By Katheren Koehn, MA, RN, FAAN, executive director of the Minnesota Organization of Registered Nurses (MNORN) and a member of AJN‘s editorial board.

I have been a member of the American Nurses Association (ANA) for over 40 years, an active member for about 35 years. I “grew up” in the association as a delegate to the House of Delegates. I learned to “edit on the fly” by debating perhaps hundreds of resolutions introduced by state nurses associations at the annual, then biannual meetings of the highest level of governance of ANA.

Debating resolutions.

Resolutions had a formal structure of “whereas” and “be it resolved.” Whereases contained the facts; the be-it-resolved contained the actions delegates wanted the ANA to enact. Whereases could not be edited or debated; be-it-resolveds could be edited and debated for hours, or until someone remembered to use the Robert’s Rule “Call the Question.” Debate over resolutions had more to do with proving your point than listening to another’s point of view. It was great theater, but I don’t know how often those resolutions moved our profession forward. I’m sure some of them did, but I remember the debate more than the resolution.

Making the ANA governing body a membership assembly.

When the 2012 ANA House of Delegates voted to change the governing body of the association to a membership assembly, one of its key purposes was to identify and discuss issues of concern to members and provide direction to the ANA Board of Directors. Delegates hoped that the membership assembly would provide a forum for discussion of critical nursing practice and policy issues, and to receive input from a broad cross section of nursing leaders. Each year since 2012, the membership assembly has attempted to achieve the goal of in-depth discussion of meaningful nursing issues.

A forum for ‘all points of view.’

I believe the vision of the 2012 House of Delegates was achieved at last month’s meeting. There was discussion of a large number of topical issues during an action-packed, two-day meeting. Topics were discussed using a variety of formats: dialogue forums, a ‘policy cafe,’ and topical lunchtime sessions.

All of the topics were complex, without clear or easy answers. Rather than the debate format of the ANA House of Delegates, the format used at the membership assembly allowed for representatives and other attendees to listen carefully to all points of view.

Addressing a potentially divisive issue.

Let me give you an example. One of the dialogue forum topics was to discuss ANA’s current United States presidential endorsement process and whether this process should be reevaluated. Thirty-four years ago the ANA House of Delegates voted that the association should endorse candidates running for the president of the United States. A policy and procedure were created based on this vote, and the ANA has endorsed candidates in every election in the ensuing years. (Contributions to endorsed candidates have come from donations made by individuals to the ANA-PAC. No dues money has been used to support presidential candidates—or any other candidate endorsed by ANA.)

Endorsement of presidential candidates has been a consistently challenging process because ANA’s membership supports candidates in all parties. Some state nurses associations report having lost members in the past due to ANA’s choice for endorsement. In our current political climate, I was afraid that this discussion could be emotional and divisive among attendees at the membership assembly.

The old approach.

The older ANA House of Delegates structure would have begun the discussion with a resolution, “be it resolved that ANA continue the current presidential endorsement process,” or “be it resolved that ANA cease endorsing presidential candidates.” Debate would then ensue and proponents or opponents would try to “count the votes” to see if they had enough to pass or defeat the resolution. A majority would vote to pass or defeat the resolution after a debate designed to “win the vote.” There would be clear winners and losers and relatively little understanding of the other perspective.

The current approach.

Instead, the ANA Membership Assembly format allowed for discussion of pros and cons of the current endorsement process; changes that might be considered to adapt the current process to today’s environment; and what other advocacy strategies might prove to be more valuable that any of the strategies used currently. Each person who spoke had the attention of all attendees.

The final decision of the voting representatives was to ask the ANA Board of Directors to develop a revised proposal after they’d received even more input from members and other stakeholders. They asked the ANA Board to consider, at the minimum, these elements in relation to the question of any potential ANA presidential endorsement:

  • member education
  • ANA visibility, influence, and role
  • resource capacity
  • impact on membership growth and retention

The ANA Board will prepare a Report for the 2019 ANA Membership Assembly for consideration of a revised proposal. And, hopefully, that discussion will be as respectful and informed as it was at this year’s membership assembly and be followed by thoughtful decisions that will guide the ANA for the next 34 years.

For more info, see https://www.nursingworld.org/news/news-releases/2018/2108-membership-assembly-day-2/.