Allnurses Central

Why Nurses need the best shoes for plantar fasciitis to stay active in their job

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Nursing or being a nurse in a medical center is one of the busiest jobs that a person may have because of the 24 hours’ work and consistent performance that is expected. Though most of the nurses know the challenges of being a nurse in a hospital, they also have to take care of their own health to make sure they can perform better. Among the common issues like getting viral problems or other things, the most common issue is the fatiguing muscles and pain in the feet and calf muscles.

This is because nurses have to walk, have to stay in the standing position for most of the work hours and have to move briskly to reach the wards and serve patients upon call. Not all nurses may feel acute or chronic pain in their feet and leg muscles but those who develop plantar fasciitis due to severe pressure on the heel area may need some sort of accessory or support shoe that can help them in dealing with such issues easily.

plantar fasciitis

Nurses are really in need to wear on shoes which are comfortable, supportive cool and dry and support their long work hours by keeping their feet pain free.

No doubt having plantar fasciitis means a lot of pain due to the pressure on the muscles in the heel area. Here are some of the reasons for which nurses may look for some specialized features in their shoes to stay away from the pain in their feet and especially the plantar fasciitis issues.

They have to stand and walk for the whole day

Nursing is not a job that allows you to sit an relax rather nurses have to walk and move from ward to ward and patient to patient briskly when they are on their duty hours.  They don’t have much time to relax and that is why the only way to relax is by keeping the feet easy in the shoe no matter for how long they have to be on the go.

They have more pressure on the heel due to consistent standing position

Due to the fact, there is more pressure on the heel area they are more vulnerable to developing plantar fasciitis meaning that they would be needing shoes specially designed to support and cradle the heel are and keep the foot in a comfortable position.

For staying active all the time and avoid fatigue

In order to cope with the consistent and active job hours, nurses need to have shoes that increase efficiency and make sure not to let the muscles get fatigued and strained. For staying active, it is better to wear on shoes which offer better energy and relaxed foot posture to keep them away from issues.

To avoid squishy feet

Due to long hours of work, nurses may have to wear on their shoes for a long time and that may cause squishy feelings inside. Airy, cool and dry shoes are the ones that nurses may need. That is why they need a pair of shoes that make sure consistent airflow towards the inside to keep the inside dry and cool.

Nurses need a lightweight shoe

Shoes that are specially made for the nurses are usually lightweight to make sure they would not feel any kind of pressure and problems while working, walking or standing all the time. Wearing heavy shoe may cause extra fatigue and problems that may cause pain and issues which may impair their capacity to work actively and serve as expected. To help cope with such issues, nurses must find a lightweight shoe that is supportive as well.

All these needs and requirements assure that nurses may not be able to stay comfortable and may get into more issues and problems if they are wearing average shoes which have no special kind of support structure to help them avoid pressure points on their feet. There is a need to find shoes which not only keep the feet comfortable but also help in performing well in their work hours. In order to fulfill such unique needs in their work hours, wearing the specially made nursing shoe could serve the purpose in an active way.

Health Care Reform and Long-Term Care

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After a year of rancor and wrangling, partisan politics, strident public debate, rallies and protests, back-room deals, and media brawls, the Patient Protection and Affordable Care Act (PPACA) finally passed the House of Representatives in March 2010. It was amended into the final version by the Health Care and Education Reconciliation Act, which was signed into law by President Barack Obama on March 30, 2010. 

At first, few had any idea as to what sorts of provisions were included in the 2310 pages of this verbose historic legislation. It was quite the surprise to discover that the PPACA contains several provisions significantly affecting long-term care that will start taking effect over the next four years.

The demographic shift in increased numbers of elderly in our society will cause a shift in focus from acute care to long-term care health services. The present long-term care system, however, is not prepared for the burgeoning elderly population and is in dire need of reform. Weaknesses are many and include: reimbursement-driven and inequitably-distributed services; a fragmented, uncoordinated, and “user-unfriendly” system; a confusing blend of health and social services; multiple entry points; domination by the acute care system; poor public image; and, inadequate support for informal caregivers.

The following summary outlines key provisions of the PPACA for long-term care: 1) introduction of national long-term care insurance; 2) expansion of Medicaid options for community based services and supports; 3) mandating chronic care coordination; 4) more stringent criminal background check requirements for prospective long-term care employees; and, 5) nursing home reforms (the transparency provisions).

