Health Access Team Members
Teamwork But Much, Much More
Enough Team Members with a Variety of Skills and Training
Trained in Health Access for Health Access
Retained in Continuity in Place and with the Same Patients and Populations
Of the Community Served for Maximal Awareness, Efficiency, Efficacy
Experienced in the Multiple Dimensions of Health Access
Moving Up in Responsibility and Training Internally, Not Stolen By Hospital and Specialty Care
Team Members Should Experience No Sacrifice for Remaining in the Most Complex Health Delivery – Basic Health Access Primary Care
Entry Level Personnel to Move Up and also to Become Practitioners, Supervisors, Administrators
- Graduation age increase to age 31
- 1 million short by 2020
- Most numerous health professional at Community Health Centers
- Only 10% in ambulatory settings and another 10% in community health
- Training variable for health access settings, most commonly hospital focus where 80% are found
- 60% active (most part time and inactive) for registered nurses, nurse practitioners, nurse midwives
- The RN plus FP is the smallest and potentially one of the most efficient and effective units of basic health access delivery
- Continuity of care is about people, and RN continuity of care can be more prevalent and important than practitioner continuity
The ambulatory nurse faces numerous challenges with the demise of basic health access in multiple dimensions.
- Poorly considered methods of care such as hospitalists end up dumping major responsibilities of recently discharged patients (still very ill) into the care of ambulatory nurses.
- Beyond basic primary care services, the nurse is arranging all other needed care.
- Triage functions are a critical component. Insufficient health access facilities and nurses guarantee excessive morbidity and mortality from any epidemic, pandemic, or disaster.
Registered Nursing Workforce Faces Great Obstacles
- Too few are graduated
- Salaries have not improved relative to the cost of living in decades, similar to teachers and public servants and more recently primary care practitioners have been added to this list
- Entry level hospital nursing positions have become more limited and even basic health access facilities are cutting nurses, or hiring fewer. Public health cutbacks also impact nursing demand. With declines in demand, fewer enter nurse training
- Nurse practitioner increases over 160,000 graduates have taken nurses out of nursing and basic health access nursing
- Nursing faculty shortages have also been exacerbated by departures of faculty to become nurse clinicians drawing more pay and support
- Nurses report personal safety issues, patient safety issues, and difficulties with employment such as not knowing if nurses on the next shift will be their to relieve them.
Foundation of Basic Health Access Primary Care
Atlas of Basic Health Access