Susan McCarthy MSN RN CNRN PA Nurse Alliance SEIU Quality Care Summit 2012 suemac1128aolcom September 25 2012 Objectives Identify professional nurse role taking responsibility to shape social policy ID: 676474
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The Professional Nurse and Political Activism
Susan McCarthy MSN, RN, CNRNPA Nurse Alliance, SEIUQuality Care Summit 2012suemac1128@aol.comSeptember 25, 2012Slide2
Objectives
Identify professional nurse role, taking responsibility to shape social policy. Discuss policy, politics and power in nursingIdentify barriers to nursing political activismExplore skills to achieve political competenceList points of access for policy developmentRecognize past and current nurse activistsSlide3
Laws, Standards, CodesRoots of activism, social justice embedded in professional practice laws, standards, ethics
A social contract with society, demands professional responsibilities.The Pennsylvania Code : State Board of NursingRegulates by licensing: protects public healthANA Code of Ethics, advocate for profession
Nurses should act individually, collectively through political actions for social change.Slide4
and for Social Justice Provision 9.4 : Social Reform
Professional Nursing associations speak for nurses in reshaping health care policy, legislation Accessibility, Quality, CostViolation of human rights, homelessness, hunger, violence, stigma of illnessSlide5
Is Healthcare the New Civil Right?
http://www.seiuhealthcarepa.org/nursealliance/Supreme_Court_Upholds_Health_Reform_Law.aspxSlide6
The Nurse Alliance of SEIU
Politics and Policy Statement: Good healthcare policy happens when practicing RNs are sitting at political and policy-making tables Effective partners with a strong, clear agenda Advocate for more nurse political involvement
Current focus on healthcare reform implementation.Slide7
Politics and Social Justice
Poverty, cruelty rise, level of social awarenessPolitical action is taken, Acts, U.S. Congress. The 1935 Social Security Act1946 Mental Health Act1964 Civil Rights Act1965 Medicare Act1990 Americans with Disabilities Act2010 Affordable Care Act
(http://www.nih.gov/about/almanac/historical/legislative_chronology.htm)
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Nurse Activists
Florence Nightingale (1850’s), Environment, British Army, Educational Reform Clara Barton (1881), Founded USA Red CrossLillian Wald,(1893), Founded Public Health NursingDiane Carlson Evans (1993), Vietnam Women’s MemorialKaren Daley (2000), Needle-Stick Prevention and Safety ActSlide9
http://upload.wikimedia.org/wikipedia/commons/thumb/b/b2/Lillian_Wald_
Lillian Wald,(1893)
Public Health Nursing
http://blog.tcs-inc.us/Portals/39196/images/needle_stick.jpg
http://georgiainfo.galileo.usg.edu/statues/vietnam-women2.jpg
Diane Carlson Evans (1993)
Vietnam Women’s MemorialSlide10
http://www.empirecontact.com/images/statuary/Sisters_memorial_right.jpg
http://www.arlingtoncemetery.mil/photos/SpanAmericanNurses.jpg
Spanish American War
Nursing Memorial
Arlington Cemetery
Civil War Nursing Memorial
Dupont Circle
Washington D.C
.Slide11
Nurse Activists Needed Now
U.S. Healthcare System in Crisis2012, U.S. will spend $2.8 trillionCost of healthcare is unsustainable Environment ↑ complex, inefficient, stressfulWaste $750 billion/yearPlan: Best Care at Lowest CostDo more, with less $, increase efficiency
(IOM, 2012)Slide12
Result: Demand ↑ AccountabilitySlide13
Joint Commission
NDNQI
Press Ganey
Department of Health
IOM
Patient Satisfaction Survey
OSHA
Never Events
CDC
Magnet Status
HCAHPS Slide14
Nursing’s Accountability
~15% of hospital patients still being harmed 20% discharged elderly patients readmitted , 30 daysNurses spend 30% time, direct patient care (IOM, 2012)Slide15
Why Nursing?
“When we are hospitalized, in a nursing home, managing a chronic illness, nurses are the ones we will encounter, spend most time, be dependent upon.” (Keeping Patients Safe, IOM,2004)Gallup Poll 2011, 12th time/13 years, Nurses #1, ethics and honestyNurses full partners, with physicians, health care professionals, redesign health care in U.S. (IOM, 2008)Opinion leaders, 90% want nurses to improve quality, safety, reduce medical errors
(GallupPoll,2010) Slide16
Nurse Political Actions
Nursing Professional Organizations/Unions advocated for and wonFederal Needlestick Safety and Prevention Act, 2000California (1999, effective 2003) , Mandated Nurse -to -Patient Staffing RatiosIncreased Scope of Practice, Advanced Practice Nurses (2007)Elimination of Mandatory Overtime (2008)Slide17
Barriers to Political Involvement
PowerlessnessLack a structure to be heardLimited leadership opportunitiesHIPPA, fear to breach confidentialityDiffering levels of educationLack of education in policy development
Overwhelmed by complex policies
Need more mentors, leaders
(Des Jardin, 2001)Slide18
“
There is still so much to do” Florence Nightingale, 1893ACA Implementation
Safe, Healthy Work Environments
Eliminate Manual Patient Handling
Reduce Work Place Violence
Mandate Safe Staffing
Education, Recruitment, RetentionSlide19
Making it Happen
Policy is a course of action.Politics, process of influencing allocation of scarce resources. The result is policy.Power enables a group to influence others through political process.To effect policy, must be involved in politics so others do not speak for nursing practice. If we understand process around policy formation we can target our nursing leadership into influence.
