Friday October 24th 2014

Nurses explore trends, take action & celebrate

Representatives attending the American Nurses Association’s (ANA) inaugural Membership Assembly had opportunities to brainstorm about nursing’s future, take actions to continue ANA’s transformation, and discuss licensure issues related to cross-border nursing practice. But first, they engaged in an energy- and unity-building drumming exercise to help them complete their work.

The two-day event begins with the National Anthem.

The Assembly, which was held June 28 and 29 in the Washington, DC-area, is comprised of representatives from the constituent and state nurses associations (C/SNAs), the Individual Member Division, the specialty-focused organizational affiliates and the ANA Board of Directors. The theme that carried through the event was “A Look into the Future: Advancing the Association; Advancing the Profession.” The first day was largely spent with nurses both onsite and offsite engaging in an environmental scan of current and future trends affecting nursing and health care environments.

With several ANA board members and ANA CEO looking on, President Karen A. Daley’s remarks kicked off a future-focused discussion on nursing.

“We are here to talk about the future and start to create a new beginning for this association,” said ANA President Karen A. Daley, PhD, RN, FAAN, in her opening remarks. “Our outlook is 10 years in the future. That may seem far way, but a decade goes by quickly, and our goal is to shape our future rather than react to it.”

She also spoke about ANA’s progress in its ongoing transformation, such as streamlining its governance; bolstering its technology infrastructure; and strengthening its services and engagement opportunities for nurses.

Participants listen, drum and build unity with a little help from the Drum Café leader Pavel Lempert.

Before beginning the environmental scan, Assembly representatives and the audience each picked up a djembe (drum) and participated in an exercise that tested their ability to listen, work together to follow a rhythm, and be empowered to create their own beat.

“These are the rhythms and stories passed down to generations to create something for the future and to be connected,” said the leader of the five-person Drum Café, who facilitated nurses in this teambuilding exercise. “We are using music to clarify and amplify your connection today. Everyone has the opportunity to be engaged, to be heard and to be a contributor.”

Group facilitator John Mahaffie of Leading Futurists, LLC then shared how the digital age, the shrinking middle class and people’s increased perception that they are living in a risky world are shaping the environment. He urged participants to open up their thinking as they approached their small-group, environmental scanning discussions.

“Look for positive actions while change is occurring and develop a ‘foresight culture’—that’s the way to have the future that you want,” Mahaffie said.

One of the major trends participants identified was the greater and ongoing use of technology, including robotics and the use of health-related apps by nurses and patients. While recognizing the importance of technology, they also expressed that nurses should manage it and not the other way around, and that caring and empathy must remain central to nursing. Yet another ongoing theme was access to health care, including access to health care information via technology by persons who are socioeconomically disadvantaged.

Participants create a “futures wheel” to explore the implications of trends.

They further pointed to  increasing trends toward home-based care, a true wellness and prevention focus, and a “back to nature movement”  that considers the environment’s impact on health.

Mahaffie’s presentation also was video-streamed, which allowed more nurses from around the country to tune in and later share their thoughts on future trends.

Practice & governing issues

Beyond the environmental scanning, representatives discussed a resolution introduced by the Indiana, Montana, Ohio, Oregon and Washington State nurses associations on licensure for cross-border nursing practice. The proposed measure focused on ANA advocating for policy supporting licensure jurisdiction at the location of the RN — and not where the patient is — as a way to address the issues surrounding technology-enabled care.

Oregon Nurses Association President Stephen Rooney addresses the Assembly.

In a reference report that accompanied the resolution, the associations’ authors wrote that the population is increasingly mobile and more likely to communicate with health care professionals via cell phone and the Internet to receive health care services. For example, retired persons who live in warmer climates during the winter may still seek advice from their provider in their home state via the telephone, video technology or e-mail. Further, the use of electronic and other media for giving and receiving health care services is expected to continue growing, they reported.

Providing care to a patient who is not in the same location, however, raises questions about licensure requirements for nurses who provide technology-assisted care across state lines, as well as the role of licensing boards in assessing safe practice. The authors also noted that the advice given to nurses by boards of nursing, as well as state and federal regulations, varies and is sometimes murky.

During a hearing on the measure, nurses raised a number of issues. Several spoke about the importance of being able to continue providing patients with the follow-up or ongoing remote care they need while ensuring the nurses themselves are legally licensed to do so. Other nurses wanted to ensure that there is a clear and not burdensome path for patients to report care they deem as harmful or negligent. Others questioned how any action taken by the Assembly might impact states that participate in the Nurse Licensure Compact.

At left, Winifred Kennedy adds new affiliate ANA-New York’s ribbon to ANA’s flag.

Given the complexity of the issue and ongoing questions, the Assembly voted to refer the proposal back to the ANA board to further review licensure implications for nurses providing technology-enabled care across state lines.

