Hospitals and medical practices brace for administrative change under Obamacare
Written by Alyssa Clark
As the new healthcare law took effect Wednesday, practitioners and medical offices across the US braced themselves for the confusion and administrative struggles that inevitably accompany huge healthcare changes. With the number of people enrolling in private plans totaling 2 million during the initial sign up stage alone, the health benefits and administrative hassles are just beginning. Enrollment started last October and will continue into March of the New Year, however most Americans already enrolled by last week in order to receive coverage for the new year. That being said, it’s no wonder why hospitals and medical offices are being hit with patient confusion and new administrative challenges all at once.
After the huge let down that was the Obamacare website, public health officials and private practices were equally weary about how this transition would affect business productivity as a whole. A spokeswoman for the Centers for Medicaid and Medicare Services reported no problems or let downs during the first day of operations. Since Obamacare was the largest piece of sweeping legislation in the past 50 years, it was inevitable that this period would not only be transitional and slow, but difficult to overcome for some of the less steady medical offices.
"We are ready ourselves to assist consumers as well with our full complement of call center representatives available," said Julie Bataille, spokeswoman for the CMS.
At the start, confirming a patient's plan may present headaches for care providers. The Obama administration has acknowledged that errors occurred in transmitting enrollment data to insurers, especially early in the enrollment period. An official said it was "reaching out" to providers who have expressed concerns about implementation, and was also trying to help anticipate problems.
"It will be difficult for us to actually verify coverage - that's my concern," said Dr. William Wulf, chief executive of Central Ohio Primary Care, which has 250 primary-care physicians.
Shortcomings are inevitable no matter what healthcare system is in place, it is just a matter of how hospitals are responding to this adversity and how public healthcare will change for the better (hopefully) due to these somewhat radical changes.
"The challenges in our healthcare system were decades in the making and won't be solved overnight, but now more than 6 million Americans have been enrolled in marketplace or Medicaid coverage and are getting peace of mind," wrote White House health policy adviser Phil Schiliro in a blog post.
ACA supporters and customer service representatives are working around the clock to assist all medical practices, from hospital to private offices, in hopes of supporting Obamacare to be the greatest success possible. Major corporations like WalMart and Walgreens are getting behind the Obamacare push, and working with the established system to help ensure an easier transition for patients and providers alike.
COVID-19 "causing mass trauma among world’s nurses"
Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels.
Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it.
What does it mean to be suffering from burnout?
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care.
While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.
Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them.
Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness.
How widespread is this problem?
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions.
Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.
Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses.
Have either of you experienced burnout?
Rindt: I have experienced burnout as an RN. I was constantly fatigued, never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.
Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job.
I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.
What impact is COVID-19 having on nurses' wellbeing?
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.
New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators.
However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.
How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?
Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.
Nurse burnout not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes.
Strategies to address burnout include training improving nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals.
What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.
Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously. We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.