Online Companion: Fundamentals of Nursing Standards and Practice 2E
Is a nationalized health insurance plan the best answer to the problems
of the U.S. health care delivery system?
In countries such as Canada that have national health insurance, the system
is managed by the central government that is the "single-payer" of
health care costs. There is a long history in the U.S. of opposition to government-managed
health care. All of the attempts to design such a system for America have not
succeeded. Americans seem to prefer a combination of public and private sector
resources for health care. The competition between the two types of settings
has encouraged quality and progress. The health care expenditures for health
care in the U.S. is higher than in any other nation; the government currently
pays about 42% of this expense through Medicare, Medicaid and other government-sponsored
health programs. Unfortunately, much of these funds go to administrative costs
and a significant number of U.S. citizens do not have adequate health care coverage.
This is a challenge facing this country. The profession of nursing supports
an integration of public and private programs and resources. Public dollars
are required to help the poor and those whose do not have health care services
available through the workplace. Each citizen should have a basic required package
of services as a minimum coverage. The health care system should be safeguarded
from becoming a two-tiered system based on an individual's personal resources.
How is the role
of the advanced practice registered nurse's (APRN) role different from the traditional
role of the registered nurse?
Chapter 4 outlines seven roles of the nurse and describes the activities within
each of these. The role of caregiver is identified as the traditional and most
essential role of the nurse. Other roles listed include teacher, advocate, manager,
case manager and team member. No wonder nurses are so busy at work!! Another
role that is identified is the role of expert. The advanced practice registered
nurse (APRN) elects to gain advanced skills and in-depth knowledge in a specific
area of practice. Examples of this advanced practice include certified nurse
midwives, nurse anesthetists, pediatric nurse practitioners. There is evidence
that APRNs can independently diagnose and resolve over 80% of the primary health
problems of the American public.