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President's message.

I attended this year's Constituent Assembly (presidents and executive directors of the states and ANA staff) with Executive Director, Ernest Klein, in St. Louis, Missouri, in early March. As usual, the agenda was full of information from each state nurses association as well as from our national organization. ANA has been busy positioning nurses on key national committees to ensure our voice is heard. With the implementation of the Affordable Care Act, nurses' contributions are essential to the success of the proposed mandates. President Karen Daley gave a phenomenal speech about ANA and the contributions of nurses to the health of the nation. She announced the first ethics conference sponsored by ANA for which over 400 have registered to date. Her itinerary has included visiting state nurses associations, listening to the concerns and aspirations of RNs, and working with other organizations so that ANA can represent us as clearly as possible.

Maria Weston, Executive Director of ANA, announced that the Nurses Career Center is available to help new RNs with resume writing and recruiting. The National Database of Nursing Quality Indicators (NDNQI) conference boosted over 1100 attendees with over 100 posters of best practices. She noted ANA has appointed a task force addressing the IOM Report on the Future of Nursing. Their mandate will be to promote three of the recommendations from the report. I will update you on this in future bulletins. It was obvious, while I listened to Maria, that she is an exceptional executive director. Her energy, ability to organize and build consensus is a testament to the strength and effectiveness of the organization. We are in good hands.

The Coalition for Patients Rights report highlighted the work being done to counter the attack by physician groups that hope to discredit the contribution and limit the scope of practice of advanced practice nurses. Thirty-five organizations have organized to develop a plan to protect the patient's right to choose their health care provider. The IOM report on the Future of Nursing supports the advanced practice role in its full scope to help solve the nation's health care crisis. Some in the medical community want to continue thinking vertically about health care. This is antiquated and does not promote the kind of quality and efficiency we need in health care today or in the future. Medical care is one aspect of health care. Health care in its fullness is more than what traditional medicine has to offer. While it is true that we have the best medicine in the world, the depth and breadth of health care requires the contributions of many disciplines, each having primary importance and contribution in any given patient experience. We have to allow the expression of each health care discipline, in particular nursing, to fully serve the individual, family and community health care needs. It is difficult to change our thinking about the paradigm of health care. We have to. Our system can be improved, and it needs to change if we are to meet the demands of the future. More of the same will not do.

Discussion, during the Constituent Assembly, was passionate about impending legislation in Wisconsin, Indiana and Ohio concerning the restrictions on collective bargaining for state employees. Many nurses are part of health care institutions affected by these pieces of legislation. ANA reaches out to these nurses because ANA is similar to a family, with each state being a family member, each with different needs and strategies to solve their problems. We have states with collective bargaining units represented by their state nurses associations, states with nurses who are represented by other non-nurse groups, and states with no collective bargaining units. ANA is diverse in many ways and I see this as one area which causes more conversation, emotionalism and polarization than any other. Just like families, the unit must serve all members individually and collectively. And just like families, it is not easy to keep the unit together and on track. We (the state organizations) are the same yet we are different... autonomous and dependent. This is a difficult task for ANA and each state, and requires respect and sensitivity.

When nurses run out of options to ensure the safety of the patients they serve and to secure fair and safe work environments, collective bargaining is a tool to help them achieve these goals. If nursing administrators and managers are engaged, understand, and act upon what it takes to provide a safe patient and fair work environment then collective bargaining units are not necessary. (I recognize that this is easier said than done, but still the truth!) We need to ensure that our administrators and managers are equipped with knowledge of the best practices for their work environment. Nurses need to be involved at all levels, from bedside care, to writing policies, to developing solutions to our health care crisis. Hospitals securing Magnet status is one way to keep nurses involved at all levels of care. As each state deals with its work environment issues, we must respect their decisions to use collective bargaining or not use it. ANA supports nurses who decide to use collective bargaining as one tool and those who do not choose to use this method to ensure a safe patient and work environments. Whether you believe in union activity or not, it is part of the family conversation and will not and should not deter from our work.

These are just a few highlights from our time together at the Constituent Assembly. It is a good time to be a nurse. We have lots of work to do to make the changes needed to transform health care. The Constituent Assembly was a great place to have the family conversation.
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Author:Kelly, Barbara
Publication:ISNA Bulletin
Date:May 1, 2011
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