THE ROLE OF THE NURSE IN LEGISLATIVE ADVOCACY Robin Schaeffer, MSN, RN, CAE Executive Director, Arizona Nurses Association Co-Lead, Arizona Action Coalition Nurse Advocacy Who watches out for your profession, while you take care of patients? Why should you care? STRATEGIC PLAN PROMOTE A SAFE AND HEALTHY WORK ENVIRONMENT ADVANCE PROFESSIONAL AND LEADERSHIP DEVELOPMENT DEVELOP COMMUNITY PARTNERSHIPS ADVANCING THE NURSING PROFESSION AND PROMOTING A HEALTH ARIZONA ENGAGE MEMBERS ADVOCACY - PUBLIC POLICY - PRACTICE 1919-1969 1
1921- We are prepared to stay until our bill is heard TO PROTECT AND PROMOTE THE WELFARE OF THE PUBLIC BY INSURING THAT EACH PERSON WITH A NURSING LICENSE OR CERTIFICATE IS COMPETENT TO PRACTICE SAFELY. Nurse pay mandatory licensure fee MISSION COMPARISON ADVANCING THE NURSING PROFESSION AND PROMOTING A HEALTH ARIZONA Nurse chooses to join voluntary 1930 s 1940 s ASNA supported the establishment of an Arizona State Department of Public Health Much of the business of ASNA was put on hold during WWII. Many nurses entered the armed services. 1960 s 1950 s ASNA became involved in community health ASNA used their voice to advocate that programs and represented ASNA on agency committees and boards. employers adopt a forty hour work week. A nurse was appointed to the Health Advisory Committee of the Selective Service Board of Arizona. They also urged the formation of departments of ASNA advocated for upgrades to nursing homes. nursing at both Arizona State University and The State Board of Health adopted almost verbatim University of Arizona. ASNA s recommendations for proposed Rules and Regulations governing Nursing Homes and Hospitals. 2
1970 s AzNA focused on ensuring that advanced practice nurses gained access to legislative authority to fulfill their role. Arizona became the first state in the nation to legitimize the practice of RNs in extended roles. 1980 s During this decade, AzNA was active in drafting bills that amended the Nurse Practice Act. Much of the focus was on scope of practice for Nurse Practitioners. ADVOCACY 1989 public support for or recommendation of a particular cause or policy AzNA hires Rory Hays, lobbyist. Rory remains in that position today! LOBBYING seek to influence (a politician or public official) on an issue 1990 s Whistleblower Protection Bill Mandatory Overtime AzNA and the Arizona State Board of Nursing forged a strong working relationship. Legislation enabling advanced practice nurses to enlarge their scope of practice became a model for the country. 3
11/15/16 "Get to the table and be a player, or someone who does not understand nursing will do that for you." - Loretta Ford, EdD, RN, PNP, FAAN, FAANP LOBBYING & ADVOCACY 2013, 2014 Building & Using Political Capital 1. Medicaid Restoration and Expansion 2. Proposition 480 A M e ssa ge from Gove rnor Bre w e r t o Arizona N urse s May 1, 2013 Arizona fa c e s it s m ost im port a nt he a lt h c a re issue sinc e t he c re a t ion of our unique M e dic a id syst e m AH CCCS - t hirt y ye a rs a go. T w ic e, t he vot e rs of Arizona ha ve support e d AH CCCS c ove ra ge of c hildle ss a dult s up t o 1 0 0 % of t he Fe de ra l Pove rt y Le ve l. M y M e dic a id Re st ora t ion Pla n w ill not only honor t he w ill of t hose vot e rs, it w ill a lso provide c rit ic a l he a lt h c ove ra ge t o Arizona s w ork ing poor, c re a t e t housa nds of qua lit y jobs a nd r e duc e t he im pa c t s of unc om pe nsa t e d c a re upon our hospit a ls a nd Arizona fa m ilie s. Le t m e t ha nk you for t he support of t he Arizona N urse s Assoc ia t ion in t his im port a nt e ffort. I k now m a ny of you ha ve e -m a ile d or m e t pe rsona lly w it h your le gisla t ors a s you a sk for t he ir vot e in fa vor of re st ora t ion. But I st ill ne e d your he lp. Y our voic e s ne e d t o be he a rd! I w ould a ppre c ia t e it if