Home Nursing Where are the Nursing Voices?

Where are the Nursing Voices?

By Vivien Mudgett, RN, MA, MSN

There are 3.1 million Registered Nurses in the United States, and seven RN’s represent the profession in Congress. For eleven years, consumers have ranked nurses as the highest profession in honesty, respect and ethical standards. A glaring gap exists when we look at these facts. Why are nurses so highly regarded, yet missing from the table when health policy decisions are made?

In 2013, Marilyn Tavenner, RN, was confirmed by the Senate as the head of the Centers for Medicare and Medicaid Services.  Her appointment represented a giant leap for nursing; it is rare to have a nurse in such an influential leadership government position.  Ms. Tavenner has the opportunity to make a positive impact on the lives of millions.  Not every RN can achieve something as significant, but every nurse can take an action step to move health policy forward and advocate for patient care.

The Affordable Care Act and Health Care Reform of 2010 does not just change the number of insured patients in the country. The law’s effects are far reaching and include matters such as the number of practitioners needed in the next decade; the core measures that hospitals are reimbursed and not reimbursed for, and most importantly, the way care is delivered

While hospitals fight for their lives to stay viable, due to a complex combination of decreasing reimbursements and increased regulations, the nursing profession also faces key issues. The need for nurses to engage in health policy at the local, state and national level has never been more critical. If nurses understand the process of health policy, they can learn to use their collective voice: a rich voice which Washington wants and needs to hear.  

 Nurses are now often compelled to practice within guidelines and mandates created by persons outside of the nurse-patient relationship, such as insurance companies, legislators, and lobbyists.  While safety goals and quality initiatives brought forth by the Affordable Care Act are crucial, nurses must become aware of their ability to influence future health policy. Nurses must believe they have more insight than most when it comes to clinical needs and the therapeutic value of nursing care. Additionally they must be able to speak to the resources they need to provide quality care. 

So why aren’t more nurses involved in health care policy? Why are nurses missing from the discussions at decision making tables? Many nurses have the opinion that they can only affect patient care by giving good quality bedside care. Others, trying to achieve a work- life balance think they don’t have time.  

The complexity of issues today can leave a nurse paralyzed by the fear of speaking to a legislative representative. Nurses worry about how to articulate the value they bring to patient care. Finally, some nurses are so frustrated by all the changes and current constraints that they are leaving nursing. This is not the time to leave; this is the time to get active, energized and start making a difference! 

Here are four key steps any nurse can take TODAY to have input into their own practice:

Get involved.  Join a Nursing Organization that has special advocacy arms, such as the American Nurses Association. Explore the advocacy tabs to gain a wealth of knowledge.

Learn the Key issues: Nursing has important legislation pending. The ACA is not the only issue on the table. Start by understanding the law and its effects. Then learn about issues such as Advance Practice Nursing, Unlicensed personnel and workplace advocacy. 

Find your cause. Identify an issue that resonates and start emailing, writing or visiting a legislator’s office. When nurses speak, legislators listen!  If they are not available speak to their aides. Take advantage of state nursing organizations that sponsor a day at the state or U.S. Capital.

Connect with your state representative. Use a site such as www.whoismyrepresentative.com  to find the right legislator.  Use templates from nursing websites to email or write to them. 

Remember, just take ONE SMALL STEP at a time. As the late Mother Teresa said,”I can do things you cannot, you can do things I cannot; together we can do great things.” Patients are counting on nurses to accomplish great things together. 

Vivien Mudgett has been a nursing leader for over 25 years.  She founded the Healthcare Leadership Coalition in 2013 to assist nurses and consumers learn how to navigate the maze of the healthcare world and healthcare policy today. The four cornerstone words of the Coalition are Education, Reform, Advocacy, Power. For more information, visit www.healthclc.com or email her at vmudgett@healthclc.com.

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