[NP-Clinical] Breast mammograms was Breast MRIs

[Robert Blumm]

The more I listen the more strongly I feel about advocating for our
patients. I mentioned last week that the ACC will discuss an aggressive
Advocacy program to eliminate the ability of insurance companies to say
"no" to MRI's. It is obvious from this communication that although this
will be helpful and gain attention it is not the entire solution. As
long as patients are not aware of their rights as citizens of this
country and residents of states where there is, in fact, a program; we
have a large problem relating to inadequate communication. 
I am also going to ask the Board if we can address this issue by
commissioning a committee to perform a study and to create a plan.
Studies without plans for rectification are bogus. We need to walk the
talk! There is no profession that I am aware of that has the passion and
the commitment to their patients as the Nursing profession. I am proud
to be a member of a team where we can all work together but that is
driven by an ethereal force called nursing. Compassion goes beyond a
smile and a warm hand. I am not negating the smile, the touch, the kind
words but advocacy must be a part of our agenda. We need to be
proactive, approach the players without apology and remember our
strength lies not only in our numbers but in those whom we can
influence. 
As I have mentioned in the past, I will share the results of our
teleconference with this list-serv.
Warmly,

Robert Blumm, MA, RPA-C
President
American College of Clinicians


-----Original Message-----
From: np-clinical-bounces at nurse.net
[mailto:np-clinical-bounces at nurse.net] On Behalf Of Lea
Sent: Tuesday, March 13, 2007 4:48 PM
To: 'NP Clinical'
Subject: [NP-Clinical] Breast mammograms was Breast MRIs

	Yesterday, I saw a patient for the first time to our office. She
came in for a swollen, tender breast w/ discharge.  Lump for about 6
months
then two months of the presenting sx which were worsening.  On exam, her
entire breast was ecchymotic, firm- almost rock hard, aeorla was yellow
peau
d'orange type. On opposite side I palpated a 3-4 cm axillary node.  I
suspect advanced inflammatory breast cancer.
	I was able to get her diagnostic mammogram w/ PRN US etc for
tomorrow.  I spoke with the nurse case manager (Sue) at the breast
center
where the mammography is scheduled.  Sue will be there and meet w/ the
pt.

	So why did pt wait so long... no insurance!  She didn't know
that
our county health department has a Breast and Cervical Cancer detection
program. 
	In talking w/ the case manager I learned they ensure that those
who
need follow up get the procedures regardless of insurance.  And she will
follow up with another pt who also did not proceed w/ a biopsy because
she
didn't have insurance.


-Lea
Melinda L Poso, MN, ARNP
Family Nurse Practitioner

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