Posts Tagged ‘American Nurses Association’

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Takeaways from 2014 ANA Membership Assembly

June 23, 2014
Pamela Cipriano, incoming ANA president

Pamela Cipriano, incoming ANA president

By Maureen Shawn Kennedy, AJN editor-in-chief

So far, so good

In June, the American Nurses Association (ANA) convened its second membership assembly, which included representatives of constituent and state nurses associations, individual members groups and affiliated entities, plus the board of directors. (This is the structure that replaced the House of Delegates as the official governing body of the ANA, when ANA restructured in 2012. See our 2012 report on the restructuring.)

The assembly was preceded by ANA’s annual Lobby Day on June 12th, in which nurses visited legislators on Capitol Hill to talk up legislation important to nursing, like bills on staffing, safe patient handling, and one that would remove barriers to efficient home care services.

This membership assembly was subdued—perhaps a gift for Karen Daley, the outgoing two-term president who shepherded the organization through a turbulent period of change. There were no contentious resolutions to deal with this time—there were only three issues brought to the group through dialogue forums, to develop recommendations for the board of directors:

  • scope of practice (full practice authority for all RNs)
  • integrating palliative care into health care delivery
  • promoting interprofessional health care teams

While the scope of practice topic was ostensibly promoting full practice for ALL RNs, most of the discussion (and a video) focused only on APRNs as physician colleagues. I wonder: are we fostering a message in which only nurses who are APRNs are perceived as physician colleagues? Read the rest of this entry ?

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Nursing Blogs Roundup: Some Veteran Voices and Some Lively New Ones

August 5, 2013

By Jacob Molyneux, senior editor/blog editor

Blogging - What Jolly Fun/Mike Licht, NotionsCapital.com, via Flickr Creative Commons

Blogging – What Jolly Fun!/Mike Licht, NotionsCapital.com, via Flickr Creative Commons

Here are some new or newish posts of note on various nursing blogs:

At Nursetopia: “You Get What You Put In To Your Nursing Association.”

At Nursing Stories: “Memories of MICU,” a post about visiting a new state-of-the-art medical intensive care unit (MICU) and comparing it to one the author worked on in the 1970s.

At the American Nurses Association (ANA) blog called One Strong Voice: “Working With a New Graduate or Novice RN? If So, Be Mindful of Workplace Bullying.”

Episode six is now up at The Adventures of Nurse Niki, a newish blog written by Julianna Paradisi (her other blog is JParadisi RN). This blog is made up entirely of first-person episodes told by a fictional nurse named Niki. Each episode is short, detailed, and engaging, and it’s easy to keep up with it on a regular basis, or quickly catch up if you haven’t yet read any episodes.

At Digital Doorway: “Evolving as a Nurse: The Work of the Soul.” Here’s a brief excerpt:

“The evolution of a nurse and his or her career is a very individual experience, and this experience expresses the spirit, nature and personality of the nurse in question. And when soul is infused into that journey, the entire tenor of the journey is deeply and irrevocably changed.”

At Nursing Notes of Discord: “Failed Inspection.” I wasn’t familiar with this blog until I stumbled on it today. This was an intriguing post. Read the rest of this entry ?

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Something Like Grace

July 22, 2013

By Marcy Phipps, RN, a regular contributor to this blog. Her essay “The Love Song of Frank” was published in the May (2012) issue of AJN.

ViewFromPlaneWindowMark was in town to be the best man in an old friend’s wedding—on a vacation, of sorts—when the unthinkable happened and he was involved in a horrendous traffic accident. He was ejected from his rental car. His injuries were severe and life threatening.

Mark’s family was halfway across the country. Getting to Mark quickly seemed impossible. But this is where the story takes a turn:

Mark’s family found a flight leaving that morning from their local airport, with the exact number of available seats that they needed. As they bought the tickets, they explained the nature of their emergency. They got to the airport in the nick of time. While checking in, they were approached by an airline employee who asked if they’d already arranged a rental car. They told him that they hadn’t—they hadn’t even stopped to get their clothes.

