THE FINISH LINE...

Hello Class!!!

I have a Jing for you...

http://screencast.com/t/dHa2njp3j

Hi Everyone,

You all posted some great sections of the law and gave excellent reasons as to how it impacts and improves nursing practice and patient care! I was so happy to read how you were impressed with all the sections pertaining to our practice. This is what it means to be a nurse-citizen; to be informed of these laws! There are many portions of the law that we can share with our patients to improve their access to care. It is also great for us to be aware of the funding available for higher education (Hint Hint!!!!)

Ok... we have a loaded blog post today, so we will jump right in!!! We are going to talk about one major area advanced practice nurses are pushing for change.

As you have read in your assigned reading this week, there is going to be a huge influx of patients entering the health care system. The new health care law took this into consideration when they added Section 5501 and Section 2706. Under PL 111-148, Section 5501 it calls for an expansion of access to primary care and general surgery services (American Association of Colleges of Nursing [AACN], 2010). This section of the law includes advanced registered nurse practitioners (ARNPs) as primary care providers and stipulates they are to receive incentive payments for primary care services (AACN, 2010). Section 2706 mandates insurance companies cannot refuse to pay for services provided by an ARNP barring the ARNP is in compliance with their scope of practice as defined by their state laws (AACN, 2010). Making these changes in the manner ARNPs are reimbursed for services offered is a major step in allowing them the autonomy to practice independently; however, the debate is far from over as to how much autonomy nurse practitioners should be allowed to have.  Several states are debating whether or not to allow nurse practitioners the autonomy to practice primary care on their own without the supervision of a physician (Corleone, 2010; Trinity Mother Frances Hospitals & Clinics, 2010).  This is a very worthwhile debate as the Association of American Medical Colleges projects there will be a shortage of approximately 63,000 doctors by 2015 (Lopatto, 2012).  In addition to this, a recent survey of medical school graduates showed that only 2% were choosing to work in primary care (McGuire, 2010).  Who will provide primary care services to Americans, especially with the estimated 30 million plus increase in patients by 2014 (Lopatto, 2012)?

This is a major debate and hot topic in health care across the nation!!! Nurses, nursing organizations, medical organizations, stakeholders, patients, physicians, politicians, and many others are involved in this issue. Let’s jump in and give our opinions, thoughts, and experience on the topic. For this post I want you to find an electronic source such as a newspaper article, journal article, document from a professional organization, audio file, or video showing one or both sides of this debate. Please post a link to the source along with a full reference in APA in case we have difficulty getting the link to work. Then, share a brief comment or thought on at least 2 of your peers’ sources. We would love to hear what is going on in your states regarding this topic!

To get you started I have 2 videos for you to review:

https://www.youtube.com/watch?v=_65woayNegM

https://www.youtube.com/watch?v=QbRUGPsQ3zU

                                           References

American Association of Colleges of Nursing. (2010). Patient

     Protection and Affordable Care  Act Public Law No: 111-148:

     Nursing education and practice provisions. Retrieved from

     http://www.aacn.nche.edu/government-affairs/HCRreview.pdf

Corleone, M. (2010, April 18). The fight to give nurses more power

     [Video file]. Retrieved from

     https://www.youtube.com/watch?v=_65woayNegM

Lopatto, E. (2010, March 22). Nurse Practitioners, handmaidens

     no more. Business Week. Retrieved from

     http://www.businessweek.com/

McGuire, K. (2010, December 30). Expanding scope of practice

     for  advanced registered nurse  practitioners, physician

     assistants, optometrists, and dental hygienists. The Florida

     Legislator. Retrieved from  http://www.floridanurse.org/arnp
 
     corner/ARNPDocs/OPPAGAScopeofPracticeMemo.pdf

Trinity Mother Frances Hospitals & Clinics. ( 2010, April 15). A nurse

     may soon be your doctor [Video file]. Retrieved from 

     https://www.youtube.com/watch?v=QbRUGPsQ3zU

Patient Protection 

          & Affordable Care Act

One of the resources listed for this week is the American Association of Colleges of Nursing overview of specific sections of PL 111-148 (AACN, 2010). The AACN dissected the provisions from the law which deal with nursing practice such as education, workforce development, primary and preventative care, health promotion, improving patient outcomes, coordinating care, and patient and provider rights (AACN, 2010). I want you to review this document and post what section you like most and why. Give at least 1 reason you think this will improve nursing practice and/or patient care. You can access the document at the link provided or within your online classroom portal.  

