nti2010 policy politics and you act with intention
DESCRIPTION
2010 NTI Mastery PresentationTRANSCRIPT
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Policy, Politics and You: Act with intention unifying Nursing’s
Political VoiceTodd M. Grivetti, MSN, RN, CCRN, CNML
Clinical Nurse ManagerRegional Neurosciences Center
Poudre Valley HospitalFt. Collins, CO
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House Keeping
Please Turn your Cell phones and pagers to Vibrate.
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Disclosure Statement
As a member of AACN’s Speaker’s bureau I have received an honorarium from AACN for this presentation. I have no
other vested interest(s) from any other organization.
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Learning Objectives
At the end this session participants will be able to: Identify four spheres of political action in nursing
along with identifying AACN’s public policy links and other resources to Act With Intention and be the Bold Voice of Nursing.
Discuss the four stages of political development of nursing and how nurses navigate to become key players in policy arenas.
Described how nurses can Act With Intention and become the voice of healthcare policy utilizing nursing’s historic mandates.
Identify resources available for political activism
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Introduction to Policy & Politics
Policy: The principles that govern action directed towards given ends
(Titmus, 1974). More Definitions:
A policy is a deliberate plan of action to guide decisions and achieve rational outcome(s). The term may apply to government, private sector organizations and groups, and individuals. Presidential executive orders, corporate privacy or human resource policies, and parliamentary are all examples of policy.
A set of interrelated decisions taken by a political actor or group of actors concerning the selection of goals and the means of achieving them.
Within a specified situation where those decisions, should, in principle be within the power of these actors to achieve (Jenkins, 1978).
An art and a craft… Involves: vision, creativity and imagination in :
Identifying and explaining social problems Creating policy to solve problems Ensuring the implemented policy leads to positive or negative impact.
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Types of Policy
Types of Policy Public Social Health Institutional Organizational
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Public Policy
Public policy is formed by governmental bodies – Legislation passed by Congress and the
regulations written from that legislation. Public policy related to tobacco use –
including laws that ban selling cigarettes near schools and require health warning labels.
Policies made by government departments or other public agencies with respect to their internal operations when they affect the public at large.
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Public Policy Nursing Legislative issues
Shortage, education, workplace issues Resources?
Professional Organizations (AACN, ANA, AONE, ICN)
Patient safety goals Medication safety Falls New CMS guidelines Resources
Joint Commission Organizational policies Centers for Medicare and Medicaid Services
(CMS)
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Public Policy & Political Competency Guidelines
Be aware of the impact of the state board of nursing, Center’s on Medicare/Medicaid services, and the department of health services within your state on the practice of nursing
Participate in organizations that impact the practice of nursing.
Expect colleagues to actively participate in nursing and health-care policy organizations.
Meet with your state legislator at least every three months.
Invite legislator to your organization and chapter meetings to share ideas and influence policy
Malloch, 2005
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Social Policy
Social policy pertains to the policy decisions that promote the welfare of the public: Local ordinance on age limit for purchase of
tobacco products. Aim at improving
Health Education Welfare Social Security
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Healthcare Policy
Health Policy: The decision made to promote the health
of individual citizens. Federal may pay for smoking cessation /
prevention programs for all persons in the military and their families.
States might require coverage for smoking cessation programs by Medicaid managed care plans.
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Healthcare Policy Sources:
Organizational Organizational policy sources are developed by health care
institutions to govern work places and direct behaviors. They are influenced by the demands and resources of key external suppliers, purchasers, communities, agencies and media.
Social Public policy sources are authoritative decisions made within
government that pertain to health. They can take the form of laws or operational rules, and can be allocative or regulatory in nature. Public policy sources are influenced by broad contextual factors such as interest groups, diverse segments of society, economics, demographics, and environmental forces.
Professional Professional sources are discipline specific and multidisciplinary
organizations that establish standards, guidelines, and research-based recommendations for providers and healthcare delivery systems.
Taft, Nanna (2008).
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Health Policy
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Health Policy
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Institutional Policy
Institutional policies govern workplaces: What the institution’s goals are and how
will it operate. No Smoking ban – prohibiting patients and
staff from smoking anywhere in the building to the grounds.
Time and Attendance Nursing process Palliative care Internet usage
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Institutional Policy Development Scope: Who the policy is intended for:
Example: Identify the range for the organization – (i.e., All PVHS Hospitals).
