As 2017 moves into February, all eyes are on the Donald Trump administration in relation to the promised repeal of the Affordable Care Act (ACA). Nurses, physicians, hospitals, insurers and patients are all feeling the uncertainty.
How can nurses navigate the shifting sands of American healthcare and insurance coverage?
Not knowing is the new normal
As the most trusted professionals in the United States year after year, nurses are seen as reliable sources of information and advice by friends, family and neighbors. Everyone knows they can trust a nurse, so when questions about healthcare arise, asking a nurse makes sense to many Americans.
At the time of this writing, the ACA is still the law of the land, but the rumblings in Washington, D.C., tell us the earth may soon quake beneath our feet in terms of this government-mandated insurance program instituted by Barack Obama during his first term in office. The future of the ACA has been called into question, and what its replacement will look like is anyone's guess at this point in time.
When a nurse is approached by a worried patient about this reality, it's highly likely that the nurse will be as much in the dark as any other citizen. At the same time, it could be seen as the nurse's responsibility or duty to allay patients' fears and offer some form of reassurance.
In light of the doubt facing the future of the ACA, can a reasonable nurse be reassuring without making false promises or spouting cliché responses?
Knowledge and resources
The prudent nurse can begin with whatever knowledge to which she or he is privy. If the patient in question is insured by the Medicaid expansion mandated under the ACA, the patient can be guided to a hotline or online resource for Medicaid recipients; hospital social workers or financial advisors may also have other resources to share.
Meanwhile, for self-employed patients who are anxious that their health insurance may be revoked in the near future, the nurse can discuss the patient's conditions, potential medical costs and prescription drug regimen, and determine whether there are resources to which this particular patient can be guided. And it is always prudent to discuss self-care, good nutrition and other ways to remain healthy.
And when a nurse is approached by a patient whose insurance is through an employer, the patient can be reassured that the pending changes to the ACA will likely not have such a potentially catastrophic impact on that segment of the population. In such a case, the human resources department at the patient's place of employment would likely be the best place to go with inquiries and concerns.
A calm in the storm
No matter how tumultuous the times, nurses are often seen as the calm in the storm, a bulwark against the chaos of the larger healthcare system and complicated economics. Nurses are the very backbone of the system, and the public's trust in the profession is understandable and appreciated.
For the foreseeable future, Americans face great uncertainty about the fate of the Affordable Care Act and the more than 20 million people who gained coverage under its protections. Until more details emerge, nurses can offer reassurance, point patients towards resources, listen to patients’ concerns, and act as a calm presence amidst the growing storm.
Nurses may not have the answers — if anyone does at all — but being on the front lines of healthcare means at least offering a shoulder, an ear and an understanding acknowledgment of the uncertainty faced by the country.
