- Email: [email protected]
Advocacy: Nurses Making a Difference
EMERGENCY NURSING ADVOCACY
ADVOCACY: NURSES MAKING
A
DIFFERENCE
Author: Cindy L. Hearrell, BA, RN, CEN, Fredericksburg, VA Section Editor: Kathleen A. Ream, MBA, BA
dvocacy is defined as the act of pleading or arguing in favor of something, such as a cause, idea or policy— that is, active support.1 The nursing profession as it is today would not exist if it were not for nursing advocates. During the Crimean War, Florence Nightingale advocated for improvements in sanitation, crowding, and nutrition, which resulted in decreased mortality from infections.2 In addition, she advocated for her profession and was instrumental in the development of the first nursing school in London. Nightingale believed that nursing should be controlled by nurses. She truly reformed health care through her ideas about sanitation, education, and separation of nursing and medicine. Her efforts greatly affected patient care and the future of nursing.3 Over the years other nurses have advocated for change as well. In 1893, Lillian Wald and Mary Brewster opened the Henry Street Nurses Settlement in New York City, where they provided nursing care, health education, and social services. Their efforts created public health nursing, and they were instrumental in developing school nurse programs.3 Another nurse, Beatrice Kalisch, published an article in Nursing Outlook in 1978 titled “The Promise of Power.” This promise was “what nursing lacked today it will have tomorrow: a solid resource and power base upon which to move the profession forward.” She indicated that nurses in 2003 would have 2 qualities that were underdeveloped in nurses in 1978: creative imagination and political awareness. She believed this promise would include a structural evolution that would occur as the result of socially committed nursing science that enhances decision making mechanisms, defines nursing projects, and transforms ideas, opinions, and attitudes into actions.4 As emergency nurses we have the same skills our predecessors did to make changes and, as Kalisch stated, we are
A
Cindy L. Hearrell is Trauma Program Director, Mary Washington Hospital, Fredericksburg, VA. For correspondence, write: Cindy L. Hearrell, BA, RN, CEN, Mary Washington Hospital, 1001 Sam Perry Blvd, Fredericksburg, VA 22401; E-mail: cindy. [email protected]. J Emerg Nurs 2011;37:73-4. Available online 20 October 2010. 0099-1767/$36.00 Copyright © 2011 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. doi: 10.1016/j.jen.2010.09.019
January 2011
VOLUME 37 • ISSUE 1
capable of initiating change. We serve as advocates for our patients, peers, communities, and profession. At the bedside we are advocating for quality patient care that is ethically sound. In our local communities we are advocating for change by promoting such issues as roadway safety and patient access to care. We are involved in efforts to increase safe practice and to encourage the future of nursing through support of federal funding initiatives that bolster the availability of academic nursing programs. Because of the diversity of our practice, we are experts in many areas. We have a wealth of information to share on varied and endless initiatives. The ENA mission statement states, ”The mission of the Emergency Nurses Association is to advocate for patient safety and excellence in emergency nursing practice.”5 Professionally, the ENA membership is encouraged to uphold this mission by serving as advocates at various levels of their professional expertise. The options for advocacy opportunities range across the spectrum of nursing to include bedside initiatives as well as initiatives outside the hospital walls, where the opportunities are endless. The level of involvement is driven by personal choice and commitment and can be as basic as sending an e-mail message, writing a letter to your local, state, or national legislator, or making a face-to-face congressional visit. Your level of involvement is determined by commitments you can make. As a starting point, you may want to get involved locally on a health advisory board. Local legislators frequently hold public health care forums, which provide a great opportunity to voice your concerns and meet your representatives and senators, engaging them on a more personal level. This personal contact can pave the way for an ongoing relationship that will open the door to acceptance of phone calls and face time when important health care issues are on the political agenda.. An advocate is a person who is intensely committed to seeing a particular change happen, is willing to gain the knowledge and develop an understanding about the issue, and is not hesitant about sharing that understanding in public.6 During the 2010 ENA Government Affairs Chairs Workshop, groups of advocacy leaders discussed how they are involved at various levels to promote health and safety initiatives (Table). A common thread to the discussion was that collaboration is critical to shaping creative and effective policy and is the key to making change occur. Working
WWW.JENONLINE.ORG
73
EMERGENCY NURSING ADVOCACY/Hearrell
TABLE Advocacy opportunities
Local • Cancer coalition • Civic organizations • Health care boards • Public health and education committees • School boards • 4H county extensions Regional/State • Board of Nursing committees • Child death review panels • Emergency Medical Services for children • EMS committees/councils • Governor's advisory boards • Mothers Against Drunk Driving • Regional alcohol advisory boards • Rural Health Association • Safe Kids coalitions • Transportation advisory councils • Trauma committees • Legislative coalitions National • COMCARE • Nursing Quality Alliance • AAA Medical Advisory Council
