Word Games? ANA Says We’ve Already Got a National Nurse; Others Disagree

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

On a new post at Homeland Voice, author Fiona Regina, MSN, RN, presents a rather critical discussion of the American Nurses Association’s opposition to the National Nurse initiative. She writes, “For heaven’s sake, it’s time for the ANA to get on board. The entire ANA organization would be better served by embracing motivated, politically active nurses willing to improve the health of our nation.” 

Regina offers several theories as to why the ANA might be taking the position (that is, aside from their stated reasons, one of which is that the U.S. Public Health Service already has a Chief Nursing Officer); what’s lacking in her piece, though, is any comment from the ANA to refute her charges or further elucidate their position. 

The ANA stance aside, the notion of a National Nurse keeps coming up and has support from many sectors. Diana Mason, AJN‘s editor-in-chief emeritus, argued for it here last September. More nurses should join the debate so that this issue can either move forward or be put to rest. What’s your opinion?
Bookmark and Share

Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. […] From “Off the Charts” at the American Journal of Nursing has a post about the AJN’s sta… […]

  2. Diane LeDonne March 30, 2010 at 9:42 pm

    I agree and disagree with the above discussion from so many responders. First, was the Surgeon General of the United States “at the table?” If so, she could have brought along her Chief Nurse. Second, I don’t think the PHS mobilizes teams that go to help out during disasters – maybe we need a nurse in Homeland Security? The Director of the American Red Cross used to be a nurse – if not, there is a top nurse in the Red Cross. The Red Cross does assemble and mobilize teams during emergencies. Third, I thought the ANA was “at the table” – if so, didn’t they stand up for nurses? Fourth, if you are a practicing RN, why don’t you belong to the ANA? More than likely two reasons: membership costs, and/or you belong to a nurse speciality organization. The specialty organizations have drawn many potential or existing members away – nurses cannot afford both. For some of it the costs became prohibitive. And for some of us, participation became difficult if not impossible. Some of us felt that our opinion – even when we were members – didn’t count. The loss of the conventions also hurt membership – the fellowship and education opportunities lost by not having conventions hurt all of us. I am a late-comer to the debate re: The National Nurse. Remember, the SG doesn’t “speak” for all doctors. The AMA and the doctor specialty organizations do that. So don’t think the National Nurse will be able to “speak” for all RNs. Should the ANA endorse this effort? Well, it would certainly be nice if the official nurses organization would do that. But what is the real reason behind the reluctance to endorse? Have we as yet uncovered the real reason? Perhaps we need to know that reason before we condemn the ANA.

  3. Karon Gibson RN March 26, 2010 at 4:56 pm

    I hope all Nurses will watch our shows, Outspoken with Karon RN and see the public opinions we voice as patient advocates in many arenas. You can go to Ustreamtv.com and click on videos at bottom of the page and put in Outspoken which will take you to a page that you can search for Outspoken with Karon…our email: auntclaus@yahoo.com

  4. Anne Llewellyn March 26, 2010 at 9:43 am

    I have supported the HB to broaden the scope the Public Health System. As many know who are keeping up to date on current events, the key to containing escalating health care cost is prevention. To education and empower consumers, we need a unified effort and the nursing workforce can do this. The Office of the National Nurse has been a grassroots campaign that builds on what we have and recognizes the value each nurse brings. I would hope the ANA would see the value of this as it would raise the visibility of nurses and encourage more nurses to enter the practice. It is a win-win.
    Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN
    Editor in Chief, Dorland Health

  5. Becky Bowers-Lanier March 24, 2010 at 2:49 pm

    I support the National Nurse bill, and it saddens me that our national organizations seem to ignore this large grassroots effort to elevate the Chief Nurse of the USPHS to that position. Strikes me of a power struggle over which I do not have total understanding, but I am not surprised. I’ve been a member of ANA for 45 years, and this will probably be my last.

    If you want to make change, unfortunately, you have to work at the state level where the nurses wear too many hats to argue over turf and territory.

    I hope I’m wrong. With the passage of federal health care reform, I should be optimistic, but I’m not there yet.

    Go National Nurse initiative!

