A Sense of Community by Robin Hertel, EdS, MSN, RN, CMSRN President, AMSN It’s been a tough couple of months for nursing. In February, a nurse at Vanderbilt was arrested and charged with reckless homicide after a medication error resulted in the death of a patient. Just last month, nurses were in an uproar over Washington Senator Maureen Walsh’s uninformed comments about what nurses do. Incidents like these, and those that happen on a daily basis can bring nurses closer together to offer support and build a sense of community. Nurses spend a lot of time together in the practice setting; sometimes more time than we spend with our outside friends or members of our family. Incidents such as those that made the news recently provide an opportunity for nurse leaders such as yourself to build and strengthen the sense of camaraderie and teamwork among all the members of the nursing team. Building a sense of community needn’t (and shouldn’t) wait for a negative or traumatic incident to draw nurses together. Beginning now, you can take steps to form a tight community of support that will increase resilience and decrease the risk of burnout for all the members of the team. Begin by discussing your shared values – What brought you into nursing? What does excellence in patient centered care look like? What is your ultimate goal in the delivery of nursing care? By discussing these questions and identifying areas of similarity you can begin to build a community with a sense of purpose and a set of values that everyone is working towards. Also, pay attention to those areas that are different – recognizing that each of us brings different life experiences and talents to the table. Capitalizing on these differences to make a stronger and broader sense of community is a way to promote the synergy of the group. I was working on a fairly good-sized med-surg unit when I started my nursing career. The nurses had a wide variety of backgrounds and educational levels. Our colleagues - patient care technicians, physical therapists, nursing students and support staff would often visit for short periods throughout the day and we found that despite the varied job responsibilities, educational level, and cultural background, we had a lot in common. It was only after a tragedy that shook us all to the core however, that brought us together into a tightly knit group. My mentor, and one of my favorite nurses, was killed tragically in an accident with a semi-truck one Saturday morning. Needless to say, I was devastated. Yet our little community pulled together even tighter and supported one another; calling each other to check on how we were doing, discussing the impact one person’s life had on so many, picking up shifts for those who needed some time to grieve. We all wanted to attend the funeral of course and pay our last respects to our colleague and friend. The nursing students and their instructors along with nurses from other units all volunteered to cover our unit so we could attend the funeral together! Following this, we took some time to tell our stories about our colleague – but it didn’t stop there. We created opportunities to share our own stories in daily huddles. We had created an environment of safety, trust, and collegiality that lasted for quite some time. Everyone has gone their own separate ways of course; pursuing new avenues of practice or retiring. Yet I remember those days of having a little community as one of my favorite things of nursing.
Support Title 8 Legislation with strong funding for key AMSN workforce development and research priorities cleared its first hurdle in Congress April 30. The House Labor-HHS-Education Appropriations subcommittee approved a bill (not yet numbered) providing increases in Title 8 nurse workforce development and the National Institutes of Nursing Research. It also provided level funding for the Agency for Health Care Quality and Research (AHRQ), though overall AHRQ funding was cut from expiration of a key funding source authorized by the Affordable Care Act (ACA). Along with the Nursing Community Coalition, AMSN and its members have been urging Congress to support these vital funding priorities. Their next step is in the full House Appropriations Committee, expected to act early May. However, the long-term prospects for such funding increases are in question, as the bill’s overall $11 billion increase in funding depends on bipartisan congressional leaders and the Administration agreeing to increase overall domestic spending for 2020. See AMSN’s written testimony to Congress: https://www.amsn.org/amsn-news/amsn-submits-testimony-calling-for-appropriations-decisions. Support this legislation: https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit Health Information Technology Health information technology industry and policymakers should pay closer attention to the experience of medical-surgical nurses and other end users of health IT systems, AMSN said to the U.S. Department of Health and Human Services May 3. “In the interest of patients, the involvement and leadership of nurses is crucial to successful health information technology policy and systems development and implementation,” wrote AMSN President