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Susan McCarthy MSN, RN, CNRN PA Nurse Alliance, SEIU Quality Care Summit 2012 September 25, 2012.

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Presentation on theme: "Susan McCarthy MSN, RN, CNRN PA Nurse Alliance, SEIU Quality Care Summit 2012 September 25, 2012."— Presentation transcript:

1 Susan McCarthy MSN, RN, CNRN PA Nurse Alliance, SEIU Quality Care Summit 2012 September 25, 2012

2  Identify professional nurse role, taking responsibility to shape social policy.  Discuss policy, politics and power in nursing  Identify barriers to nursing political activism  Explore skills to achieve political competence  List points of access for policy development  Recognize past and current nurse activists

3  Roots 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 Nursing  Regulates by licensing: protects public health  ANA Code of Ethics, advocate for profession  Nurses should act individually, collectively through political actions for social change.

4  Provision 9.4 : Social Reform  Professional Nursing associations speak for nurses in reshaping health care policy, legislation  Accessibility, Quality, Cost  Violation of human rights, homelessness, hunger, violence, stigma of illness

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6  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.

7  Poverty, cruelty rise, level of social awareness  Political action is taken, Acts, U.S. Congress.  The 1935 Social Security Act  1946 Mental Health Act  1964 Civil Rights Act  1965 Medicare Act  1990 Americans with Disabilities Act  2010 Affordable Care Act (http://www.nih.gov/about/almanac/historical/legislative_chronology.htm)

8  Florence Nightingale (1850’s), Environment, British Army, Educational Reform  Clara Barton (1881), Founded USA Red Cross  Lillian Wald,(1893), Founded Public Health Nursing  Diane Carlson Evans (1993), Vietnam Women’s Memorial  Karen Daley (2000), Needle-Stick Prevention and Safety Act

9 Lillian Wald,(1893) Public Health Nursing Diane Carlson Evans (1993) Vietnam Women’s Memorial

10 Spanish American War Nursing Memorial Arlington Cemetery Civil War Nursing Memorial Dupont Circle Washington D.C.

11  U.S. Healthcare System in Crisis  2012, U.S. will spend $2.8 trillion  Cost of healthcare is unsustainable  Environment ↑ complex, inefficient, stressful  Waste $750 billion/year  Plan: Best Care at Lowest Cost  Do more, with less $, increase efficiency (IOM, 2012)

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14  ~15% of hospital patients still being harmed  20% discharged elderly patients readmitted, 30 days  Nurses spend 30% time, direct patient care (IOM, 2012)

15  “ 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 honesty  Nurses 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)

16  Nursing Professional Organizations/Unions advocated for and won  Federal Needlestick Safety and Prevention Act, 2000  California (1999, effective 2003), Mandated Nurse -to -Patient Staffing Ratios  Increased Scope of Practice, Advanced Practice Nurses (2007)  Elimination of Mandatory Overtime (2008)

17  Powerlessness  Lack a structure to be heard  Limited leadership opportunities  HIPPA, fear to breach confidentiality  Differing levels of education  Lack of education in policy development  Overwhelmed by complex policies  Need more mentors, leaders (Des Jardin, 2001)

18  ACA Implementation  Safe, Healthy Work Environments  Eliminate Manual Patient Handling  Reduce Work Place Violence  Mandate Safe Staffing  Education, Recruitment, Retention

19  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)

20  Expert:  Combines science, technology, caring  Interpersonal:  Excellent negotiators, communicators, problem solvers, team players  Power in Numbers: 2.9 million  # will grow 26%, 2010 to 2020  Latent Power:  Untapped, underused

21  Eddie 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 Safety  Virginia Trotter Betts, national nurse leader, mental health policy  As of 2011, seven nurses in U.S. House of Representatives  Mary Wakefield, Ph.D., R.N., current administrator of the Health Resources and Services Administration (HRSA)

22  Workplace:  Procedures, budget, practice, bargaining table shared governance committees  Government:  Local, state, national legislation, run for office  Professional Organizations:  Provide information, activities, leaders  Community, Public Education:  ↑ Nurse visibility, health fairs, endorse candidates

23 1. Nursing Expertise as Valued Currency  Clinical experience, policy connections  Values: caring, health promotion, informed and self care, holism (Cohen et al, 1996)  Observation, decision making skills 2. Networking, crucial for action, change  Establish, maintain interdisciplinary relationships, asking for help is OK 3. Powerful Persuasion  Passion, thoughtful analysis of ideas, clarity, ability to communicate, important to audience

24  4. Collective Strength  Professional organizations, interdisciplinary  Voices louder, persuasion greater  Group consensus, strengthen the individual  5. Strategic Perspective  Stepping back, place health in broad context  See Nursing as political activity  Questions emerge, government influence on populations, health, environments of care  6. Perseverance  Remain Optimistic, you don’t always win

25  SEIU Nurses share political action experiences

26  Stage One: Buy-In Individual nurses take position/react to issue affecting profession, public. Decide to take action.  Stage Two: Self-Interest Individuals 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.

27  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

28  Political actions bring social change  Nurse laws, ethics code support political action  Keep informed  Join professional organizations  Take Action  Achieve political competency

29  Nurse Alliance Round Up  CDC  AHRQ  World Health Organization  IOM  ANA Smart Briefs  Professional Journals  www. RN.com  Project Vote-Smart (PVS),Non-profit, non- partisan, collects and distributes information, U.S elected official’s voting records and candidate’s positions,  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

30  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,  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),  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.

31  Hughes, F. ( 2005) Role of nursing management in health care policy development. Retrieved from of-nursing-management-in-health-care-policy-development  IOM (Institute of Medicine) 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  SEIU (2001) The Fight for Our Lives: How We Won Safer Needles. Retrieved from B9zpEk  Warner, J. ( 2003). A Phenomenological Approach to Political Competence: Stories of Nurse Activists. Policy, Politics, & Nursing Practice. (4).2.


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