Strategies for development: Criteria for a good policy
Useful for intended users. Includes policies on all levels and meets
relevant criteria for accreditation and legislative requirements.
Will it improve quality service.
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Institutional Policy
Tips for writing good policies: Devote time at least once per month to
brainstorm issues pertaining to one area of the policy and review draft versions as required.
Be aware of the need to actually tailor policies to your own organization.
Be aware that borrowing other policies may result in approaches and styles of policy which are not compatible to others.
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Institutional Policy
Tips Continued: Keep it Simple Ensure Drafts have a number and date for
ease of tracking. Endorsed policies should include who
authorized the policy and when. Ensure there is someone in the
organization who is responsible for maintaining control of policies and production of policy manual.
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Organizational Policy
Organizational policies are positions taken by organizations: State nurses’ associations Associations Professional organizations
ANA – American Nurses Association AACN – American Association of Critical
Care Nurses AONE – American Organization of Nurse
Executives ICN – International Council of Nurses
Members may put forth a resolution for free continuing education programs.
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Politics - Definition
Simply: The process of influencing the allocation of scarce resources.
Webster: 1a: The art or science of government b: the art or science concerned with guiding or influencing governmental policy c: the art or science concerned with winning and holding control over a government. (www.meriam-webster.com) 2010.
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Perception of Politics Positive perceptions
InfluencingThe opportunities to alter the outcomes
of a process. Allocation
Decisions being made about how to divide resources among competing groups or individuals.
Scarce Resources Implies there are limits to the amount of resources
available Financial backing Time Staff Other entities in the process
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Perceptions of Politics
Negative perceptions Smoke filled rooms Shady deals made by power brokers
Pork Barrel spendingTeapot DomesUnethical compromisesVote buying
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Perception of Politics
Factors An individual’s own biases, experiences,
and knowledge of politics How the “game” of politics is played -
System in which politics is operating What rules have been established as
acceptable Whether the goals or end is important Whether one is in a position to change the
rules of the system
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Values Associated with Policy & Politics
Nursing: Caring Collaboration Collectivity High-touch care
Often conflict with dominant values of society
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Values Framework
Pol
itics P
oliticsVal
ues
EvaluationEvaluation
ImplementationImplementation
PolicyPolicy
AlternativesAlternatives
GoalsGoals
AgendaAgenda
PoliticsPolitics
Values
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Values Framework
Complex Multidimensional Examples:
Prenatal care in the U.S. Not guaranteed Some women receive very little or no
prenatal care Mandatory overtime used by hospitals Nurse to patient ratios
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Values, Policy & Politics
Taft & Nanna (2008). Recognition has grown that nursing has a
responsibility for engaging in actions that influence health policy, and that advocacy may reasonably be considered a role expectation for the professional nurse. If so, what knowledge and competencies do nurses need?
Power Empowerment
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Values, Policy & Politics
Mason, et.al (1991) Nonetheless, the idea of empowerment is
one that remains important to nursing’s political development, because it “requires a commitment to connection between self and others, enabling individuals or groups to recognize their own strengths, resources, and abilities to make changes in their personal and professional lives.”
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Identify your Policy & Political Resources
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Four Spheres of Political Action in Nursing
Workplace Government Professional Organizations Community
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Four Spheres FrameworkCommunity
Government
Organizations
Workplace
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Four Spheres - Workplace
Workplace Acute Care Home Care Nursing Homes School-based clinics Occupational Health clinics Physician’s Offices
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Four Spheres - Workplace
Policies & Procedures Manuals Workplace policies Nursing care Written & unwritten
Examples: Designation of no-smoking areas or ban on
smoking Requirement for nurses to work overtime Decisions concerning the use of unlicensed
personnel Policy permitting loved ones being present during
an emergency
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Four Spheres - Workplace
Magnet Hospitals Hallmark of a Magnet organization is
nurses’ involvement in decision making at all levels of the organization and inclusion as an important voice in the development of policies
Robert Wood Johnson Foundation (RWJF) Transforming Care at the Bedside (TCAB)
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Four Spheres - Workplace
Summary: Workplace policies also shaped by:
Government Policies on handling of hazardous waste**
Professional Organizations May pressure nurses’ workplaces to use
particular protective equipment in high-risk areas.
