The Torch, Spring/Summer 2010

22 TORCH | Spring–Summer 2010 JONATHAN PHILIPS | ISTOCKPHOTO W henever we’re faced with new legislation, our first reaction is to ask, “How will this affect us, as individuals and as a nation?” In dealing with the recent health care reform bill specifically, the answer to that question may be different depending on whether you are a doctor, patient, small-business owner, or insurance agent. As nurses with a large stake in the health care system, the faculty in the nursing department of Cedarville University watched the health care debate with great curiosity, interested to see how the legislation would influence our roles as nurses and educators. And since our responsibilities profoundly affect our patients and students, we knew the bill could have far-reaching implications. In seeking to understand the legislation, we realized that, whatever happens, nurses — and Christian nurses in particular — still have a code of ethics to follow. Fortunately, the bill contains nothing that contradicts that code, meaning nurses maintain their moral obligation to provide compassionate care for each individual and to show respect for the inherent worth and dignity of every person. Increased Influence A nurse’s responsibility begins with the aforementioned code of ethics, considered the “standard of practice” for nurses nationwide. This code highlights the importance of the patient and stresses the nurse’s ethical and moral obligation to all people, regardless of their ability to pay for services. Additionally, nurses follow laws that are written and enforced at the state level. While they must pass a national standardized exam in order to receive a license to practice, the state government regulates licensure, the requirements to maintain licensure, and what activities constitute nursing scope of practice. The health care bill in its current form will have very little effect on the way registered nurses are educated and practice nursing. In other words, the RN who works as a floor nurse, a flight nurse, in the emergency department, or in the operating room will not see any significant change to his or her practice. On the other hand, advanced practice nurses, public health nurses, and school nurses may see some alterations in role expectations and reimbursement for services. The legislation proposes to increase federal reimbursement for midwives to 100 percent that of physicians by 2011. Additionally, the act proposes to increase state Medicaid reimbursement of primary care services provided by nurse practitioners to 100 percent that of Medicare by 2012. Other adjustments include reducing student-to-nurse ratios in public elementary and secondary schools, increasing federal funding for nurse-managed care centers, and offering reimbursement for health education provided by nurses. While none of these policies would change the scope of nursing practice, they do allow nurses to have greater access to patients through reimbursement of services. In addition, the bill will directly affect U.S. nurses through the increase in funding for nursing education and loan repayment grants for nursing faculty. As a general rule, when access to health care increases, the demand for nurses and primary caregivers increases as well. Based on our previous health care system, the nursing shortage was projected to reach record numbers by 2025. Under the new bill,