 

http://www.aacn.nche.edu/government-affairs/HCRreview.pdf

                                 Reference

American Association of Colleges of Nursing. (2010).

     Patient Protection and Affordable Care Act Public

     Law No: 111-148: Nursing education and practice

     provisions. Retrieved from http://www.aacn.nche

     .edu/government-affairs/HCRreview.pdf

Hello class!

We are going to transition into the fourth sphere of political action; government. There are 3 primary roles for nurses within this sphere which include nurse-citizen, nurse-activist, and nurse-politician. As I have stated before, all 4 spheres overlap and work together; therefore, these nursing roles are also applicable in other spheres. The nurse-citizen fulfills a very fundamental role focusing more on personal responsibilities, the nurse-activist takes a more politically charged role, and the nurse-politician is the most politically active, typically holding a governmental/organizational position or office (Hughes, 2012; Mason, Leavitt, & Chaffee, 2007).

Here are a few pictures and cartoons depicting the issues nurses are concerned about and how they hope lobbying and presenting ideas for change to lawmakers can improve these issues.

Voting for health care and nursing issues:

Address the nursing shortage:

Address nurse to patient ratios:














Lack of access to care due to cost:


















For this blog, I want you to post a function a nurse can perform within each role. For example, a nurse-citizen has the responsibility to vote.  As you will see the nurse-activist assumes all the functions of a nurse-citizen, but then preforms additional functions as well.  Likewise, a nurse-politician encompasses the roles of a nurse-citizen and nurse-activist, and then preform additional duties exclusive to their role. Please do not post that a nurse-politician votes as this falls into the nurse-citizen area. Do not limit yourself to the text book, be creative and write something different than your peers!

*** Starting next week we will be looking at PL 111- 148 known as the Patient Protection and Affordable Care Act or Obamacare. We will look at the nursing provisions within the law as well as the affects national health insurance will have on nursing and health care. Make sure you review the assigned readings as this will help you not only in your discussion posts, but also here in the blog.

                                 References

Hughes, F. (2012, June 19). Relationship between

     leadership, policy, and politics [PowerPoint slides].

     Retrieved from http://www.slideserve.com/tod/

     relationship-between-leadership-policy-and-politics

Mason, D. J., Leavitt, J. K., & Chaffee, M., W. (2007).

     Policy and politics in nursing and health care (5th

     ed.). St. Louis, MO: Elsevier Saunders.

Hello Class,

I hope you had fun with the wordsearch! All of you found the answers which are 

1. LOCAL POLITICIANS
2. COMMUNITY MEMBERS
3. LOCAL ORGANIZATIONS 
4. HEALTH CARE PROVIDERS
5. SCHOOLS

One of the things we are looking at in your discussion questions this week is what you can do to impact the overall health of your community. I realize this seems like a very daunting task, but it is very import to realize your influence within your community.

 

An example of health concern within my community is the high incidence of melanoma and other types of skin cancer. I live in southwest Florida which means lots of sun and high ultraviolet light (UV) index’s throughout the year. The average UV index in my county is 6, which is considered high by the Environmental Protection Agency (EPA, 2011). For a UV index this high it is recommended individuals only spend 10-60 minutes outside at a time and use sunscreen, sunglasses, wear a hat, long sleeve shirts, and seek shade (Pustisek, Sikanić-Dugić, Hirsl-Hećej, & Domljan, 2010). This is a challenge when one is dealing with children. Studies show that 80% of an adult’s sun exposure occurs before age 18 (Pustisek et al., 2010) with 50% or more occurring during childhood, often times resulting in moderate to severe sun burns (Shanton Saleheen, O’Riordan, & Roy, 2003). These statistics underscore the need for children to have adequate sun protection when outside. As a politically active nurse within my community, my agenda would be to ensure playgrounds provide children with adequate shade to decrease the incidence of sun related damage and disease within my community.

