Primary healthcare is a critical aspect of the community's well-being and takes into account accessibility and client-specific approaches tailored to suit everyone's needs. The Healthcare system involves health professionals, health care facilities, and patients. Patients are beneficiaries of the services provided in healthcare institutions, and therefore, their interests and wishes must be taken into account. Nurses interact with patients more frequently as compared to other health professionals. To protect patients and healthcare professionals, nurses are bound by a code of conduct and ethics. The code of ethics is used as a basis of reference for settling most conflicts that arise between patients and nurses. One cause of patient-nurses conflict is cost and medical billing services in institutions. This paper analyses one such situation based on an article that appeared in The New York Times (Beil, 2019).
Over the years, there have been cases of patients suing hospitals and practitioners for malpractice or negligence. However, in 2019, a hospital in New Mexico sued Anna (not her real name) over unpaid hospital bills (Beil, 2019). The bills included payments which her insurance policy could not cover. On matters concerning hospital charges, nurses usually have limited influence as such decisions are made by top hospital management. Nurses only implement the documented charges by billing upon service provision. That notwithstanding, nurses have a critical role in patients' financial obligations in that they should disclose all available treatment options, cost of each, and any effects they may have on the patient (Diane & Fowler, 2015). With that information, patients can confidently make informed decisions that best suit their financial status without necessarily infringing on the quality of treatment outcome.
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Medical bills paid by patients either directly or through insurance policies cover hospital running costs in terms of paying healthcare staff and the purchase of medical supplies. It is the nurses' responsibility to record services offered to individual clients in the ward or outpatient for billing upon discharge. If the services are not documented, such revenue will be lost and consequently have a negative economic implication on the hospital. The sustainability of running the institution will be threatened. In the case of Anna, her asthmatic son was rushed to an emergency room and unknown to her, the hospital had some extra charges which her insurance policy could not cover (Beil, 2015). The additional charges were not explained to her before the medical procedures for her to make a decision. Access to quality healthcare is essential for all citizens. However, it should be affordable and within moderate costs so as not to overstrain resources.
In the American Nurse Association guide to the code of ethics, the right to self-determination article stipulates respect for patients' autonomous decisions concerning their treatment (Diane & Fowler, 2015). The well-being of patients is the top priority in health care, but it should not go against the client's wishes. A multidisciplinary approach in patient management involves the participation of clients in their treatment.
Anna's scenario provides ground for better planning on how to resolve patient-nurse conflicts. Close patient involvement in every procedure is critical. Other alternatives could be explored, such us amicable out of court settlements. Institutional policies in healthcare facilities should be made accessible to anyone seeking services. Additionally, Charges and accepted modes of payment should be explained to the patients. Written consents affirming the patient's commitment before treatment could be adopted. Insurance companies could also explore the possibility of increasing variety of services covered even if it means reviewing their premium payments slightly upwards.
Nurses, by the nature of their profession, tend to be compassionate and sometimes make sound judgments on patient care but without seeking opinion or consent from patients, especially in emergency cases (Belle et al., 2019). While it is acceptable to have the best interest of the patient at heart, the client should be aware of all the procedures being undertaken and why, including all the available options for him/her to choose from. Policies and guidelines on emergency cases must be restructured to align with patients' economic status and health insurance policies.
References
Beil, L. (2019). "As Patients Struggle With Bills, Hospital Sues Thousands." The New York Times
Fowler, M. D. M. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application. Silver Spring, MD: American Nurses Association.
Van Belle, E., Giesen, J., Conroy, T., van Mierlo, M., Vermeulen, H., Huisman ‐ de Waal, G., & Heinen, M. (2020). exploring person-cantered fundamental nursing care in hospital wards: multi ‐ site ethnography. Journal of Clinical Nursing, 29(11-12), 1933-1944.