  6. Betsy Salter March 24, 2010 at 12:02 am

    I believe having a National Nurse will raise public awareness of and thus help to:

    – slow the growing epidemics of preventable diseases:

    – Promote health awareness, increase health literacy, and reduce health disparities:

    – promote health careers and increased resources:

    – enhance visibility and public recognition of nursing:

  7. DebiO March 23, 2010 at 9:55 pm

    I support the National Nurse campaign and find it incomprehensible that the ANA does not. I thank my colleagues who have so articulately explained why a National Nurse is important. I was gratified to see the positive article reported through the ANA SmartBrief. I hope the ANA will reconsider its position.
    Debi Onken, MSN GNP-BC

  8. Teri Mills MS, RN, CNE March 23, 2010 at 10:14 am

    Correction to above comment:
    2. The ANA includes in their social policy the importance of health promotion and prevention in nursing practice.

  9. Teri Mills MS, RN, CNE March 23, 2010 at 10:11 am

    I am also a long time ANA member and what I fear most is the perception that those who read HR 4601 The National Nurse Act of 2010 will believe that the ANA is against exactly what they say they stand for.

    1. The ANA asked for years in their publications that all 2.9 million nurses (now the profession numbers above 3 million) become politically active. Is this only for the bills they introduce or the candidates they choose to endorse or are nurses allowed to critically think and make decisions on their own to choose issues and individuals to support that are congruent with their own values?

    2. The ANA includes in their social policy the. Even ANA President Becky Patton stated this is worthwhile for nurses to pursue in her “bucket list” editorial in a recent American Nurse, the official publication of the ANA. Health promotion and prevention are the cornerstone of every nurse’s practice, regardless of specialty or educational background. HR 4601 enhances duties of the CNO to increase public awareness for the necessity of these principles, and “encourage(s) practicing nurses and other health professionals, including retired health professionals and students enrolled in health professional programs, to participate in health promotion activities and replicate successful health promotion activities. Please read the bill in its entirety at http://thomas.gov/cgi-bin/query/z?c111:H.R.4601:

    3. We all agree the media portrayal of nurses and our profession leaves much to be desired. Again, elevating and having an existing position, the CNO of the USPHS, to be known as the National Nurse will help to accurately demonstrate to the public what nurses are capable of doing and that we do indeed have a unique body of knowledge. We all know who Dr. Sanjay Gupta is; should we not have this kind of visible representation for the largest sector of the health care workforce?

    Do we really have time for “Word Games” or should we come together as one, and fulfill the reason we all chose to be nurses in the first place — to keep the public well!

  10. lydia March 22, 2010 at 9:43 pm

    As nurses we educate and listen to our community. There needs to be a national nurse to be the voice of these nurses who work so hard and care so much about their jobs, issues, and communities.

  11. Kathy QUan RN BSN March 22, 2010 at 9:24 pm

    ANA is a huge power conglomerate who could lead the nurses in this country if it had any real sense of what and how to do it. The fact that ANA’s strength has been eroding year after year because it refuses to really stand up for the nursing profession is testament to this fact. It is unfortunate, but ANA needs to step aside and let the real leaders emerge.

    We have a crisis in the making with the shortage of nurses, nurse educators and other health care professionals. Yes, the economic downturn has forestalled it temporarily, but now that we have have some form of real health care reform, we’re going to see a rapidly growing need for more nurses.

    And this force of nurses needs some STRONG LEADERSHIP to take us where we need to go in helping this country find the quality of wellness and the health care it needs and deserves.

    We need a NATIONAL NURSE NOW, and we don’t need any more rhetoric and game playing about it. We need to stand strong and united behind this grass roots effort and the new bill before Congress (H.R. 4601) to get the leadership and assistance we need and deserve to help us move forward and face the challenges we will face in this decade and beyond.

  12. Kim March 22, 2010 at 7:48 pm

    Well, I put my money where my mouth is and I am now a member of the ANA – they will hear my voice from the inside, as a member.

    We need the National Nurse for the country more than for the nursing profession! There is not a single citizen in this country who would not benefit from a visible spokesperson who is a Registered Nurse. We talk about health care, we talk about prevention and we hear how wonderful nurses are and how we are the heart of health care, but we don’t rate anything more than a PART-TIME Chief Nursing Officer that no one has ever heard of?

    We need a National Nurse and we need them all over social media spreading the word on health and prevention. For the patients – for us!

    And, in the process, nursing gets a visible representative and advocate.

    We can never have too many advocates for nursing. There is a place for ANA and for the National Nurse. I’ve been on board for years.

    Don’t sell ANA short – join them. Let them hear us. Let’s change it from the inside out.

