nti2010 policy politics and you act with intention

Policy, Politics and You: Act with intention unifying Nursing’s

Political VoiceTodd M. Grivetti, MSN, RN, CCRN, CNML

Clinical Nurse ManagerRegional Neurosciences Center

Poudre Valley HospitalFt. Collins, CO

House Keeping

Please Turn your Cell phones and pagers to Vibrate.

Disclosure Statement

As a member of AACN’s Speaker’s bureau I have received an honorarium from AACN for this presentation. I have no

other vested interest(s) from any other organization.

Learning Objectives

At the end this session participants will be able to: Identify four spheres of political action in nursing

along with identifying AACN’s public policy links and other resources to Act With Intention and be the Bold Voice of Nursing.

Discuss the four stages of political development of nursing and how nurses navigate to become key players in policy arenas.

Described how nurses can Act With Intention and become the voice of healthcare policy utilizing nursing’s historic mandates.

Identify resources available for political activism

Introduction to Policy & Politics

Policy: The principles that govern action directed towards given ends

(Titmus, 1974). More Definitions:

A policy is a deliberate plan of action to guide decisions and achieve rational outcome(s). The term may apply to government, private sector organizations and groups, and individuals. Presidential executive orders, corporate privacy or human resource policies, and parliamentary are all examples of policy.

A set of interrelated decisions taken by a political actor or group of actors concerning the selection of goals and the means of achieving them.

Within a specified situation where those decisions, should, in principle be within the power of these actors to achieve (Jenkins, 1978).

An art and a craft… Involves: vision, creativity and imagination in :

Identifying and explaining social problems Creating policy to solve problems Ensuring the implemented policy leads to positive or negative impact.

Types of Policy

Types of Policy Public Social Health Institutional Organizational

Public Policy

Public policy is formed by governmental bodies – Legislation passed by Congress and the

regulations written from that legislation. Public policy related to tobacco use –

including laws that ban selling cigarettes near schools and require health warning labels.

Policies made by government departments or other public agencies with respect to their internal operations when they affect the public at large.

Public Policy Nursing Legislative issues

Shortage, education, workplace issues Resources?

Professional Organizations (AACN, ANA, AONE, ICN)

Patient safety goals Medication safety Falls New CMS guidelines Resources

Joint Commission Organizational policies Centers for Medicare and Medicaid Services

(CMS)

Public Policy & Political Competency Guidelines

Be aware of the impact of the state board of nursing, Center’s on Medicare/Medicaid services, and the department of health services within your state on the practice of nursing

Participate in organizations that impact the practice of nursing.

Expect colleagues to actively participate in nursing and health-care policy organizations.

Meet with your state legislator at least every three months.

Invite legislator to your organization and chapter meetings to share ideas and influence policy

Malloch, 2005

Social Policy

Social policy pertains to the policy decisions that promote the welfare of the public: Local ordinance on age limit for purchase of

tobacco products. Aim at improving

Health Education Welfare Social Security

Healthcare Policy

Health Policy: The decision made to promote the health

of individual citizens. Federal may pay for smoking cessation /

prevention programs for all persons in the military and their families.

States might require coverage for smoking cessation programs by Medicaid managed care plans.

Healthcare Policy Sources:

Organizational Organizational policy sources are developed by health care

institutions to govern work places and direct behaviors. They are influenced by the demands and resources of key external suppliers, purchasers, communities, agencies and media.

Social Public policy sources are authoritative decisions made within

government that pertain to health. They can take the form of laws or operational rules, and can be allocative or regulatory in nature. Public policy sources are influenced by broad contextual factors such as interest groups, diverse segments of society, economics, demographics, and environmental forces.

Professional Professional sources are discipline specific and multidisciplinary

organizations that establish standards, guidelines, and research-based recommendations for providers and healthcare delivery systems.

Taft, Nanna (2008).

Health Policy

Institutional Policy

Institutional policies govern workplaces: What the institution’s goals are and how

will it operate. No Smoking ban – prohibiting patients and

staff from smoking anywhere in the building to the grounds.

Time and Attendance Nursing process Palliative care Internet usage

Institutional Policy Development Scope: Who the policy is intended for:

Example: Identify the range for the organization – (i.e., All PVHS Hospitals).