Robin Hertel, MSN, EdS, RN, CMSRN, in two comment letters to regulatory proposals from the federal Centers for Medicare & Medicaid Services and the Office of the National Coordinator of Health Information Technology. In her comments on behalf of AMSN, Yoder: • Supported an agency proposal to make more patient health information available to health care professionals through trusted exchange networks. “Respecting concerns that health care delivery systems may lack sufficient infrastructure to put such powerful tools to use today, as nurses we know that the more accurate, complete and timely a picture a nurse may have of a patient’s health and care history, the higher quality of care we can provide, and the more effectively we can support transition of the patient’s care and recovery to home or the next care setting,” she said. • Supported a proposal requiring hospitals to improve the effectiveness and reliability of electronic patient notifications. “Medical-surgical nurses are commonly directly engaged in patient discharge and patient care transition. The objective of effective care transition is to support smooth recovery for the patient in a safe and supportive environment, and smooth uptake of information about changes in the patient’s condition among the health care professionals and facilities involved in the patient’s subsequent care,” she said. “The expertise of nurses is vital to care and both governments and information technology industry would be wise to call upon nurses in support of improvement of health IT systems architecture, development, implementation and evaluation,” she concluded. Both AMSN regulatory comment letters appear here: https://www.amsn.org/amsn-news/amsn-has-important-recommendations-health-information-technology After the public comment period closes June 4, 2019, the agency will evaluate the comments and publish a binding final rule in several months’ time. HB 2604 Legislation in Illinois imposing rigid nurse-to-patient staffing ratios in that state conflicts with AMSN policy trusting nurses to develop safe staffing plans. AMSN has responded by sending bill sponsor State Rep. Fred Crespo (D-44th District) and key committee members a letter in opposition to the bill, HB 2604 (http://www.ilga.gov/legislation/billstatus.asp?DocNum=2604&GAID=15&GA=101&DocTypeID=HB&LegID=118738&SessionID=108), on April 26. “AMSN policy states that safe staffing for patient care depends on nurse authority, patient acuity, and the skill and capability of individual nurses in a unit,” wrote AMSN President Hertel. “By contrast, HB 2604 sets fixed nurse-patient ratios in Illinois health care facilities; therefore, our organization is opposed to the legislation in its present form.” The bill would amend state laws that already require local shared governance plans to be given weight in nurse staffing decisionmaking. AMSN also noted that a proposal similar to HB 2604 was put to voters in Massachusetts last November. “The Massachusetts Health Policy Commission estimated its annual costs between $676 million and $949 million and possibly more,” adding that Massachusetts voters defeated it by a 70.2 – 29.8% margin. The full text of the letter is available here: https://www.amsn.org/amsn-news/amsn-responds-illinois-staffing-ratio-legislation HB 811 Could nurses’ CMSRN and CCCTM credentials be put at risk by legislation pending in Pennsylvania? A bill introduced as HB 811 (https://trackbill.com/bill/pennsylvania-house-bill-811-an-act-amending-title-63-professions-and-occupations-state-licensed-of-the-pennsylvania-consolidated-statutes-providing-for-licensing-for-individuals-with-a-criminal-conviction-and-for-occupational-licensing-for-low-income-individuals/1738492/) intended to expand pathways for persons convicted of crimes to reenter the workforce once they have paid their debts to society instead adds confusion to credentialing and licensure vital to safe health care delivery. “We respect that the intent of HB 811 is to open employment and economic opportunity for persons who have criminal records and have paid their debts to society,” wrote AMSN President Hertel to bill sponsor State Rep. Jim Cox (R-129th District). “Our organizations are concerned that HB 811 as introduced includes several problematic and unclear provisions. Its definition of ‘licensing or certifying body’ is unclear whether it applies to governmental or private entities or both. It places unusual parameters on the use of the term ‘certification,’ particularly as they might apply to medical-surgical nurses, other registered nurses, or other individuals engaged in health care delivery and administration of controlled substances.” Consistent with the recommendations of the Professional Certification Coalition (PCC) to which MSNCB belongs, AMSN recommended amending the legislation to clarify that it would apply only to state government licensing agencies and not to voluntary professional credentialing bodies. The full text of the letter is available here: https://www.amsn.org/amsn-news/cmsrn-and-ccctm-credentials-risk-pennsylvania
