A presidential executive order supports nurses and other health care professionals practicing to the fullest extent of their scope and skill – a longtime priority of AMSN and other nursing organizations. Released on Oct. 3, the executive order requests that federal agencies develop regulatory proposals to “enable provider to spend more time with patients” and eliminate policies that “limit professionals from practicing at the top of their profession.” The executive order is a positive development that supports change in law and regulation, but it does not change laws and regulations by itself. AMSN is supporting health research as a major priority as Congress continues work on its 2020 appropriations. Signing on to an advocacy letter circulated by the Friends of AHRQ (Agency for Health Care Research and Quality), AMSN requested that Congress “fund the Agency for Healthcare Research and Quality (AHRQ) at a level equal to or more than that included in the House bill of $358.2 million. AHRQ is an essential element of the nation’s health care ecosystem, charged with improving the quality and delivery of health care.” Most state legislatures are not in session this fall, meaning that an Illinois bill to institute mandatory nurse staffing ratios, which is opposed by AMSN, is not moving in 2019. But one of 7 states with the legislature still in session, Pennsylvania, continues to consider a bill affecting voluntary professional nurse credentialing programs like MSNCB. AMSN has expressed concerns about the Pennsylvania bill, HB 811. It has not moved in committee and AMSN continues monitoring it.
The last few weeks have been a whirlwind! I have attended a think tank on the professional identity formation of nurses in which I had the honor to collaborate with 49 other nurse leaders across education, legislation, and practice. Last week was AMSN’s National Convention and what a wonderful experience that was! More than 1,300 nurses gathered to discuss, learn, and network. It was 3 days filled with plenty of joy, comradery, and hard work. If you haven’t been to a national convention, please consider attending next year in Las Vegas – it’s money well spent, and you will make memories of a lifetime in addition to connections to friends new and old and information that is cutting edge to guide your practice. We announced exciting initiatives during the convention as well such as the upcoming release of behavioral health modules and the development of an evidence-based practice program to help nurses develop their own evidence-based practice projects and integrate findings into their practice. One initiative that I am very excited about is AMSN’s participation in the Nightingale Challenge. This is an initiative developed by the World Health Organization and the International Council of Nurses in recognition of the International Year of the Nurse and Midwife which is also the 200th anniversary of the birth of Florence Nightingale. AMSN’s participation in the Nightingale Challenge will entail the leadership development and opportunities for volunteerism of at least 20 young professional nurses under the age of 35. The initiative will be headed up by Dr. Terry Jones and I’m sure that all those who participate will enjoy the experience. One of the members of this group will also be selected to participate at the board of director’s level as a non-voting member. This nurse will provide insight into the challenges and needs of young professional nurses and will learn about leadership at this higher level. Today, I’m headed to Washington, D.C. to participate in the Nurses on Boards Coalition. This coalition is made up of a group of nurse leaders who are working to provide the leadership skills and knowledge to nurses so that they can serve on boards in their facilities, their communities and at the national level. I’m very excited that AMSN is a participant in this work as well; every nurse should consider themselves a leader. If we can envision it, want it ardently enough, and act upon it we can ensure that in the near future, nurses will be an important part of every conversation regarding the health of the population in the private, corporate, and legislative sectors! As nurses who work more closely with patients than any other health professional, it should be a given that we have a seat at the board. Once we arrive there, we need to stand up, speak up, present evidence to support our concerns, and continue to help the development and progression of younger professional nurses. Individually, nurses are powerful; collectively, we are a force to be reckoned with!