Strategies for development: Criteria for a good policy

Useful for intended users. Includes policies on all levels and meets

relevant criteria for accreditation and legislative requirements.

Will it improve quality service.


Tips for writing good policies: Devote time at least once per month to

brainstorm issues pertaining to one area of the policy and review draft versions as required.

Be aware of the need to actually tailor policies to your own organization.

Be aware that borrowing other policies may result in approaches and styles of policy which are not compatible to others.


Tips Continued: Keep it Simple Ensure Drafts have a number and date for

ease of tracking. Endorsed policies should include who

authorized the policy and when. Ensure there is someone in the

organization who is responsible for maintaining control of policies and production of policy manual.

Organizational Policy

Organizational policies are positions taken by organizations: State nurses’ associations Associations Professional organizations

ANA – American Nurses Association AACN – American Association of Critical

Care Nurses AONE – American Organization of Nurse

Executives ICN – International Council of Nurses

Members may put forth a resolution for free continuing education programs.

Politics - Definition

Simply: The process of influencing the allocation of scarce resources.

Webster: 1a: The art or science of government b: the art or science concerned with guiding or influencing governmental policy c: the art or science concerned with winning and holding control over a government. (www.meriam-webster.com) 2010.

Perception of Politics Positive perceptions

InfluencingThe opportunities to alter the outcomes

of a process. Allocation

Decisions being made about how to divide resources among competing groups or individuals.

Scarce Resources Implies there are limits to the amount of resources

available Financial backing Time Staff Other entities in the process

Perceptions of Politics

Negative perceptions Smoke filled rooms Shady deals made by power brokers

Pork Barrel spendingTeapot DomesUnethical compromisesVote buying

Perception of Politics

Factors An individual’s own biases, experiences,

and knowledge of politics How the “game” of politics is played -

System in which politics is operating What rules have been established as

acceptable Whether the goals or end is important Whether one is in a position to change the

rules of the system

Values Associated with Policy & Politics

Nursing: Caring Collaboration Collectivity High-touch care

Often conflict with dominant values of society

Values Framework

Pol

itics P

oliticsVal

ues

EvaluationEvaluation

ImplementationImplementation

PolicyPolicy

AlternativesAlternatives

GoalsGoals

AgendaAgenda

PoliticsPolitics

Values

Values Framework

Complex Multidimensional Examples:

Prenatal care in the U.S. Not guaranteed Some women receive very little or no

prenatal care Mandatory overtime used by hospitals Nurse to patient ratios

Values, Policy & Politics

Taft & Nanna (2008). Recognition has grown that nursing has a

responsibility for engaging in actions that influence health policy, and that advocacy may reasonably be considered a role expectation for the professional nurse. If so, what knowledge and competencies do nurses need?

Power Empowerment

Values, Policy & Politics

Mason, et.al (1991) Nonetheless, the idea of empowerment is

one that remains important to nursing’s political development, because it “requires a commitment to connection between self and others, enabling individuals or groups to recognize their own strengths, resources, and abilities to make changes in their personal and professional lives.”

Identify your Policy & Political Resources

Four Spheres of Political Action in Nursing

Workplace Government Professional Organizations Community

Four Spheres FrameworkCommunity

Government

Organizations

Workplace

Four Spheres - Workplace

Workplace Acute Care Home Care Nursing Homes School-based clinics Occupational Health clinics Physician’s Offices


Policies & Procedures Manuals Workplace policies Nursing care Written & unwritten

Examples: Designation of no-smoking areas or ban on

smoking Requirement for nurses to work overtime Decisions concerning the use of unlicensed

personnel Policy permitting loved ones being present during

an emergency


Magnet Hospitals Hallmark of a Magnet organization is

nurses’ involvement in decision making at all levels of the organization and inclusion as an important voice in the development of policies

Robert Wood Johnson Foundation (RWJF) Transforming Care at the Bedside (TCAB)


Summary: Workplace policies also shaped by:

Government Policies on handling of hazardous waste**

Professional Organizations May pressure nurses’ workplaces to use

particular protective equipment in high-risk areas.

