Nurses and health care insurance in western Pennsylvania: A qualitative study of the personal and professional effects of the absence of health care insurance

Forty-six million people in the United States have an absence of health care insurance coverage (U.S. Census Bureau, 2008). A segment of that population is nurses, employed at various points on the nursing career ladder, their spouses, and their dependent children. This qualitative study explores the perceptions of uninsured nurses at various points on the nursing career ladder and relates their phenomenological perspective. The study compares nurses struggling with health care insurance with the uninsured general population. Finally, nurses are asked to assess various political options and select that which would best fit their circumstance.;Nurses have similar feelings of struggling physically and psychologically with the absence of health care insurance coverage. Nurses report the lack is disheartening, embarrassing, and a worry affecting health care decisions and lifestyle choices. Nurses sacrifice their health or that of their loved ones using practices of splitting medications, forgoing annual check-ups, delaying diagnostic testing, and waiting for medical consultation until a condition is exacerbated, realizing that this is a gamble. Nurses do use their knowledge of disease processes and pharmacology to self-diagnose, self-medicate, and use their relationship with physicians to request medical treatment. Nurses believe all should have basic health care coverage. Pay to play or employer sponsored insurance is the most selected policy option, depending upon the cost.