 

Now, remember those stakeholders? Constructing shades structures is not a cheap endeavor. It will be a major challenge to get funding for this effort with the financial deficit and cutbacks our local and state governments face. It will be critical to get stakeholder support throughout the community, not just the politicians. Other stakeholders to consider include community members, health care professionals, faith-based institutions, schools, the health department, and other health driven community organizations. These groups can petition to community leaders such as county commissioners, county council members, the county manager, and county parks and recreation leaders with a proposal for the change.

 

It will be important to be armed with data. A community survey should be preformed to assess how many schools, parks, and community playgrounds are without adequate shade. Also, research and statistics showing this as a community health issue would be important to secure buy-in. Also, Healthy People 2020 goals and initiatives related to skin cancer should be included to further impress the need for shade structures.  The nurse activist could get quotes from multiple companies on the cost of shade structures, and could map a time line for construction. 

 

As you can see, planning is an essential component when looking to create change. Please share what nurses are doing in your community to create change. An excellent place to look is your local news, local newspapers, and organizations within the community. 

 

 

 

References

 

Environmental Protection Agency. (2011).UV Index.

     Retrieved from 

     http://www.epa.gov/sunwise/uvindex.html

Lewis-Washington, C., & Holcomb, L. (2010). Empowering

     community health: An educational approach. Journal

     of Community Health Nursing, 27(4), 197-206.

     doi:10.1080/07370016.2010.515454

Pustisek, N., Sikanić-Dugić, N., Hirsl-Hećej, V., &

     Domljan, M. (2010). Acute skin sun damage in children

     and its consequences in adults. Collegium

     Antropologicum, 34(2), 233-237.

Shanton, W. R., Saleheen, H., O’Riordan, D., & Roy, C. R.

     (2003). Environmental conditions and variation in

     levels of sun exposure among children in child care.

     International Journal of Behavioral Medicine, 10(4),

     285-298.

Stakeholders and Puzzle Pieces

 

Hello Class,

Excellent job last week with your responses in the blog! You guys are right on track! We have spent the past 2 weeks discussing the 4 spheres of political action in nursing and have looked specifically at the workplace and professional organizations. It is time to take a closer look at another sphere, which is community. Ah, the community! What could you possibly contribute to a community issue? The answer... A solution! I really enjoy talking about and seeing how nurses work within their communities to fix issues affecting the overall health of the community. The key to success in making a change within your community is support and buy-in from key stakeholders. Identifying and making a strong case to stakeholders is so vital because they have the resources, finances, partnerships, and ability to take your idea and help you turn it into reality. Stakeholders are like puzzle pieces; you need to figure out how to make them work together to make an effective change. Below is a wordsearch puzzle. There are 5 stakeholders listed within the wordsearch. I want you to find them and then post your findings in the blog. Your text book will be a useful tool for this exercise! Have fun ~ Laraine 
 

R J S V I H X O R S H J F K Y Z H

C Q R W W P D A N N J F I L G Y Z

O F E K N H K T L O Y X H L D Q M

M S D U S A R F C I U R V F J L P

M T I W U L S H H T X V H X H O R

U G V E O M Y X S A H K Z L N C T

N S O J T O J Q X Z S R I X T A C

I L R S J L P D O I A S U R R L P

T O P Y X A V X N N N W F F N P B

Y O E K X R T P G A L K F S V O H

M H R D E S L V U G P J B Z Y L A

E C A L S K F V C R Y E O M A I I

M S C Q U P K S I O N T K C J T W

B J H U P F S I N L X J Y G J I T

E Y T F O E H M H A S A H H F C C

R Z L M Q L V M Q C N S I L G I K

S Z A A V V E G N O L S I G W A P

S N E O X A V W A L F U A R F N A

U G H C K W I B V R V S A F Z S M

E C T F W S G E K Q H H H N D B A

Hello Class,

This is my third and final post for this week and it is one I really enjoy. In your discussions posts this week we are discussing the role nursing organizations play in policy and politics. You are writing about the benefits of these organizations, as well as barriers to nurses not getting more involved. For this blog post I want you to go to your state nursing association website and find legislation they are actively working on to improve the profession and/or patient care. Please name the organization and write a 5-7 sentence paragraph about your findings. You do not need to reference information other than the name of the association. Please note we are not looking at state boards of nursing but the nursing associations such as the Florida Nurses’ Association (FNA), Ohio Nurses’ Association (ONA), Oklahoma Nurses’ Association (ONA), New York State Nurses’ Association (NYSNA), or the Hawaii Nurses' Association (HNA). To get you started, this link will take you to the state nursing associations websites.  

http://www.theagapecenter.com/Organizations/State-Nursing.htm

A couple states do not have their site listed so you will need to search for it in that case. It will be interesting to see what is going on around the country! Enjoy ~ Laraine

Good Morning Class!