They didn’t know it at the time, but the employee who’d approached them was the pilot of the plane. He’d learned of the family emergency and held the plane for them. He knew how serious Mark’s accident had been, as he’d happened to drive right past the accident scene on his way to the airport before the first leg of the flight.

When the plane landed, the pilot requested that Mark’s family be given priority in leaving the plane, then he followed them and drove them to the hospital. Amazingly, Mark’s entire family reached the hospital before he’d even come out of the operating room.

Mark’s dad told me this story while Mark, dozing in his ICU bed, chimed in occasionally with a word or two. It gave me chills—as his nurse, I’d read the operative reports and seen the scans; I knew how critical his injuries had been, how easily things could have gone much differently.

The American Nurses Association definition of nursing includes “alleviation of suffering through the diagnosis and treatment of human response.” All too often, especially in the trauma ICU, people are responding to unexpected tragedy and loss with shock and pain, and alleviation of suffering is not always possible or realistic.

In Mark’s case, I was reminded of the flip side of suffering, where the love and bonds of family, good medicine, and the unsolicited kindness of strangers come together to paint a beautiful picture of the human experience.

It’s nursing that affords me this view. I feel fortunate to be a member of a profession that I love.

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Behind Our Ambivalence About Flu Vaccines

November 9, 2012

By Amy M. Collins, editor

Influenza virus particle/CDC

Tis the season to start thinking about getting the flu vaccination. Every year I consider doing so, but due to my own personal vaccine angst I usually decide to just take my chances (while simultaneously lecturing elderly family members to make sure they get theirs, of course).  Working in Manhattan, with the vaccine available at most pharmacies and even vaccine access through work, gives me very little reason to forgo vaccination. And my theory that I am young and strong and can brave illness gets weaker as I pass the point of being able to comfortably claim youth. Riding the subway every day amid a festival of germs reminds me that I should know better.

The vaccine has caused a stir over the past few years: during the 2009 H1N1 pandemic, people worried about whether or not to get the new combined vaccine, and the question of mandatory vaccination for health care workers remains a hot topic even now.

But a new report, The Compelling Need For Game-Changing Influenza Vaccines, released by scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota, suggests that the flu vaccine may not be as effective as it is touted to be. According to the report, influenza vaccinations provide only modest protection for healthy young and middle-aged adults, and little if any protection for those 65 and older—those who are most likely to contract the illness and suffer its complications. In addition, the report’s authors concluded that federal vaccination recommendations are based on inadequate evidence and poorly executed studies.

With as many as 49,000 Americans dying from influenza each year, approximately 90% of them elderly, should the report matter to those on the fence about getting vaccinated? Not according to Dr. Joseph Bresee, chief of epidemiology and prevention in the CDC’s influenza division, who was quoted in the New York Times as saying, “Does it work as well as the measles vaccine? No, and it’s not likely to. But the vaccine works.” And the risk of being on the safe side and getting the vaccination appears to be quite low—the report acknowledges that currently licensed influenza vaccines in the United States are among the safest of all available vaccines.

The report ends by issuing an urgent call for improved vaccines: “novel-antigen game-changing seasonal and pandemic influenza vaccines that have superior efficacy and effectiveness compared with current vaccines are urgently needed.” These game-changing vaccines, says the report, must demonstrate increased efficacy and effectiveness for populations at increased risk for severe influenza morbidity and mortality.

So, will the report make a difference to nurses’ recommendations to patients this season, or affect their own decision about whether or not to get vaccinated? Will it influence the ongoing debate about mandatory vaccination for health care workers? For the record, it didn’t for me. At my yearly check-up, the flu vaccine was strongly recommended. The American Nurses Association continues to urge people to get vaccinated as part of their Unite to Fight the Flu initiative.

The report is not saying not to get vaccinated, just that it may not work as well as we’d hoped, and knowing this isn’t a deal breaker for me. So now I just have to get over my vaccine angst and take the plunge!

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Nurse Staffing: Are the Brits on the Right Track?