The following statement will be sent to the following representatives of the Subcommittee on Labor, HHS and Education: Sen. Roy Blunt, Rep. Nita Lowey, Sen. Patty Murray, Rep. Tom Cole on behalf of AMSN. Dear Chairs and Ranking Members, On behalf of the 14,000 members of the Academy of Medical-Surgical Nurses (AMSN), as the organization’s President I write to submit this letter as testimony for the record to the House and Senate Appropriations Subcommittee on Labor, HHS and Education, regarding FY 2020 appropriations for Title 8 nurse workforce development programs, the National Institute of Nursing Research, and the Agency for Healthcare Research and Quality, all of which are priorities for members of our organization. AMSN is the only national specialty nursing organization dedicated to developing medical-surgical nurses personally and professionally. You know our members well as the type of nurse who would provide care for a person in the hospital. Our practice is the largest specialty in nursing, consisting of an estimated 650,000 professionals, and is the foundation of all hospital and community nursing practice. Our national agenda includes promoting evidence-based safe staffing models, addressing social determinants of health and the links between hospital care and postoperative health, promoting professional respect and safety in nursing and health care professions, and advancing nurses into leadership roles in health, community and public service. We simply request that Congress, in making appropriations decisions, listen to nurses. Med-surg nurses work on the front lines of care delivery every day. America’s 4 million nurses represent the largest workforce in our nation’s health care sector. We know what is best for our patients. We know what makes for effective, efficient, compassionate care. We live it every day, and we bring this experience to our agenda for advocacy. AMSN Requests for FY 2020 Labor, HHS and Education Appropriations AMSN requests the Congress provide the following appropriations within the Labor, HHS and Education Appropriations bills for FY 2020: • U.S. Department of Health and Human Services, Health Resources and Services Administration, Title 8 Nursing Workforce Development … $266,000,000 • U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Nursing Research … $173,000,000 • U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality … $460,000,000. Title 8 Nursing Workforce Development AMSN requests Congress provide $266,000,000 in appropriations for nurse workforce development programs under Title 8 of the Public Health Service Act for FY 2020. We urge Congress once again to not accept the Administration’s proposal to severely reduce this program, and to support the joint recommendations of the Nursing Community Coalition, which we share. Administered by the Health Resources and Services Administration, Title 8 Nursing Workforce Development programs are instrumental in bolstering and sustaining the nation’s nursing pipeline. Title 8 programs address all aspects of the nursing workforce demand, including education, practice, recruitment, and retention. Furthermore, these programs increase access to care in communities that need it most; those in rural and underserved areas. It is also critically important that these nursing workforce programs continue to have individual line items, which include: • Advanced Nursing Education (Sec. 811), which includes the Advanced Education Nursing Traineeships and Nurse Anesthetist Traineeships • Nursing Workforce Diversity (Sec. 821) • Nurse Education, Practice, Quality, and Retention (Sec. 831) • NURSE Corps Loan Repayment and Scholarship Programs (Sec. 846) • Nurse Faculty Loan Program (Sec. 846A) • Comprehensive Geriatric Education (Sec. 865) Our members have ranked nursing workforce development among their highest priorities in policy. In a survey of AMSN members taken August 2019, they stated that they prioritized: • Health care workforce development • Advocacy for nurses entering the academic workforce and valuing what nurse educators do and provide • Nurse staffing - including conversations that innovate care delivery • Addressing gaps in education that contribute to provider burnout and lack of quality care. Title 8 programs effectively address these priorities. They must be sufficiently funded. America’s population is growing, aging, becoming increasingly diverse, and requiring more health care year by year. Its investment in the future nursing workforce through Title 8 appropriations delivers important value by helping to ensure a supply of highly educated and well-prepared caregivers, supporting the development of nursing faculty and needed educational infrastructure, and expanding incentives for nurses to choose public health careers. National Institute of Nursing Research (NINR) AMSN requests Congress provide $173,000,000 in appropriations for the National Institute of Nursing Research (NINR) within the National Institutes of Health for FY 2020. We associate ourselves with the recommendations of the Nursing Community Coalition for NINR funding. As one of the 27 Institutes and Centers at the National Institutes of Health, NINR’s research projects funded through this Institute are aimed at reducing burdensome chronic illness, improving end of life care, and promoting patient-centered care