Assembly representatives also voted on bylaws, or governing amendments, which included approving a timeline for smoothly transitioning to a smaller Board of Directors — from 15 to nine members by 2017. Additionally, they adopted a structure that acknowledges RNs who are full members of a
C/SNA as holding concurrent membership in ANA.

Making progress, voice of the future

As part of the two-day meeting, ANA Chief Executive Officer Marla J. Weston, PhD, RN, FAAN, addressed how ANA has transformed its programs, products and services to better serve nurses — from webinars on building effective leadership skills to the development of groundbreaking, national interdisciplinary safe patient handling and mobility standards.

“I have been a member of ANA for 25 years, but I have come to understand just this year, in a really profound way, what it means to be an association,” Weston said. “An association is defined as people banded together for a special purpose. We are the American Nurses Association, and our special purpose is to promote our profession and improve health for all.”

Also addressing the Assembly was National Student Nurses Association President Jesse Kennedy, who touched on highlights from the NSNA recent convention, the difficulty new grads are having in finding jobs and the need for more residency programs to mentor and help new nurses increase their skills.

“We turn to you to advocate for us, the future generation of nurses,” Kennedy said. “You are awe-inspiring, and you make us proud to be in the profession.”

Lobby Day & other activities

Registered Nurses Association in Michigan President Susan Wozniak and Joe Mayer (ANA staff) meet with U.S. Rep. Conyers’ office staff (left) to support SPHM legislation.

Assembly members and other nurses also had opportunities to engage in political advocacy, learn about ANA initiatives and participate in fund-raising and other activities.

More than 200 participated in ANA’s June 27 Lobby Day to meet in person with members of Congress and their staff to discuss safe staffing, home health care-planning and other issues important to nurses. Nearly 1,000 other nurses participated in Lobby Day virtually via e-mail, social media or by calling their federal lawmakers.

Lobby Day was kicked off with a breakfast briefing and awards ceremony where three advocates were recognized for their tireless efforts on behalf of patients and nurses:

Edward Briggs and U.S. Rep. Lois Capps

• Edward Briggs, DNP, ARNP-C, a family nurse practitioner at St. Anthony’s Hospital in St. Petersburg, FL, and Florida Nurses Association member who promotes advocacy among his nurse colleagues through education and mentoring.

• U.S. Rep. Lois Capps (D-CA), a nurse, co-chair of the House Nursing Caucus, and original co-sponsor of the Registered Nurse Safe Staffing Act (H.R. 1821).

• U.S. Rep. Greg Walden (R-OR), the original sponsor of the Home Health Medicare Improvement Act, which will allow nurse practitioners, clinical nurse specialists and certified nurse-midwives to certify Medicare patients for home health benefits.

“I can’t tell you what this award means to me,” Capps said. “I’m one of you, so it’s an honor to receive this recognition from you, my peers.”

She also thanked Lobby Day participants for their commitment.

“Your presence will be felt [on Capitol Hill], Capps said. “That’s how we change the face of health care and the issues you care about.”

In a video speech, Walden spoke of the importance nurses play in providing access and care to people within his rural district.

“Thank you for the work you do for patients and your communities,” he said.

Florida Nurses Association Executive Director Willa Fuller, BSN, RN, accepted the award for Briggs, who later came to the Assembly.

Attendees gathered for an Assembly event.

Representatives of ANA’s 30 organizational affiliates also met June 27 to discuss a wide range of issues, from workplace violence to leadership competencies.

The ANA-PAC offered several activities for nurses, including a night with the political satire group, the Capitol Steps. More than $30,000 was raised to support the PAC through these efforts. The American Nurses Foundation (ANF) also held a luncheon honoring their high donors with 54 persons in attendance.

And over the course of the meeting, more than 100 nurses stopped by ANA’s Department for Health, Safety and Wellness booth to take a health risk appraisal survey. This is the first part of a greater ANA effort to determine the overall health, safety and wellness of the nation’s RN workforce.

Alabama State Nurses Association leaders celebrate centennial recognition. From left: John Zeigler, Arlene Morris, ANA CEO Marla Weston and Brian Buchmann.

Near the end of the event, Assembly representatives welcomed ANA’s two new C/SNAs, ANA-Illinois and ANA-New York, and recognized the centennial of the Alabama State Nurses Association.

In closing, Daley thanked participants who made the accomplishments of this past year and the past two days possible.

“As you prepare to head back home to your associations, I encourage you to reflect on how we came together, worked together and led together,” she said. “This is the start of our new beginning, and I strongly encourage you to stay engaged and keep thinking and planning for our bright future together.”

Reference Committee members reviewed attendees’ input on cross-border licensure. From left: Duane Jaeger, Louise Waszak, Denise Moore (chair), Susan Howard, Julie Sadovich, Barbara Kelly.

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