Posts Tagged ‘American Nurses Association’

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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.)

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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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Placenta Facebook Photos: Nurse and Mommy Tribes See Student Expulsion Differently

January 12, 2011

By Shawn Kennedy, AJN editor in chief

Many of you may be familiar with the recent “nursing-in-the-news” topic involving nursing students and a placenta. (For those who’ve been out of touch, here it is in a nutshell: three students were involved in photographing themselves with a placenta from a recently delivered mother and posting it on, where else, Facebook. The students were expelled. One student sued; the judge ordered all the students reinstated. See this article by the Kansas City Star that sums it up.)

The incident has provoked debate on various Web sites, including our own Facebook page, where the discussion mainly concerns whether the students were treated fairly or too harshly:

“It’s a placenta. I agree that it can seem a bit juvenile to photograph yourself with it, but an offense worthy of expulsion?”

“Juvenile? Perhaps. Punishable by expulsion? Absolutely not, imo. What exactly was wrong with taking a picture of a placenta? It’s not like you can identify who the placenta came from.”

“I think she should be punished but not expelled. in all reality a placenta is medical waste after delivery but it showed no respect for her patient, which needs to be addressed.”

And a really interesting question:

“Would she have been handed the same punishment had it been a picture of a full bed pan?”

Other sites also argue the “no harm, no foul” rationale—since there was no way to link the organ to a patient and so no breach of privacy, what was the harm? Comments on one of several posts about this issue at Those Emergency Blues came out in favor of the students. Nurse and blogger Phil Baumann’s post, “The Placenta Incident and The Shawshank Redemption,” did as well.

The school did seem to react harshly, especially when there seems to be some question as to whether the clinical faculty member might have been aware of the students’ activities.

However, there was a decidedly different tone on a blog called The Stir at CafeMom, a Web site focusing on pregnancy and motherhood, that should give us pause. Author Jean Sager writes the following in a post called “New Pregnancy Fear: Who’s Got Your Placenta Now?”: Read the rest of this entry ?

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On the Road to the Future of Nursing

November 29, 2010

By Shawn Kennedy, interim editor-in-chief  

by wfyurasko/via Flickr

I’m writing this on the train to Washington, DC, heading to the National Summit on Advancing Health through Nursing, which is taking place November 30 and December 1. This is the next step of the Robert Wood Johnson Foundation’s Initiative on the Future of Nursing (see my October 8 blog post) and will launch the Campaign for Action—the plan for implementing the recommendations of the Institute of Medicine’s report, The Future of Nursing. (You’ll be able to access the webcast and a live chat of webcast users on November 30 here.)

If you haven’t read anything about this initiative, do so. If you’re a nurse and plan to be working for the next 10 years, the recommendations from this report, if implemented, will affect you in some way. Expect to see changes in the following areas, to name just a few:

  • how and where nurses practice
  • undergraduate and graduate curricula
  • licensing and certification criteria
  • reimbursement policies
     

Other nursing initiatives have come and gone, some more successful in achieving their goals than others. AJN will cover the progress of this initiative as it attempts to evolve from a written report to an active process that creates sustainable change. As a start, in the December issue, now available at ajnonline.com, AJN brings you a guest editorial by Susan Hassmiller, director of the Initiative on the Future of Nursing. There’s also a summary and analysis of the report in AJN Reports, and a podcast interview with Marla Weston, CEO of the American Nurses Association, discussing the recommendations. And I’ll be posting updates here on the blog.

The weight of the IOM, the Affordable Care Act mandating health reform, the aging of America, and the numbers of Americans living with chronic diseases—all have come together to create the “perfect storm” for significant change. This is perhaps the best opportunity nursing will have in our lifetime to become a decision maker in shaping health care delivery in this country. Here’s hoping . . .

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Why Do Needlestick Injuries Still Haunt Us 10 Years after Protective Legislation?

November 8, 2010

By Shawn Kennedy, AJN interim editor-in-chief

By ad-vantage / Vanessa Agressti, via Flickr

In 2008, a survey by the American Nurses Association (ANA) indicated that 64% of nurses reported a needlestick injury. That startling figure was reported by Marla Weston, CEO of the ANA,  in her opening remarks last week when the ANA relaunched “Safe Needles Save Lives,” its campaign for use of safe needles in the workplace. The campaign originally launched ten years ago and was instrumental in passage of Public Law 106-430, the Needlestick Safety and Prevention Act, which requires employers to “identify, evaluate, and make use of effective safer medical devices.” And while there have been inroads towards use of safer needle systems, the 2008 data show that much needs to be done. 

Speaking from experience. Karen Daley, the ANA president, has long been a leader in advocating for safer needle systems. She sustained a needlestick injury while working in the ER a decade ago and contracted hepatitis and HIV infection. Her home state, Massachusetts, has been in the forefront of legislation. According to Angela Laramie from the Massachusetts Department of Public Health, all hospitals in Massachusetts are mandated to use sharps injury prevention devices, maintain a log of any injuries, and submit an annual report to the state. Yet, state data show an average of 3,000 needlestick injuries yearly—and more than half of these are with devices that lack safe needle systems.

Why does this continue? Why can hospitals, clinics, and other workplaces that use sharps continue to not invest in safe devices when they are available and when, by law, their use is mandated? Nurses, does your workplace protect you from needlestick injuries?