you w ould c ont a c t your le gisla t ors by e -m a il, by phone or by good old-fa shione d le t t e r t o le t t he m k now t ha t you support M e dic a id re st ora t ion for c hildle ss a dult s. Sha re w it h t he m how t he la c k of he a lt h c a re c ove ra ge im pa c t s your pa t ie nt s a nd le a ds t o t ra gic re sult s. Assure t he m t ha t t he c ost -e ffe c t ive se rvic e s provide d t o AH CCCS pa t ie nt s m e e t t he st a nda rds of c a re a nd profe ssiona lism re quire d for a ny pa t ie nt. As N a t iona l N urse s We e k a pproa c he s, I pa rt ic ula rly w a nt t o t ha nk you for your he lp a nd for t he vit a l se rvic e a nd c a re you provide t o Arizona c it ize ns. Sinc e re ly, Lack of insurance coverage leads people to use urgent care services that, while they are safe, are not intended to provide long-term health care management of the kind that has been demonstrated to improve health outcomes, said Denise Link, a Nurse Practitioner of 33 years and the Director of a Nurse Practitioner-managed health clinic in central Phoenix. J a nic e K. Bre w e r Gove rnor The influential Voice of Nursing Journey to Nurse Advocacy The Trusted & Balanced Voice of Nursing Proposition 480 is critical to help M aricopa Integrated Health System to fulfill its mission to provide quality health care to all and including our first responders and the most vulnerable. Due Diligence Phase 4
11/15/16 EBOLA OUTBREAK AzNA Interviewed by 5 different Media Outlets in 1 Day! Public Service Announcement by The Most Trusted Profession Robin Schaeffer, executive director of the Arizona Nurses Association answers questions for the media after a nurse caring for an Ebola infected patient tested positive herself. October 13, 2014 (Source: CBS 5 News) 2015-2016 Legislative Session The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education (LACE) FULL PRACTICE AUTHORITY Not a Cinderella Story CNP CRNA CNM CNS MAY 2015 The goal of this legislation is to allow Advanced Practice Nurses to practice to the full extent of their education and training, which will increase patient accessibility of safe, cost-effective care AzNA lead the way by coordinating leadership from all four Advanced Practice Registered Nurse (APRN) roles to put national standards into law in Arizona by allowing APRNs to practice to the full extent of their education and training. Our message became: Nurses Care for Arizona. 5
JUNE 2015 Historic merger: The Arizona Coalition of Advanced Practice Nurses Arizona Nurse Practitioner Council Arizona Chapter of the American College of Nurse Midwives Arizona Association of Nurse Anesthetists Goal: Share resources and support each other to achieve this monumental task. DECEMBER 7 TH 2015 FEBRUARY 2, 2016 6
400 pages of Evidence-Based Research-Safety 7
83,000 RN S + 10,671 LPN = 93,671 NP=5,750 CNS=183 CNM=256 CRNA=849 15,000 Physicians? DOES EVIDENCE MAKE A DIFFERENCE? Lessons Learned Getting groups of nurses together to advocate for our profession is easy: just ask them. The heart and dedication of a nurse is what the public has used to vote us the most trusted, honest and ethical profession for over 14 years in a row. Being voted the most trusted, honest and ethical profession does not give you a free-ticket in politics. There may be influences out of our control Not having a nurse in the AZ Legislature =loss for nurses and patients. ADJUSTING OUR SAILS 2 SEPARATE BILLS What was it that enabled Florence Nightingale to stimulate the development of a profession and change the health and lives of so many? ØNP/CNM ØCRNA S CNS-YEAR OF LEGISLATOR EDUCATION 8
PUBLIC POLICY, ADVOCACY, LOBBYING Pre-licensure Curriculum? Faculty comfort zone? How do you support our professional policy efforts? What are your ideas? 85,000 Registered Nurses Largest group of health care workers Front-line care givers 1 in 75 Arizonans 9