Future nursing considerations for the acutely ill cancer patient.

Abstract

I T HAS BEEN SAID that “nurses could change and direct the whole health system if they would only get united and all work together. ” ’ As manifested by the large attendance at the 10th Annual Oncology Nursing Society Congress in Houston, Tex, recently, it is apparent that nurses have the tools with which to be united to influence the future of health care. As health care policy is changing so rapidly, so too is our nursing practice in the field of oncology. We have advanced our levels of sophistication through further education, extending our clinical practice skills, developing research models, and implementing our findings in practice. At the same time, oncology nursing administrators are developing systems to incorporate new health care policy changes for enhancing the quality of care provided. As we all know, the federal government prospective reimbursement systems for Medicare and Medicaid patients, including diagnosis-related groups (DRGs), have already influenced, and will continue to influence, delivery of care for our cancer patients. The DRG system of reimbursement for patient services is here to stay, at least in the foreseeable future. Insurance companies and state funding agencies are already adopting, or seriously considering, similar systems for health care reimbursement . Some state agencies require precertification prior to elective admission for Medicaid patients. The trends are definite, and procedures to limit the costs of health care are much needed. It is clear that the country could not have gone on with the previous system of retrospective reimbursement with its accompanying escalating health care costs. One of the advantages of the old system was that all patients were entitled to every facet of health care provided they had money, insurance, or federal government benefits, eg, Medicare or