Community Community needs for healthcare delivery
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Four Spheres - Government
Governmental actions Laws requiring
Birth records Immunizations Legal establishment of drinking age Legal age to vote or join the military Laws determining what health services
people are eligible for in old age and how assets are distributed on a person’s death.
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BREAK
15 Minutes
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Four Spheres - Government
Government has grown bigger and centralized
Plays important role in nursing Influences reimbursement systems for
health care and nursing services Determines who receives what type of
health services. Healthcare Reform Bill 2010
www.healthreform.gov
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Four Spheres – Government
Health Insurance Plan 47 million Americans without adequate
health insurance. The type of insurance held by most
Americans and favored by public policy Employment based
Tax subsidy in excess of $100 billion annually Individual insurance
Held by 7% of Americans.
Kaiser Family Foundation, 2007; Knowledge@Wharton, 2000.
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Four Spheres – Government National Health Plan
Hacker’s Plan – 3 Principles No one loses what they currently have. Unless,
employer’s “kick” you out. Creation of Health Care for American market (HCA)
Insurers compete for business of individuals and employers.
Group market contains strong public insurer modeled on Medicare creating competition between private companies and the public market.
Source: (Kline, 2008)
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Four Spheres - Government
Wyden’s Plan: Senator Ron Wyden (OR) and Senator Robert Bennett (UT): Lacks public insurer – no public-private competition . Does away with employer health coverage almost
entirely. Create “Health Help Agencies” in each state. No “cherry-picking”, no high premiums, or denials of
coverage for pre-existing conditions. Everyone pays the same price, but everyone has to buy
insurance that’s at least comprehensive as the current Blue Cross-Blue Shield Standard Plan
Subsidies for low income Penalties for those who do not buy Medicare still exists for the elderly.
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Four Spheres - Government
National Health Plan Lewin Group – “Gold Standard” Healthcare consulting.
Estimates Hacker’s plan will save $1.04 Trillion over 10 years.
Basic Efficiencies: Administrative and technological. If it works, it will have two effects:
Money savings by mandating the HCA to spend less money.
Caps spending and induces providers to utilize available funds more cost effectively.
Estimates Wyden’s plan will save $1.48 trillion over 10 years.
Not from explicit spending caps as Hacker’s plan, but from consumers who see how much they are spending on health care and then become more price-sensitive and choose cheaper options.
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Four Spheres - Government
Children’s Health Care (SCHIP’s) Created to provide health insurance coverage
to children whose families who made too much money to qualify for Medicaid but too poor to afford private health insurance.
2007 – Reauthorization for 5 years failed and was vetoed by President Bush on Oct. 3rd, 2007.
Democratic leaders drafted a second bill, but unable to pass with less than 2/3 majority required to override the veto.
Source: http://www.sourcewatch.org/index.php?title=State_Children's_Health_Insurance_Plan
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Four Spheres – Professional Org’s.
International Council of Nurses
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Four Spheres – Professional Org’s. Instrumental in shaping nursing practice.
Developing standards of care Advocating for change in scope of nursing practice Play a role in collective action in the workplace
Could increase their influence if more nurses participated in them. ANA – Represents the interests of all nurses, yet
only 5% of U.S. nurses are members. AACN – Represents over 500,000 critical and
acute care nurses with 80,000 plus members. 240 Chapters
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Four Spheres – Professional Org’s. Professional Organizations – Should:
Be a visible force within its community Have a national presence Have local representation (chapters) Identify issues of concern to nursing and
healthcare Bring them to the attention of the public
Take a leadership role in calling for the development of policies that can improve the health of the communities and ensure the provision of quality nursing care
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Four Spheres – Professional Org’s
AACN’s Public Policy Agenda Definitions, Principles, and Outcomes:
Health Policy Agenda Framework AACN is a 501(c)3, not-for-profit educational
organization. Established in January 1996 by the Board of Directors. To be used as a guide in developing, implementing and
evaluating the association’s health policy agenda. April 1996 – Public Policy Work Group
Reviewed and clarified the framework To define a future health care policy agenda that is
founded on defined member needs and consistent with a healthcare system driven by the needs of patients and families.
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Four Spheres – Professional Org’s.
AACN Public Policy Priority Issues AACN ensures that vulnerable populations
have access to quality health care. AACN works to ensure public and
community safety. AACN works to ensure the provision of
humane and ethical care.