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Obama, Rock Star for Nurses

June 17, 2010

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief (sent yesterday from her Iphone)

So it’s Wednesday afternoon, June 16, and I’m here in Washington, DC, attending the 2010 House of Delegates meeting of the American Nurses Association (ANA). It’s easy to find the sessions—one just has to follow all the middle-aged women walking in one direction through the lobby (full disclosure: that includes me).

ANA president Rebecca Patton opened the session and announced that there would be a “special surprise guest.” She got about halfway through announcements about parliamentary procedure, using the electronic voting machines, and the other housekeeping details when I noticed a rather large muscular young man with an earpiece slip in the door near me. I noticed several clones of him at each exit. Our “special guest” had arrived.

Patton introduced President Barack Obama and he received a rock star welcome from the approximately 800 attendees. He said he came because he promised he would if nurses supported his campaign and he won the presidential election. He proclaimed, “I love nurses.” (I wonder: when he goes to other groups, does he say, “I love physicians” or “I love auto workers”?) He retold the story of how nurses took care of his wife and daughters when his daughters were born and how the nurses “got him through” when one of his daughters had meningitis and how they gave her such good care.

Obama then spoke about the changes in health care brought about by the Patient Protection and Affordable Care Act he signed  into law in March. He left the stage and spent almost five minutes among the audience, shaking hands as he slowly made his way out. The Hulk clones quietly disappeared and Patton came back to conduct business. 

It all seemed so ho-hum after the rock star had left.

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ANA Chart Compares Key Nursing Provisions in House and Senate Bills

December 4, 2009

By Judith Leavitt, MEd, RN, FAAN

There’s a tremendous amount of information available about the different congressional proposals on health reform. But it’s difficult to know how the proposed legislation might affect nurses and the profession. The American Nurses Association has just released an excellent chart offering side-by-side comparison of key provisions related to nursing in the two current bills, the House bill (H.R. 3962) and the Senate bill (H.R. 3590). These provisions include:

  • increased financial support for nursing recruitment and advanced education
  • increased funding for graduate education for nursing faculty
  • increased funding for education for students who will practice in underserved areas
  • establishment of a Public Health Workforce Corps
  • increased Medicare reimbursement rates for advanced practice nurses, including nurse–midwives
  • pilot programs to provide reimbursement under Medicare for nurse practitioners to create or lead “medical homes”
  • increased reimbursement to school-based health clinics under Medicaid

There’s much more to be gleaned here, and the chart format makes scanning for particular points of interest easy. Have a look!

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ANA Releases Letter Urging Nurses to Get Vaccinated

November 3, 2009
 

As the influenza season begins, the American Nurses Association (ANA) calls on all registered nurses to get the seasonal influenza vaccine. After all, as nurses, we have an ethical obligation not only to protect ourselves, but also to protect our patients and our families from influenza illness. ANA has long emphasized to nurses that vaccination is one simple step that everyone should take. Simultaneously, during the 2009-2010 influenza season, this nation is also facing a major health threat caused by the H1N1 virus.

 

The above is an excerpt from a letter by President Rebecca Patton, MSN, RN, CNOR, of the American Nurses Association (ANA) urging nurses to get vaccinated for both the seasonal flu and the H1N1 virus (swine flu). To read the full letter, click here: ANA Letter to Nurses.

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What Obama Told Us (Nurses) in the West Wing Yesterday About Health Care Reform

September 11, 2009

By Diana J. Mason, RN, PhD, editor-in-chief emeritus

Fuzzy cell phone shot in the Rose Garden, Sept. 10, 2009

Fuzzy cell phone image from West Wing, 9/10/09

I was pleased to represent the American Academy of Nursing yesterday at President Obama’s speech on health care reform to an audience of nurses (including new Administrator of the Health Resources and Services Administration or HRSA, nurse Mary Wakefield) in the West Wing of the White House. His remarks summarized his powerful presentation to Congress and the nation on Wednesday evening, with one exception: he used the word “nurses” in Thursday morning’s speech. In fact, in that follow-up speech, he talked a lot about nurses, noting that nurses know too well the problems with our health care system, see the impact of its failings on the lives of their patients every day, are trusted by the public, and are key to reforming health care. 

The President’s speech was introduced by Rebecca Patton, president of the American Nurses Association (ANA). He spoke about his own family’s experiences with health care and the essential work of nurses in helping his family members come into this world, leave it gently, and cope with illness. He then summarized some of the major points of the plan he laid out on Wednesday night:

• People won’t have to worry about being dropped from their health insurance plans if they become ill.
• His plan would not force people or employers to change their coverage or choice of physician (and I hope he soon learns that this language should be “provider,” since many of us get our health care from a range of health care providers who may or may not be physicians).
• His plan would forbid insurers from dropping you or refusing to cover you because of a preexisting condition, would limit out-of-pocket expenses, and would provide the uninsured and others with access to an insurance exchange that would promote competition and lower costs. (I’m hoping that this exchange would include a public plan option to spur more competition.)

He’s right. Nurses do know the importance of these elements of health care reform. He shared the example of a posting on the New York Times blog by nurse blogger Theresa Brown, about treating an insurance salesman with cancer. He asked for nurses’ help in talking with people about the importance of health care reform. We can help by talking with patients, friends, and families about the importance of actively supporting health care reform now. As the President said, “We aren’t the first to take up this course, but we’re going to be the last.”

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