Stop Complaining & Start Advocating

Advocacy in ActionSusanne Nasewich, RN

Greg Riehl, RNLaurel Stang, RN

Be the Voice – QUALITY AND PATIENT SAFETYSaskatchewan Registered Nurses Association Annual ConferenceRegina, SK May 1,2 & 3, 2012

DID YOU KNOW ?

The CNA Code of Ethics mentions ADVOCACY 15 times

ADVOCACY & THE CODE OF ETHICS• quality work environments

• social justice issues that affect heath & well-being – including policies & programs

• use of the least restrictive measure possible for those in their care

• adequate relief of discomfort and pain

• accessible, universal & comprehensive health-care services •access to their own health-care records

• fair treatment & fair distribution of resources for those in their care

• changes to unethical health & social policies, legislation and regulations; equity • ethical discussions

• initiatives to reduce environmentally harmful practices

• if they believe the health of those in their care is being compromised by factors beyond their control, includes decision-making of others; ethical discussions

ORGANIZATIONS SUPPORT ADVOCACY…

CANAC

• A national professional nursing organization committed to fostering excellence in HIV/AIDS nursing, promoting the health, rights and dignity of persons affected by HIV/AIDS and to preventing the spread of HIV infection

CANAC

• Position statements• Recognition of HIV/AIDS nursing as a speciality

• specialized knowledge and skills; committed to ongoing professional development to maintain skills; have acquired specialized knowledge and skill

• Human rights statement • CANAC fully supports Human Rights to be extended to all people regarding access to HIV/AIDS education, prevention, treatment, care and support

• HIV and criminalization• the criminal law is an ineffective and inappropriate tool to prevent HIV exposure and transmission

• HIV/AIDS Nursing Guidelines

SRNA

Promoting Equity Through Harm Reduction inNursing Practice (2008)

• HR is a vital component in the continuum of health care services provided by RNs in SK

• Gives clients choices, so they are involved in their health care

http://www.srna.org/images/stories/promoting_equity.pdf

WHAT WOULD YOU DO?

• male, history of IDU but not currently using, admitted with MRSA/osteomyelitis

• reports pain at 10/10; only analgesia ordered is Tylenol, plain, q4h

WHAT IS ADVOCACY

• Why advocacy?• How to start advocating?• How does the CNA Code of Ethics support

professional advocacy?• What seems to work best?• Does it really make a difference?• How to put advocacy into ACTION?

WHAT IS ADVOCACY?

• the act or process of supporting a cause or proposal: the act or process of advocating something – To advocate is to plead in favor of

• action to lead to changes by influencing someone who can make changes

http://www.global-campaign.org

TYPES OF ADVOCACY

All interventions have impacts onadvocacy. Some impacts are direct and others are indirect.

WHY ADVOCACY?

Unless we engage in advocacy, we will only be reacting to symptoms and not looking at the roots of the problem

WHAT WOULD YOU DO?

• transgender client admitted to your unit: MTF• admitted into a private room; needs to be

transferred from the private room • Charge RN asks you to move him into a male,

4-bed ward

WHO IS AN ADVOCATE?

• Consider who is/is not an advocate?– What are barriers to advocacy?– who will be able to participate in the different

advocacy actions and who cannot?

• Need to maximize opportunities to advocate…

HOW TO START?

• Support & resources– CANAC– Organized a PPG; SK HIV/HCV Nursing Education

Organization

• Relevancy to local situation/issue(s)– What is the problem?– How can it be addressed?

ADVOCACY: PLAN DO REVIEW• Planning

– Formal and informal meetings

• Do– Action is necessary – Have an experience

• Review– What worked in the past,

what did we learn

HOW DOES THE CNA SUPPORT?

• Promoting Equity through Harm Reduction in Nursing Practice

http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Resolution1_CANAC_Harm_Reduction_2007_e.pdf

• Harm Reduction and Currently Illegal Drugs– Implications for Nursing Policy, Practice, Education

and Research– Discussion Paper

http://www2.cna-aiic.ca/CNA/documents/pdf/publications/Harm_Reduction_2011_e.pdf

Nurses Praise Supreme Court Ruling: Insite Saves Lives And Improves Health

"Nurses throughout Canada are incredibly encouraged by this decision," says Rachel Bard, chief executive officer of CNA. "We see firsthand the evidence of how well harm reduction programs work to improve the health of Canadians, especially vulnerable populations dealing with poverty, mental illness and homelessness. As nurses, we're responsible for and committed to providing safe, compassionate, competent care and improving the health of those in need."