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Four Spheres – Professional Org’s. AACN’s Health Policy Restrictions
Chapter’s may not participate in or contribute to political campaigns.
Chapters may not lobby on behalf of AACN. AACN is a 501(c)3 organization which must comply with
restriction placed on lobbying and political activities. Chapter members are prohibited from using their membership
for any electioneering. Chapter members are prohibited from contributing to political
action committees. Chapter members are prohibited from speaking on behalf of
AACN unless they have been designated as an AACN spokesperson.
Chapter members are prohibited from endorsing, supporting or opposing issues on behalf of AACN unless they have been asked to do so by AACN.
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Four Spheres – Professional Org’s. American Organization of Nurse Executives
Through its grassroots network of 49 State Chapters, AONE keeps abreast of the latest issues affecting nursing on the legislative, regulatory and practice fronts. AONE provides the chapter leadership with up-to-date information on a variety of topics and allows the membership to access the most current information from government and other private and public sources through a leader list serve. And through quarterly chapter calls, AONE members are able to network and share with their colleagues across the country.
Source: www.aone.org/aone/advocacy/home.html
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Four Spheres – Professional Org’s. AONE Legislative agenda
Education & Leadership Development Advocates for FY2010 Federal appropriations for
the nurse education act Support the reauthorization of the Nurse
Education Act – Expired for 5 years. Broaden funding available for nursing programs
outside the direct purview of the Department of Health and Human Services (HHS)
Foster and promote a climate for patient safety and quality that is evidenced-based and NOT legislated mandates or ratios.
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Four Spheres – Professional Org’s.
AONE – Public Policy & Advocacy Build, support and work with groups that promote a
unified agenda for addressing the most pressing issues facing the nursing profession.
Continue to work and collaborate with AHA, The Nursing Community, Americans for Nursing Shortage Relief (ANSR), the Tricouncil and others to address healthful practice environments.
Effectively represent the nurse leader perspective in all aspects of the practice environment.
Continue to support efforts of ongoing partnerships and the AHA Readiness Team to ensure adequate funding of first-line defenders.
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Four Spheres – Professional Org’s. AONE Public Policy & Advocacy cont.
Advocate for and support programs and initiatives that will ensure a safe and quality driven environment for patients and patient care providers.
Develop, evaluate and support legislation that will foster the nurseexecutive’s leadership role in the management of the care environment, especially in areas related to staffing, information technology and patient care services.
Collaborate with quality partners such as the JCAHO, the National Quality Forum and the Federal government to ensure that proposed regulatory changes achieve desired results.
Work within taskforces and other aligned groups and associations to ensure nurses as knowledge-base professionals are able to function within their full professional capacity.
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Four Spheres – Professional Org’s.
American Nurses Association ANA Position Statements
The American Nurses Association (ANA) House of Delegates and the ANA Board of Directors are charged with setting policy in healthcare, the workplace, patient care, and many other areas where nurses are engaged. When a hot topic arises or there are various views and opinions about current events, the House of Delegates and/or the Board of Directors may address these concerns by way of a position statement. Position statements are an explanation, a justification or a recommendation for a course of action that reflects ANA’s stance regarding the concern. The development process for position statements initially involves internal deliberation by the Congress on Nursing Practice and Economics. A draft of the proposed position statement is then posted on ANA’s Web site, for public comment. Following public comment, the statement is revised if necessary and approved by the ANA Board of Directors. This process allows each and every nurse to voice their views and opinions on the various dimensions of the issue at hand.
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Four Spheres – Professional Org’s. ANA Policy Statements;
Drug & Alcohol abuse Ethics and Human Rights Social Causes and Health Care Nursing Practice
Electronic Health Records Supporting Nurse Practitioners in Retail-
based health clinics Credentials for the Professional Nurse:
Determining a Standard Order of Credentials for the Professional Nurse
Professional Role Competence
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Four Spheres – Professional Org’s. International Council of Nurses
INC Position Nurses have an important contribution to make in health
services planning and decision-making, and in development of appropriate and effective health policy. They can and should contribute to public policy pertaining to the determinants of health.
In addition, nurses are involved in strategic planning, budgeting, efficient resource planning and utilization, and the planning, management and evaluation of programs and services. Nurses must accept their responsibilities in health services policy and decision-making, including their responsibility for relevant professional development.
