Sunday December 17th 2017

Nurses help shape policy, strengthen the profession

Pamela Cipriano Pamela Cipriano

Bias and health disparities affecting the LGBTQ community, substance use disorder in nursing and gun violence – all issues that speak to the American Nurses Association’s yearlong campaign to promote a “culture of safety” – were at the forefront during ANA’s annual Membership Assembly.

Eligible Assembly representatives also re-elected Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, as ANA president, and cast their votes for nurses in other ANA Board of Directors and committee positions.

More than 300 attendees, including representatives and observers from constituent and state nurses associations and specialty nursing organizations, participated in the Assembly, which was held June 24 and 25 in Washington, DC. Assembly representatives specifically took action on a measure that focused on nursing advocacy for sexual minority and gender-diverse populations and another that centered on meaningful strategies to address substance use disorder within nursing.

The ANA Reference Committee presented recommendations from dialogue forums. The ANA Reference Committee presented recommendations from
dialogue forums.

Spurred by the latest tragedy from gun violence at that time — the shootings in Orlando, FL — Assembly representatives adopted a declaration calling for sensible gun control measures, including one that lifts a ban that blocks the Centers for Disease Control and Prevention from studying gun violence.

In earlier remarks, Cipriano described the prohibition as “anti-science.”

“We have to lift the ban and act on the evidence,” she said.

Cipriano also described the massacre as one that was inextricably linked to prejudice against the LGBTQ community.

“We need to stop the violence,” she said.

In other actions before the Assembly, representatives voted on measures aimed at boosting overall membership and criteria that specialty and other nursing organizations must meet to join ANA as an organizational affiliate.

As part of her formal address, Cipriano provided an overview of the continued challenges facing the nursing profession today, the need to ensure nurses are prepared for a changing health care system, and strategies for positioning nurses and ANA as vital players and leaders in the future.

Nurses shared and strategized in small groups during dialogue forums. Nurses shared and strategized in small groups during dialogue forums.

One area that she emphasized involves strengthening nursing’s ability to partner closely with consumers.

“Consumers are critical to our future,” Cipriano said. “We need to create a preference [for nurses and nursing care] in their hearts and minds. We want them to say, ‘Where’s my nurse?’”

She outlined aspects of ANA’s new strategic plan, noting ANA’s bold vision in which all nurses are a “powerful, unified force in engaging consumers and transforming health and health care.”

Cipriano said that ANA and nurses must increase their “footprint,” or influence. And she told MA representatives, “You are the leaders who can change the world.”

Patient engagement, leading & staffing

The death of keynote speaker Knitasha Washington's father (photo on screen) prompted her to advocate for patient and family engagement. The death of keynote speaker Knitasha Washington’s father (photo on screen) prompted her to advocate for patient and family engagement.

In a riveting keynote address, Knitasha Washington, DHA, FACHE, executive director of Consumers Advancing Patient Safety, shared a personal story about her journey from health care administrator to patient and family engagement advocate. The impetus: Her father died from a preventable medical error following surgery.

“I can’t tell you what that felt like,” Washington said. “I worked in a health care system that I trusted, and it failed me.” She urged nurses to work toward more effectively engaging patients and their families in their own health care, as well as in helping to shape health policy.

ANA Chief Executive Officer Marla J. Weston, PhD, RN, FAAN, provided highlights of ANA activities, from supporting health care transformation and the Affordable Care Act to quality measures to ethics. She also spoke about ANA’s work on staffing, including new resources.

“I always say that withholding staffing is the same as withholding lifesaving medication,” said Weston, who emphasized ANA’s commitment to ensuring safe staffing.

Throughout the two-day meeting, nurses engaged in small-group discussions, as well as “centering” activities led by American Holistic Nurses Association President Carole Ann Drick, PhD, RN, AHN-BC, to help them focus on the work ahead.

Learning, sharing & celebrating

PrintAssembly attendees had the opportunity to engage in several key discussions, including one that looked at defining nurses’ roles in addressing the epidemic of opioid dependence and associated drug-related overdoses. Another focused on discussing strategies to gain, engage and retain new RNs.

Nurses also had other opportunities to learn, network and unwind at ANA-PAC events, including a briefing breakfast in which political expert Nathan Gonzales discussed the 2016 presidential election and a special “unCork & unWine” evening celebration. Nearly $24,000 was raised as part of these events. The American Nurses Foundation hosted two luncheons, one for high donors and another focused on planned giving. The Foundation took in more than $23,000, including a gift from the Nurses Charitable Trust made in honor of ANA Hall of Fame inductee Patricia Ruth Messmer, PhD, RN-BC, FAAN, a Florida Nurses Association member.

ANA celebrated the achievements of 11 exceptional nurses at its national awards reception, held just prior to Membership Assembly. Among those being honored were two Hall of Fame inductees: Muriel Poulin, EdD, RN, FAAN, from ANA-Maine, and Messmer. At a subsequent event, Poulin and Messmer described what influenced them to become nurse leaders, and both cited the importance of being actively involved in ANA.

Eleven nurse honorees with President Cipriano: From left, John Lowe, Gloria Dobies, Patricia Messmer, Judy Huntington, Rose Constantino, Cipriano, Jacqlyn Sanchez, Patricia Ford-Roegner, Karen Bankston, Becky Patton, Muriel Poulin and Barbara Warren. Eleven nurse honorees with President Cipriano: From left, John Lowe, Gloria Dobies, Patricia Messmer, Judy Huntington, Rose Constantino, Cipriano, Jacqlyn Sanchez, Patricia Ford-Roegner, Karen Bankston, Becky Patton, Muriel Poulin and Barbara Warren.