with other professional groups who are vested in the issue helps increase your efforts by pure numbers. When your senator or representative gets e-mail messages, letters, and phone calls on a particular issue from their constituents, they are more likely to take notice and closely evaluate their stance on an issue, particularly when numerous professional groups have coalesced into a coalition addressing the issue in question. ENA’s Legislative Action Center provides a variety of tools to assist you in your efforts. You can
74
JOURNAL OF EMERGENCY NURSING
access this information on the ENA Web site at http://capwiz.com/ena/home/. The voice of a nurse is powerful. The nurse’s experiences and expertise provide the knowledge and professionalism needed to make a difference. Thus nurses have been very instrumental in affecting the vote on various legislative initiatives. Emergency nurses have a diverse, professional background that provides them with the expertise and skills needed to take their profession out of the hospital and into the community, the board room, and even the floor of the Senate. As 1998 ENA President Ann Manton has said, “Advocacy is a major part of the reason most of us became nurses in the first place. We wanted to help people! Many paths and many opportunities for advocacy exist in each of our lives, whether the focus is patients, families, communities, fellow nurses, or the public at large. Look for the advocacy opportunities in your life. Be willing to share your knowledge, skill, insights, energy, and time on behalf of others. Through our advocacy efforts, great or small, we can make a difference. That’s why we’re emergency nurses!”7 REFERENCES 1. Advocacy. Dictionary.com Web site. http://dictionary.reference.com/browse/ advocacy. Accessed February 2010. 2. Bernal E. The nurse as patient advocate. http://www.questia.com. Accessed February 2010. 3. Mason DA, Leavitt JK, Chaffee MW. Policy & Politics in Nursing and Health Care. St. Louis, MO: W.B. Saunders; 2002. 4. Kalisch B. The promise of power. Nurs Outlook. 1978;26(1):42-6. 5. Emergency Nurses Association. Emergency Nurses Association Vision/ Mission Statement. http://www.ena.org/about/mission/Pages/Default. aspx. Accessed February 27, 2010. 6. What is advocacy? http://www.ccih.org/conferences/presentations/2007/ What_is_advocacy.pdf. Accessed February 21, 2010. 7. MantonA. Advocacy: an integral part of emergency nursing. J Emerg Nurs. 1998;24(2):113-4.
Submissions to this column are encouraged and may be sent to Kathleen A. Ream, MBA, BA [email protected]
VOLUME 37 • ISSUE 1 January 2011
ADVOCACY: NURSES MAKING
A
DIFFERENCE
Author: Cindy L. Hearrell, BA, RN, CEN, Fredericksburg, VA Section Editor: Kathleen A. Ream, MBA, BA
dvocacy is defined as the act of pleading or arguing in favor of something, such as a cause, idea or policy— that is, active support.1 The nursing profession as it is today would not exist if it were not for nursing advocates. During the Crimean War, Florence Nightingale advocated for improvements in sanitation, crowding, and nutrition, which resulted in decreased mortality from infections.2 In addition, she advocated for her profession and was instrumental in the development of the first nursing school in London. Nightingale believed that nursing should be controlled by nurses. She truly reformed health care through her ideas about sanitation, education, and separation of nursing and medicine. Her efforts greatly affected patient care and the future of nursing.3 Over the years other nurses have advocated for change as well. In 1893, Lillian Wald and Mary Brewster opened the Henry Street Nurses Settlement in New York City, where they provided nursing care, health education, and social services. Their efforts created public health nursing, and they were instrumental in developing school nurse programs.3 Another nurse, Beatrice Kalisch, published an article in Nursing Outlook in 1978 titled “The Promise of Power.” This promise was “what nursing lacked today it will have tomorrow: a solid resource and power base upon which to move the profession forward.” She indicated that nurses in 2003 would have 2 qualities that were underdeveloped in nurses in 1978: creative imagination and political awareness. She believed this promise would include a structural evolution that would occur as the result of socially committed nursing science that enhances decision making mechanisms, defines nursing projects, and transforms ideas, opinions, and attitudes into actions.4 As emergency nurses we have the same skills our predecessors did to make changes and, as Kalisch stated, we are
A
Cindy L. Hearrell is Trauma Program Director, Mary Washington Hospital, Fredericksburg, VA. For correspondence, write: Cindy L. Hearrell, BA, RN, CEN, Mary Washington Hospital, 1001 Sam Perry Blvd, Fredericksburg, VA 22401; E-mail: cindy. [email protected]. J Emerg Nurs 2011;37:73-4. Available online 20 October 2010. 0099-1767/$36.00 Copyright © 2011 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. doi: 10.1016/j.jen.2010.09.019
January 2011
VOLUME 37 • ISSUE 1