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Four Spheres – Professional Org’s ICN cont.
ICN and its member associations promote and support all efforts to improve the preparation of nurses for management, leadership and policy development. This preparation should be broad and must include the development of knowledge and skills for influencing change, engaging in the political process, social marketing, forming coalitions, and working with the media and other means of exerting influence. It must recognize the complex processes and factors involved in effective decision-making.
Source: www.icn.ch/pspolicydev00.htm
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Four Spheres - Community
Special interest organizations: Habitat for Humanity Local / County Food banks Rotary club Community organizations
Lions, Elks, Moose County workforce centers
The other three sphere’s exist within the community sphere. Nurses have the responsibility to promote the
welfare of the community and its members Nurses visible in the community represent the
entire profession
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Four Stages of Political Development
Buy in Self-interest Political Sophistication Leadership
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Four Stages of Political Development
Stage One: Buy – In Reactive Stage Political Action Committees Understanding the relevance of politics
and policy in both our professional and personal life.
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Four Stages of Political Development
Stage One: Buy In Reactive Stage –
The profession recognizes the importance of political involvement and encourages nurses to recognize the importance of policy development to their daily lives as professionals and citizens.
Political Action Committees (PAC’s) Nurses Coalitions for Action in Politics
First PAC developed by nursing leaders in New York. Later became the PAC for the ANA.
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Four Stages of Political Development
Stage One: Buy-In Understanding the relevance of politics and policy in
professional and personal life. Political activism and political commitment must become
part of the definition of the nursing as a profession… Nurse witness daily the consequences of policies and need to work for justice and equity in the healthcare system.
Occurred when profession began to promote political awareness of nurses to injustices or changes needed – “Aha” moment
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Four Stages of Political Development
Stage Two: Self-Interest Appealing to self-interest is an important step in
engaging nurses to participate in shaping workplace and or public policies
Nursing coalitions garner political support Late 1990’s: ANA-PAC became the third largest
federal health care special interest group. Nurses must see the connection to politics and
policy in their professional lives in order to move to action.
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Four Stages of Political Development
Stage Two cont. Nursing began to develop its identity Uniqueness as a political voice It is moving from recognition of a problem to developing a
plan to deal with it Using political Skills:
Enlisting support of colleagues Planning strategies Resolving the issue Volunteer to create a task force to recommend policy
changes.
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Four Stages of Political Development Stage Three: Political Sophistication
ANA’s Nursing’s Agenda for Healthcare Reform 1992.
Nurses were appointed to federal panels, agencies and commissions.
Requires: Synergy between policymakers who recognize the
importance of nursing perspectives and nurse who are ready to respond by adding their voices to policy debates and decision making.
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Four Stages of Political Development Stage Three – cont.
National Health Council – est. 1929 “A dynamic forum for policy
development” By the end of 2005 – 110 volunteer health
agencies, nonprofit organizations with an interest in health, business and industry including the American Academy of Family Physicians, the American Thoracic Society, and the Association of Schools of Allied Health Professions
Not one Nursing organization. 2010 – Only the American Academy of Nursing is represented.
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Four Stages of Political Development Stage Four: Leadership
When nursing embraces a political identity exemplified by “setting an agenda” for change
Functioning at the highest level of political involvement.
Nursing becomes the initiator of crucial policy change
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Four Stages of Political Development Stage Four cont.
Achieving appointments outside of nursing University Presidencies Heads of agencies within federal and state governments Senate and House Seats.
Nurses are recognized for their expertise and perspectives
Seen by multiple constituencies bringing solutions to issues related to the well-being of society.
The longer nurses remain in stage four, the more the public will benefit from nurses’ knowledge and leadership in solving issues
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Advocacy & Activism
Powerful advocates Curtin (1979) – described the end purpose
of nursing “as the welfare of other human beings.”
Nursing is seen as “common humanity” leading to the development of “human advocacy”
The nurse patient advocate Revised Code of Ethics for Nurses with
Interpretive Statements. (ANA, 2001).