Community Community needs for healthcare delivery

Four Spheres - Government

Governmental actions Laws requiring

Birth records Immunizations Legal establishment of drinking age Legal age to vote or join the military Laws determining what health services

people are eligible for in old age and how assets are distributed on a person’s death.

BREAK

15 Minutes


Government has grown bigger and centralized

Plays important role in nursing Influences reimbursement systems for

health care and nursing services Determines who receives what type of

health services. Healthcare Reform Bill 2010

www.healthreform.gov

Four Spheres – Government

Health Insurance Plan 47 million Americans without adequate

health insurance. The type of insurance held by most

Americans and favored by public policy Employment based

Tax subsidy in excess of $100 billion annually Individual insurance

Held by 7% of Americans.

Kaiser Family Foundation, 2007; Knowledge@Wharton, 2000.

Four Spheres – Government National Health Plan

Hacker’s Plan – 3 Principles No one loses what they currently have. Unless,

employer’s “kick” you out. Creation of Health Care for American market (HCA)

Insurers compete for business of individuals and employers.

Group market contains strong public insurer modeled on Medicare creating competition between private companies and the public market.

Source: (Kline, 2008)


Wyden’s Plan: Senator Ron Wyden (OR) and Senator Robert Bennett (UT): Lacks public insurer – no public-private competition . Does away with employer health coverage almost

entirely. Create “Health Help Agencies” in each state. No “cherry-picking”, no high premiums, or denials of

coverage for pre-existing conditions. Everyone pays the same price, but everyone has to buy

insurance that’s at least comprehensive as the current Blue Cross-Blue Shield Standard Plan

Subsidies for low income Penalties for those who do not buy Medicare still exists for the elderly.


National Health Plan Lewin Group – “Gold Standard” Healthcare consulting.

Estimates Hacker’s plan will save $1.04 Trillion over 10 years.

Basic Efficiencies: Administrative and technological. If it works, it will have two effects:

Money savings by mandating the HCA to spend less money.

Caps spending and induces providers to utilize available funds more cost effectively.

Estimates Wyden’s plan will save $1.48 trillion over 10 years.

Not from explicit spending caps as Hacker’s plan, but from consumers who see how much they are spending on health care and then become more price-sensitive and choose cheaper options.


Children’s Health Care (SCHIP’s) Created to provide health insurance coverage

to children whose families who made too much money to qualify for Medicaid but too poor to afford private health insurance.

2007 – Reauthorization for 5 years failed and was vetoed by President Bush on Oct. 3rd, 2007.

Democratic leaders drafted a second bill, but unable to pass with less than 2/3 majority required to override the veto.

Source: http://www.sourcewatch.org/index.php?title=State_Children's_Health_Insurance_Plan

Four Spheres – Professional Org’s.

International Council of Nurses

Four Spheres – Professional Org’s. Instrumental in shaping nursing practice.

Developing standards of care Advocating for change in scope of nursing practice Play a role in collective action in the workplace

Could increase their influence if more nurses participated in them. ANA – Represents the interests of all nurses, yet

only 5% of U.S. nurses are members. AACN – Represents over 500,000 critical and

acute care nurses with 80,000 plus members. 240 Chapters

Four Spheres – Professional Org’s. Professional Organizations – Should:

Be a visible force within its community Have a national presence Have local representation (chapters) Identify issues of concern to nursing and

healthcare Bring them to the attention of the public

Take a leadership role in calling for the development of policies that can improve the health of the communities and ensure the provision of quality nursing care

Four Spheres – Professional Org’s

AACN’s Public Policy Agenda Definitions, Principles, and Outcomes:

Health Policy Agenda Framework AACN is a 501(c)3, not-for-profit educational

organization. Established in January 1996 by the Board of Directors. To be used as a guide in developing, implementing and

evaluating the association’s health policy agenda. April 1996 – Public Policy Work Group

Reviewed and clarified the framework To define a future health care policy agenda that is

founded on defined member needs and consistent with a healthcare system driven by the needs of patients and families.


AACN Public Policy Priority Issues AACN ensures that vulnerable populations

have access to quality health care. AACN works to ensure public and

community safety. AACN works to ensure the provision of

humane and ethical care.

Four Spheres – Professional Org’s. AACN’s Health Policy Restrictions

Chapter’s may not participate in or contribute to political campaigns.