June 26, 2012

By Maureen Shawn Kennedy, AJN editor-in-chief

hazard/jasleen kaur, via Flickr

According to an article at Nursing Times, hospitals in England may be required to publish “nurse-to-bed” ratios as part of an overall “dashboard” of indicators to measure  performance. While some say this is a step forward, UNISON, the public service union that represents nurses, argues that the better ratio to measure is nurse-to-patient and that variables in patient acuity should also be considered.

Nurse staffing has become an issue in National Health Service hospitals and in April UNISON released results of a survey of over 1,500 nurses and other health care workers about their shifts during the 24-hour period of March 6. The vast majority of respondents (73%) felt they did not have “enough time to spend with patients to deliver dignified, safe, compassionate care.” The Royal College of Nursing also supports mandatory safe-staffing ratios that take into account the skill mix of RNs to “health care support workers” or nursing assistants. 

Here in the United States, California is the only state to achieve any legislation for mandatory hospital staffing and it is a “minimum” nurse-to-patient ratio. While similar legislation has been introduced in a few other states and nationally, it hasn’t advanced.

The ANA does not support mandatory minimum ratios per se, noting in its Principles for Nurse Staffing (2nd edition), released earlier this month, “The solution is not as simple as increasing the number of nurses beyond what is minimally necessary.” The ANA advocates for a “nurse-directed” approach that includes minimum ratios but also takes into account patient acuity, the setting, and the skill set and mix of staff.

At the recent House of Delegates meeting, the ANA reaffirmed that safe staffing is a “top priority.” (Read the press release.) And in a December 16, 2011, letter to the Centers for Medicare and Medicaid Services, the ANA advocated for public posting of “hospital staffing plans” that take into account patient acuity, mix of staffing, and other factors, with these staffing plans to be modified as needed according to measurable patient outcomes—but did not necessarily call for staffing ratios.

What do you think? Should nurse staffing details be made public?

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Big Changes for New York Nurses

May 21, 2012

By Shawn Kennedy, AJN editor-in-chief

On Thursday, May 17, the New York State Nurses Association (NYSNA) held a special members-only meeting at New York City’s Jacob Javits Center to vote on bylaw changes that will drastically alter the future of the organization, morphing it from a professional association into a union. One of the key changes had to do with who could hold office in the organization: going forward, only bedside nurses, retirees, and “non-statutory” supervisors (i.e., those not able to hire or fire employees) would be eligible for office.

Other changes include eliminating the position of CEO and changing it to that of executive director, in order “to better reflect the union’s democratic roots and greater accountability to working nurses,” and a decision to push for nurse–patient staffing ratio legislation in the next session.

The NYSNA, which with 37,000 members, was founded in 1901 and is the oldest state nursing association in the country. Until January, when it was suspended for one year, it was the largest constituent member association of the ANA.

According to ANA documents, the NYSNA violated ANA bylaws by engaging in “dual unionism” when its newly elected board of directors replaced the CEO with Julie Pinkham, who is also the executive director of the Massachusetts Nurses Association (MNA). The MNA had disaffiliated from ANA in the past, along with the California Nurses Association, and were founding members of National Nurses United. The ANA maintains that this is a concerted effort to undermine NYSNA and, by affiliation, the ANA. The NYSNA appealed the decision, but the ANA reaffirmed the suspension in March. This also means that the member benefits of the 37,000 members are also suspended for the year.

I asked Bernie Mulligan, NYSNA’s communications director, about where he thought the organization’s relationship with ANA was heading. He said he felt it was premature to discuss the question of any future relationship and that the board would address that. The top priority for the organization now, he said, was getting nurse–patient ratio staffing legislation passed. “The members are clear, in that they overwhelmingly support this.”

Read more on this here.