across the life continuum. From disease prevention and global health, to precision medicine and genomic studies, NINR is at the forefront of nursing science and research. Agency for Healthcare Research and Quality (AHRQ) AMSN requests Congress provide $460,000,000 in appropriations for the Agency for Healthcare Research and Quality (AHRQ) FY 2020. We ask that Congress one again not adopt the Administration’s request to transfer AHRQ to the National Institutes of Health, rename it the National Institute for Research on Safety and Quality, and reduce its funding by $112.5 million. We associate ourselves with the recommendations of the Friends of AHRQ funding request. Health services research of the type supported by AHRQ and its budget holds promise for improving health care, improving health, and promoting the cost-efficiency of our nearly $4 trillion U.S. health care sector. AHRQ-funded research identifies waste in health care so that stakeholders in the system can learn and change for the better. AHRQ initiatives have helped to reduce the incidence of hospital-acquired conditions and are well-situated to help the country and the health care industry respond effectively to the growing number of patients with multiple chronic conditions. Thank you for your attention to these requests. We stand ready to provide the Subcommittees any additional information you may require on these subjects. Sincerely, Robin Hertel, EdS, MSN, RN, CMSRN President
Title 8 nurse workforce development programs are threatened by significant budget cuts, and AMSN and its members are taking action. In its 2020 budget, the Administration recommended cutting Title 8 by two-thirds. Joining forces with the Nursing Community Coalition, AMSN signed on to testimony to Congress supporting $266 million in funding for Title 8, stating, “Nursing Workforce Development programs help meet this demand by connecting patients with care across a variety of settings, including in community health centers, hospitals, long-term care facilities, local and state health departments, schools, workplaces, and patients’ homes.” AMSN President Robin Hertel, EdS, MSN, RN, CMSRN, said, “We are deeply concerned that the Administration's 2020 budget proposes deep cuts to nurse workforce development, health care quality research, nursing research, and coverage important to our patients. This budget proposal is a first step in a long process. We look forward to continuing work with our members, other nursing organizations and coalitions, and members of Congress from both political parties to support policies and funding that advance patient access to high quality, affordable health care.” And AMSN members are contacting Congress today – have you? Take action now, here: https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit AMSN is making medical-surgical nursing’s voice heard by testifying to the National Academy of Medicine’s kickoff meeting of the Future of Nursing 2020-2030 project in Washington. In her statement March 20, AMSN immediate past president Linda Yoder, PhD, MBA, RN, AOCN, FAAN, said, “To the extent that health financing and policy are barriers to health and health care delivery, we recommend transforming the health care payment system so that nurses are not only a cost but a source of revenue and a resource for solving community health needs. Paying for outcomes and value, and ending laws that keep nurses from practicing to the extent they are educated, can improve care and address challenges in nurse staffing.” Learn more about the project here: http://www.nationalacademies.org/hmd/Activities/Workforce/futureofnursing2030.aspx , see the webcast here: www.nationalacademies.org/hmd/Activities/Workforce/futureofnursing2030/2019-MAR-20.aspx and read Dr. Yoder’s statement here: http://amsnblog.org/node/16#overlay-context=node/22 Thousands of women who served their country in uniform as cadet nurses during World War II would be recognized by Congress if legislation newly introduced April 3 is enacted. The “United States Cadet Nurse Service Corps Recognition Act” (HR 2056 / S 997) would designate individuals who served in the U.S. Cadet Nurse Corps between July 1, 1943 - Dec. 31, 1948, as veterans of the U.S. Armed Forces active military service, authorize recognition of their discharge as honorable, and render them eligible for burial benefits via the Veterans Administration. It authorizes the Secretary of Defense to produce and award an appropriate U.S. Cadet Nurse Corps service medal. It does not extend them health care or pension benefits otherwise offered through the Veterans Administration. AMSN will formally express support for this legislation shortly as it did in 2018. (Images courtesy United States Government Printing Office via UNT Digital Library) AMSN advocacy listens to members! In the 2018 AMSN member advocacy survey, the top health policy issue solutions out of ten were these: “Systems intended to improve health care by addressing social determinants of health and improved monitoring of people with chronic conditions should include med-surg nurses in significant leadership roles.” 40% of respondents said it ranked among their highest priorities, 17% among their lowest. “To promote patient safety, policy should support translational research into staffing management models that ensure excellent care.” 37% highest, 25% lowest “Leading AMSN members should be nominated and named to key health policy leadership and advisory panels to ensure med-surg nursing perspective on important issues.” 37% highest, 17% lowest