Well at least it is good morning in my time zone :0)

This blog post deals with issues contributing to nurses not taking a politically active role. There are several reasons including nurses not understanding the role, not knowing their resources, not realizing their influential capability, and lack of empowerment, exposure, and emphasis in nursing education (Mason, Leavitt, & Chaffee, 2007; Zauderer, Ballestas, Cardoza, Hood, & Neville, 2009). The latter is very near and dear to my heart.

The American Association of Colleges of Nursing 'Essentials of Baccalaureate Education for Professional Nursing Practice' (2008) underscores the importance of nursing curricula containing content related to policy development, policy analysis and evaluation, political activism, and the role of professional organizations in health care policy.  Although many baccalaureate nursing programs have adopted this curriculum, the literature still shows a disparity in nursing involvement in the political arena (Zauderer, et al., 2009).

I would like for each of you to share one personal reason keeping you from being politically active. It is important to identify the barriers so we can create solutions. A reason I had was the idea that there are plenty of nurses out there doing this, so why would I need to get involved. Then I came across a startling statistic; there are approximately 314 million people in the United States and of those approximately 2.7 million are registered nurses (Bureau of Labor Statistics, 2012; United Stated Census Bureau, 2012). That is less than 1% of the population!!! With statistics like this every voice does matter!!!

                                                References

American Association of Colleges of Nursing (2008). Essentials

     of baccalaureate education for professional nursing practice.

     Retrieved from http://www.aacn.nche.edu/education-

     resources/BaccEssentials08.pdf

Bureau of Labor Statistics. (2012). Table 6: The 30 occupations

     with the largest projected  employment growth, 2010-20.

     Retrieved from

     http://www.bls.gov/news.release/ecopro.t06.htm

Mason, D. J., Leavitt, J. K., & Chaffee, M., W. (2007). Policy and

     politics in nursing and health care (5th ed.). St. Louis, MO:

     Elsevier Saunders.

United Stated Census Bureau. (2012). U.S. & world population

     clocks. Retrieved from

     http://www.census.gov/main/www/popclock.html

Zauderer, C. R., Ballestas, H. C., Cardoza, M. P., Hood, P., &

     Neville, S. M. (2009). United we stand: Preparing nursing

     students for political activism. The Journal of the New York

     State Nurses Association, 39(2), 4-7.

To Be or Not To Be Politically Active

Hello Class!

Now that we have had an introduction to the 4 spheres of political action in nursing, we need to consider factors which contribute to nurses taking a politically active role, not taking a politically active role, and how professional nursing organizations can help our voice be heard. I will make three posts this week each focusing on one of these areas. This post will look at reasons why nurses become politically active.

One thing nursing students learn very early in their education is nurses are to be the patient and family advocate. All too often this advocacy stops at the bedside. Many practicing nurses do not understand the importance of advocating for patients on a larger scale. One reason to take a politically active role as a nurse is to support policies which seek to improve the lives of patients and the quality of care they receive. Take a look at this video of nurses doing their part to advocate for patient care issues.

http://www.youtube.com/watch?v=Rd9OjW40EkY

Write a few sentences of your thoughts after watching the video. Some things to reflect on when formulating your response include do you think it is important for nurses to unite on issues affecting our practice, and when voting for politicians to represent your ideas, are nursing issues something you consider? Share 1 reason not already discussed as to why you think nurses become politically active. 

As you are learning this week about the spheres of political action, I wanted to give some additional information on the topic. As many of you pointed out, the four spheres of political action in nursing include the workplace, government, professional organizations, and the community (Mason, Leavitt, & Chaffee, 2007). These are the areas where nurses have the opportunity to be politically involved. An important element to keep in mind is that each sphere has its own independent functions; however, all 4 spheres work together to create change. So, why does this matter and how does it affect us? 