Our Commitment to You Robin’s column this month speaks about the many ways AMSN is representing you, our members, in initiatives of importance to the nursing profession. AMSN believes that it is critical that you have a voice in these initiatives and that med-surg nurses are heard. AMSN was excited to be invited to participate in the Professional Identity Formation in Nursing think-tank. We were one of the only specialty nursing practice associations to be invited. We were privileged to attend with the American Nurses Association, National League for Nursing, American Association of Colleges of Nursing, Sigma Theta Tau International, National Student Nurses Association and the National Council for State Boards of Nursing. As you can see, many of the associations present are directly involved in nursing education, so AMSN was proud to represent medical-surgical nursing at the think-tank. We are excited to continue to represent all of you in this important work. We also joined and participated in the Nurses on Boards Coalition, which aims to increase the percentage of nurses serving on professional boards of directors. We look forward to representing medical-surgical nurses in this important endeavor and demonstrating the value you can bring to organizations, professional associations and charities alike. Lastly, as Robin noted, AMSN will be participating in the Nightingale Challenge, a program developed by Nursing Now, a collaborative three-year campaign shared by the International Council of Nurses and the World Health Organization. The Nightingale Challenge seeks to develop the leadership of nurses under the age of 35. We will be developing a program that will provide leadership opportunities to 20 AMSN members during 2020, which has been declared the Year of the Nurse and Midwife. Stay tuned for more information and to sign up. We can’t wait to launch this program. I hope these initiatives demonstrate our commitment to you, our members, and our commitment to the specialty of medical-surgical nursing. You are the reason we exist, and we are working very hard to serve you in ways that are meaningful and impactful. We want to demonstrate to the world the vital role each and every one of you play in the health care arena. We want to ensure your voice is heard, and you are involved in decisions impacting the health care system. We are committed to making a difference for you.
The practice of nursing constantly evolves. Traditionally, nurses have always been at the bedside of those who suffered from illnesses or injuries. The minds (knowledge) and hands of nurses were the tools they used to facilitate healing in the patients to whom they provided care. With all the innovations in technology, nurses have increasingly become surrounded by equipment that helps support and improve the patient’s health and wellness. It is undeniable that technology has made an incredibly positive impact on patient care. However, technology has also negatively affected the amount of time nurses spend in providing direct patient care. According to a study performed by Hendrich, Chow, Skieczynski, & Lu (2017): A 36-Hospital time and Motion Study: How do Medical Surgical Nurses Spend their time, in which 767 medical-surgical nurses participated, nurses spent 43.7% of their time on patient care activities, patient assessment, & medication administration. The remainder of the nurses’ time was spent on documentation (35.3%) and care coordination (20.6%). Consequently, nurses must make every effort to interact in a sensitive and compassionate manner with patients and their families, even when time seems limited by a seemingly endless array of non-patient care responsibilities. We must learn to support our nursing care teams, teaching and demonstrating compassionate care as a standard practice in all our patient interactions. We must all understand that compassion is a broader term than empathy and refers to both an understanding of another’s pain along with the desire to somehow mitigate that pain. Clearly, demonstrating compassion is not an easy task given the number of patients who present to our facilities with addictions, mental illness, homelessness, and a lack of trust in the health care system. However, as front line staff, med-surg nurses must understand the fundamental relationships between patient care, compassion, trust, and wellness. Compassion both verbal and nonverbal is indeed an integral aspect of patient communication and is essential in developing the nurse-patient relationship. Compassion does not require a dissertation, rather a touch, a look, a smile, and open honest communication. Maya Angelou said it best: “They may forget your name, but they will never forget how you made them feel.” Let’s always remember that in nursing, compassion and technology must coexist for the best patient outcomes. Thank you med-surg nurses for adapting and thriving in an ever-changing world.
