| Washington Watch | Issues Update | Vital Signs | Health & Safety |
"Excuse me, I’m the daughter of the patient in bed five—Mr. Patton. Can you please tell me what is going on? Has the doctor seen his CT scan since surgery?”
No one can ever prepare you for a family member’s hospitalization, especially when it’s an emergency. You now assume the role of a family member who happens to be a registered nurse, a nurse who is very well informed and knowledgeable about the state of health care in America today. “This really isn’t happening. I am going to wake up and my dad is going to be fine.”
My worst nightmare was realized as I expeditiously traveled from my home to my parents’ hometown 65 miles away. As I rushed through the hospital doors to see my father, I could feel my stomach swirling about and my heart racing. “What am I going to find? Where is my mother? I hope my two brothers and sister are there. I want my father transferred to Cleveland.”
As my parents have reached their 60s, their health care needs have abruptly changed. Their acute illnesses have required immediate interventions and hospitalizations. No longer are the decisions regarding who and where to go for their health care made in isolation, but rather collectively as a family. From the time my father was first diagnosed in the summer of 1996 with adenocarcinoma at the esophageal-gastric juncture, to his more recent hospitalization with seizures from the brain metastases and subsequent brain surgery, I have seen health care differently as a consumer than as a registered nurse. “This isn’t supposed to be happening to us.”
All too often, I found myself waiting during the first emergency visit and each of his ensuing admissions, and wondering what was going to happen. “How is he going to do this time in the operation? How are we as a family going to cope during the subsequent months of daily radiation and chemotherapy treatment? I hope his insurance will cover this.”
My mind would frequently drift back to countless stories of poor quality care and limited access to services for all too many in this country. Market driven initiatives to control costs have altered the face of health care, and no one seems immune to the changes. “I want my father transferred to Cleveland.”
While he was being evaluated, I quickly made arrangements for a transfer to the regional academic medical center, University Hospitals of Cleveland. I have firsthand knowledge that the hospital’s high standards would ensure delivery of quality care to my father, and that the staff would provide support to my family. I didn’t think about what his insurance would cover. He needed and desired the best possible care available. One of the great democratic privileges in America is that all people, regardless of all considerations—including their ability to pay—have a right to the best possible care. But I know all too well how that privilege is caught in the collision between financial considerations and desired care—a collision occurring in hospitals all over the country.
Despite my father’s illness, I consider my family and myself lucky. We have what so many others don’t in this current climate—that is, access to quality care and services. The care he received did not disappoint us. And his insurance, though accompanied by a heavy price tag, did not deny access when we wanted a second opinion, and also when we needed more than what his community hospital could provide. “How lucky we are.”
I have no illusions about the limitations of managed care and other insurance coverage. These restrictions have made it more difficult for us as nurses to care for patients the way we want to. For this reason, we need to fully understand how the economics of health care are decided and driven. Whatever becomes of the future depends on what we do now to shape it.
My family was lucky that access to specialists was not restricted. However, what has become difficult to comprehend and to live with is that many individuals are not this lucky when it comes to health care, and many have no choices. As changes in health care continue, let’s be proactive in seeking positive measures we can all live with.
Throughout its more than 100 years in existence, the American Nurses Association has fought for access to quality health care for all people. Only by joining together can we realize our power and make this long-sought dream a reality. Everyone deserves the same access to care that my family was fortunate enough to receive.
Join me today in making health care more available to others. Join me today in the ANA.