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Essential Nursing Resources: A Crucial Tool for Nurses Seeking Information on the Web

April 10, 2012

This nursing resource will help you find anything you need to know

By Maureen Shawn Kennedy, AJN editor-in-chief

Back in the dark ages, before the Web, when I was in school and researching a topic, I would go to the university library (in Manhattan, this meant a subway ride to the main campus), fill out a form, and hand it to the librarian. After a couple of hours, I’d check back and the librarian would have pulled up to eight “on-reserve” books (no more were allowed until these were returned) from the stacks and have them waiting for me. This cycle would repeat itself several times, and sometimes I’d have to wait for an “ILL”—an interlibrary loan. Of course, if I procrastinated, the material I wanted might already have been taken out by other students and I’d be out of luck, facing a deadline with no source material.

Of course, it’s all different now with the Web. This week, even the venerable Encyclopedia Britannica announced it is ceasing print production after almost 250 years and will only be available in digital format.

Now, researchers and students have virtually every article published available to them via the Internet. For nurses, there’s something called Essential Nursing Resources (pdf), an annotated listing of resources for nursing published by the Interagency Council on Information Resources in Nursing (ICIRN). 

Virginia Henderson

Founded in 1960 (here’s a brief history) by librarian and nursing organizations, including representatives from the Medical Library Association, the National Library of Medicine, the American Nurses Association, the National League for Nursing, and others (Virginia Henderson was one of the founders), it worked to organize and index the nursing literature.

The 26th edition of Essential Nursing Resources (updates happen biennially) is “a resource for locating nursing information and for collection development.” It lists “print, electronic, and web sources to support nursing practice, education, administration, and research activities,” plus other information to guide the user when pursuing nursing topics on the Web, like articles on signing up for RSS feeds, a list of nursing blogs of note (this blog is included!), and more.

This isn’t just a resource—it’s a truly essential stop for finding nursing content and Web resources, a gift from some forward-looking people back in 1960.

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Boards of Nursing and the Amanda Trujillo Case

February 17, 2012

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Amanda Trujillo

Our prior post on the Amanda Trujillo case elicited many comments, on a variety of themes. There were also referrals and crosslinks to other sites supporting, analyzing, and weighing in on the situation, including statements from the Arizona Nurses Association and the ANA, and a post on a physician blog, “White Coat’s Call Room,” which has vowed to carry all the details once the case is decided.

One complaint raised by several people in response to our post was that the Arizona Board of Nursing wasn’t supporting Amanda. State nursing or medical boards are regulatory boards that exist to ensure the protection of the public and to regulate professional practice according to the law (in nursing’s case, according to nursing practice acts). They do not aim to protect the individual nurse, but to assure that all those who claim to be nurses are eligible to claim that title and practice within their scope of practice as defined by law.

Some historical context: Regulatory boards were set up back in the early 1900s, after nursing associations successfully lobbied for registration laws to keep out unqualified women who posed as nurses. In 1903, North Carolina was the first state to enact a nurse practice act; by the mid-1920s, all 48 states had laws regulating who could practice and who could use the title “registered nurse.”

Thus, boards of nursing are intended to protect the consumer and the standards of the profession.

While I agree with several comments saying that nurses should be able to practice within the full scope of their education and training, as recommended by the Institute of Medicine Report on the Future of Nursing, what’s also important to keep in mind is that we must do so in accordance with the law—which unfortunately may not always measure up to our ideals or accurately reflect actual professional practice.

Nurses and state associations need to work to change the law where it needs to be changed—and there are many people who devote themselves to making such change happen—but until the law does change, this is how nurses’ actions will be judged, whatever other motives may appear to be in play or not.

(Editor’s note: A few readers have misconstrued the last paragraph as implying a judgment in the Amanda Trujillo case. This is by no means the intended meaning. The focus here is a more general look at the roles of boards of nursing and the importance for all nurses of not leaving themselves vulnerable to accusations of going beyond their scope of practice, as it has been defined in a particular state’s practice acts. Further note: The Arizona Board of Nursing did subsequently release the Notice of Charges against Ms. Trujillo to those who requested a copy. It can be found via a link in this post from nurse/blogger Not Nurse Ratched.)

