As the first enrollees in the Affordable Care Act begin seeking care at my hospital, I wonder how my practice as a Registered Nurse will change. We’re told the goal of the new law is to remodel healthcare in the United States into a system that promotes wellness and prevention, rather than just providing care to sick people. This seems like a great objective, but I worry that the switch may compromise the quality of the care our patients receive.
As a bedside RN working at an acute care hospital in Oakland, California, I care for an incredibly diverse patient population. Most of my patients have had health insurance through employer-based programs, private purchase, or Medi-Cal. Most have interacted with the health care system prior to being admitted to my hospital.
Now, I will take care of patients who are new to health care. Some haven’t had care in a long time (or ever). Some may have pre-existing conditions that enabled insurance companies to refuse them coverage. As they enter my care, their needs may be more complicated.