Look Me Up at Convention: A Time to Catch Up with Colleagues by: Robin Hertel, EdS, MSN, RN, CMSRN, President - AMSN I’m excited to return to Chicago for this year’s AMSN National Convention, the site of my first convention. I was inspired from the time of the opening ceremony until the close of the convention by the high-level sessions, networking opportunities, and wonderful posters. I meet wonderfully talented nurses at convention and make friendships that continue despite time and distance. Each year, convention allows me to catch up with colleagues; sharing news and laughter, enjoying discussions of hot topics in nursing and the sessions we’ve attended. It was also in Chicago that I attended a review course and took the certification exam. (I’m now preparing to re-certify for the second time!) I thought I would be anxious about taking the test but the convention sessions reinforced the learning from the review course while the networking and support from other nurses throughout the convention gave me confidence. I was so pleased after obtaining the results notifying me that I was now qualified to include the credentials CMSRN along with my title! (I still feel I stand a little taller every time I get to list those credentials.). If I had one regret that convention, it was turning down some tickets to the Oprah Winfrey show, a show in which she gave away a car to everyone in the audience! The city is amazing though and everyone had a great time. A friend and I attended a speakeasy dinner theater, window-shopped along the Miracle Mile and walked the Navy Pier. We took our pictures in front of “The Bean” in the park and enjoyed the wonderful food the city had to offer, including Chicago style hot dogs! I would encourage anyone attending this year’s convention to have one; but a word of advice, don’t ask for ketchup, which the Chicagoans consider a rookie mistake. I’ve attended every convention since that first one in Chicago years ago. There are always a variety of sessions addressing topics such as professionalism, leadership, and legislative issues in addition to medical-surgical topics; presented for the beginning, intermediate and advanced practitioner. This year won’t be any different! Look for sessions about self-care, resiliency, and incorporating evidence-based practices which are sure to provide excellent tools you can take back for use on your unit. Take advantage of all the networking opportunities available as well; you never know where it might lead! Perhaps, like my experience, the connections you make at convention could take you to places you had never imagined! Look me up at convention and say hello! I can’t wait to hear your stories and thoughts on the convention as well as your experiences. Maybe we’ll have an opportunity to sit down and have a Chicago Red Hot together! I know it will be an experience filled with learning, laughter, collegiality, and fun. It will be an experience you won’t soon forget and will never regret.
Welcome to the April/May Edition of MSNCB's Certification Central, your must-read recertification resource. One of the most common questions I am asked by both new and seasoned nurses concerns my career path in nursing. Specifically, they want to know the how and the why behind my career. When I reflect on my career, I remember that as a newer nurse I was always eager to learn new skills, techniques, and of course new knowledge. I volunteered for committees, helped with annual skills competency days, and later became a nursing preceptor. In my quest for knowledge and knowledgeable sources, I discovered the Academy of Medical-Surgical Nurses (AMSN). At the time there was no Internet, so I had to go to a medical library to read the AMSN journals! I was pretty fascinated with the journals because they were easy to read and applicable to my medical-surgical practice as a trauma nurse. Eventually, I joined AMSN and began receiving my own journals. One day while reading the journal, I saw an advertisement about the AMSN Annual Conference and I decided the easiest way to attend was to submit a poster that reflected my nursing practice. Thankfully, it was accepted and I had a wonderful time at the conference. I became convinced that certification as a Certified Medical-Surgical Registered Nurse (CMSRN) was going to be a key component in my pursuit of excellence in nursing. The more I thought about CMSRN certification, the more important it became to share this concept throughout my healthcare organization. As a result, I was inspired to develop an in-house CMSRN Preparation Course to certify our inpatient and outpatient nursing staff. In developing and teaching the CMSRN course with my colleagues, I developed a love of teaching and began to teach in the Surgical Services Specialty Orientation Program, Trauma Nurse Core Certification, and later became adjunct faculty at a local university. As my scope of practice broadened, I saw an email from the Medical-Surgical Nursing Certification Board (MSNCB) seeking to fill the position of board director. Reflecting on my nursing career, I felt I was an ideal candidate and I hoped they did too. Needless to say, I applied for the position, was accepted, joined the board, and recently became its president. In reflecting on my career pathway, CMSRN certification was definitely the catalyst that started my nursing journey. Sincerely, Ann Ann Falker, DNP, RN, GCNS-BC, CMSRN, CBN MSNCB Board President Clinical Nurse Specialist Barnes-Jewish Hospital Saint Louis, MO