You have learned throughout your nursing education that nursing practice is highly focused on patient safety, quality of care, outcomes, and evidenced based practice. As you will be graduating and starting your new careers, it will be important for you to review the policies and procedures of your employer, with specific attention to the nursing policies and procedures. What does it say about delegation to a licensed practical nurse? Presence of family members at a code? Expectations to work overtime? Refusing admissions based on acuity? You might be surprised at what you find and you will most certainly be amazed at the differences between the policy and procedure manual of a rural hospital and a Magnet hospital. In your workplace you need to think about changes that will impact the quality and safety of your work environment, patient outcomes, safety, and quality of care, and whether or not evidenced based nursing practice is implemented. 

Literature often shows that nurses view themselves as politically powerless. They see their role at the bedside as a technical activity, not a political opportunity. What nurses do not realize is the very act of being a nurse makes one politically involved (Cameron, Ceci, & Salas, 2011). This is due to the fact that our practice is shaped by governing bodies, ethical standards, professional standards, governmental standards, and health care itself (Bjornsdottir, 2009). Since we are already politically involved, why not take the plunge and become politically active?

Reflect on a health care or nursing practice issue you feel passionate about and would like to change. Share this with the class, the sphere(s) of political action it falls into, and why you think it is important to address. The idea is to get us thinking about different areas we can impact as nurses. This does not have to be a long response.

An example: Smoking in the workplace, which is a community hospital. I would like to ban smoking on the hospital campus. Political spheres include the workplace and community, possibly government with the federally mandated health insurance laws rolling out. This is important as the negative effects of smoking and second hand smoke are well documented, and patients requiring hospitalized care do not need to be exposed.

And guess what?! There are 2 health care systems in the county that have accomplished this with buy-in from nurses, physicians, hospital administration, and insurance companies!!! Change can happen if nurses speak up and voice their concerns :0)

                               References

Bjornsdottir, K. (2009). The ethics and politics of home

     care. International Journal of Nursing Studies, 46,

     732–739.

Cameron, B., Ceci, C., & Salas, A. (2011). Nursing and the

     political. Nursing Philosophy, 12, 53-155.

     doi:10.1111/j.1466-769X.2011.00499.x.

Mason, D. J., Leavitt, J. K., & Chaffee, M., W. (2007).

     Policy and politics in nursing and health care

     (5th ed.). St. Louis, MO: Elsevier Saunders.

Hello Class,

Welcome to the blog for our 8 week long elective course titled 'Nursing Role in Health Care, Policy, and Politics'. It is my pleasure to facilitate the course. This blog has been designed to help you further explore the role nurses play in policy and politics. Although the course is 8 weeks long, the blog will only be utilized in weeks 2 through 5 for a total of 4 weeks. 

I will post 2-3 times a week and include additional resources for your review. Some posts will focus on further discussion of in-class topics, while other posts will include links to videos, articles, or other relevant documents. In order to get the most out of the blog I encourage you to check it frequently throughout the week. You can expect a post from me every other or every third day from the previous post. I do ask questions within my post and I expect you to reply to each of them. This is done to encourage deeper thought and reflection on course content and concepts. I do not expect you to post long responses here as that is what the discussion boards are for. Replies are to be a few sentences to a small paragraph in length. Feel free to comment on each other's posts and I will be commenting as well.

If you have not yet setup a Google email account, I encourage you to do this as soon as possible. This will allow all of us to participate and comment within the posts. If you need help setting up a Google email account I am more than happy to walk you through it during my office hours. Additionally, I have provided you with step by step directions in your student resources tab of our course.

As this course uses a blended learning design (both in-class and online learning environment), the blog will give us additional opportunity to interact and learn from one another. Please refer to the syllabus for specific information regarding expectations for participation and professional conduct within the blog. Keep in mind that participation within this blog counts toward your final participation grade in the course.

Please take a moment to read my bio/introduction as it will give you a little more information regarding the blog. I am excited to share my thoughts and knowledge with all of you, and cannot wait to start learning alongside of you! ~ Laraine

P.S. Let's see who can post what the 4 spheres of political action in nursing are first! (Hint: Look in your text book :-)