Chapters may not lobby on behalf of AACN. AACN is a 501(c)3 organization which must comply with

restriction placed on lobbying and political activities. Chapter members are prohibited from using their membership

for any electioneering. Chapter members are prohibited from contributing to political

action committees. Chapter members are prohibited from speaking on behalf of

AACN unless they have been designated as an AACN spokesperson.

Chapter members are prohibited from endorsing, supporting or opposing issues on behalf of AACN unless they have been asked to do so by AACN.

Four Spheres – Professional Org’s. American Organization of Nurse Executives

Through its grassroots network of 49 State Chapters, AONE keeps abreast of the latest issues affecting nursing on the legislative, regulatory and practice fronts. AONE provides the chapter leadership with up-to-date information on a variety of topics and allows the membership to access the most current information from government and other private and public sources through a leader list serve. And through quarterly chapter calls, AONE members are able to network and share with their colleagues across the country.

Source: www.aone.org/aone/advocacy/home.html

Four Spheres – Professional Org’s. AONE Legislative agenda

Education & Leadership Development Advocates for FY2010 Federal appropriations for

the nurse education act Support the reauthorization of the Nurse

Education Act – Expired for 5 years. Broaden funding available for nursing programs

outside the direct purview of the Department of Health and Human Services (HHS)

Foster and promote a climate for patient safety and quality that is evidenced-based and NOT legislated mandates or ratios.


AONE – Public Policy & Advocacy Build, support and work with groups that promote a

unified agenda for addressing the most pressing issues facing the nursing profession.

Continue to work and collaborate with AHA, The Nursing Community, Americans for Nursing Shortage Relief (ANSR), the Tricouncil and others to address healthful practice environments.

Effectively represent the nurse leader perspective in all aspects of the practice environment.

Continue to support efforts of ongoing partnerships and the AHA Readiness Team to ensure adequate funding of first-line defenders.

Four Spheres – Professional Org’s. AONE Public Policy & Advocacy cont.

Advocate for and support programs and initiatives that will ensure a safe and quality driven environment for patients and patient care providers.

Develop, evaluate and support legislation that will foster the nurseexecutive’s leadership role in the management of the care environment, especially in areas related to staffing, information technology and patient care services.

Collaborate with quality partners such as the JCAHO, the National Quality Forum and the Federal government to ensure that proposed regulatory changes achieve desired results.

Work within taskforces and other aligned groups and associations to ensure nurses as knowledge-base professionals are able to function within their full professional capacity.


American Nurses Association ANA Position Statements

The American Nurses Association (ANA) House of Delegates and the ANA Board of Directors are charged with setting policy in healthcare, the workplace, patient care, and many other areas where nurses are engaged. When a hot topic arises or there are various views and opinions about current events, the House of Delegates and/or the Board of Directors may address these concerns by way of a position statement. Position statements are an explanation, a justification or a recommendation for a course of action that reflects ANA’s stance regarding the concern. The development process for position statements initially involves internal deliberation by the Congress on Nursing Practice and Economics. A draft of the proposed position statement is then posted on ANA’s Web site, for public comment. Following public comment, the statement is revised if necessary and approved by the ANA Board of Directors. This process allows each and every nurse to voice their views and opinions on the various dimensions of the issue at hand.

Four Spheres – Professional Org’s. ANA Policy Statements;

Drug & Alcohol abuse Ethics and Human Rights Social Causes and Health Care Nursing Practice

Electronic Health Records Supporting Nurse Practitioners in Retail-

based health clinics Credentials for the Professional Nurse:

Determining a Standard Order of Credentials for the Professional Nurse

Professional Role Competence

Four Spheres – Professional Org’s. International Council of Nurses

INC Position Nurses have an important contribution to make in health

services planning and decision-making, and in development of appropriate and effective health policy. They can and should contribute to public policy pertaining to the determinants of health.

In addition, nurses are involved in strategic planning, budgeting, efficient resource planning and utilization, and the planning, management and evaluation of programs and services. Nurses must accept their responsibilities in health services policy and decision-making, including their responsibility for relevant professional development.

Four Spheres – Professional Org’s ICN cont.