By Terri Hinkely, MBA, BSN, RN, CCRC, AMSN CEO Continuing education is a passion of mine. No, really. I work for a professional nursing society where we promote professional development and encourage continuing education. We know that in today’s volatile, uncertain, complex and ambiguous (VUCA) health care environment, continuing education and professional development are critical to navigating our workplaces. That’s why the board of directors and the AMSN staff are focused on providing you with the education and tools you need to be successful at work. To demonstrate our commitment to your continuing education, AMSN is currently developing new educational content in behavioral health, a new and improved certification review course, and making some improvements to our clinical development leadership program. We have a fabulous program for our 2019 Annual Convention, and we are confident you’ll learn lots if you join us in Chicago. We’re also expanding the ways you can consume that education, with face-to face offerings, e-Learning courses, podcasts, blogs and peer-reviewed articles in our journal, the MedSurg Nursing Journal, because we know that you’re busy and sometimes finding time for continuing education and professional development is difficult. Stay tuned because there are more exciting things to come. We want AMSN to be your trusted source for information and education on topics that matter to you. I am also passionate about my own continuing education. I graduated in 1986 with a diploma in nursing from a community college in Toronto, Canada. I then went on to complete a critical care certificate. Once I had completed my certificate and was working in an ICU, I went back to school to earn my BScN. I graduated with my BScN in 2000 and went back to school in 2002 for an MBA. I did my MBA online, well before most universities were offering online programs, because the flexibility and autonomy were important for me. Lastly, I’m graduating next month from the George Washington University with my EdD. Is that it for me? Likely not. Clearly, I love learning. I’m sure something else will fascinate me and I’ll head back to school again. Next month I’ll be a guest on the AMSN Podcast: MedSurg Moments, where I will talk about my dissertation research on second victim syndrome. My study explored the combined impact psychological capital (often described as who you are or your overall developmental state) and social capital (or the network of relationships you have) on the severity of second victim syndrome experienced in registered nurses. Did you know that second victim syndrome doesn’t just result following an error? It can happen for a number of reasons, and we’ll explore some of those during the podcast. Given the focus on clinician well-being that surrounds the healthcare environment, this topic is critical. I hope you’ll tune in
PREPARED STATEMENT OF DR. LINDA YODER, PhD, MBA, RN, AOCN, FAAN ACADEMY OF MEDICAL-SURGICAL NURSES IMMEDIATE PAST PRESIDENT BEFORE THE NATIONAL ACADEMIES OF SCIENCE, ENGINEERING AND MEDICINE FUTURE OF NURSING 2020-2030 INAUGURAL PUBLIC PANEL WASHINGTON, DC ==== Co-chair Doctors Wakefield and Williams, members of the panel, colleagues: I am Dr. Linda Yoder, immediate past president of the Academy of Medical-Surgical Nurses. Thank you for the opportunity to present on behalf of our AMSN President Robin Hertel and our members. Medical-surgical nurses are the ones who provide care for you and your loved ones in the hospital. Our practice is the largest specialty in nursing, consisting of an estimated 650-thousand professionals. Medical-surgical nursing is the foundation of all hospital and community nursing practice. A system provides the outcomes it was designed for - and we have a flawed system! In the United States, we have miraculous innovations and outstanding care for some. Yet, a woman is three times as likely to suffer maternal complications or death if she’s black. Our health sector costs two to three times that found in other industrialized nations, but we’re not living twice as long or as well. 90 percent of a person’s health is the result of social determinants and heredity. Yet, as a nation, we annually spend nearly 4 trillion dollars on health care interventions that impact only 10 percent of our health. Through focused attention and action addressing social determinants of health and the factors driving health disparities, this Committee can draw a path to a healthier American future, one where all our people live fuller, stronger lives, and where nurses are