The Community Living Assistance Services and Supports (CLASS) Act establishes a new federally administered voluntary long-term care insurance program that will be financed by participating enrollees. This program is an entirely new public-private enterprise to finance and access long-term services and supports in the home or in a facility. Individuals will be automatically enrolled if their employers agree to participate. Premiums will be paid through payroll deductions unless the employee opts out. Many details in the new program have yet to be determined. The CLASS Act may end up crowding out the private long-term care market, which was not that significant in the first place.

The PPACA expands Medicaid and Medicare community-based long-term care pilot and demonstration programs to improve quality and reduce the cost of care, with the ultimate aim of keeping frail elders in their homes longer. These payment and delivery arrangements, if successful, may be expanded nationally. These include community-based prevention and wellness pilot programs, individualized wellness plans, the National Pilot Program on Payment Bundling, the Community First Choice Option, the Programs for All-Inclusive Care of the Elderly (PACE), the Money Follows the Person demonstration, and the Independence at Home demonstration program. The PPACA also introduces a three-pronged structural reform: single point of entry; case management; and standardized eligibility/ need assessments. 

The chronic care coordination provisions are a diverse set of new initiatives offered through the PPACA with the goal of better coordinating the care of individuals with multiple chronic conditions. Addressing care coordination is a critical issue in health care payment reform, since many people with multiple chronic illnesses need expensive long-term care services. Presently, care for chronic conditions is poorly coordinated, and the costs of care are increasingly shifted to the client. Care coordination initiatives include: more closely aligning Medicare and Medicaid for dual enrollees; enhancing linkages between health care needs and long term care services; improving primary care provisions for persons with multiple chronic conditions; and, facilitating seamless transitions in care settings across the entire health care continuum. In accordance with these initiatives, the PPACA calls for the establishment of a federal coordinated health care office, Medicare Special Needs Plans, and medical health homes.

The PPACA requires the establishment of a nationwide program for background checks of direct care employees in a wide variety of community and institutional long-term care entities. The new requirements cover employees of nursing facilities, assisted living facilities, intermediate care facilities, and providers of home health, hospice, and adult day care services. 

The nursing home transparency provisions are the most sweeping reforms in nursing home quality since the Omnibus Budget Reconciliation Act (OBRA) of 1987. The PPACA provisions require disclosure of ownership, governance, and indirect controlling interests. When fully implemented, the law will provide consumers a substantial amount of new information about individual facilities. The Medicare Nursing Home Compare website will contain staffing data; links with information regarding state surveys, inspection reports, and certification programs; information on accurately interpreting these reports; and, facility responses to these reports. Additionally, the Nursing Home Compare site will include a consumer rights information page.

These reforms are a good start in addressing some of the weaknesses in the present-day system of long-term care. However, they are not the comprehensive overhaul that the long-term care system so desperately needs. The wording for many of these provisions is distant and vague. It is also troubling that many of these mandates, especially the expansion of Medicaid, are unfunded, and risk further bankrupting the states. It will be interesting to see how these reforms unfold over the next few years to decades as the massive baby boomer cohort enter their senior years.

References

Healthcare Reform: Implications for Long-Term Care Providers

Justice, D. (2010). Long term services and supports and chronic care coordination: Policy advances enacted by the Patient Protection and Affordable Care Act. Portland, ME: National Academy for State Health Policy. Retrieved from http://www.nashp.org/sites/default/files/LongTermServ%20Final.pdf

Pilot Programs and Demonstration Projects – The Patient Protection and Affordable Care Act (PPACA) and Health Care and Education Reconciliation Act of 2010

Pratt, J. (2009). Long term care: Managing across the continuum (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc. 

Program of All-Inclusive Care for the Elderly (PACE) 

Public Health, Workforce, Quality, and Related Provisions in the Patient Protection and Affordable Care Act (PPACA)

Text of Patient Protection and Affordable Care Act

Medicare, Medicaid, and the Elderly Healthcare Consumer

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Exploring the complex subject of Medicare and Medicaid healthcare services for the older population. A brief history of both entitlement programs, the eligibility criteria, the similarities and differences, the strengths and weaknesses, services provided, regulatory agencies, and the financing mechanisms for each are compared and contrasted. Implications for the future are also explored.