ICN and its member associations promote and support all efforts to improve the preparation of nurses for management, leadership and policy development. This preparation should be broad and must include the development of knowledge and skills for influencing change, engaging in the political process, social marketing, forming coalitions, and working with the media and other means of exerting influence. It must recognize the complex processes and factors involved in effective decision-making.

Source: www.icn.ch/pspolicydev00.htm

Four Spheres - Community

Special interest organizations: Habitat for Humanity Local / County Food banks Rotary club Community organizations

Lions, Elks, Moose County workforce centers

The other three sphere’s exist within the community sphere. Nurses have the responsibility to promote the

welfare of the community and its members Nurses visible in the community represent the

entire profession

Four Stages of Political Development

Buy in Self-interest Political Sophistication Leadership


Stage One: Buy – In Reactive Stage Political Action Committees Understanding the relevance of politics

and policy in both our professional and personal life.


Stage One: Buy In Reactive Stage –

The profession recognizes the importance of political involvement and encourages nurses to recognize the importance of policy development to their daily lives as professionals and citizens.

Political Action Committees (PAC’s) Nurses Coalitions for Action in Politics

First PAC developed by nursing leaders in New York. Later became the PAC for the ANA.


Stage One: Buy-In Understanding the relevance of politics and policy in

professional and personal life. Political activism and political commitment must become

part of the definition of the nursing as a profession… Nurse witness daily the consequences of policies and need to work for justice and equity in the healthcare system.

Occurred when profession began to promote political awareness of nurses to injustices or changes needed – “Aha” moment


Stage Two: Self-Interest Appealing to self-interest is an important step in

engaging nurses to participate in shaping workplace and or public policies

Nursing coalitions garner political support Late 1990’s: ANA-PAC became the third largest

federal health care special interest group. Nurses must see the connection to politics and

policy in their professional lives in order to move to action.


Stage Two cont. Nursing began to develop its identity Uniqueness as a political voice It is moving from recognition of a problem to developing a

plan to deal with it Using political Skills:

Enlisting support of colleagues Planning strategies Resolving the issue Volunteer to create a task force to recommend policy

changes.

Four Stages of Political Development Stage Three: Political Sophistication

ANA’s Nursing’s Agenda for Healthcare Reform 1992.

Nurses were appointed to federal panels, agencies and commissions.

Requires: Synergy between policymakers who recognize the

importance of nursing perspectives and nurse who are ready to respond by adding their voices to policy debates and decision making.

Four Stages of Political Development Stage Three – cont.

National Health Council – est. 1929 “A dynamic forum for policy

development” By the end of 2005 – 110 volunteer health

agencies, nonprofit organizations with an interest in health, business and industry including the American Academy of Family Physicians, the American Thoracic Society, and the Association of Schools of Allied Health Professions

Not one Nursing organization. 2010 – Only the American Academy of Nursing is represented.

Four Stages of Political Development Stage Four: Leadership

When nursing embraces a political identity exemplified by “setting an agenda” for change

Functioning at the highest level of political involvement.

Nursing becomes the initiator of crucial policy change

Four Stages of Political Development Stage Four cont.

Achieving appointments outside of nursing University Presidencies Heads of agencies within federal and state governments Senate and House Seats.

Nurses are recognized for their expertise and perspectives

Seen by multiple constituencies bringing solutions to issues related to the well-being of society.

The longer nurses remain in stage four, the more the public will benefit from nurses’ knowledge and leadership in solving issues

Advocacy & Activism

Powerful advocates Curtin (1979) – described the end purpose

of nursing “as the welfare of other human beings.”

Nursing is seen as “common humanity” leading to the development of “human advocacy”

The nurse patient advocate Revised Code of Ethics for Nurses with

Interpretive Statements. (ANA, 2001).

Advocacy & Activism

Nursing Serving as Advocates Legal Advocacy

Protect patient rights Moral-Ethical Advocacy

Uphold patient values Spiritual Advocacy

Provide access to spiritual support Substitutive Advocacy

Protect vulnerable patients Political Advocacy

Facilitates equal access to health care

Advocacy & Activism

The Nurse Activist Contacts public officials through letters, e-mails or

telephone Registers people to vote Contributes money to political campaigns Works on a political campaign Lobbies decision-makers by providing pertinent

statistical and anecdotal information Forms or joins coalitions that support an issue of

concern

AACN’s Advocacy Tool Kit:12 Rules for Working with Public Officials

Don’t underestimate public officials.

