The Call for a National Nurse

Is it time for nursing to have a seat at the nation's healthcare table. You are listening to ReachMD, The Channel for Medical Professionals. Welcome to The Clinician's Roundtable. I am Susan Dolan, your host and with me is Teri Mills, Registered Nurse and President of the National Nursing Network Organization and Alisa Schneider, Registered Nurse and Secretary of the National Nursing Network Organization.

SUSAN DOLAN:

Teri and Alisa welcome to The Clinician's Roundtable.

TERI MILLS:

Thank you Susan and thank you so much for having Alisa Schneider and I on the program today. We really appreciate this opportunity.

SUSAN DOLAN:

Teri what led to your passion to advocate for a national nurse?

TERI MILLS:

Well Susan as you and your listeners know, we presently are facing a healthcare crisis in our country. We see increasing epidemics or preventable chronic conditions, the continuation of health disparities coupled with poor health literacy and a projected shortage of physicians and nurses and Health Affairs, renowned journal that is read by many in the healthcare arena, projects that the United States will be spending $4.2 trillion or about 20% of the gross domestic product on healthcare in less than (01:30) 8 years, and that really drove our desire to seek change. As nurses and educators, we see the problems in the system and really the cost to the public every single day and although nurses have traditionally been on the sidelines, we actually are well positioned to initiate a change and a solution. So we are advocating for a national nurse, a visible nursing leader at the federal level because we really believe that nurses have years of education and experience, we are present in every community, we are the largest healthcare sector of the workforce at 2.9 million and according to the Gallop poll year after year, the public consider nurses to be the most honest, ethical, and trusted professionals.

SUSAN DOLAN:

Number one on that list, ah. Teri what is the National Nursing Network Organization?

TERI MILLS:

Well it’s a grassroots organization of working nurses across many specialties and really wants to see nursing at the forefront of much needed prevention efforts and in order to lobby for legislation to create a national nurse, we really found that no nursing organization was focusing 100% of its attention on prevention and health promotion. So we formed a nonprofit legislative advocacy organization.

SUSAN DOLAN:

How is the organization funded?

TERI MILLS:

We really truly (03:00) are a grassroots organization, we don’t really have sponsorship, we don’t have dedicated funding. We do not charge a membership fee. However, we have received many small and also much generous donations from individuals, who really see the value of our work and even our website was built by a volunteer. Or logos and graphics came from supporters and this movement has just been so unique because it really runs primarily on passion. The passion the nurses feel to make a difference and bring about needed change.

SUSAN DOLAN:

I love that primarily runs on passion. You can't go wrong. Teri describe the legislative history in support of the National Nurse?

TERI MILLS:

Well the campaign really began in 2005 with the publication of an op-ed article that was written and submitted to The York Times suggesting what America needs is a National Nurse and it caught the attention of Congressman, Earl Blumenauer, from Portland, Oregon who introduced the piece into congressional record and what happened from there was just nothing short and remarkable. The article was the third most e-mailed story, it generated an aftermath of publicity and interest that propelled immediately to a trip to Washington DC and we were afforded a very unique opportunity to meet with the 3 nurses in The US Congress and that included Representative Lois Capps from California who actually introduced a bill to create (04:30) the National Nurse. Although the legislation of course was not passed that initial year, nurses had garnered the bipartisan support from 42 members of Congress by the end of that session. So we were pretty thrilled with the response.

SUSAN DOLAN:

Have you received support from President-Elect Obama?

TERI MILLS:

Well the new administration in Congress and their clear commitment to wellness and prevention really present an ideal opportunity to advance the concept of a National Nurse and make it a reality. And Barack Obama's team is eager to initiate needed change, thought we really feel the office of The National Nurse Initiative when you hear more about it, is a very easy, cost-effective, pragmatic approach to immediately give prevention a higher priority and begin to reverse the growing trends of chronic preventable diseases that cost our nation so much.

SUSAN DOLAN:

Who would serve as the National Nurse?

TERI MILLS:

Our proposal asked that Congress designate the existing Chief Nurse Officer of the US Public Health Service, who also serves as the Assistant Surgeon General to be elevated to become a full-time positioned within the Office of the Surgeon General and be officially titled The National Nurse for Prevention. Because Susan it is our goal to elevate and enhance the Office of the Public Health Service Chief Nurse to bring more visibility to the critical role nursing plays and occupies in promoting, protecting, and advancing the nation's health.

SUSAN DOLAN:

Alisa how would (06:00) the National Nurse role differ from the US Public Health Service Chief Nurse Officer position?

ALISA SCHNEIDER:

Well Susan as Teri had mentioned earlier, we recommending that the Chief Nurse Officer of the US Public Health Service be elevated and become a full-time position. Currently that position is half-time and the current Chief Nurse Officer's time is shared between NIH and the Surgeon General's office. So we are asking for this to be one and the same, but that the Chief Nurse Officer would have an elevation in rank and become full-time.

SUSAN DOLAN:

Describe the goals of the National Nurse?

