consistent with the research concerning this reforms since there will be the need for more healthcare professionals such as nurses and physician due to the expected increase in the inflow of patients. Another issue that arose is the cost adopting these reforms to the healthcare system and the implications for the taxpayers (Aoughsten et al., 2015). Other causes of increased costs the nurse pointed out were the funds required in setting up medical homes and nurse-managed clinics. The colleague also had the doubts of whether the reforms would be implemented completely. Due to the requirement of integrating information technology into the system, the issue of contact technology advancement would be an issue which would bring problems implementing reforms in Accountable Care Organizations. The nurse pointed out some benefits of the reforms despite the skepticism. One of the benefits was the likelihood of continuity of care which would lead to the provision of various service such as outpatient and group therapy (Adler et al., 2010). This nurse was able to provide feedback on the perceived benefits and possible complications.

Over the years, the United States healthcare system has been through changes, but there has been no single solution to the increasing cost of medical care. The objective of these reforms is to solve the issue of high medical cost through the provision of insurance coverage. The implementation of the reforms will also be a solution to challenges of inaccessibility to quality healthcare. For successful implementation of the reforms, it will be crucial to include nurses since they constitute a larger percentage of the care providers. Most nurses are looking at the merits and not the possible complications resulting from the implementation of the reforms. It would, therefore, be crucial to ensure that they are enlightened on both the merits and demerits of the reforms. This will ensure the nurses are well equipped with relevant information to deal with the issue that might arise.


Adler, R., Vasiliadis, A., & Bickell, N. (2010). The relationship between continuity and patient satisfaction: a systematic review. Family Practice, 27(2), 171-178.

Aoughsten, J., Johnson, S., Kuruvilla, M., & Bionat, S. (2015). The Effect of the Affordable Care Act on Medicare: Opportunities for Advanced Practice Nursing. Nurse Leader, 13(3), 49-53.

Auerbach, D., Chen, P., Friedberg, M., Reid, R., Lau, C., Buerhaus, P., & Mehrotra, A. (2013). Nurse-Managed Health Centers and Patient-Centered Medical Homes Could Mitigate Expected Primary Care Physician Shortage. Health Affairs, 32(11), 1933-1941.

Barnes, A., Unruh, L., Chukmaitov, A., & van Ginneken, E. (2014). Accountable care organizations in the USA: Types, developments and challenges. Health Policy, 118(1), 1-7.

Sullivan, D. (2013). Rising to the Challenge of Health Care Reform With Entrepreneurial and Intrapreneurial Nursing Initiatives. Creative Nursing, 19(3), 166-167.

Sutton, L., & Jarden, R. (2016). Improving the quality of nurse-influenced patient care in the intensive care unit. Nursing In Critical Care.

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