Addendum: January 10, 2013: The eventual outcome of this case can be seen in the “consent agreement” that Amanda Trujillo has signed with the Arizona Board of Nursing, which states that she “admits the Board’s Findings of Fact and Conclusions of Law” and agrees to fairly onerous terms for continuing to practice as an RN on probation. Thanks to blogger Not Nurse Ratched for providing a link to this document in her recent post about the case and its unfortunate history on the Web.

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Webnotes: Nurse Comics, Uninsurance, Hospital Image vs. Reality, Social Media Guidance

September 15, 2011

The Web comes back to life after Labor Day weekend. Will, the nurse and artist who relates episodes from his life in comics at Drawing on Experience, has a new post about starting a job in a cardiothoracic intensive care unit (CTICU). There’s a thumbnail version of it below—click it to see the actual post in full size at his blog.

The best hospitals? The New York Times reports that “the country’s leading hospital accreditation board, the Joint Commission, released a list on Tuesday of 405 medical centers that have been the most diligent in following protocols to treat conditions like heart attack and pneumonia.” Many of the hospitals often considered among the “best” (including those in New York City) did not, however, make this list (though some came very close). While hospital representatives argue that there are several mitigating factors that might have influenced these findings, this is a reminder that reputation and the presence of famous specialists may not necessarily mean the best care.

Their own darn fault. Though some may laugh at letting sick people who can’t pay for care just die, many of us are able to imagine ourselves, a friend, or neighbor in such a situation. For those who believe America should be more like Victorian England in its division between the the haves and have-nots (bring back debtors’ prisons!), good news: such hilarious down-on-their-luck characters should be easier than ever to find:

Nearly one million more Americans went without health insurance in 2010 than in 2009. This distressing news is further evidence of the need for government safety net programs and the national health care reforms that will take effect mostly in 2014.

Social media guidance for nurses. Last, but not least, the American Nurses Association (ANA) has released new social networking principles (which, somewhat surprisingly, given the topic, you have to purchase!). Still, it’s good that these exist, since nurse blogger Megen Duffy recently noted in her September iNurse column in AJN, “Patient Privacy and Company Policy in Online Life”:

Social media is a newcomer to health care, and policies are still being formulated. Mistakes will occur, and policies will be revised. Nurses can rise to the challenge and make sure their voices are heard in the formulation of workable guidelines; we live and breathe the nursing process, and if something isn’t working, we reassess and implement another plan.

Leave us your comments. This is social media, after all.—Jacob Molyneux, senior editor 

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HCR: Been There, Done That

January 18, 2011

By Maureen ‘Shawn’ Kennedy, AJN editor in chief

I was doing some research in the AJN archives and came across an editorial written in November 1993 by Virginia Trotter Betts, then-president of the American Nurses Association. “The Best Buy in Health Care” (click through to the PDF option; article will be free until July 18) reads like it was written with the Institute of Medicine’s Future of Nursing report in mind. Here’s an excerpt for those who don’t have access to the AJN archives (a shameless plug: subscribers have full access to ALL the issues of AJN, back to the very first issue in 1900—a treasure trove of nursing history):

“But we must also face the fact that such reform will require significant changes in nursing. Nurses will have to operate with greater autonomy and deliver care to a broader clientele. To foster enhanced roles for nurses as case managers and team leaders, nursing administrators must alert the work environment to offer a continuum of care on site and off site. Nurse educators will need to offer innovative programs, curricula, and clinical placements that prepare nurses for careers characterized by critical thinking and maximum flexibility. Nurse researchers will need to add more health care system, economic and policy studies to their repertoire.”

And another:

“Nurses want to do more in a reformed system to facilitate access at a reasonable cost.  We want to do what we are educated to do – provide basic health services like well and ill baby care, immunizations, and health screenings; manage chronic conditions; care for the sick and dying using both technology and interpersonal techniques; and a multitude of other essential services that are well within our expertise.  We want to educate our client and our communities and form a health care partnership with them.  We are team players and are ready to try to make new systems work for consumers.”

If only nurses ruled the world . . .

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