ALISA SCHNEIDER:

The goals of the National Nurse as our initiative has set out is to establish symbolic national leadership, to promote this cultural shift to prevention that we believe the country needs to begin to prioritize policy and funding for wellness and health promotion. We also believe that the Office of The National Nurse would raise the visibility and enhance the prestige of the nursing profession, which would help to support recruitment efforts. The office would provide a portrayal of nurses as they truly are as health educators as well as health promoters at the bedside and in other roles. We believe that this office would provide guidance for state and local leadership to mobilize nurses (07:30) as volunteers through existing networks such as the Medical Reserve Corps and then certainly this office would do the research and data analysis of current programs that are successful in providing services to our communities and promote ways to replicate those services.

SUSAN DOLAN:

What feedback are you receiving from nurses?

ALISA SCHNEIDER:

Well this has been really exciting and the feedback from nurses and other healthcare service providers has just really maintained the momentum of this initiative. Nurses at the bedside, the rank and file, the working nurse has overwhelmingly responded with rousing cheers of move forward and they have been giving us donations. We have multiple organizations made up of nurses, tens of thousands of nurses actually represented by the nursing and other healthcare organizations that have signed on in support.

SUSAN DOLAN:

What feedback have you received from physicians?

ALISA SCHNEIDER:

Well we have several physicians' organizations who have signed on in support. We have the National Physicians Alliance and the Physicians for Social Responsibility and we continue to communicate with all healthcare service provider organizations. Our supporters also include emergency responders. Certainly, the public retirees' who are concerned about their health, their healthcare, and the costs of their medications. We have organizations that represent teachers and attorneys and insurers (09:00), healthcare organizations. We have a wide variety of support out there among the general public and healthcare.

SUSAN DOLAN:

Have any objections been raised?

ALISA SCHNEIDER:

Well of course, you know, with any political action comes some controversy and resistance, but we have been working very hard to address any objections or concerns or misconceptions and really have worked to reduce duplication and costs of our proposal and yet still money is a concern certainly now more than ever, not just for individuals who are trying to afford day-to-day food, gas, and so on, but our government. So our government is really holding tight on their dollars, but what we are asking for is a long-term effort to put money towards prevention, wellness, and health promotion. So that we can stave off the cost of our health care system. We know that currently the cost of diabetes care alone in 2007 was projected at $174 billion and that is just one disease that we know has many preventable aspects. If we could prevent some of the issues and some of the cases of diabetes, we could reduce the cost of $174 billion.

SUSAN DOLAN:

What does the research reveal about wellness and prevention initiatives?

ALISA SCHNEIDER:

We see in the research now that prevention programs (10:30) that focus on getting people more active and eating better have positive results and actually save money. We have also heard reports from the Robert Wood Johnson Foundation about a program where nurses become actually involved with pregnant women after they give birth that saves taxpayers tens of thousands of dollars. So the investment in prevention is well worth the costs.

TERI MILLS:

And I just would like to add Susan prevention is really a focal point in healthcare reform. It is a cornerstone and there are so many organizations that are researching and coming up with the data to support the need for prevention and I urge your listeners to go to healthyamericans.org and read the Trust For Healthy Americans report on this. It provides page after page of data just exactly about the need for prevention and what we are trying to do is we are trying to come up with a program that we can implement, that we can actually deliver this message of prevention, because we know that simply talking about it isn't going to be enough.

SUSAN DOLAN:

What is enough, what makes that connection between a patient and healthcare providers where they are motivated, they are inspired and they get it.

TERI MILLS:

Well I think that nursing is in a unique place in our healthcare system because we are there (12:00) with our patients everyday and we are used to put in messages into easy to understand language and really into actions that are easy for them to do and so one of the ways that you can engage people is to ask them, what do they see possible to change in their own lifestyle. There is a lot of studies about motivational interviewing, really getting the patient involved and engaged in their own healthcare plan. So that's one reason why we believe in this.

SUSAN DOLAN:

Would the National Nurse have any initiative that would incentivize or engage employers to affect their workforce?

TERI MILLS:

Well right now we are working more on the general concept rather than specifics because the Chief Nurse Officer has a huge job responsibility as it is and so what we are really trying to do in this initiative is really spotlight a nurse so that when there is some kind of an outbreak of a communicable disease or a message regarding cancer screening and they want to get a nurse's perspective, this would be the individual that they go to. The other thing is that we know that nurses were often called upon to actually act out the programs or implement the programs, but rarely do we ever see at the policy table and this is what we are hoping to accomplish, to give nurses more of a voice.

SUSAN DOLAN:

How can listeners learn more? (13:30).

TERI MILLS:

Well we encourage them to visit our website, www.nationalnurse.org and e-mail us if you would like to receive the National Nurse newsletter because it is really the only way we can update our thousands of supporters and interested stake holders. We also have links to a variety of articles that have been written and published about the initiative and please feel free to e-mail us even if you have a question or feedback to give us because we do try to personally answer all of our e-mail.

SUSAN DOLAN:

Thanks to Teri Mills President of the National Nursing Network Organization and Alisa Schneider, Secretary of the National Nursing Network Organization for joining us to discuss the National Nurse. I am Susan Dolan, you have been listening to The Clinician's Roundtable on ReachMD, The Channel for Medical Professionals. Please visit our web site at ReachMD.com which features our entire library of on-demand podcasts or call us toll-free with your comments and suggestions at 888-639-6157. Thank you for listening.

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