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Advocacy & Activism
Nursing Serving as Advocates Legal Advocacy
Protect patient rights Moral-Ethical Advocacy
Uphold patient values Spiritual Advocacy
Provide access to spiritual support Substitutive Advocacy
Protect vulnerable patients Political Advocacy
Facilitates equal access to health care
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Advocacy & Activism
The Nurse Activist Contacts public officials through letters, e-mails or
telephone Registers people to vote Contributes money to political campaigns Works on a political campaign Lobbies decision-makers by providing pertinent
statistical and anecdotal information Forms or joins coalitions that support an issue of
concern
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AACN’s Advocacy Tool Kit:12 Rules for Working with Public Officials
Don’t underestimate public officials.
Don’t look down on government and politics.
Be understanding. Forge Relationships. Be Reasonable. Be Thoughtful.
Don’t blame public officials for “Failing” to do what you wanted.
Be Cooperative. Be Realistic. Be Practical. Be a good Proponent. Be Informed
Source: AACN-Advocacy Tool Kit
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Nursing’s Influence & Historical Mandates
Florence Nightingale Sojourner Truth Lillian Wald Margaret Sanger Other contemporary pioneers
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Nursing’s Influence & Historical Mandates
Florence Nightingale Consummate politician and visionary. Transformed
British health care Indian health care Military health care
Knew the value of data in influencing policy changes
Saw nursing in all its forms as advocacy
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Nursing’s Influence & Historical Mandates Sojourner Truth
Provided nursing care to union soldiers and civilians – Civil War
Advocate for abolishing slavery Supporter of women’s rights Helped transform racist and sexist policies limiting
the health and well-being of African Americans and women
Worked to free slaves – Underground Railroad Fought for human rights Lobbied for federal funding to train nurses and
physicians.
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Nursing’s Influence & Historical Mandates Lillian Wald
Recognized the connection between health and social conditions
Established – Henry Street Settlement House in New York City.
Safe place built to help establish programs for largely poor immigrant population
Driving force behind development of the Children’s Bureau
Called by the White House frequently to participate in developing national and international policies.
Campaigned for Presidents even she could not vote.
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Nursing’s Influence & Historical Mandates
Wald cont. Promoted Public Health Nursing education Formed the National Organization of Public
Health Nursing (NOPH). 1902 – Moved the board of health to hire a
school nurse
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Nursing’s Influence & Historical Mandates
Margaret Sanger Transformed the nation’s attitudes and
approaches to family planning Jailed and risked own life
Distributed literature on birth control when at the time it was illegal
1912 wrote article about Syphilis – US Post Office invoked the Comstock Act (1873) and prohibited the distribution of information about contraception
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Nursing’s Influence & Historical Mandates Sanger cont.
1914 – Traveled to Europe seeking safe contraception measures.
October 1914 fled the US after being indicted on claim that women could separate procreation from the sexual act and published her ideas in Women Rebel
1915 – Returned to U.S. and with public sympathy, government dropped the charges
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Nursing’s Influence & Historical Mandates
Sanger cont. Best known for what?
Planned Parenthood of America
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Nursing’s Influence & Historical Mandates
Contemporary Leaders Wilma Scott Heide (1973)
National Organization for Women (NOW) JoAnn Ashley
Challenged nurses to reflect on who they were and what their role was as a nurse
Feminist movement Senator Lois Capps (R-CA). 2005.
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Legislation 2010
What is currently in the works?
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Nursing Legislation - 2010
H.R. 4601 – The National Nurse Act of 2010 Amend the Public Health Service to establish the Office
of the National Nurse
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Nursing Legislation 2010
S. 73 / H.R. 4138 – Registered Nurse Safe Staffing Act of 2009 – Reintroduced to the 111th Congress as S. 54. Would require establishing a staffing system that ensures a number
of registered nurses on each shift and in each unit. Would require public reporting of staffing information. Hospitals must
post daily for each shift the number of licensed and unlicensed staff providing direct patient care, specifically noting the number of RNs.
The staffing system takes into account the following: account for architecture and geography of the environment and available technology; reflect the level of preparedness and experience of those providing care; reflect staffing levels recommended by specialty nursing organizations; account for ancillary staff support; provide that an RN not be assigned in a particular unit without first having established the ability to provide professional care in such a unit; be based on methods that assure validity and reliability.
Sponsor: Sen. Daniel Inouye (D-HI).
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Nursing Legislation
H.R. 1001 – Nursing Relief Act 2009 Purpose:
To create a new non-immigrant visa category for registered nurses, and establish admission requirements for such nonimmigrant's.
