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In this forum for discussing the “hot button” issues facing the nursing profession today, we welcome your thoughts and opinions. Our question this issue: I have worked in an emergency care setting for three years,
and during those years I have seen inequity in care. Many times we get “frequent
fliers”—people who are seen over and over again for the same problems;
problems that recur because they don’t do what they are told to do to
fix the problem. They won’t take their meds, or they are intoxicated
and forget, so they end up back in the ER once again for the same thing just
12 to 24 hours after they left. When the staff is confronted by these people
over and over again, it is difficult to remember that they need as much
care as everyone else—especially when you are running seven different
directions at once and have patients [lined up everywhere]. Often inequality
in care occurs during these times. I will happily share my story because I hope it will help
someone. I have experienced health care inequalities as a patient with respect
to insurance. When I was
getting ready to go to college, I needed a few immunizations and things
for my medical records for school. I had not been given these immunizations
before
because my family did not have health insurance and the cost of them was
too high. When my mother began working for the State of Maryland, she obtained
health insurance through her job for our family. The carrier was a health
maintenance organization (HMO). Although eventually we found a good doctor
and dentist, we had to go through almost hell to get there. I went to a
doctor’s
office crowded with patients where the doctor only gave me five minutes to
do a complete physical and fill out the forms I needed for school. When I
needed blood work, I had to run around town to find a lab that would do it.
My doctor at the time could not just draw the samples and send them in. I
remembered going to a dentist’s office located in a dark basement
in a dangerous neighborhood. All of this was horrible. I am not sure if
everyone
who has an HMO experiences this, but there is definitely a problem here.
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