How will Nursing Fare during the 2010 State Legislative Sessions
Prior to the January 19th special Senate election in Massachusetts and resultant tip of power in Congress, this column was to have been devoted to a discussion of the potential impact of federal health care reform on states and ultimately nursing’s agenda. It now seems the outcome of reform is even more elusive. But there are some assumptions that can be made with regard to state legislation during the 2010 sessions based upon state budget deficits.
State legislatures will be trying desperately to balance budgets which means new initiatives will either need to be revenue generating or budget neutral. There are a number of policy issues for which nursing can advocate that will not impose additional cost burdens on the state.
Crucial with or without federal health care reform is that of increased access to quality care and choice of provider. Each state’s nurse practice act determines the qualifications and scope of practice for advanced practice registered nurses (APRNs). Securing recognition of qualified APRNs as primary care providers remains a key to increasing entry to health care services for many, particularly in rural areas. Removing unnecessary and burdensome barriers such as requirement for physician supervision and/or collaborating agreements will not cost the state any money. Both of these practices assume the APRN is not accountable for their own practice. Why would a physician want to add responsibility for supervising care for patients they may only know through the medical record and never see?
There are more than twenty states without laws restricting who may use the title “nurse”. For those states, the public is at risk for being misled that individuals may possess the education, skill and the legal authority to provide nursing care by virtue of their calling themselves a “nurse” (office nurse, baby nurse). Efforts to advance title protection are often thwarted because legislators do not see a need. This is another initiative whose time has come and will not cost the state money, but will extend protections the public deserves.
While these are two examples of legislation that will not add to the drain of the state coffers, there are other significant issues that in many states remain unresolved for nurses. Inadequate staffing levels, mandatory overtime, safe patient handling, workplace violence and whistleblower protections are some examples. Some would argue that in those states where these issues have been addressed, money has been saved.
Poll after poll finds that nurses are either the most trusted group of professionals or one of the most trusted groups in the country. And yet, a recent opinion poll of leaders ranked nurses behind six other stakeholders when it comes to who they expect will influence health reform over the next five to ten years.
The Robert Wood Johnson Foundation released results of a groundbreaking new opinion leader survey on nurses’ influence on health systems and services. Entitled “Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions,” the survey was conducted by Gallup on behalf of the Robert Wood Johnson Foundation. Gallup interviewed 1,504 opinion leaders across key roles and industries for the survey, which was conducted Aug 18-Oct 30, 2009. Opinion leaders identified the top barriers to nurses’ increased influence and leadership as not being perceived as important decision makers (69%) or revenue generators (68%) compared with doctors; nurses’ focus on primary rather than preventive care (62%); and nursing not having a single voice in speaking on national issues (56%).
How can nurses become more influential? Join your professional association. It is one of the best ways to keep informed of the issues and trends and ensure we are speaking with one voice. Membership dues also contribute to acquiring needed resources to represent nursing’s agenda with government officials. Advocacy can be exercised collectively through your professional organization as well as individually. Get to know your elected officials. Make appointments to meet with them when they are in their district offices and become their “go to” person for nursing and related issues. Write letters and make phone calls when an issue is being considered. Now is the time; increase YOUR influence; increase nursing’s influence.
To read about state actions related to a number of nursing related issues, please click here.
Janet Haebler, MSN, RN
Tags: APRNs, January 2010, state legislatures
