The Backbone of Health Care
In terms of cost effectiveness, nurse practitioners save consumers on multiple levels. According to the American Association of Nurse Practitioners, nurse practitioners provide equivalent or improved medical care at about one-third of the cost of physicians. These savings are due, in part, to the lower cost of education for nurse practitioners and lower salary compared to physicians.
When it comes to health care providers, Joy Kubotsuka prefers the nurse-managed experience at UF Health Archer Family Health Care, or AFHC, the UF College of Nursing’s primary care practice. The practice is a federally designated Rural Health Clinic in the small town of Archer, just west of Gainesville, that provides care to vulnerable, underrepresented populations. Approximately 60% of the patients there have incomes less than twice the federal poverty level and about half have no health insurance.
Kubotsuka had no health insurance when she became a patient at AFHC 12 years ago, and despite living 45 minutes away and having other options, she is a loyal patient of AFHC because of the way she is treated there. Her first visit was based on the recommendation of a friend, who received care there. Kubotsuka was experiencing depression and lethargy, which she said is unlike her. When she made an appointment at AFHC, the nurse practitioner ran tests and discovered she had an issue with her thyroid, which has since been managed through medication.
“I feel very comfortable with the nurses at Archer Family Health Care,” Kubotsuka said. “I feel like they really listen to my health care problems and care about me and are respectful of me.”
Several years ago, Kubotsuka obtained health insurance and briefly had to find another provider through a medical practice in Gainesville. She said it was not the same intimate, caring atmosphere that she is used to, and she was happy when she was able to return to the nurse practitioners at AFHC. She said especially as she and the rest of the population ages and she begins to experience more health problems, she is wary of the nursing shortage and what it may mean to health care.
“It’s a little scary because I’m a baby boomer, and I have noticed as I get I older, I need more care,” she said. “I know I may not get as much or as good care if there are not enough nurses that we need.”
She said her hope lies in the next generation of nurses being able to provide the same kindness and care that she has received, which has really made a difference.
“You can’t function without nurses,” she said. “They’re the backbone, I think, of the health care system. I think it’d crumble if you didn’t have nurses.”
The Changing Role of Nurses
Nurses are considered the heart of health care, and serve in myriad roles that range from diagnosing and treating in primary care, delivering babies, prescribing and administering medication, performing and assisting in medical procedures and — perhaps the most humbling and rewarding role — supporting and serving as advocates for patients and families.
But nursing has changed over the decades and many are asking what will the workforce lose as veteran nurses prepare to retire?
Bush, a veteran nurse herself, earned her BSN degree from the UF College of Nursing in 1990. Her now-husband, Robert Bush, was in the same class and also works at UF Health. She said an aging baby boomer population with multiple comorbidities and critical needs, in addition to the demands placed on nurses, can also lead to burnout and contribute to the nursing shortage. After 30 years in bedside nursing, she is planning a new path to make a difference in nursing.
In December, Bush earned her Master of Science in Nursing degree and became a licensed advanced practice registered nurse because she said as she gets older, the physical and emotional demands of bedside nursing is starting to take a toll. As a nurse practitioner, she plans to retire from 8 East and practice nursing in the community, which will still allow her to make a difference but be a little less taxing physically and emotionally.
As for the next generation of nurses, she said there is power in the support nurses can receive from one another.
“I think one of the things we can do, because we don’t always take good care of ourselves as nurses, is be supportive and take care of each other,” Bush said. “It is a hard job and it’s very stressful. In the heat of the moment, anybody can be critical or heated or stressed. We have to step back and remember we are in this together and we can’t do it alone. It does take a village.”
The Future of Nursing
There may be a dire need for more nurses, but nursing is not for everyone. And certain specialties of nursing are more suited for some than others.
UF College of Nursing BSN senior Marianna Colon is a first-generation college student who grew up in a military family. She initially thought she wanted to be a doctor until volunteering at a hospital showed that nurses are the ones who interact the most with patients.
“Seeing the love and compassion and empathy that nurses have in everything that they do is what I wanted,” Colon said.
But it was not until she participated in a College of Nursing international study abroad trip to Grenada in the spring that she solidified her decision to pursue a nursing career. Specifically, Colon learned of opportunities in public health and the community that align with her own values after watching the Grenadian nurses, who are vastly outnumbered but still care for their patients like family and support one another.
“A lot of people have different definitions of what nursing is, and I was still trying to form my own,” Colon said. “But going to Grenada and seeing how these Grenadian nurses welcomed all of us in with open arms and took us under their wing, it just showed that nursing is also a family-oriented career.”
During her summer break, Colon worked as a night-shift certified nursing assistant three days a week. She said she has witnessed the nursing shortage, which leads to nursing burnout and high turnover in the profession. She knows an overworked nurse who skips lunches or bathroom breaks to care for patients can actually backfire and be a danger to patients.
“I’m one that I like challenges, but this actually seems frightening in a sense because I already know with the shortage there is going to be a higher patient-to-nurse ratio, and with more patients to fewer nurses, it’s not going to be as safe,” she said.
But Colon is not daunted by the challenges that lie ahead for nursing. As she prepares to enter her last year in the BSN program, she knows she still has a lot to learn, and also a lot to contribute.
“Personally, I feel like with me becoming a nurse in general, I’m adding to the number and I can help any way possible. Since I do want to go further in my education, I can also come back and teach. Teaching will also rise up a new generation and encourage more nurses.”