In yet another meeting, representatives from ANA’s 36 specialty nursing organizational affiliates met to share information about their initiatives and discuss ways to partner on mutual health care and nursing issues.

For more information on Assembly activities, go to www.nursingworld.org/membershipassembly. To watch a video recap, go to https://www.youtube.com/watch?v=09aB_UhNh1c.

 

Promoting multiple strategies to address substance use disorder in nursing

The importance of treating substance use disorder as a chronic illness was one of the points emphasized by a presenter during a dialogue forum that focused on the occurrence of SUD in nursing.

In her presentation, Suzanne Alunni-Kinkle, BS, RN, CARN, chief nursing director, Intervention Project for Nurses, talked about the overall scope of substance use disorder. In 2013, an estimated 21.6 million persons were classified with substance dependence or abuse. And of all drug users, 74.8 percent are employed in the workplace.

She noted that, when it comes to this chronic illness, nurses and the general public have many things in common. For example, an estimated 10 to 15 percent struggle with drug or alcohol abuse, and SUD is a disease that ends in recovery or death. However, nurses with untreated SUD can place patients at risk. Further, nurses have access to medication through their workplace, and they know how drugs work.

“One big risk factor is that our colleagues enable [nurses with SUD],” Alunni-Kinkle said. “They either don’t think their co-worker really has a problem, or they don’t want to report it to a supervisor because the nurse could lose his or her job.”

She outlined aspects of alternative to discipline programs, and her co-presenter, Jillian Scott, MSN, RN, director, Recovery and Monitoring Program, spoke specifically about RAMP, which is managed by the Institute for Nursing, the charitable affiliate of the New Jersey State Nurses Association. They also noted how nurses could work toward promoting the adoption of these non-punitive programs nationwide.

Scott reported that RAMP provides nurses with the support they need for treatment and throughout a closely monitored recovery program.  RAMP is confidential and voluntary – with a goal of having nurses return to work as long as they comply with all components of the program.

Dialogue forum participants then shared the types of programs that exist within their states; identified barriers to developing a recovery and monitoring program in their states, such as legal issues and stigma; and reported potential solutions to barriers, including providing education on stress-reduction measures and creating resources on SUD, and peer mentoring and alternative to discipline programs.

Assembly representatives subsequently voted on recommendations asking ANA to:

• Engage stakeholders in exploring gaps in current research and policy on SUD in the nursing population;

• Promote strategies to educate students, nurses and employers about preventing, identifying and reporting those with suspected SUD across care settings;

• And partner with stakeholders to develop model programs to support employers and nurses before, during and after treatment.

 

Providing better, culturally sensitive care to the LGBTQ community

To fulfill the profession’s quest to effectively meet the needs of all patient populations, nurse leaders at the American Nurses Association’s Membership Assembly took action to boost quality, culturally sensitive care to the LGBTQ community.

As part of events accompanying the Assembly, nurse participants had the opportunity to engage in a June 24 dialogue forum focused on nursing advocacy for sexual minority and gender-diverse populations.

Before engaging in small-group discussions, nurses heard a presentation from Tanya Friese, DNP, RN, CNL, [U.S. Navy (Ret.)], assistant professor at Rush University’s College of Nursing in Chicago and vice chair of the Diversity Leadership Council LGBTQ Health Committee at Rush, who shared statistics and research on the LGBTQ population.

Among the troubling research statistics she cited were: 19 percent of 6,450 transgender individuals surveyed have been refused medical care because of gender expression, 29 percent postponed or canceled needed care due to discrimination and 36 percent have attempted suicide, which is 22 times higher than the suicide rate for the general public.

Friese noted that about 3 out of 4 nurses and other providers expressed feeling ill-prepared to address the unique health care needs of the LGBTQ population. Further, although 62 percent of students felt they possessed the knowledge to work with LGBTQ patients, 85 percent reported that their nursing education did not prepare them to do so.

“As educators, we have the ability to effect change,” said Friese, an ANA-Illinois member. “And by having this discussion, it shows that we [Membership Assembly] are committed to diversity and inclusion.”

During a general discussion, dialogue forum participants shared examples of culturally insensitive health care facility policies and experiences, as well as offered strategies to strengthen education, practice and advocacy.

At the Assembly, eligible representatives formally voted to adopt recommendations calling on ANA to:

• Promote the application of “ANA’s Code of Ethics for Nurses with Interpretive Statements” to ensure unwavering, culturally sensitive, unbiased and nondiscriminatory care of members of the LGBTQ community;

• Foster strategies to educate nurses about the potential impact of personal bias, whether conscious or unconscious, particularly involving the care of LGBTQ patients;

• Identify strategies to raise nurses’ competency in addressing the needs of this population;

• And promote standardized gender-neutral terminology and documentation.

The Individual Member Division and ANA’s Center for Ethics and Human Rights submitted this dialogue forum topic.

“As nurses, we have an opportunity to make a difference for those patients and clients [in the LGBTQ community] and their families,” IMD Chair David Hanson said.

An issue brief underscored nurses’ ethical duty to respect the beliefs, values and decisions of all patients, as well as an obligation to address disparities and inequalities through solutions that are ethical and respectful of human rights. Further, nurses are well-positioned to identify and address barriers, such as intended and unintended bias and prejudice, to effectively promote change toward all-inclusive, quality health care.

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