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telehealthA relatively new health care option that is changing the way patients interact with their doctors and nurses is telehealth. Telehealth is the method of providing healthcare services from a different location than where the patient is through the use of technology. Telehealth has provided patients with a sense of control over their own health care, resulting from easier access to their medical documents and doctors/nurses from home. What common forms does this take, what are the perceived pros and cons of this trending healthcare service?

There are three main forms of telehealth: live video conference, store-and-forward, and remote patient monitoring. Live video conferencing includes such circumstances as a nurse walking patients through pre-op preparation or examining a rash. Store-and-forward occurs in instances where a patient takes a photo of a mole and sends it to his/her doctor, and remote patient monitoring is when certain devices measure and wirelessly transmit such information as blood pressure and heart rate.

The Pros

Telehealth has enabled many patients who experience chronic conditions to replace the frequent in-person visits with remote patient monitoring, allowing for more convenient contact between patient and nurse. Telehealth has significantly increased access to healthcare services for patients living in more rural areas, where those in need of healthcare services usually must travel hundreds of miles to receive treatment. Telehealth is also resulting in personal savings to patients. With no travel time required and no need to wait in a doctor’s office, patients are able to save what would otherwise be wasted time. Moreover, telehealth means patients can avoid urgent care or emergency room visits, leading to cost savings for patients.

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Nursing EducationAccording to the U.S. Bureau of Labor Statistics, nearly 1.1 million new registered nurses will be needed by 2022. These new nurses will replace the expected 500,000 retirees and fill the 100,000 new RN positions created each year. With this need for new nurses comes a need for nurse educators to provide proper training. Nurse educators play the crucial role of ensuring that new nurses are prepared to meet the growing demand for their services.

There has been a shift in thinking for hospitals, with more seeking nurses who have acquired a bachelor’s in nursing (BSN) under the belief that such training leads to better expected patient outcomes. Nurse educators are in an important position within this hospital system. They are trained nurses who can deliver the most crucial information to new nurses, given their intimate understanding of the challenges of the profession and how to best convey critical knowledge that is essential to a hospital’s success. As for nurses, this increasing need in the education field has a certain additional incentive. There is a reported $20,000-$30,000 pay gap between nursing faculty and practicing nurses, inducing more nurses to turn to teaching.

Another area offering career and education growth for nurses is through the Doctor of Nursing Practice programs. Due to a physician shortage, there is an increased need for direct providers, and nurses are entering such programs in order to fill the gap. The doctoral programs prepare nurses for careers in health administration, education, clinical research and advanced practice, allowing nurses to become experts in their profession and assume a variety of leadership roles.

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Third-party payer interferenceWhen seeking out medical treatment, the most important relationship that arises is between the doctor and the patient. One of the main problems threatening that relationship is third-party payer interference. Third-party payers have seen a rising power in the exam room over the actual doctors treating patients. While the medical field has sought to empower patients in making their own medical decisions, third-parties are interfering with this ability. How have third-party payers acquired such influence?

Even though doctors are taught to recognize the patient as top priority, third-party insurers make the ultimate determination related to patient access to treatments and medications doctors have recommended, not only to improve patient health, but to save their lives. As unfathomable as it may seem, it is fairly common practice for patients to be denied the treatments their doctors have described. Patients are often unaware that when insurers deny this access, they can appeal the decision and fight to receive the treatment their doctors recommended. However, obstacles to overturning the insurers’ denial, even if patients are aware of this option, often scare off patients from pursuing claims.

As frustrating as denial is on the patient side, it likewise hinders a doctor’s ability to most effectively treat their patients. It is generally unethical to deny a patient treatment, especially if other treatments have proven ineffective. Yet, doctors are required to jump through third-party insurers’ hoops to eventually provide the treatment they recommended in the first place. For instance, certain types of therapy treatment require that a patient must first fail on a less expensive medication, even if it is likely to be less effective. Doctors also find themselves caught up in a situation where patients must independently prove they require the treatment or medication recommended by a doctor. Patients must demonstrate this through a doctor using certain diagnostic procedures or lab studies in coming to a conclusion regarding treatment.

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Wheaton licensure defense attorneyThe nursing profession has never lacked its challenges, but two major issues have increasingly affected the quality of work environments for nurses: short-staffing and extended working hours. What negative effects are resulting from these problems?

Short-staffing of hospitals has become a top concern for nurses. The U.S. Bureau of Labor Statistics estimates that, by 2022, there will be a need for more than 1 million registered nurses due to occupational growth and replacement hiring. What is viewed as the most dangerous concern for short-staffing? A lack of sufficient patient care. In hospitals suffering nurse shortages, nurses often do not have time to provide the necessary care for patients or their families, as they are rushed to assist a patient and then move on to the next one. Such feelings can lead to moral distress, in which nurses become physically and emotionally drained when they repeatedly cannot provide the care they feel is necessary.

In order to address problems that arose due to short-staffed hospitals, some nurses are required to work longer shifts involving extended hours and overtime. This solution creates an inherent problem: nurse fatigue. With an increase in fatigue affecting nurses, there is a corollary risk of increased medical errors involving patients, as fatigue can lead to mistakes or oversights related to patient care. The typical number of hours a nurse should work in a week is at most 40 hours, working no more than 12 hours in a day. Nurses who work beyond that start to experience cognitive decline, resulting in a higher probability of mistakes being made that can adversely affect patients.

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Chicago license defense lawyerIn October 2019, the Illinois Department of Financial and Professional Regulation announced a new requirement for prescribers renewing their Controlled Substances Registration in 2020: the completion of 3 hours of continuing education on safe opioid prescribing practices. The requirement applies to individuals that are prescribers under the Controlled Substances Act, which includes such licenses for dentists, optometrists, physicians, and veterinarians.

The change does not come as much of a surprise given the continuing spotlight on opioid addictions and overdoses turning into a nationwide epidemic. While most lawsuits have been filed against opioid manufacturers relating to their misleading marketing of these drugs, there is no doubt that prescribers of opioids, most specifically physician prescribers, have been viewed as playing a crucial role in this problem. The Centers for Disease Control and Prevention reported that in 2017 more than 70,000 people died from drug overdoses and of those deaths, nearly 68% involved a prescription or illicit opioid.

In a study conducted by Johns Hopkins Bloomberg School of Public Health examining about 350,000 prescriptions written for patients operated on by nearly 20,000 surgeons from 2011 to 2016 – the latest year for which data was available – researchers found that many doctors wrote prescriptions for doses of opioid tablets after surgeries, including operations that resulted in relatively little pain for patients. The highest-prescribing 5% of surgeons performing these less painful procedures prescribed 40 to 70 pills on average.

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