Presentation on theme: "The Professional Nurse and Political Activism"— Presentation transcript:
1The Professional Nurse and Political Activism Susan McCarthy MSN, RN, CNRNPA Nurse Alliance, SEIUQuality Care Summit 2012September 25, 2012
2ObjectivesIdentify 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 activists
3Laws, Standards, CodesRoots of activism, social justice embedded in professional practice laws, standards, ethicsA social contract with society, demands professional responsibilities.The Pennsylvania Code : State Board of NursingRegulates by licensing: protects public healthANA Code of Ethics, advocate for professionNurses should act individually, collectively through political actions for social change.
4and for Social Justice Provision 9.4 : Social Reform Professional Nursing associations speak for nurses in reshaping health care policy, legislationAccessibility, Quality, CostViolation of human rights, homelessness, hunger, violence, stigma of illness
6The Nurse Alliance of SEIU Politics and Policy Statement:Good healthcare policy happens when practicingRNs are sitting at political and policy-making tablesEffective partners with a strong, clear agendaAdvocate for more nurse political involvementCurrent focus on healthcare reform implementation.
7Politics 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)
8Nurse ActivistsFlorence Nightingale (1850’s), Environment, British Army, Educational ReformClara 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 Act
9Vietnam Women’s Memorial Diane Carlson Evans (1993)Vietnam Women’s MemorialLillian Wald,(1893)Public Health Nursing
10Civil War Nursing Memorial Spanish American WarNursing MemorialArlington CemeteryCivil War Nursing MemorialDupont CircleWashington D.C.
11Nurse Activists Needed Now U.S. Healthcare System in Crisis2012, U.S. will spend $2.8 trillionCost of healthcare is unsustainableEnvironment ↑ complex, inefficient, stressfulWaste $750 billion/yearPlan: Best Care at Lowest CostDo more, with less $, increase efficiency(IOM, 2012)Unsustainable growth: Post wwII, eggs would cost $55, health care costs increasing much faster than the economyHealth care costs in the United States far outpace the growth rate of costs in the rest of the economy.The growth in health care costs has contributed to stagnation in real income gains for American families.A substantial portion of health care spending is wasteful.Wasteful health expenditures directly stifle progress on other priorities
13OSHA Never Events CDC HCAHPS Magnet Status IOM Joint CommissionPress GaneyIOMNDNQINever EventsOSHACDCOverwhelmed by complex public policyDo not address policy decisions affect nursingDo not see our lack of political actionLeads to inability to influence policyRemain task oriented, loss of vision,Implementers, not designers of policyAffects our clinical environmentDepartment of HealthHCAHPSPatient Satisfaction Survey
14Nursing’s Accountability ~15% of hospital patients still being harmed20% discharged elderly patients readmitted ,30 daysNurses spend 30% time, direct patient care(IOM, 2012)Overwhelmed by complex public policyBECOME TUNNEL VISIONED ON OUR TASKSDo not address policy decisions affect nursingDo not see our lack of political actionLeads to inability to influence policyImplementers, not designers of policyAffects our clinical environment
15Why 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)Gallup Poll: Firefigheter #1 in 2001, nest higherst were pharmacists, doctors, lowest were Members of Congress, lobbysits, car salesmanWhat is the IOM
16Nurse 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)
17Barriers to Political Involvement PowerlessnessLack a structure to be heardLimited leadership opportunitiesHIPPA, fear to breach confidentialityDiffering levels of educationLack of education in policy developmentOverwhelmed by complex policiesNeed more mentors, leaders(Des Jardin, 2001)Sources of Powerlessness: time constraints, heavy workloads, shift work, understaffing, family time, moral distress, fear of retaliation oppressive images, heriarchail structures limits opportunuty for involvementComplex public policy: Joint commission, never Events, NDNQI nUrse sesitive Indicators, HCAHPS conumer assessemnts, includes nursingGovernmental bodies influence our work: nurse practice acts, reimburesment issues, resource allocation, medicare reimbursement, health structure reformNurses need clear guidance on how to accompish policy development
18“There is still so much to do” Florence Nightingale, 1893 ACA ImplementationSafe, Healthy Work EnvironmentsEliminate Manual Patient HandlingReduce Work Place ViolenceMandate Safe StaffingEducation, Recruitment, Retention
19Making 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)
20Power in Nursing Expert: Interpersonal: Power in Numbers: 2.9 million Combines science, technology, caringInterpersonal:Excellent negotiators, communicators, problem solvers, team playersPower in Numbers: 2.9 million# will grow 26%, 2010 to 2020Latent Power:Untapped, underused
21Nurse Politicians/Leaders 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 , nursingLois 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)
22Points of Access for Policy Development Workplace: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 candidates
23Six 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 OK3. Powerful PersuasionPassion, thoughtful analysis of ideas, clarity, ability to communicate, important to audienceIntroduce Study
24Political Competence Skills 4. Collective StrengthProfessional organizations, interdisciplinaryVoices louder, persuasion greaterGroup consensus, strengthen the individual5. Strategic PerspectiveStepping back, place health in broad contextSee Nursing as political activityQuestions emerge, government influence on populations, health, environments of care6. PerseveranceRemain Optimistic, you don’t always win
25Our 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 experiences
27Strategies for Political Involvement Keep informed of issues affecting nurses and publicJoin Professional organizations, SEIU committees/actionsFind a Mentor, be a mentorParticipate in public demonstrationsParticipate in shared governance councils,Meet with elected officials in their officesWrite a letter to elected officialsPublish
28Key Points Political actions bring social change Nurse laws, ethics code support political actionKeep informedJoin professional organizationsTake ActionAchieve political competency
29Health Policy Resources Nurse Alliance Round UpCDCAHRQWorld 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 ,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.
30ReferencesAbood, 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. 6th 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.
31References, cont’d.Hughes, F. ( 2005) Role of nursing management in health care policy development. Retrieved fromIOM (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 fromSEIU (2001) The Fight for Our Lives: How We Won Safer Needles. Retrieved fromWarner, J. ( 2003). A Phenomenological Approach to Political Competence: Stories of Nurse Activists. Policy, Politics, & Nursing Practice. (4).2.