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Health care reform and the nursing profession

Dialogue: UM President Donna E. Shalala discusses health care reform, as a panel of experts, from left, Ann-Lynn Denker of Jackson Health System, Aubrey L. Florom-Smith, a recent nursing grad, and David Zambrana, chief nursing officer at University of Miami Hospital, looks on.

Dialogue: UM President Donna E. Shalala discusses health care reform. Also contributing to the discussion was as a panel of experts that included, from left, Ann-Lynn Denker, of Jackson Health System; Aubrey L. Florom-Smith, a recent nursing grad; and David Zambrana, chief nursing officer at University of Miami Hospital.

Any serious discussion on health care reform must ultimately address its effect on nursing, a profession currently experiencing a workforce shortage that is expected to worsen as baby boomers age and the need for health care increases.

To that end, the University of Miami’s School of Nursing and Health Studies on Monday held a special dialogue on that topic, examining a broad range of issues—from President Obama’s proposed health care plan to how giving greater responsibilities to advanced practice nurses can help bring relief to a health care system also burdened by a shortage of primary care physicians.

“Nurses are the backbone of the health care system,” Florida Surgeon General Ana M. Viamonte Ros told an audience of mostly nursing students and practicing nurses who attended the discussion, held inside a classroom at UM’s M. Christine Schwartz Center for Nursing and Health Studies.

But their already low numbers, Viamonte Ros said, will dwindle even further as the profession’s practitioners continue to age. In Florida, for example, 40 percent of the RN workforce, she noted, is older than 51 years of age and 14 percent is older than 62, putting the state at risk of losing as much as 40 percent of its nursing population by 2015.

Viamonte Ros called for an increase in the racial and ethnic makeup of Florida’s nursing workforce, particularly in the northern part of the state, where more African-American nurses are needed, and in the southern part of the state, where more Hispanic nurses are needed. She noted that the state will soon offer free cultural competency training to all health care providers.

The surgeon general, a graduate of UM’s Miller School of Medicine, was one of several health care experts contributing to the discussion, which took place just one day before the Senate Finance Committee voted to back a sweeping overhaul of the nation’s health care system.

UM President Donna E. Shalala, who was Secretary of Health and Human Services in the Clinton administration, said that in addition to facing a workforce shortage, the nursing profession must also address the challenge of retaining talent. She also noted a dearth of primary care physicians, saying the nation must “reorganize primary care to integrate nurses into the practice.”

Other panelists included Nilda Peragallo, dean of UM’s School of Nursing and Health Studies, who called for an “investment in nursing” as a way to recruit more nurses for the future; Ann-Lynn Denker, director of the Center for Nursing Excellence at Jackson Health System and an adjunct professor at the school; David Zambrana, chief nursing officer at University of Miami Hospital; Aubrey L. Florom-Smith, a recent UM nursing school graduate and current doctoral student; and Lillian Rivera, an administrator with the Miami-Dade County Health Department.

Additional topics discussed at the forum included ending gender discrimination in health care, ensuring medical coverage and access for everyone, addressing the issue of health care for undocumented immigrants, facing the need for more nurses in public schools, expanding the scope of services to give advanced practice nurses more responsibility, and training and retaining more nursing faculty members.

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