Robin’s column this month referenced the important role coaching and mentoring played in her career and personal development. I was also fortunate to have many wonderful peer coaches during my nursing career and I am forever grateful for the relationships I was able to build and cultivate over that time. AMSN feels connection is a critical component of the value we bring to medical-surgical nurses. It’s so important to us that we’ve made it part of our tagline and work continuously to provide opportunities for our members to make connections with other medical-surgical nurses to build a strong and dynamic community. Given that it is September (where has the year gone?!) and our annual convention is literally only weeks away, what better time to talk about building connections? AMSN’s annual convention is the largest event we host, and the best in-person networking opportunity we offer. We do our best to balance your need and desire for education with the ability to network with your peers. This year we’re bringing some new and improved opportunities for you to connect with other attendees. Each year we do an orientation session to help first-time attendees plan for their convention experience. This year we’re also hosting a networking reception in advance of our orientation session so you can meet other attendees, board members, volunteers and staff prior to the convention. The event is Thursday September 26th from 2:30 to 3:15, so we hope to see you there! This year we’re doing even more with our convention app to foster conversation and engagement. In fact, people have already begun chatting and connecting on the app so be sure to download it and join the conversation! We look forward to getting to know you before we connect in Chicago in a few weeks. We’ve expanded our exhibit hall booth space and have some networking couches and chairs so you can connect with friends or make new ones. We’ll have a strong staff and volunteer presence in the booth to answer any questions you might have. Stop by and visit us during the exhibit hall hours. We’ll have some great giveaways and materials for you. We’ve significantly expanded our store onsite at convention. Last year was the first time we sold AMSN branded items at convention and it was an overwhelming success. We’ve decided that you all need more med-surg nursing gear and products, so be sure to stop and see us at the store. We have apparel, notebooks, tumblers, and other goodies for you to proudly display your love for your med-surg specialty. We are so excited to connect with you in Chicago. There is so much to see and do! Local restaurants are looking forward to serving you and there are several tours you can participate in with your new friends. We know you’ll enjoy the education we have planned for you, and we are equally as confident that you’ll make many connections over the course of your time at convention. I look forward to seeing you there!
I’ve been very blessed in my professional career due, in large part, to the mentors and coaches I’ve had along the way. During my initial training and then later as an academic colleague, faculty members Sandra Gottschalk, Beryl Dinges and Michele Unrein provided encouragement and guidance, accepting no less than the very best I could do. Each of these leaders instilled a love of the nursing profession in me and sparked my interest in nursing leadership. After graduating, my first job was on the surgical unit of a local hospital. The unit director was Wilma Ross, a nurse who was always willing to provide nursing care when an extra hand was needed. She taught me that nurses earn respect of healthcare colleagues by professionalism in practice, a willingness to learn, and through excellence in care delivery. She taught me the importance of leading by example. I’ve had other excellent coaches along my professional journey, too many to list here. But each of them taught me something unique regarding leadership. As a leader of AMSN, I want to continue to encourage others in their role as a nurse leader. I have dedicated many years of my professional career to the professional development of new nurses. As a member of AMSN’s board of directors, I also feel a responsibility for the development of future leaders. One of the ways AMSN is doing this is through our student program. Not only do students receive free membership in AMSN, but we are also working to develop a program which will assist the nurse in their progression from student, to nurse, to nurse leader including certification as a medical-surgical nurse. AMSN also supports leadership development of our members through participation in the Nursing Alliance Leadership Academy (NALA). Over the past several years, board members have attended NALA to network with other nursing organization leaders and to further develop the skills necessary to lead AMSN. In the future, I look forward to sending volunteer leaders who are interested in board positions to this event. AMSN’s leadership believes that it is vital to identify and foster the next generation of leaders through training, coaching, mentoring and providing opportunities for volunteer leaders to develop leadership skills. One of the initiatives announced at the recent International Council of Nurses Congress was a challenge to employers and professional organizations to provide leadership opportunities and training to nurses under the age of 35. Another is the Nurses on Boards Coalition, of which AMSN is a member, which focuses on increasing the presence of nurses on corporate, health-related, and other boards in order to improve population health. I look forward to implementing programs in the coming months to meet each of these goals. I would like to challenge each of you to consider your own leadership goals and skills. If you are interested in developing further as a leader, please drop me a line or visit with me at the national convention held later this month. I look forward to it!
