New National Nurses Union Forms — But What’s It Mean to You?

By Peggy McDaniel, BSN, RN

Yesterday a new and powerful union was formed. The National Nurses United brings over 150,000 nurses together by combining the California Nurses Association/National Nurses Organizing Committee with the Massachusetts Nursing Association and some members of the United American Nurses.  The new “superunion” intends to focus both on influencing health care reform and on improving quality of care through such efforts as extending California’s patient ratio law into other states.

I have never worked in a union-supported hospital, nor have I ever belonged to a union. My father was an electrical engineer and although he was a union member, he always talked about the “union guys” who worked as little as possible. I remember his frustration at members who took advantage of the positive conditions promoted by unions. When I was a newly employed nursing graduate, one of my friends was a card-carrying pipefitter. He bragged about not doing any work for days on end because there were no laborers around to carry his materials! 

As a hardworking staff nurse, I was angered by his complacency. I couldn’t imagine not clearing away a patient tray if the nurse’s aide hadn’t had time. I approached my nursing role as a team member focused on taking care of the patients—sometimes to my own detriment, since I was one of “those” nurses who often skipped breaks to complete tasks or charting. That said, I have seen the good that unions have done for nursing, especially around working conditions and benefits.

Given the current push to reform health care, […]

ANA Chart Compares Key Nursing Provisions in House and Senate Bills

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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‘Who Do You Trust?’ asks ANA President Patton in White House Video

As the Senate debates health care reform legislation, lobbyists across the political spectrum are busy trying to make themselves heard both by legislators and the American public. In an attempt to blunt the impact of the numerous campaigns aimed at killing or gutting the legislation, the White House has released a video called “Who Do You Trust?”, in which Rebecca Patton, president of the American Nurses Association (ANA), appears with Joe Biden and Lori Heim, president of the American Academy of Family Physicians.

But questions do remain. Despite the obvious need for many of the insurance reforms proposed in the plan, the Democrats have yet to fully address the question of how this will be paid for by real changes in the delivery of care or real limits on the influence of pharmaceutical companies or medical device manufacturers.

How, for example, can cost controls ever occur in a system dominated by a fee-for-service model in which physicians’ income is often directly related to the numbers of tests and procedures they recommend, one in which they are rarely bound or directed by evidence-based guidelines or protocols? Would physicians’ organizations like the one represented in the White House video ever support a plan in which most physicians were, like most nurses, on salary? Why is that unthinkable?

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If You Think ‘Evidence-Based Practice’ Is Just Another Buzzword, Think Again

Do you ever wonder why nurses engage in practices that aren’t supported by evidence, while not implementing practices substantiated by a lot of evidence? In the past, nurses changed hospitalized patients’ IV dressings daily, even though no solid evidence supported this practice. When clinical trials finally explored how often to change IV dressings, results indicated that daily changes led to higher rates of phlebitis than did less frequent changes. In many hospital EDs across the country, children with asthma are treated with albuterol delivered with a nebulizer, even though substantial evidence shows that when albuterol is delivered with a metered-dose inhaler plus a spacer, children spend less time in the ED and have fewer adverse effects. Nurses even disrupt patients’ sleep, which is important for restorative healing, to document blood pressure and pulse rate because it’s hospital policy to take vital signs every two or four hours, even though no evidence supports that doing so improves the identification of potential complications.

That’s from the start of an article in the November issue of AJN, the first in a new series we are running to highlight the way’s evidence-based practice (EBP) changes what nurses do at the bedside—and saves lives. The authors point out that every day nurses perform dozens of actions and procedures without ever really asking whether the way they are doing them is the best way, or whether or not they are even helping patients by performing these actions.

While […]

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