Background: Hospitals spending hundreds of millions of dollars recruiting foreign
nurses under current immigration laws. Cost is passed on to consumer’s and adds to the rising cost of
healthcare Healthcare providers cannot efficiently and effectively recruit qualified
foreign nurses through existing immigration process Sponsors: John Shadegg (R-AZ), Co-Sponsors: Jeff Flake (R-AZ)
and Ed Pastor (D-AZ).
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Communicating with Legislators
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Telephone Communication
Telephone: 202-224-3121 Ask for your Senator’s or Representative’s office. Search the Congressional database for your
representative. http://www.capwiz.com/criticalcare/directory/condir.tt
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Telephone Communication
Phone calls are not generally handled by the member of Congress. They have assigned staff aides which do this. Identify yourself and ask to leave a brief message for
Senator/Representative (_____) that you either support or oppose (S.____/H.R.___).
“Good Morning, My name is _____ and I am a Critical Care Registered Nurse. I would like to leave a message for Representative _____ in support/opposition of HR 1001.”
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Telephone Communication
You may also want to state your reason for your support or opposition.
Ask for the senator’s or representative’s position on the bill. Also request a written response to your telephone call.
Write down the name of staff member you spoke with for future reference. Utilize them as your point of contact.
Source: AACN – www.capwiz.com/criticacare/issues/basics/?style=comm
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Telephone Communication - Pitfalls
No written documentation – no visual proof you actually made the phone call.
No way of guaranteeing that your message or your name, telephone number or address is recorded correctly.
Generally not ideal for introducing yourself to a legislative assistant.
Source: (Mason, 2007).
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Letter Writing tips
The saying “The pen is mightier than the sword” is prolific in nursing’s political action arena. As nurses, we know what happens on a daily basis and WE have the power to Act With Intention and facilitate change in daily practice.
The nurse with political competency knows what the rules
are or policies are for the profession and the industry
knows who or what organization created them, the rationale for their existence, and how they impact the provision of health-care services.
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Three “rights” of letter writing:
Right Letter.
Right elected official.
Right time.
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Writing guidelines
When writing to members of congress or a state or local official there are general guidelines:
Direct your letter according to the legislator’s responsibility.
Only write to the elected officials that represent you.
Clarify your issue. You may write to the chair of a specific committee if your representative does not sit on that particular committee.
Time your letter(s) to allow staff to address issues prior to pressing any legislation.
Your purpose for writing should be stated in the first paragraph of the letter. If the letter pertains to a specific legislative bill, identify it accordingly, e.g., House bill: H.R. ____, Senate bill: S.___.
Be courteous, to the point and include key information, using specific examples to support your position.
Address only one issue per letter. Keep the letter to a minimum of one page.
Source: AACN Legislative Center Source: AACN Legislative Center http://www.capwiz.com/criticalcare/issues/basics/?style=comm
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Letter to Senator
Address: The Honorable (Full Name), (Rm #), (name
of) Senate Office Building. United States Senate, Washington, D.C. 20510
The Honorable ___________702 Hart Senate Office Building, Washington, D.C. 20510-0605.
Salutation: Dear Senator ______________
Source: (AACN Legislative Center, 2008; Mason, 2007).
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Letter to Representatives
Address: The Honorable (Full Name), (Rm#), Name of House
Office Building. United States House of Representatives, Washington, D.C. 20515
The Honorable ______________, 1507 Longworth House Office Building, Washington, D.C. 20515-0604
Salutation: Dear Representative _________,
Source: AACN Legislative Center.
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E-Mailing Tips
Generally, same guidelines as with letter writing. Most legislators have e-mail addresses embedded
on their websites.
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Political Resources
How to identify the issues at hand to allow you to Act With Intention
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American Nurses Association
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American Nurses Association
Current Health Care policy agenda’s Nursing’s agenda for the future ANA’s Health Care Agenda 2005 Workforce trends among U.S. Registered Nurses.
Position Statements: Stem Cell Research 1/10/2007 Privacy and Confidentiality 12/8/2006 Assuring Patient Safety: Registered Nurses’
Responsibility in All Roles and Settings to Guard against Working when Fatigued 12/8/2006.