The Medicare program was created in 1965 as Title XVIII of the Social Security Act. Its primary purpose was to provide health care coverage for the elderly, who were defined at that time as anyone 65 years of age or older. In 1972, provisions were added to include people who were permanently disabled and those with end-stage renal disease. 

Medicare is the chief federal government program that pays for health care for 40 million Americans over age 65 and another 7 million disabled people of all ages. Medicare has serious limitations: It does not pay for the first day of hospitalization; it also does not cover hearing aids, eyeglasses, or dental care. It lacks an emphasis on preventive care. Additionally, it excludes coverage for long-term care services and supports, except for limited periods after hospital discharge. 

Medicare is a federal health insurance program. It is the nation’s largest federal health insurance program, covering nearly 47 million Americans (i.e., one in seven Americans). It is basically the same everywhere in the U.S., and is run by the Centers for Medicare and Medicaid Services (CMS), an agency of the federal government. Medicare funding comes primarily from three sources: payroll tax revenues, general revenues, and premiums paid by recipients. 

For senior citizens, eligibility for Medicare is not tied to individual needs (income) or to health status. Rather, it is a federal entitlement program; beneficiaries are entitled to it because they or their spouse paid for it through employment or self-employment taxes. The Medicare program is the first level safety-net for America’s elderly and disabled.

Medicare was created in an attempt to address the fact that many older citizens have medical expenses significantly higher than the rest of the population, while it is much more difficult for most seniors to continue to earn enough money to cover those costs.

At the same time that the Medicare program was developed to provide health care for the elderly, Congress also created Medicaid as a program to provide health care for the poor. Enacted as Title XIX of the Social Security Act, Medicaid is different from Medicare in several very specific ways. 

Medicaid is a joint federal and state health care assistance program for low-income, financially needy people, set up by the federal government and administered differently in each state. It helps pay medical costs for people with limited income and resources. Medicaid serves the “medically indigent,” those who have no other coverage, and cannot afford to pay for their own care. It is run by state and local governments within federal guidelines set by CMS. 

Like Medicare, Medicaid is also a federal entitlement. Eligible persons cannot legally be denied medical assistance, even if the state is facing a massive budget deficit. Waiting lists and enrollment caps are prohibited. 

Medicaid programs vary from state to state. Federal guidelines require states to provide 16 basic healthcare services for elderly Medicaid beneficiaries. These services include inpatient and outpatient services, primary care provider services, skilled and intermediate nursing facility services, laboratory and medical imaging services, and home health care. Other services, such as physical therapy, rehabilitation, prescription drugs, hospice, and transportation, are optional. 

An estimated 60 million Americans are covered by Medicaid, with the enrollment numbers swelling due to the economic recession. To further stress state financing mechanisms, the new PPACA healthcare reform legislation could add 16 to 23 million people to the Medicaid rolls due to Medicaid expansion. In addition to the considerable drain on state budgets, there are federal budget considerations as well. Currently, Medicare, Medicaid and Social Security consume more than 40 percent of the federal budget. This startling figure will be overshadowed in the next few decades as the massive baby boomer cohort enter their senior years.

Although an individual may qualify for and receive coverage from both Medicare and Medicaid, there are separate eligibility requirements for each program. Being eligible for one program does not necessarily mean someone is eligible for the other. Also, Medicaid pays for some services for which Medicare does not. If a person is eligible for Medicaid, Medicaid may pay Medicare deductibles and the Medicare premium.

The people who qualify for both Medicare and Medicaid programs are called “dual eligibles.” Approximately 8.8 million Medicaid consumers are simultaneously enrolled in Medicare. These individuals are among the nation’s most vulnerable populations – seniors and non-elderly people with disabilities. Most are low-socioeconomic status, in poor health, and have complex comorbid healthcare needs. Given these social and health circumstances, duals are a costly population for whom to provide coverage.

Medicare and Medicaid work together to pay health care costs for low-income persons. Medicare pays first. Then, Medicare recipients with low incomes may also be eligible to receive aid from Medicaid to cover many of the costs not covered by Medicare. For those who are fully covered by Medicaid, the Medicare health care coverage is supplemented by services provided under their respective state’s Medicaid program. Some of these services include:

  • Nursing facility care beyond the 100-day limit provided by Medicare.
  • Prescription drugs.
  • Eyeglasses.
  • Hearing aids.

References

Center for Medicare Advocacy

Medicare & You 2010

Medicaid and North Carolina’s Aging Population

The Medicaid Program at a Glance