Don’t look down on government and politics.

Be understanding. Forge Relationships. Be Reasonable. Be Thoughtful.

Don’t blame public officials for “Failing” to do what you wanted.

Be Cooperative. Be Realistic. Be Practical. Be a good Proponent. Be Informed

Source: AACN-Advocacy Tool Kit

Nursing’s Influence & Historical Mandates

Florence Nightingale Sojourner Truth Lillian Wald Margaret Sanger Other contemporary pioneers


Florence Nightingale Consummate politician and visionary. Transformed

British health care Indian health care Military health care

Knew the value of data in influencing policy changes

Saw nursing in all its forms as advocacy

Nursing’s Influence & Historical Mandates Sojourner Truth

Provided nursing care to union soldiers and civilians – Civil War

Advocate for abolishing slavery Supporter of women’s rights Helped transform racist and sexist policies limiting

the health and well-being of African Americans and women

Worked to free slaves – Underground Railroad Fought for human rights Lobbied for federal funding to train nurses and

physicians.

Nursing’s Influence & Historical Mandates Lillian Wald

Recognized the connection between health and social conditions

Established – Henry Street Settlement House in New York City.

Safe place built to help establish programs for largely poor immigrant population

Driving force behind development of the Children’s Bureau

Called by the White House frequently to participate in developing national and international policies.

Campaigned for Presidents even she could not vote.


Wald cont. Promoted Public Health Nursing education Formed the National Organization of Public

Health Nursing (NOPH). 1902 – Moved the board of health to hire a

school nurse


Margaret Sanger Transformed the nation’s attitudes and

approaches to family planning Jailed and risked own life

Distributed literature on birth control when at the time it was illegal

1912 wrote article about Syphilis – US Post Office invoked the Comstock Act (1873) and prohibited the distribution of information about contraception

Nursing’s Influence & Historical Mandates Sanger cont.

1914 – Traveled to Europe seeking safe contraception measures.

October 1914 fled the US after being indicted on claim that women could separate procreation from the sexual act and published her ideas in Women Rebel

1915 – Returned to U.S. and with public sympathy, government dropped the charges


Sanger cont. Best known for what?

Planned Parenthood of America


Contemporary Leaders Wilma Scott Heide (1973)

National Organization for Women (NOW) JoAnn Ashley

Challenged nurses to reflect on who they were and what their role was as a nurse

Feminist movement Senator Lois Capps (R-CA). 2005.

Legislation 2010

What is currently in the works?

Nursing Legislation - 2010

H.R. 4601 – The National Nurse Act of 2010 Amend the Public Health Service to establish the Office

of the National Nurse

Nursing Legislation 2010

S. 73 / H.R. 4138 – Registered Nurse Safe Staffing Act of 2009 – Reintroduced to the 111th Congress as S. 54. Would require establishing a staffing system that ensures a number

of registered nurses on each shift and in each unit. Would require public reporting of staffing information. Hospitals must

post daily for each shift the number of licensed and unlicensed staff providing direct patient care, specifically noting the number of RNs.

The staffing system takes into account the following: account for architecture and geography of the environment and available technology; reflect the level of preparedness and experience of those providing care; reflect staffing levels recommended by specialty nursing organizations; account for ancillary staff support; provide that an RN not be assigned in a particular unit without first having established the ability to provide professional care in such a unit; be based on methods that assure validity and reliability.

Sponsor: Sen. Daniel Inouye (D-HI).

Nursing Legislation

H.R. 1001 – Nursing Relief Act 2009 Purpose:

To create a new non-immigrant visa category for registered nurses, and establish admission requirements for such nonimmigrant's.

Background: Hospitals spending hundreds of millions of dollars recruiting foreign

nurses under current immigration laws. Cost is passed on to consumer’s and adds to the rising cost of

healthcare Healthcare providers cannot efficiently and effectively recruit qualified

foreign nurses through existing immigration process Sponsors: John Shadegg (R-AZ), Co-Sponsors: Jeff Flake (R-AZ)

and Ed Pastor (D-AZ).

