The reluctance to refer patients to specialists may also mean that nurses must practice more holistic, rather than specialized forms, of nursing. The desire for cost containment has resulted in many nurses assuming physician's duties, such as those duties confined in previous eras to the patient's primary care physician. In states with high HMO (Health Maintenance Organization) enrollment, more nurses were shifted to lower-paying nonhospital settings, such as in home health care settings, to defray costs (Buerhaus & Staiger 1996).
What affect has manage care had on nursing education?
Surprisingly, the majority of nursing schools still do not work with a managed care organization or with physician training programs to facilitate educating student nurses in managed care competencies. However, 57% of hospitals do offer continuing education to staff members though educational seminars, staff meetings, and other programs (Copeland 2003, p.2-3). Although the managed care system is likely to change in the not-so-distant future as calls for healthcare reform become increasingly loud, the fact that the managed care approach is unlikely to entirely to disappear, coupled with unique challenges posed by the financial demands of healthcare has caused many nursing schools to either revise their curriculums or to add certification for nurses seeking to specialize in managed care organizations or approaches.
Nursing practice and the environments within which nurses work are under constant influence from health care financing changes, shortages of health care workers, new technologies, and other national, societal, and economic factors. The impact of fewer resources, escalating costs, and more chronically ill patients calls for continuing education in managed care type skills in nursing as well as in all health care provider groups. With...
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