The Building of a Legislative Program Terri Hinkley, EdD, MBA, BScN, RN - Chief Executive Officer, AMSN & MSNCB Robin’s column this month speaks to the critical role nurses play in legislation impacting health care access and cost, the workplace, and workforce issues. For many years AMSN has had a legislative team of volunteers addressing legislative issues of importance to medical-surgical nurses. They’ve written position statements on topics relevant to med-surg nurses, they have signed on to letters from other nursing organizations and they tried to stay abreast of policy and legislative activities. During their annual strategic planning meeting in 2018, the Board of Directors discussed and embraced the critical role AMSN must play in advocating for medical-surgical nursing and their patients. Specific and actionable strategies were developed and we’re working diligently to deliver on these strategies and tactics. The first step we took was to engage with a legislative expert with relevant health care/nursing knowledge. We were lucky to find Frank Purcell from Cardinal Waypoint to partner with. We sent out a call for volunteers to bolster the number of med-surg nurses that would be responsible for monitoring and addressing issues on behalf of AMSN. We surveyed you, our members, on the legislative issues of importance to you, and we built a legislative priority list based on your feedback. We conducted a two-day training program in DC for newly appointed legislative volunteers. We have been building a program that allows AMSN to identify and respond to legislation at both the state and federal level. Our team of legislative advisors has grown to 31 individuals, who are monitoring activities in their assigned regions and bringing any relevant legislation back to the legislative team for discussion and action. We have a legislative team of 9 volunteers, chaired by Yalanda Comeaux, who meet regularly with our legislative consultant to address our legislative priorities. As a result of this new structure and deliberate focus on AMSN’s advocacy strategy, AMSN was invited to speak at the kickoff to the Future of Nursing 2020-2030 initiative, where Linda Yoder, AMSN’s Immediate Past President was able to provide remarks. AMSN has had volunteers and/or staff attend each of the Future of Nursing Town Hall meetings in Chicago, Philadelphia and Seattle and submit or present written statements. We have hosted a webinar on safe staffing, “Safe Staffing: Evidence, Issues, and Action for Med-Surg Nurses”, which is available as a recording in our online library, if you weren’t able to attend live and have another planned for November during Med-Surg Nurses Week. We have launched an online community in our AMSN Hub for members to hear about issues and news related to our advocacy efforts. Lastly, we have continued to notify membership about Title VIII funding and reauthorization legislation and recognition of the WWII-era Cadet Nurse Corps. I hope this demonstrates our commitment to advocating for you and with you on issues of importance for med-surg nurses but also to educating you, our members, about the role you can play in legislative activities at your local, state and national level. Stay tuned, there are even more great things to come!
I recently reflected on the amazing journey I’ve experienced throughout my nursing career. One of the many highlights was my experience as a participant in the Nurse in Washington Internship (NIWI) program sponsored by the Nursing Organizations Alliance. Each year, nurses from many different areas of practice, education levels and from throughout the country converge in Washington, D.C. to learn about advocacy and the legislative process. Initiatives related to nursing and healthcare are a key component of the discussions. The pinnacle of the experience is the opportunity to interact with the legislators from your own state in one-on-one discussions. I spoke with my legislators about Title VIII funding and the opioid crisis. I have to admit, I was quite nervous at the thought of speaking to these legislators; after all I thought, I’m just one person with no real clout and nothing to offer that the legislators would be interested in. I confess I was also a bit cynical. My news feeds are filled daily with negativity and identity politics that convinced me that they wouldn’t even care about the topics of importance to me. How wrong I was! I shared stories from my own experience regarding how each of these topics impacted my practice and me personally. Both the senator and the representative were very interested in my perspective and we had wonderful conversations. I left those meetings feeling as if I had made a positive impact. There’s also something special about being in the nation’s capital. It has so much history and so many wonderful sites to visit. One of my favorite places was the Vietnam Women’s Memorial which depicts the dedication, compassion, and fortitude of the women serving in the war, many of whom were nurses. These women had important roles in the conflict and met the challenges they faced head on. Nurses today also have important roles in the many challenges we encounter including workplace violence, staffing issues, gender inequality, social inequity, and the high cost of medications which places our patients in situations in which they have to choose between feeding themselves or their family and purchasing medications needed to survive. We can choose to share our stories and use our collaborative voices to tackle the many issues we face. Participation in NIWI was truly a wonderful experience and the knowledge I gained as a result of the internship is empowering. I am prepared to continue to advocate on issues that are important to me as a nurse and a citizen. I know that grass roots efforts can make a big difference and I remain involved, using the tools learned to make my voice heard. Students and registered nurses are eligible to participate in NIWI. AMSN is proud to sponsor a member’s attendance at NIWI each year. The application for a scholarship will open soon. Please look for an announcement and consider how this experience can impact your own professional journey. It may very well lead you to places and opportunities you have never imagined. Visit here to find out more about NIWI: https://www.amsn.org/practice-resources/legislative/nurse-washington-internship-niwi