Source: American Nurses Association, 2008.
http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements.aspx
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ANA Resources Center
Created to be a one-stop resource to help find information about the 2008 elections. Provides information on election processes Candidate information both Democrat and
Republican. Publish Capitol update 10 times annually.
http://www.capitolupdate.org/newsletter
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American Organization of Nurse Executives
www.aone.org
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American Organization of Nurse Executives Education of members Public Policy and Advocacy Information Technology International Nurses Access and Coverage Reimbursement Policy PAC Web Resources: www.aone.org/aone/advocacy
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American Association of Critical Care Nurses
www.aacn.org
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AACN ResourcesCapwiz Home Page
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AACN - Resources Capwiz Elected Officials
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American Association of Critical Care Nurses
http://www.capwiz.com/criticalcare/home
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International Council of Nursing
www.ich.ch
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Joint Commission
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Joint Commission
Mission:
To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.
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Joint Commission
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Institute for Healthcare Improvement - IHI
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Institute for Healthcare Improvement
Programs Improvement map Passport Campaign
5 Million Lives – Video link http://www.ihi.org/ihi/files/campaign/2006_12_12_Berwick5MillionForumPlenary.wmv
Critical Care
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IHI – Critical Care
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Robert Wood Johnson Foundation
www.rwjf.org/publichealth
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Robert Wood Johnson Foundation
www.rwjf.org/healthreform
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State and Local Resources
Utilize Kaiser Family Foundation Utilize your state nursing association Utilize your state’s hospital association
to find out any upcoming or pending legislation issues.
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References
American Association of Critical Care Nurses (2008) Legislative Action Center. http://capwiz.com/criticalcare/home
Eliss-Najar, B., Hubbard, H. (2008). The Value of Nurse Leaders on Federal Advisory Panels: Experience with the Agency for Healthcare Research and Quality. Policy, Politics and Nursing Practice. 9: 299-304. Retrieved May 28, 2009 from, http://ppn.sagepub.com.dml.regis.edu/contect/vol9/issue4.
Hewison, A. (2008). Evidence-Based Policy: Implication for Nursing and Policy Involvement. Policy, Politics and Nursing Practice. 9: 288-98. Retrieved May 22, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol9/issue4.
International Council of Nursing (2000). Participation of Nurses in Health Services Decision Making and Policy Development. Retrieved May 30, 2009 from, http://www.icn.ch/pspolicydev00.htm.
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References
International Council of Nursing (2001). Guidelines on Shaping Effective Health Policy. Retrieved May 30, 2009 from, http://www.icn.ch/Guidelines_shaping.pdf.
Kurtzman, E. (2009) Unifying Nursing’s Political Voice. Editorial. Policy, Politics and Nursing Practice. 10: pg. 6. Retrieved May 30, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol10/issue1.
Mason, D., Leavitt, J., Chaffee, M. (2007). Policy and Politics in Nursing and Health Care (5th Ed). Philadelphia, Saunders Elsevier.
Mattie, A., Ben-Chitrit, R. (2007). Patient Safety Legislation: A look at health policy development. Policy, Politics and Nursing Practice. 8: 251-61. Retrieved May 22, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol8/issue4.
Taft, S., Nanna, K. (2008). What are the sources of health policy that influences nursing practice. Policy, Politics and Nursing Practice. 9: 274-87. Retrieved May 28, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol9/issue4.
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Web References
Agency for Healthcare Research and Quality (AHRQ) – www.ahrq.gov
American Association of Critical Care Nurses Legislative Action Center – www.capwiz.com/criticalcare/home
American Hospital Association – http://www.aha.org American Nurses Association – http://www.nursingworld.org/gova/ American Organization of Nurse Executives – www.aone.org C-SPAN – www.c-span.org GEM-Nursing: Online mentoring Program – www.gem-nursing.org Hastings Center – http://www.thehastingscenter.org Institute for Healthcare Improvement – http://ww.ihi.org Institute of Medicine (IOM) – http://www.iom.edu International Council of Nursing – http://www.icn.ch Kaiser Family Foundation – http://www.kff.org
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Web References
Library of Congress – http://thomas.loc.gov
Policy analysis site – www.hschange.org
Resource on multiple policy issues – http://hippo.findlaw.com/hippohome.html
Roll Call – Congressional news source – www.rollcall.com
Synopses of national political news – http://politicalinsider.com
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Estes Park, CO
Fish Creek – Steamboat Springs, CO