Communicating with Legislators

Telephone Communication

Telephone: 202-224-3121 Ask for your Senator’s or Representative’s office. Search the Congressional database for your

representative. http://www.capwiz.com/criticalcare/directory/condir.tt


Phone calls are not generally handled by the member of Congress. They have assigned staff aides which do this. Identify yourself and ask to leave a brief message for

Senator/Representative (_____) that you either support or oppose (S.____/H.R.___).

“Good Morning, My name is _____ and I am a Critical Care Registered Nurse. I would like to leave a message for Representative _____ in support/opposition of HR 1001.”


You may also want to state your reason for your support or opposition.

Ask for the senator’s or representative’s position on the bill. Also request a written response to your telephone call.

Write down the name of staff member you spoke with for future reference. Utilize them as your point of contact.

Source: AACN – www.capwiz.com/criticacare/issues/basics/?style=comm

Telephone Communication - Pitfalls

No written documentation – no visual proof you actually made the phone call.

No way of guaranteeing that your message or your name, telephone number or address is recorded correctly.

Generally not ideal for introducing yourself to a legislative assistant.

Source: (Mason, 2007).

Letter Writing tips

The saying “The pen is mightier than the sword” is prolific in nursing’s political action arena. As nurses, we know what happens on a daily basis and WE have the power to Act With Intention and facilitate change in daily practice.

The nurse with political competency knows what the rules

are or policies are for the profession and the industry

knows who or what organization created them, the rationale for their existence, and how they impact the provision of health-care services.

Three “rights” of letter writing:

Right Letter.

Right elected official.

Right time.

Writing guidelines

When writing to members of congress or a state or local official there are general guidelines:

Direct your letter according to the legislator’s responsibility.

Only write to the elected officials that represent you.

Clarify your issue. You may write to the chair of a specific committee if your representative does not sit on that particular committee.

Time your letter(s) to allow staff to address issues prior to pressing any legislation.

Your purpose for writing should be stated in the first paragraph of the letter. If the letter pertains to a specific legislative bill, identify it accordingly, e.g., House bill: H.R. ____, Senate bill: S.___.

Be courteous, to the point and include key information, using specific examples to support your position.

Address only one issue per letter. Keep the letter to a minimum of one page.

Source: AACN Legislative Center Source: AACN Legislative Center http://www.capwiz.com/criticalcare/issues/basics/?style=comm

Letter to Senator

Address: The Honorable (Full Name), (Rm #), (name

of) Senate Office Building. United States Senate, Washington, D.C. 20510

The Honorable ___________702 Hart Senate Office Building, Washington, D.C. 20510-0605.

Salutation: Dear Senator ______________

Source: (AACN Legislative Center, 2008; Mason, 2007).

Letter to Representatives

Address: The Honorable (Full Name), (Rm#), Name of House

Office Building. United States House of Representatives, Washington, D.C. 20515

The Honorable ______________, 1507 Longworth House Office Building, Washington, D.C. 20515-0604

Salutation: Dear Representative _________,

Source: AACN Legislative Center.

E-Mailing Tips

Generally, same guidelines as with letter writing. Most legislators have e-mail addresses embedded

on their websites.

Political Resources

How to identify the issues at hand to allow you to Act With Intention

American Nurses Association

American Nurses Association

Current Health Care policy agenda’s Nursing’s agenda for the future ANA’s Health Care Agenda 2005 Workforce trends among U.S. Registered Nurses.

Position Statements: Stem Cell Research 1/10/2007 Privacy and Confidentiality 12/8/2006 Assuring Patient Safety: Registered Nurses’

Responsibility in All Roles and Settings to Guard against Working when Fatigued 12/8/2006.