capable of initiating change. We serve as advocates for our patients, peers, communities, and profession. At the bedside we are advocating for quality patient care that is ethically sound. In our local communities we are advocating for change by promoting such issues as roadway safety and patient access to care. We are involved in efforts to increase safe practice and to encourage the future of nursing through support of federal funding initiatives that bolster the availability of academic nursing programs. Because of the diversity of our practice, we are experts in many areas. We have a wealth of information to share on varied and endless initiatives. The ENA mission statement states, ”The mission of the Emergency Nurses Association is to advocate for patient safety and excellence in emergency nursing practice.”5 Professionally, the ENA membership is encouraged to uphold this mission by serving as advocates at various levels of their professional expertise. The options for advocacy opportunities range across the spectrum of nursing to include bedside initiatives as well as initiatives outside the hospital walls, where the opportunities are endless. The level of involvement is driven by personal choice and commitment and can be as basic as sending an e-mail message, writing a letter to your local, state, or national legislator, or making a face-to-face congressional visit. Your level of involvement is determined by commitments you can make. As a starting point, you may want to get involved locally on a health advisory board. Local legislators frequently hold public health care forums, which provide a great opportunity to voice your concerns and meet your representatives and senators, engaging them on a more personal level. This personal contact can pave the way for an ongoing relationship that will open the door to acceptance of phone calls and face time when important health care issues are on the political agenda.. An advocate is a person who is intensely committed to seeing a particular change happen, is willing to gain the knowledge and develop an understanding about the issue, and is not hesitant about sharing that understanding in public.6 During the 2010 ENA Government Affairs Chairs Workshop, groups of advocacy leaders discussed how they are involved at various levels to promote health and safety initiatives (Table). A common thread to the discussion was that collaboration is critical to shaping creative and effective policy and is the key to making change occur. Working
WWW.JENONLINE.ORG
73
EMERGENCY NURSING ADVOCACY/Hearrell
TABLE Advocacy opportunities
Local • Cancer coalition • Civic organizations • Health care boards • Public health and education committees • School boards • 4H county extensions Regional/State • Board of Nursing committees • Child death review panels • Emergency Medical Services for children • EMS committees/councils • Governor's advisory boards • Mothers Against Drunk Driving • Regional alcohol advisory boards • Rural Health Association • Safe Kids coalitions • Transportation advisory councils • Trauma committees • Legislative coalitions National • COMCARE • Nursing Quality Alliance • AAA Medical Advisory Council
with other professional groups who are vested in the issue helps increase your efforts by pure numbers. When your senator or representative gets e-mail messages, letters, and phone calls on a particular issue from their constituents, they are more likely to take notice and closely evaluate their stance on an issue, particularly when numerous professional groups have coalesced into a coalition addressing the issue in question. ENA’s Legislative Action Center provides a variety of tools to assist you in your efforts. You can
74
JOURNAL OF EMERGENCY NURSING
access this information on the ENA Web site at http://capwiz.com/ena/home/. The voice of a nurse is powerful. The nurse’s experiences and expertise provide the knowledge and professionalism needed to make a difference. Thus nurses have been very instrumental in affecting the vote on various legislative initiatives. Emergency nurses have a diverse, professional background that provides them with the expertise and skills needed to take their profession out of the hospital and into the community, the board room, and even the floor of the Senate. As 1998 ENA President Ann Manton has said, “Advocacy is a major part of the reason most of us became nurses in the first place. We wanted to help people! Many paths and many opportunities for advocacy exist in each of our lives, whether the focus is patients, families, communities, fellow nurses, or the public at large. Look for the advocacy opportunities in your life. Be willing to share your knowledge, skill, insights, energy, and time on behalf of others. Through our advocacy efforts, great or small, we can make a difference. That’s why we’re emergency nurses!”7 REFERENCES 1. Advocacy. Dictionary.com Web site. http://dictionary.reference.com/browse/ advocacy. Accessed February 2010. 2. Bernal E. The nurse as patient advocate. http://www.questia.com. Accessed February 2010. 3. Mason DA, Leavitt JK, Chaffee MW. Policy & Politics in Nursing and Health Care. St. Louis, MO: W.B. Saunders; 2002. 4. Kalisch B. The promise of power. Nurs Outlook. 1978;26(1):42-6. 5. Emergency Nurses Association. Emergency Nurses Association Vision/ Mission Statement. http://www.ena.org/about/mission/Pages/Default. aspx. Accessed February 27, 2010. 6. What is advocacy? http://www.ccih.org/conferences/presentations/2007/ What_is_advocacy.pdf. Accessed February 21, 2010. 7. MantonA. Advocacy: an integral part of emergency nursing. J Emerg Nurs. 1998;24(2):113-4.
Submissions to this column are encouraged and may be sent to Kathleen A. Ream, MBA, BA [email protected]
VOLUME 37 • ISSUE 1 January 2011