REMARKS OF TERRI HINKLEY, EdD, MBA, BScN, RN CEO, ACADEMY OF MEDICAL SURGICAL NURSES AND MEDICAL-SURGICAL NURSING CERTIFICATION BOARD ON MEETING OF NATIONAL ACADEMY OF MEDICINE FUTURE OF NURSING 2020-2030 TOWN HALL Health Care Workforce, Quality and Patient Safety, Select Populations and Health Equity JULY 24, 2019, PHILADELPHIA PA ------ I’m Dr. Terri Hinkley, CEO of the Academy of Medical-Surgical Nurses and the Medical-Surgical Nursing Certification Board. We are proud to support and engage this process. As care delivery changes, so too does our med-surg nursing profession. At this project’s first hearing in Washington, our immediate past president said to focus on disparities in health care and health, transforming payment to address social determinants, and engaging nurses in information technology innovation. In Chicago, our legislative team chair said to diversify nursing, the industry needed to start in elementary schools and must engage diverse communities. I’d like to raise an additional priority: the health, wellness, and safety of nurses. To achieve a culture of health in America, we must embed wellness everywhere health care is taught and delivered. We know why. Burnout and injury drive nurses out. The health of nurses affects patient care, as does the presence, or absence, of mutual professional respect. But there’s no evidence it builds wellness into our profession or our industry from the beginning. A better approach is more difficult because it depends on everyone playing a role: Policy, industry, education, and leadership must embed nurse wellness and safety into their standards, into their education and training, and into their systems for certification, evaluation and quality. Already important exemplars exist, such as AMSN’s PRISM recognition program. The National Academy of Medicine can significantly advance a culture of health in America if it prioritizes development and implementation of a culture of health for nurses from the beginning. Thank you.
The International Council of Nurses (ICN) Congress was an inspirational and educational conference attended by thousands of nurses from around the world. It certainly was enlightening to recognize that nurses around the world face some collective opportunities and challenges. As you read in President Robin Hertel’s ‘Robin’s Nest’, one focus of the conference was the importance of the social determinants of health (SDOH) in managing the health of our patients. That topic reminded me of the times I spent volunteering as a nurse in a homeless shelter in Alexandria, Virginia. One of the things I learned very quickly was the role social determinants of health play in health and wellness of individuals. We ran a completely volunteer medical clinic once a week in a residential shelter that housed both individuals and families. We saw diabetic patients, patients with hypertension, congestive heart failure, renal disease, liver disease, COPD, and asthma - often made worse due to compliance issues resulting from substance use disorders and/or behavioral health disorders. Some, though, simply didn’t have access to or couldn’t afford medical care, medication, employment, transportation, stable housing, or nutrition. The patients we saw each week lacked health insurance. We were the only care they received. We counseled them on nutrition, self-care, wound care, alcohol and drug rehabilitation, birth control, and more. We had a small pharmacy that was stocked through financial donations from the shelter and leftover medications from the clinic physicians’ personal practices. I helped patients apply for medication coverage through programs offered to those that couldn’t afford medication by pharmaceutical companies. I gave out medications that were expired, hoping there was enough active pharmaceutical product left in them to be efficacious. I got to truly know them, and their struggles, and I realized what mattered most to their health were basic essentials that many of us take for granted: housing, healthy food, employment, education, and social support. For many years as an acute care nurse on a medical unit, in the ICU or the ED, I questioned patients and/or family members on the home situation a patient would be returning to. I asked about support systems and help at home. However, often I failed to ask about some of the more basic SDOH, like access to healthy food, proximity to health care, and employment and financial resources. My time in the shelter taught me the importance of those factors. I wish I had worked in the shelter at the beginning of my nursing career, it would have transformed my nursing practice. AMSN wholeheartedly supports the work of the Future of Nursing 2020-2030 and the importance of the social determinants of health. We will continue to educate our members about SDOH and we will equip you with the knowledge and tools you need to embed their use in your practice, regardless of the practice setting you work in. We know that providing these resources can help you transform your nursing practice and make a difference for your patients – not only for their presenting medical issues, but for their overall health.