(Hughes, F., 2005)Slide20
Power in Nursing
Expert: Combines science, technology, caringInterpersonal: Excellent negotiators, communicators, problem solvers, team playersPower in Numbers: 2.9 million# will grow 26%, 2010 to 2020Latent Power: Untapped, underusedSlide21
Nurse Politicians/LeadersEddie Bernice Johnson ( D-TX), first nurse elected to U.S. House of Representatives (1992)
Carolyn McCarthy, LPN ( D-NY), elected 1996, US House, leader on gun control , nursing Lois Capps (D-CA), third nurse elected to House 1998, school nurse, Medicare Reform, Nursing , School Health and SafetyVirginia Trotter Betts, national nurse leader, mental health policyAs of 2011, seven nurses in U.S. House of RepresentativesMary Wakefield, Ph.D., R.N.,
current
administrator of the Health Resources and Services Administration (HRSA)Slide22
Points of Access for Policy DevelopmentWorkplace:
Procedures, budget, practice, bargaining tableshared governance committeesGovernment: Local, state, national legislation, run for officeProfessional Organizations: Provide information, activities, leadersCommunity, Public Education:
↑ Nurse visibility, health fairs, endorse candidatesSlide23
Six Skills for Political Competence(Warner, 2003)
1. Nursing Expertise as Valued CurrencyClinical experience, policy connectionsValues: caring, health promotion, informed and self care, holism (Cohen et al, 1996)Observation, decision making skills2. Networking, crucial for action, changeEstablish, maintain interdisciplinary relationships, asking for help is OK
3. Powerful Persuasion
Passion, thoughtful analysis of ideas, clarity, ability to communicate, important to audienceSlide24
Political Competence Skills
4. Collective Strength Professional organizations, interdisciplinaryVoices louder, persuasion greaterGroup consensus, strengthen the individual 5. Strategic PerspectiveStepping back, place health in broad contextSee Nursing as political activityQuestions emerge, government influence on populations, health, environments of care
6. Perseverance
Remain Optimistic, you don’t always winSlide25
Our Experience“We see a future where America leads not only by the example of our power, but by the power of our example.”
Joe Biden, DNC, 2012SEIU Nurses share political action experiencesSlide26
Stages of Nursing’s Political Development (Cohen et al, 1996)
Stage One: Buy-In Individual nurses take position/react to issue affecting profession, public. Decide to take action.Stage Two: Self-InterestIndividuals begin establish political identity, voice. Organize, develop strategies to resolve issue.
Stage Three: Political Sophistication
Seek to influence policymakers, ↑awareness ,value contributions of nursing to public, health policy. Testify before legislative committees, appointed to policy-making bodies.
Stage Four: Leading the Way
Very involved, setting agenda, initiating policy development, often enacted through legislative process.
Copyright © 2003, New Jersey Collaborating Center For Nursing Workforce Development. Slide27
Strategies for Political Involvement
Keep informed of issues affecting nurses and public
Join Professional organizations, SEIU committees/actions
Find a Mentor, be a mentor
Participate in public demonstrations
Participate in shared governance councils,
Meet with elected officials in their offices
Write a letter to elected officials
Publish Slide28
Key Points
Political actions bring social changeNurse laws, ethics code support political actionKeep informedJoin professional organizationsTake ActionAchieve political competencySlide29
Health Policy Resources
Nurse Alliance Round Up CDCAHRQWorld Health OrganizationIOMANA Smart BriefsProfessional Journalswww. RN.comProject Vote-Smart (PVS),Non-profit, non- partisan, collects and distributes information, U.S elected official’s voting records and candidate’s positions , www.votesmart.org
The Pennsylvania Health Access Network (PHAN) is a statewide coalition of organizations working to protect high quality health insurance coverage for individuals and businesses and to expand coverage to the uninsured.
www.paheathaccess.org 215-557-0822
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References
Abood, S. (January 31, 2007). "Influencing Health Care in the Legislative Arena". OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2. Antrobus S (2003) What is political leadership? Nursing Standard. 17, 43, 40-44.Chitty, K. K., Black, B.P. (2011). Professional Nursing—Concepts and Challenges. 6
th
Edition. Philadelphia, PA: Elsevier, Saunders.
Cohen, S.S., Mason, D.J., & Kovner, C., Leavitt, J.C., Pulcini, J., & Sochalski, J. (1996). Stages of nursing’s political involvement: Where we’ve been and where we ought to go.
Nursing Outlook, 44(6),
259-266.
Des Jardin, K. (2001) Political involvement in Nursing: education and empowerment. AORN Journal. (74)4.
Des Jardin, K. (2001).
Political Involvement in Nursing: Politics, Ethics, and Strategic Action
. AORN Journal, (74) 5. Slide31
References, cont’d. Hughes, F. ( 2005)
Role of nursing management in health care policy development. Retrieved from http://www.slideserve.com/rubaina/role-of-nursing-management-in-health-care-policy-developmentIOM (Institute of Medicine). 2012. Best care at lower cost: The path to continuously learning health care in America. Washington, DC: The National Academies Press . Robert Woods Johnson Foundation (2010). Nursing Leadership from Bedside to Boardroom: Opinion Leaders' Perceptions. Retrieved from http://www.rwjf.org/pr/product.jsp?id=5435
SEIU (2001)
The Fight for Our Lives: How We Won Safer Needles
.
Retrieved from http://www.youtube.com/watch?feature=player_embedded&v=g51WkB9zpEk
Warner, J. ( 2003).
A Phenomenological Approach to Political Competence: Stories of Nurse Activists.
Policy, Politics, & Nursing Practice. (4).2.