This literature abstract includes a review of a “must read” article and two books. The research article provides a thoughtful evaluation of the State Child Health Insurance Program (SCHIP) at a point 6 years after its implementation. It provides solid data about the positive effect the SCHIP has had on improving access to health care for children in low-income families. The books were selected because they encourage readers to critically think about two pertinent issues. One book looks at how nurses incorporate persons with disabilities into the profession, and the other addresses how to improve excellence in pediatric nursing care.

The State Children’s Health Insurance Program (SCHIP), enacted in 1997, was designed to address specific key issues related to limited access to health care for children in the United States. The article by Duderstadt et al. reports the findings of their study about the effect that SCHIP has had on increasing pediatric access to health care and the use of health care services. The results are both interesting and encouraging. Duderstadt et al. analyzed data from the 1997 and 2003 National Health Interview Survey for a total of 25,734 children, ages 0 to 18 years. The 1997 and 2003 data were used to represent pre- and post-SCHIP access to health care, respectively. The variables of interest were changes in health insurance coverage rates, health care access, and utilization of the SCHIP for children in the target population, namely, those living in families with incomes between 100% and 199% of the federal poverty level.

The study results comparing 1997 and 2003 data revealed two significant findings: (a) children in the SCHIP target income group experienced the largest reduction in rates of uninsurance among children in the following income groups: <100%, 100% to 199%, and ≥200% of the federal poverty level, and (2) the proportion of children without a usual source of care or who were without a provider visit in the past year both was significantly reduced in the target income population. There were no significant changes between pre- and post-SCHIP groups for the following measures: reported unmet needs, delayed care, volume of provider visits, receipt of well-child care, and dental care.

Access to care for children is a cause that is near and dear to the hearts of all advanced practice nurses who work with children and their families. This study, spearheaded by a pediatric nurse practitioner (Duderstadt), provides a wealth of information about the impact of the SCHIP and its positive effect in terms of access and utilization for children in the target income population. It also notes the positive halo effect the SCHIP has had on increased rates of Medicaid enrollment for children with family incomes below the SCHIP income eligibility floor. What has been described here is just a portion of the information that this article has to offer its readers. I urge the members of NAPNAP to sit down and read the entire article. NAPNAP’s support of and past advocacy efforts on behalf of the implementation of the SCHIP were well worth our efforts, as the evidence demonstrates that children reaped the benefits of pediatric professionals advocating for a much-needed program.

The framework of this text comes from the 2001 work of the American Academy of Nursing’s Expert Panel on Children and Families, which was charged with developing effective indicators of high-level quality in pediatric nursing practice. This group identified 18 guidelines in question format that parents can ask when either selecting or evaluating health care for their children. Members from all the leading pediatric and child-health focused nursing organization served on this Expert Panel. They were charged with the task of issuing a consensus statement that identified core elements and indicators of nursing excellence in the care of infants, children, and families. From their work, 18 essential elements or indicators were identified to be used as gold standards of excellence in pediatric nursing practice, and the meaning and implementation of each of these elements is discussed in depth in this text.

The goal of this text is to discuss what each of these indicators means in relationship to best practices, whether at the generalist or advanced practice level of pediatric nursing. Each of the chapters is written by a leading nursing expert, many of whom are pediatric nurse practitioners. Their discussions give greater meaning and depth of understanding about quality indicators that can be used to evaluate best practice. The discussions by the contributing authors discuss how to assess and also lend credibility to the need for nurses to assess more effectively whether quality of care is rendered to infants, children, and their families in various pediatric health settings, as well as emphasizing the responsibility of nurses to advocate for improved services.

Dr. Maheady is a pediatric nurse practitioner who, as the mother of a daughter with disabilities, knows first hand the challenges that individuals with disabilities face throughout their lives. Her book features stories of nurses with physical and/or mental health disabilities who have carved a unique niche for themselves in nursing. Some of the nurses developed disabilities after entering nursing that required a career shift in their nursing focus, while others who later became nurses had disabilities viewed by some educators and nursing professionals as barriers that would eliminate them from even considering nursing as a career option. Dr. Maheady’s purpose in writing this book was to help describe the stigma faced by nurses with disabilities and their feelings as they attempted to become nurses or continue in their careers. These individuals told stories of how they focused on their abilities, in contrast to employers and educators who focused first on their disabilities and overlooked their nursing capabilities.

When I started reading, I thought that this would be just another “nice” book about people’s abilities to overcome hardships. However, this book was about how the profession of nursing greets those with disabilities as their fellow colleagues—sometimes in an embracing manner, and other times shunning them. For me, the soul searching I did after reading these narratives was what makes this text stand out from other literature about living with disabilities. The emphasis in Maheady’s book is to focus on the “ability,” not the first three letters (“dis”) in the term disability. As Maheady notes, disabilities present challenges for those in nursing, but with perseverance, planning, and knowledge, no nurse should ever be left behind.