    Support our National Nurse!

  13. Kara Couch March 22, 2010 at 7:42 pm

    I am proud to be a nurse practitioner who spends a great deal of time educating my patients on nursing and how we improve healthcare. I consider myself to be very up to speed on legislation that affects nursing directly and I have never heard of the CNO before. Whoever is in that position does not wield it effectively to promote the profession and health promotion and disease prevention. The NN Initiative will fill this sorely needed gap. Nurses need to stand on the front lines nationally as healthcare authorities. After all, we take charge of the patients in hospitals; why would we not want to spread the message on a larger scale. The ONN needs to happen ASAP!

    Kara Couch, MS, CRNP, CWS

  14. Alisa March 22, 2010 at 6:37 pm

    Whether or not the ANA approves, nurses are also tax paying citizens and we are asking that our tax dollars be used wisely. The epidemics of preventable conditions continue to plague us despite all the money spent on “health care”, and especially becasue of the huge losses of funds from the Public Health system. We need a reliable source for accurate information and health education and a publicly recognized Office of the National Nurse would serve to meet this need and strengthen the US Public Health system.

  15. Susan Sullivan MSN PHN BSN March 22, 2010 at 4:47 pm

    As health care reform moves forward, what a “seize the moment” opportunity nurses will have to influence and help implement needed changes. Elevating the Chief Nurse of the USPHS to serve as the Natinal Nurse alongside the Surgeon General will result in a visible National Nurse to advocate for dynamic evidence based community prevention efforts. Techology based social marketing, media appearances and PSAs would promote National Nurse visability, impact recruitment to nursing careers, and support involvement of willing nurses. Just as physicians receive valued guidance from the Surgeon General, nurses across all specialties would be supported to implement evidence based intervention and strengthen existing networks that need nurses providing for their local communities. This adds up to an exciting time for nursing to take action to slow the growth of preventable conditions.

  16. KJ Page March 22, 2010 at 3:32 pm

    A National Nurse can take a stand for Prevention and Promote good health Practices. A National Nurse can coordinate volunteer efforts in local communities through consistent message and event suggestions. Especially in this economic climate there is no need to spin wheels or reinvent wheels. With attention focused on a National Nurse, more can be done with limited resources. The ANA should support this beacon and focused attention on Nursing.

  17. Laura Stokowski March 22, 2010 at 2:08 pm

    No matter what the ANA has to say, when they finally gather their lawyers and advisors around the table to figure it out, it won’t be the truth. How do you admit that you are afraid of losing power? How do you admit that deep down, you wish YOU were the National Nurse, and that you are angry with yourself for not thinking of it?

    I don’t doubt that the ANA will come up with something. After all, creative manipulation of the facts is one of their strengths. On their own web site they claim to represent the interests of the nation’s 3.1 million nurses, yet fewer than 6% of those nurses are members of the organization. Good one!

  18. Paula Guthat March 22, 2010 at 1:50 pm

    The ANA’s position on this makes no sense. I agree with June Schulte’s comment above. I too am not a nurse and had never heard of the Chief Nursing Officer. In order for nurses to promote health and an environment that fosters health, they need visibility. The Office of the National Nurse would accomplish this and also act as an advocate for ordinary people.

  19. Shelly Johnson, RN March 22, 2010 at 1:32 pm

    Updating the function of the Chief Nurse Officer is vital- just look at the rates of preventable disease in this country and it is apparent that not enough emphasis is placed on health promotion and disease prevention. Updating the name to something the public recognizes is also important. How many people know we have a Chief Nurse Officer? How many care?
    The public can identify with a title like “National Nurse”, and the name change could increase public awareness of the role of the nurse in this country.

  20. June M. Schulte March 22, 2010 at 1:28 pm

    There may already be a Chief Nursing Officer for nurses, but I am not a nurse. I am a grandmother and I need a National Nurse. I need someone who can be a strong advocate and supporter of our nurses who work on the front lines of healthcare, while also focusing our whole nation, average citizens included, on prevention! I have long known about our Surgeon General but had never heard of us having a Chief Nursing Officer; and even now that I know, I have never heard mention of that person in the conversation on health care or in the media. So it can’t be a very effective position, currently, because I am an aware citizen. I need a National Nurse. Please support H.R. 4601. Thank-you!