prepared to serve, innovate and lead the way. We know the barriers to this future. We may have the most dynamic and productive economy the world has known. But failures of imagination and policy keep this economically strong nation unhealthy. Our systems for financing health care pay for sickness not health, for procedures not outcomes. In doing so they warp the delivery of care against the people paying the highest social prices for it. Among the people paying a high price: people of color. Women. People who are economically poor. And people with multiple health conditions incurring unimaginable costs for uncoordinated care. Rural America is paying a high price and their hospitals are closing. I served in the Army 28 years and can state with authority my fellow Veterans pay a high price. Most Veterans do not receive their care in VA hospitals and civilian professionals do not always appreciate Veterans’ unique health care needs. In America, we also pay a high price in health for failures in technological innovation and integration. Often nurses and other professionals do not get the patient data they need to make the right decisions every time. And rarely is the patient’s health information smoothly communicated to their next step in care. A new proposed regulation on health IT interoperability shows promise, though it’s 20-19 and it should have been done already. In America, discontent drives creativity. That gives me hope. For example, Del Valle, Texas, is a food and health care desert where there is no hospital. Nurses from the University of Texas at Austin, working with the local fire department, have made the Del Valle firehouse the people’s health clinic. Health care is being brought to people where they are and we witness their health improving. In low-resource countries, nurses have developed systems supporting new mothers. Teams of nurses educate lay health workers to come alongside new mothers for practical training and to teach them how to care for their babies when they go home. With such models, they’re improving lives and communities from birth onward. In these new models and more, medical-surgical nurses work from the front lines to serve populations lacking health and health care. They collaborate with patients one-on-one to find solutions that work. So our counsel to this panel is to plant practical guidance that everyone in the health sector can act upon, from patients to professionals, to facilities, systems, plans, industry, and governments. To the extent that health financing and policy are barriers to health and health care delivery, recommend transforming the health care payment system so that nurses are not only a cost but a source of revenue and a resource for solving community health needs. Paying for outcomes and value and ending laws that keep nurses from practicing to the extent they are educated, can improve care and address challenges in nurse staffing. To the extent information technology has underperformed in health, drive industry to spur innovation alongside the nurses delivering the care. Because health care resources are focused on the sickness challenge and not on building a culture of health, we must make clear a path for nurses to drive elimination of health disparities and improve social determinants of health through changes in reimbursement policies. Thank you.
AMSN Asks Members to Contact Congress: Support Safe Staffing and Reauthorize Title 8 The time is now to build support for improving patient access to quality care by strengthening nursing education! Will you take a few moments today and write or call your U.S. Representative and say “support safe patient care, cosponsor HR 728 to reauthorize Title 8”? Learn: Title 8 is the federal government’s nurse workforce development program, critical to strengthening the nursing profession to provide care for America’s growing and aging population. Below is a link to some additional official detailed information about Title 8. Title 8: https://www.hrsa.gov/sites/default/files/hrsa/advisory-committees/nursing/meetings/2018/Title-VIII-nursing-workforce-programs-final-2018.pdf Learn: Below are links to an introductory statement and text of HR 728. AMSN supports this important legislation - now you can take action to express your support too! Introductory Statement: https://joyce.house.gov/uploads/%20Joyce%20Re-Introduces%20Legislation%20to%20Improve%20Nursing%20Workforce%20Development%20Programs%20.pdf HR 728 Text: https://www.congress.gov/bill/116th-congress/house-bill/728 Our four-step action plan is here (1) Act: Here is a link to look up your U.S. Representative. https://www.house.gov/htbin/findrep Once you find your representative’s name, click the name, connect to the legislator’s website, and use its “Contact” utility to send your message. (2) Act: Will you contact your U.S. Representative today? It’s easy and always best to use your own words. To make it more convenient for you, here is some draft text to consider copying and pasting if your Representative is not one of the more than 40 who have cosponsored HR 728: SUBJ: Support safe patient care, cosponsor HR 728 to reauthorize Title 8 As your constituent and a member of the Academy of