Don't underestimate the nurse

Public health nurse Vickie Porter in Shreveport, Louisiana.


Tess Vigeland: For all the national discussions about health care and reform, one thing is clear: And that's that nothing is clear.

We surveyed some folks at Philadelphia's Reading Market about the confusing morass that is the American health care system.

Woman 1: Probably in the day and age, just knowing which doctor is in which network.

Man 1: Pay for it, really.

Woman 2: How to compare the different providers.

Woman 3: What's covered, what's not.

Man 2:Paper work, there's a lot of papers involved.

Woman 4: The options, there's so many of them.

Woman 5: Dealing with issues like preexisting conditions.

Man 3: Understanding your benefits. I worked for an insurance company. Most of the time, when we would receive calls, it was to explain benefits and to explain why benefits were denied.

Makes you wish you had someone to hold your hand through the entire process, doesn't it? Well, here's someone who does just that. She's been a nurse in the Philadelphia area for the last 20 years.

Betty Long: My name is Betty Long and I'm president and founder of Guardian Nurses Healthcare Advocates. The analogy that I always use is that you wouldn't enter the legal system without an attorney. And I think it's likely that you shouldn't enter the health care system without an advocate. Who better to advocate for someone than a nurse?

I think the health care system is complex. Patients who are confused don't really know which way to go, and I think it's helpful to have someone buy your side who understands the system, who understands what needs to happen, what needs to be asked -- and we can take that stress from them.

It's not that we tell patients what to do; it's we guide them and give them the options so they can make a better decision. Is it better or worse for your loved one to endure this chemo, this experimental treatment? Or is it better to have a quality of life that allows him to interact with his family?

Guardian Nurses was really started in 2003. My uncle had fallen and had a cerebral bleed. He was taken to a critical care unit and my aunt called me. And I went down, and there was a moment where the resident was talking to my aunt and telling her that we're going to put a breathing tube in your husband's throat. And I saw my aunt nodding her head, and I looked at her and I looked at the doctor, and I thought, "She has no clue what he's talking about."

What do other people do that don't have someone like a nurse or someone clinical to explain it after the doctor leaves? A lot of us who are young and healthy don't think about that, and maybe if we've had an experience where one of our loved ones or our parents have had that, then maybe it's more in our head and we'll consider it. But most people don't think about it.

Vigeland: Betty Long's interview was reported by Joel Rose.

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Other reasons for becoming a nurse practitioner include; healing the pain of the people, to offer a positive contribution to your society, to take care of your own health in a better way, to be of service to humanity, to get rewarded in this life and the life hereafter, Nursing is recession proof and to have greater growth opportunities. http://www.online-nursepractitioner.com/

I think one has to be a bit careful in designating nurses as the "only" or "true" patient advocates. To be honest, despite all the different certifications and titles that are shown on the badge, most nurses simply do not understand the different treatment options or the actual disease processes. My two cents

What a shame many of the insured don't even read their policies to see that most payers offer FREE case management. Most insurance companies have at least 100 RNs on staff to advocate their clients. This "personal nurse" benefit is part of most group plans and all individual plans. I think it would have been nice for the author(s) of this story to mention this FACT.

Doctors give patients oral instructions, perhaps misheard, forgotten.

Yet fear is not conducive to memory.

The more fearful the diagnosis, the more likely that fearful patients get confused or forget important oral instructions, but the greater the need to get doctors' oral instructions right.

Some elderly memories are none too good at the best of times.

Some with poor hearing are too timid to ask for repeated instructions.

There’s usually no friend or family member there to allay panic, to remember instructions.

However, voice recognition programs can instantly turn oral instructions into print for patients, also saving doctors paper work, report writing time.

Betty Long provided important insights into the role of the Professional Patient Advocate. As a critical care nurse I agree having a patient advocate is needed in today's environment. The health care system is complex, confusing and easy for patients to get lost in the system. The Patient Advocate empowers the patient and their family to have a voice.

To learn more about the emerging field of Patient Advocacy visit the Professional Patient Advocate Institute www.patientadvocatetraining.com

Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN

My daughter, who has a business in Phila.,refered me to Betty. That was great for me. My rural area does not have anything like this service.
She arranged for my appointment with a specialist and went with me.
She is a wonderful caring person.

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