DOES IT MAKE A DIFFERENCE?

Yes!• Able to affect attitudes, laws, policies, and the situations in need of change• Increases awareness, behaviour, and common knowledge

Indicators of success?• policy change or implementation; laws or practices reviewed, revised, introduced

PUTTING ADVOCACY INTO ACTION?

•Work from within the system – sitting at decision-makers’ tables (e.g., consultations, planning committees, community advisory boards, etc.)•Lobbying or petitioning government and other civic officials•Arranging face-to-face meetings with decision-makers•Writing and delivering position papers and briefing notes•Preparing and giving public presentations•Creating and performing dramatic presentations•Staging public demonstrations•Writing letters•Writing e-mails•Making phone calls•Working with the media:

• Newspapers, magazines and other print media; television; radio ; internet

•Working with the media in these ways:• Writing press releases and media advisories; press conferences; media interviews; website or blog

Keeping the Minister of Health Informed through RN AdvocacySeptember 2012

We were there . . .

PLANNING AND IMPLEMENTING

• Step 1 – Select an issue or problem you want to address

• Step 2 – Analyse and gather information on the issue or problem

• Step 3 – Develop an aim and objectives for your advocacy work

• Step 4 – Identify your targets• Step 5 – Identify your allies• Step 6 – Create an action plan• Step 7 – Identify your resources• Step 8 – Implement, monitor and evaluate

COSTS OF ADVOCATING

• Increased work• Increased public visibility

– good and bad; some negative results?

• Increases in stigma and discrimination• Perception of not being politically neutral

DOES ADVOCACY WORK?

• Monitor• Evaluate

ADVOCACY IN OUR DAILY WORK

• advocacy does NOT require a complete shift of focus away from other valuable work

• can actually reduce your workload by improving the environment in which you and your clients live

• advocacy can happen at all levels of service delivery– advocacy work by making use of

opportunities

WHAT WOULD YOU DO?

• HIV+, new Canadian, female• just delivered a baby girl; you go in to asses and mom BFing; husband and exended family present; upon further assessment, mom discloses issues of cultural practices r/t BF• family unaware of her dx

ADVOCACY AND OUR PPG

Consider:• Client voice

– peers

• Nurses’ voice– Knowledge exchange, mentoring

• Local issues– HIV/HCV

• Strength in numbers

MISSION STATEMENT

The mission for the Saskatchewan HIV/HCV Nursing EducationOrganization is achieved through:• Providing accessible and affordable education and learning

opportunities• Creating a network of members by which support and mentorship

can occur• Serving as a provincial voice for issues related to HIV and Hepatitis

nursing care• Advocating for the rights and dignity of people who are living with

HIV/AIDS and/or HCV, or who are vulnerable to these infections• Supporting a collaborative professional practice environment• Promoting professional growth• Improving patient/client/resident outcomes

ADVOCACY=ACTION

• TeleHealth• Email• Participating with PPGs/SRNA• Promoting and sharing - World AIDS Day and

World Hepatitis Day• Face-to-face meetings• Partnerships• Mentoring• Networking

OUR ACTIONS-ADVOCACY SUPPORTS NURSES

• Effective advocates communicate clearly and memorably.• People need to understand and remember the ideas

being advocated• Effective advocates build credibility and generate affinity.

• Trust and reputation is crucial to inspiring confidence.• Effective advocates build relationships that let ideas prosper.

• Coordination and alliances support networking and relationships.

• Effective advocates influence others.• Advocacy is about persuasion

WITHOUT RELATIONSHIPS, WE HAVE NO POWER AS A GROUP

Ask questions, get answers, stay quiet.

What we have learned from our experiences is that we should . . .

ADVOCACY, THIS IS WHAT WE DO…

“It isn't that they cannot see the solution, it is that they cannot see the problem”

G.K. Chesterton

SK HIV/HCV PPG

Contact us at:skhivhcv@gmail.com

Save The DateFace-2-Face HIV & Hepatitis C Education Event

September 8, 2012Prince Albert, SK

More information to follow – email us!