Medical-Surgical Nursing (AMSN), I am writing to ask you to cosponsor HR 728, legislation to reauthorize Title 8 nurse workforce development programs. The 12,000-plus member AMSN is the only national organization fully representing medical-surgical nurses, who provide the kind of care you or a loved one would receive in the hospital. Because ensuring excellent nurse staffing is vital to safe patient care, I join my national organization in supporting reauthorizing nurse workforce development programs of Title 8 of the Public Health Service Act. Congress funded Title 8 at $249 million for 2019 with bipartisan support. But the program’s legislative authorization has expired, and its continuation is vital to health care in our community and around the country. Without reauthorization, its future funding is at risk - and they are needed resources to strengthen and expand nursing education for our aging population. I hope you will cosponsor HR 728 reauthorizing Title 8 and I look forward to your response. If you U.S. Representative is one of the more than 40 who have cosponsored HR 728, write and say thank you! Here’s a draft text to say thanks: SUBJ: Thank you for cosponsoring HR 728 As your constituent and a member of the Academy of Medical-Surgical Nursing (AMSN), I am writing to thank you for cosponsoring HR 728, legislation to reauthorize Title 8 nurse workforce development programs. The 12,000-plus member AMSN is the only national organization fully representing medical-surgical nurses, who provide the kind of care you or a loved one would receive in the hospital. Because ensuring excellent nurse staffing is vital to safe patient care, I join my national organization in supporting reauthorizing nurse workforce development programs of Title 8 of the Public Health Service Act. Congress funded Title 8 at $249 million for 2019 with bipartisan support. As you know, the program’s legislative authorization has expired, and its continuation is vital to health care in our community and around the country. Without reauthorization, its future funding is at risk - and they are needed resources to strengthen and expand nursing education for our aging population. Because the availability of nurses is so critical to health care delivery in our community, I thank you for supporting nurse workforce development by cosponsoring HR 728 reauthorizing Title 8. I look forward to your response. (3) Feedback: When you get a response, use this AMSN link and form below to let us know. https://docs.google.com/forms/d/e/1FAIpQLSfB8J847otNsxkFXLXgRkQDz7tNcmiDaneKjcmLBQg-d4NV9Q/viewform (4) Act: Here is some draft social media text you can use to urge support for Title 8! Facebook: Join me and @MedSurgNurses in asking your U.S. Representative to support safe staffing for health care and cosponsor #HR728 #Title8. https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit?usp=sharing Determine if your representative has already COSPONSORED Title 8 using the link below. https://www.congress.gov/bill/116th-congress/house-bill/728/cosponsors Then find your U.S. REP’S OFFICIAL FACEBOOK ADDRESS AND POST IF POSSIBLE: Thanks Rep. [LASTNAME] for supporting safe staffing for health care and cosponsoring #HR728 #Title8! @MedSurgNurses Twitter: Join me and @MedSurgNurses in asking your U.S. Rep to support safe staffing for #health care and cosponsor #HR728 #Title8. https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit?usp=sharing IF ALREADY COSPONSORED: LOOK UP YOUR U.S. REP’S OFFICIAL TWITTER ADDRESS AND TWEET: Thanks @RepsTwitterAddr for supporting safe staffing for #health care by cosponsoring #HR728 #Title8! Thank you for your assistance and taking AMSN's Call to Action. The AMSN Legislative Team
AMSN 2019 Legislative Agenda The following AMSN Legislative Agenda was adopted by the Board of Directors in February 2019. The CEO has been directed to mobilize appropriate resources at the federal and state levels to carry it out consistent with the AMSN strategic plan and strategic objectives: ● Safe staffing. Advance evidence-based initiatives promoting safe staffing to improve patient health care quality and access, and to reduce health care costs; ● Social determinants of health. Leverage medical-surgical nurses’ roles in patient discharge and transfer processes to advance evidence-based initiatives addressing social determinants of health (SDOH) to improve health and reduce health care costs. ● Nurse workforce development. Promote patient access to high quality health care by supporting reauthorization, improvement and full funding of federal nurse workforce development programs; ● Medical-surgical nurses in leadership. Seek opportunities to successfully place medical-surgical nurses in health care stakeholder advisory bodies and leadership positions at the state and federal levels and within the health care sector. ● Safe workplaces and professional respect. Identify and promote evidence-based strategies that improve workplace safety for medical-surgical nurses and advance their professional recognition. ● Opioid crisis. Promote implementation and funding of the SUPPORT for Patients and Communities Act (P.L. 115-271) and related initiatives at the federal and state levels.