Source: American Nurses Association, 2008.

http://www.nursingworld.org/MainMenuCategories/HealthcareandPolicyIssues/ANAPositionStatements.aspx

ANA Resources Center

Created to be a one-stop resource to help find information about the 2008 elections. Provides information on election processes Candidate information both Democrat and

Republican. Publish Capitol update 10 times annually.

http://www.capitolupdate.org/newsletter

American Organization of Nurse Executives

www.aone.org

American Organization of Nurse Executives Education of members Public Policy and Advocacy Information Technology International Nurses Access and Coverage Reimbursement Policy PAC Web Resources: www.aone.org/aone/advocacy

American Association of Critical Care Nurses

www.aacn.org

AACN ResourcesCapwiz Home Page

AACN - Resources Capwiz Elected Officials

American Association of Critical Care Nurses

http://www.capwiz.com/criticalcare/home

International Council of Nursing

www.ich.ch

Joint Commission

Joint Commission

Mission:

To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

Joint Commission

Institute for Healthcare Improvement - IHI

Institute for Healthcare Improvement

Programs Improvement map Passport Campaign

5 Million Lives – Video link http://www.ihi.org/ihi/files/campaign/2006_12_12_Berwick5MillionForumPlenary.wmv

Critical Care

IHI – Critical Care

Robert Wood Johnson Foundation

www.rwjf.org/publichealth

Robert Wood Johnson Foundation

www.rwjf.org/healthreform

State and Local Resources

Utilize Kaiser Family Foundation Utilize your state nursing association Utilize your state’s hospital association

to find out any upcoming or pending legislation issues.

References

American Association of Critical Care Nurses (2008) Legislative Action Center. http://capwiz.com/criticalcare/home

Eliss-Najar, B., Hubbard, H. (2008). The Value of Nurse Leaders on Federal Advisory Panels: Experience with the Agency for Healthcare Research and Quality. Policy, Politics and Nursing Practice. 9: 299-304. Retrieved May 28, 2009 from, http://ppn.sagepub.com.dml.regis.edu/contect/vol9/issue4.

Hewison, A. (2008). Evidence-Based Policy: Implication for Nursing and Policy Involvement. Policy, Politics and Nursing Practice. 9: 288-98. Retrieved May 22, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol9/issue4.

International Council of Nursing (2000). Participation of Nurses in Health Services Decision Making and Policy Development. Retrieved May 30, 2009 from, http://www.icn.ch/pspolicydev00.htm.

References

International Council of Nursing (2001). Guidelines on Shaping Effective Health Policy. Retrieved May 30, 2009 from, http://www.icn.ch/Guidelines_shaping.pdf.

Kurtzman, E. (2009) Unifying Nursing’s Political Voice. Editorial. Policy, Politics and Nursing Practice. 10: pg. 6. Retrieved May 30, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol10/issue1.

Mason, D., Leavitt, J., Chaffee, M. (2007). Policy and Politics in Nursing and Health Care (5th Ed). Philadelphia, Saunders Elsevier.

Mattie, A., Ben-Chitrit, R. (2007). Patient Safety Legislation: A look at health policy development. Policy, Politics and Nursing Practice. 8: 251-61. Retrieved May 22, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol8/issue4.

Taft, S., Nanna, K. (2008). What are the sources of health policy that influences nursing practice. Policy, Politics and Nursing Practice. 9: 274-87. Retrieved May 28, 2009 from, http://ppn.sagepub.com.dml.regis.edu/content/vol9/issue4.

Web References

Agency for Healthcare Research and Quality (AHRQ) – www.ahrq.gov

American Association of Critical Care Nurses Legislative Action Center – www.capwiz.com/criticalcare/home

American Hospital Association – http://www.aha.org American Nurses Association – http://www.nursingworld.org/gova/ American Organization of Nurse Executives – www.aone.org C-SPAN – www.c-span.org GEM-Nursing: Online mentoring Program – www.gem-nursing.org Hastings Center – http://www.thehastingscenter.org Institute for Healthcare Improvement – http://ww.ihi.org Institute of Medicine (IOM) – http://www.iom.edu International Council of Nursing – http://www.icn.ch Kaiser Family Foundation – http://www.kff.org

Web References

Library of Congress – http://thomas.loc.gov

Policy analysis site – www.hschange.org

Resource on multiple policy issues – http://hippo.findlaw.com/hippohome.html

Roll Call – Congressional news source – www.rollcall.com

Synopses of national political news – http://politicalinsider.com

Estes Park, CO

Fish Creek – Steamboat Springs, CO

Questions &

Answers

Contact Information:

Todd M. Grivetti, MSN, RN, CCRN, CNML

[email protected]

nti2010 policy politics and you act with intention

Health & Medicine