Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 95

As a nurse practitioner, there are many things about the American health care system that I really value. There are minimal wait times and there are lots of specialties.

I like that a patient whom I refer with a serious diagnosis can be seen by a specialist within 2 weeks. We develop and make top‐notch technology available and we have great health care standards. For all of these reasons, we keep the world on track and it follows our lead. I'm also aware every day of the shortcomings of the health care system. It's far too expensive, there are too many special interest groups, and it's all going to collapse under its own weight, a classic example of capitalism gone amuck. For example, health insurance companies have too much power, and I hate how all the insurance hoops prevent me and my colleagues from giving the best care to our patients. We need a national health policy, and if the American people make enough noise, politicians will get behind it, too. I'm in favor of a national health plan, one that will ensure that all Americans have access to care. It needs to be one that incorporates what we already do best with what's useful from other countries such as Japan and Canada. We have a lot to learn from what they do well that we don't do.

Nadine Lamoreau, RN, MSN, FNP, APRN‐C

Fort Fairfield, Maine

When you look at a group of 1,000 people, it is estimated that 800 of them will experience symptoms of some disease or condition. Of this group of 800, 265 people will be seen in a practitioner's office or hospital outpatient department or emergency department, or they will use home health care. Only eight will eventually be hospitalized. The majority of the people don't need hospitalization and would benefit from more resources available for primary health care delivery outside the hospital (Green, Gryer, Yawn, Lanier, & Dovery, 2000). This finding seems odd when considering where the research dollars are targeted and where the majority of health care dollars are devoted, that is, acute care settings in hospitals. Note that a consistent focus on illness and injury, often referred to as a downstream focus, means fewer dollars are invested in upstream efforts. A focus on upstream efforts would be directed at keeping the population well through health promotion and illness prevention strategies and would be less costly.