  21. D. Paxson Barker, PhD(c), BS, RN March 22, 2010 at 1:25 pm

    I am a member of the ANA and am very proud of the recent actions they have taken to improve the nurses’ work environment by collaborating with EWG, HCWH, and PSR to name a few. I believe that this is such a great opportunity for the ANA to strenghthen their commitment to nurses at the bedside across practice settings by endorsing and campaigning for the position of the National Nurse. As a clinical nurse for over 30 years, I never joined the ANA because I did not believe they represented me as a working nurse. After all of these years, I now admire and support the ANA leadership for standing up for nurses regarding physical and chemical hazards in the workplace. I strongly support the bill HR 4601 and encourage the ANA to join us in making a strong statement to the front-line nurse that they care and support her in the trenches and acknowledge that it is the nurses that assumes the role of health educator of patients in this country.

  22. Sheryl Oakes Caddy RN JD March 22, 2010 at 12:30 pm

    The ANA continues to claim that the United States already has a National Nurse, can they truly believe their own words? If the US had a National Nurse, a visible nurse representative promoting health care and disease prevention, where is this person? We are in health crisis in this country. We need a national nurse. On February 4, 2010, Congressman Earl Blumenauer of Oregon, introduced H.R. 4601, which designates the Chief Nurse Officer of the US Public Health Service as the National Nurse. The National Nurse would be elevated in rank and made a full time position. Focusing citizens on health promotion and disease prevention would be the National Nurses’s goal. The National Nurse bill aligns with the President’s Health Care program, I ask, ANA if you support the health care plan how can you not support the National Nurse?

  23. Lillian Gonzalez March 22, 2010 at 11:52 am

    Wow! I just googled Dennis Smith, the person who wrote the intro into this article. He’s a major Federal player for HomeLand Security. http://en.wikipedia.org/wiki/Dennis_Smith_(firefighter). His intro into this article really struck me. We have no way to organize nurses in times of catastrophe – I know cause I tried hard to help out during the Tsunami and Katrina disasters. I didn’t bother for Haiti cause it seemed hopeless.

    A National Nurse needs to do exactly that – mobilize us during disasters. And in between disasters, a National Nurse should take the lead in mobilizing the millions of nurses – retired and students perhaps – to educate communities about health and wellness.

    Seems like a common sense approach and the ANA’s opposition is really hurting the nation.

    Oh, I was also surprised to find that the ANA has only 3.8% of membership of all nurses. What’s up with that? I think if they supported the National Nurse, then maybe they’d get more members to support them. And then maybe they could be more effective in getting the pet projects approved – pet projects for the higher educated nurses.

    Like I said, Wow!

    Lily – tgrlil@live.com

  24. Claudia Michel March 22, 2010 at 11:37 am

    If there is already a National Nurse (CNO), where is this person in this current health care debate? Where was the nurse at the table yesterday during the analysis of the health care bill? Why don’t people in this country know about the Chief Nurse officer? Where is the nursing voice? We need a National Nurse who can bring this perspective to the table.

  25. Kari Stuber March 22, 2010 at 11:16 am

    The nurses need a full time person to represent the nurses of this country, just as the doctors do.
    The National nurse proposal is the right thing, and the right time is now, for this country.

  26. Anne Nowlin March 22, 2010 at 10:45 am

    Where do I start? The ANA has stated time and again that they feel that having a National Nurse would be a duplication of nursing services. Not true at all. The NN proposal, HR 4601, would change the position of the United States chief Public Health RN from that of a part-time position; to a full-time position. There would not be any new hiring.

    The proposal for a National Nurse does NOT come close to adding another position, thereby potentially duplicating services. From where I sit, it appears that the ANA is obstructing the progression of nursing and health care in America. Can there ever be enough nurses to teach prevention?

    Somehow the President’s spoke of ANA endorsing his plans for a new health care bill. Why doesn’t the ANA be honest, indicate their small representation of RNs; then discuss it’s endorsement of the National Nurse, HR 4601?

  27. misti March 22, 2010 at 10:10 am

    We would not be advocating for a national nurse if there wasn’t a need.

  28. Liyah March 18, 2010 at 4:54 pm

    Not enough is done, as we can see. Especially during this time in the Obama admin, there needs to be change for the better in healthcare. Nurses can make a major impact in setting standards for an American lifestyle of wellness. Go nurses.

Comments are moderated before approval, but always welcome.

%d bloggers like this: