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American Nurses Association house of delegates works to protect patients, nurses
SEPTEMBER 1997, VOL 66, NO 3 ANA HOUSE OF DELEGATES
American Nurses Association house of delegates works to protect patients, nurses Thursday. June 26, to Sunday, June 29, 1997 he reason that I came into nursing is the reason I’m still here,” stated American Nurses Association (ANA) President Beverly L. Malone, RN. PhD. FAAN, at the opening of the ANA’s 67th session. “It’s still the most passionate thing that I know-it‘s about the delivery of safe. quality care to patients.” From June 26 through June 29 in Washington. DC. the ANA house of delegates reinforced nursing’s commitment to safe and quality patient care. Among the issues discussed by the ANA house of delegates were economic equity for RNs within the Department of Veterans Affairs (VA). international mobility of RNs. multistate licensure. unlicensed assistive personnel (UAP), and reduction of health care production of toxic pollution. Issues discussed on the house floor that directly affected ANA included the election of ANA officials by constituent members by mail ballot, the ANA presidential endorsement procedure, and the ANA’s vision statement and 1998-1999 goals.
T
ECONOMIC EQUIN FOR DEPARTMENT OF VETERANS AFFAIRS NURSES
T
he ANA house overwhelmingly voted that the association advocate for competitive salary rates for RNs in the VA. Registered nurses are the only professional group in the VA restricted to the locality pay system, which creates a pay scale based on community salaries, and which has resulted in six years of little or no salary advances. Delegates approved the motion that ANA must analyze the impact of the locality pay system. advocate for changes to the locality pay system, and reaffirm its core mission to advance the economic and general welfare of all RNs.
INTERNATIONAL MOBILITY OF REGISTERED NURSES elegates discussed the trend of a “boundaryless” society (eg. international trade agreements, Internet access) and its effect on nursing. In response to these concerns, the ANA will develop strategies designed to have an impact on international trade agreements. Specifically, ANA’s strategies will include nursing practice, occupational health and safety, increased international employment mobility. comprehensive education standards, standards of practice for RNs, and workplace advocacy issues, including collective bargaining in the United States and other countries. As the sphere of competition is growing constantly, the ANA will achieve these goals by collaborating with international and national organizations and by monitoring the impact of international trade agreements.
D
UNLICENSED ASSlSTlVE PERSONNEL he issue of UAP sparked a lengthy and impassioned discussion among the delegates. Many delegates objected to the action report presented at the house because it no longer included the original report of the UAP task force. The original report promoted legislation to protect the right of the professional nurse to provide, delegate, and oversee quality care within the RN’s scope of practice, whereas the current delegates argued that the report before them proposed how to use UAP. The many proposed amendments forced the discussion to be continued at a separate session, at which the two reports were merged in a manner more satisfactory to the delegates. Delegates approved the final report by a 96% vote.
T
MULTISTATE LICENSURE
D
clegatcs discussed collcctive bargaining, rack-
ing thc number of nurses in various scttings. and ctisciplinar),implications of tcleheulth and niultistatc liccnsure. Onc dclegate s u p p o r ~ dthe me;isure by saying. “Just ;IS my Ohio
~1313 collcction.
398 AORN JOURNAL
SEPTEMBER 1997, VOL 66, NO 3 ANA HOUSE OF DELEGATES
driver’s license allows me to drive in California, so should nursing certification [allow me to practice in other states]. It is my responsibility to know that state’s driving rules and regulations.” The delegates recommended that ANA examine issues surrounding multistate licensure for RNs and continue to collaborate with the National Council of State Boards of Nursing on this topic.
REDUCTION OF HEALTH CARE PRODUCTION OF TOXIC POLLUTION
0
ffering personal testimonies, more than 95% of the ANA delegates voted to reduce health care production of toxic pollution. In addition, delegates moved to endorse the position statement on regulated medical waste published by AORN. AORN President Jeannie Botsford, RN, MS, CNOR, spoke in support of the report, saying, “AORN is aware of the OR’S contribution to hazardous waste. We continue to gamer support for this document.” The delegates agreed to collaborate with other organizations in developing federal and state standards for dioxin emission from medical waste incinerators and to educate RNs and other health care providers about medical waste issues.
RACISM-FREE NURSING WORKPLACE
By
a 92% majority, the House voted to develop a position statement on the elimination of racism. One delegate in support of this action said, “It is important to make a stand-alone statement, not something buried in another statement.” Another delegate thanked those who proposed the position statement because she was aware of what a difficult topic racism is to discuss.
ELECTION OF OFFICIALS his report before the house of delegates presented a proposal to have all ANA officials elected by direct vote of individual members rather than by their delegates. Many delegates opposed the report, citing that the costs would be astronomical and the logistics of disseminating information to all members would be prohibitive. An ANA board member responded that this report was just a feasibility study to see if the proposed change would fit in the current structure. Delegates speaking in support of the report
T
said voting by mail would allow members to participate more directly in the voting process.
PRESIDENTIAL ENDORSEMENT ach year since 1984, ANA has endorsed a candidate for president of the United States. The question before the house was whether to change this process by placing the authority for presidential endorsement with the house of delegates. Many delegates opposed the change, citing that for delegates to participate in this process, the decision would have to be made during ANA’s convention in June. The convention would coincide with primary elections, by which time a presidential front-runner may not have emerged. In addition, delegates voiced concerns that such an endorsement should be the result of policy study and data collection, not personal opinion.
E
COMMITTEE OF THE WHOLE
I
n a break from tradition, ANA held a committee of the whole, in which the house of delegates gave detailed comments on topics much in the manner a committee would. The session centered around the following questions. What needs to be done to strengthen and protect the association and the profession at both the national and the state levels? What do we, as leaders of the association, need to do to make this association a more effective vehicle for advancing nursing and protecting the public? Dr Malone served as moderator for the committee of the whole and encouraged delegates to speak. She said, “We are not about playing it safe. We are challenged about looking at ourselves critically. This is a time of constructive debate and creative thinking.” The delegates’ responses were many and varied and included the following. ANA’s representation of nurses must continue to grow. Promote membership activities. Trust leaders. Increase communication between members and leaders. Mentor new nurses. Strengthen advocacy efforts. Strengthen cultural diversity programs. Address quality care.
.
399 AORN JOURNAL
SEPTEMBER 1997, VOL 66. NO 3 A N A HOUSE OF DELEGATES
AMERICAN NURSES ASSOCIATION VISION AND GOALS
Standards of Clinical Nursing Practice were to them. “Managed Care: Barriers and Opportunities for Nursing,” which provided attendees an overview of managed care issues and regulation designed as the first step in an ANA initiative called “Nursing’s Blueprint for Managed Care.”
than 96% of the delegates voted to accept 1\11 ore the following short-term vision and two-year goals and priorities. The ANA short-term vision states: Quality health care for all people is assured by protecting and enhancing professional nursing practice in all environments. The goals and priorities for 1998-1999 follow. The American Nurses Association and state nurses associations will assure that the registered nurse is an essential provider in all practice settings through education, research, collective bargaining, workplace advocacy, legislation, and regulation. The American Nurses Association and state nurses associations will collectively and collaboratively advocate for access to comprehensive quality health care. affordable for all people. The American Nurses Association and state nurses associations as multipurpose organizations will continue to be strong and effective at the state, national, and international levels.
FORUMS
I
n addition to the items voted on in the house of delegates, three forums were presented for ANA delegates. “Code of Ethics: Guidance for a New Millennium,” which reported on proposed revisions to the 1985 Code for Nurses with Interpretive Statements. “Getting Your Say: Help Mold the Standards of Clinical Practice,” which reported on the results of two surveys in which 695 RNs responded to questions about how often and how relevant ANA’s
SPECIAL GUEST
F
irst Lady Hillary Rodham Clinton spoke at a luncheon with more than 300 attendees and credited nurses with much of the progress made in improving the quality of health care. She acknowledged the important role nurses played in the passage of the Health Care Insurance Portability and Accountability Act and the Mothers and Newborn Protection Act by saying, “Your work has been paying off over the past several years-we’re changing the climate.” Clinton also praised the nursing profession for alerting the public to the health care changes that threaten patient safety. Refemng to the trend in hospitals to cut costs by reducing nurse staffing and replacing RNs with UAP, Clinton said, “I believe [these things] will have an adverse effect on the care patients receive.” The First Lady concluded by saying, “The voices of nurses will be heard even more as consumers see these changes. You are really doing work that needs to be done.”
NEXT YEAKS MEETING he ANA house of delegates meets annually to T vote on issues important to the nursing profession. The next meeting will be held in San Diego, as part of ANA‘s biennial convention, June 26 to July 1, 1998. JENIFER F. WALKER MANAGING EDITOR
Shark Cartilage as Anticancer Agent Debated According to the June 19, 1997. Medical Trihirn~. new data negate health food store claims that shark cartilage is an effective anticancer agent. The article reports the largest study to date, which involved 60 patients with advanced cancers-primarily of the breast. colon, lung. and prostate. These patients were followed for up to 10 months and were taking no standard anticancer medication. Although they ate large quantities of powdered shark cartilage,
results showed no benefit of this therapy. The amount of powdered shark cartilage taken dissolved in juice or flavored water three times per day would cost the consumer $1,000each month. In capsule fonn, a person would have to take 100 or more 500mg capsules per day. “New data challenge anti-cancer claims for shark cartiluge, ”Medical Tribune 38 (June 19, 7997) 29. 400
.-\OR% J0L;RNAL
American Nurses Association house of delegates works to protect patients, nurses Thursday. June 26, to Sunday, June 29, 1997 he reason that I came into nursing is the reason I’m still here,” stated American Nurses Association (ANA) President Beverly L. Malone, RN. PhD. FAAN, at the opening of the ANA’s 67th session. “It’s still the most passionate thing that I know-it‘s about the delivery of safe. quality care to patients.” From June 26 through June 29 in Washington. DC. the ANA house of delegates reinforced nursing’s commitment to safe and quality patient care. Among the issues discussed by the ANA house of delegates were economic equity for RNs within the Department of Veterans Affairs (VA). international mobility of RNs. multistate licensure. unlicensed assistive personnel (UAP), and reduction of health care production of toxic pollution. Issues discussed on the house floor that directly affected ANA included the election of ANA officials by constituent members by mail ballot, the ANA presidential endorsement procedure, and the ANA’s vision statement and 1998-1999 goals.
T
ECONOMIC EQUIN FOR DEPARTMENT OF VETERANS AFFAIRS NURSES
T
he ANA house overwhelmingly voted that the association advocate for competitive salary rates for RNs in the VA. Registered nurses are the only professional group in the VA restricted to the locality pay system, which creates a pay scale based on community salaries, and which has resulted in six years of little or no salary advances. Delegates approved the motion that ANA must analyze the impact of the locality pay system. advocate for changes to the locality pay system, and reaffirm its core mission to advance the economic and general welfare of all RNs.
INTERNATIONAL MOBILITY OF REGISTERED NURSES elegates discussed the trend of a “boundaryless” society (eg. international trade agreements, Internet access) and its effect on nursing. In response to these concerns, the ANA will develop strategies designed to have an impact on international trade agreements. Specifically, ANA’s strategies will include nursing practice, occupational health and safety, increased international employment mobility. comprehensive education standards, standards of practice for RNs, and workplace advocacy issues, including collective bargaining in the United States and other countries. As the sphere of competition is growing constantly, the ANA will achieve these goals by collaborating with international and national organizations and by monitoring the impact of international trade agreements.
D
UNLICENSED ASSlSTlVE PERSONNEL he issue of UAP sparked a lengthy and impassioned discussion among the delegates. Many delegates objected to the action report presented at the house because it no longer included the original report of the UAP task force. The original report promoted legislation to protect the right of the professional nurse to provide, delegate, and oversee quality care within the RN’s scope of practice, whereas the current delegates argued that the report before them proposed how to use UAP. The many proposed amendments forced the discussion to be continued at a separate session, at which the two reports were merged in a manner more satisfactory to the delegates. Delegates approved the final report by a 96% vote.
T
MULTISTATE LICENSURE
D
clegatcs discussed collcctive bargaining, rack-
ing thc number of nurses in various scttings. and ctisciplinar),implications of tcleheulth and niultistatc liccnsure. Onc dclegate s u p p o r ~ dthe me;isure by saying. “Just ;IS my Ohio
~1313 collcction.
398 AORN JOURNAL
SEPTEMBER 1997, VOL 66, NO 3 ANA HOUSE OF DELEGATES
driver’s license allows me to drive in California, so should nursing certification [allow me to practice in other states]. It is my responsibility to know that state’s driving rules and regulations.” The delegates recommended that ANA examine issues surrounding multistate licensure for RNs and continue to collaborate with the National Council of State Boards of Nursing on this topic.
REDUCTION OF HEALTH CARE PRODUCTION OF TOXIC POLLUTION
0
ffering personal testimonies, more than 95% of the ANA delegates voted to reduce health care production of toxic pollution. In addition, delegates moved to endorse the position statement on regulated medical waste published by AORN. AORN President Jeannie Botsford, RN, MS, CNOR, spoke in support of the report, saying, “AORN is aware of the OR’S contribution to hazardous waste. We continue to gamer support for this document.” The delegates agreed to collaborate with other organizations in developing federal and state standards for dioxin emission from medical waste incinerators and to educate RNs and other health care providers about medical waste issues.
RACISM-FREE NURSING WORKPLACE
By
a 92% majority, the House voted to develop a position statement on the elimination of racism. One delegate in support of this action said, “It is important to make a stand-alone statement, not something buried in another statement.” Another delegate thanked those who proposed the position statement because she was aware of what a difficult topic racism is to discuss.
ELECTION OF OFFICIALS his report before the house of delegates presented a proposal to have all ANA officials elected by direct vote of individual members rather than by their delegates. Many delegates opposed the report, citing that the costs would be astronomical and the logistics of disseminating information to all members would be prohibitive. An ANA board member responded that this report was just a feasibility study to see if the proposed change would fit in the current structure. Delegates speaking in support of the report
T
said voting by mail would allow members to participate more directly in the voting process.
PRESIDENTIAL ENDORSEMENT ach year since 1984, ANA has endorsed a candidate for president of the United States. The question before the house was whether to change this process by placing the authority for presidential endorsement with the house of delegates. Many delegates opposed the change, citing that for delegates to participate in this process, the decision would have to be made during ANA’s convention in June. The convention would coincide with primary elections, by which time a presidential front-runner may not have emerged. In addition, delegates voiced concerns that such an endorsement should be the result of policy study and data collection, not personal opinion.
E
COMMITTEE OF THE WHOLE
I
n a break from tradition, ANA held a committee of the whole, in which the house of delegates gave detailed comments on topics much in the manner a committee would. The session centered around the following questions. What needs to be done to strengthen and protect the association and the profession at both the national and the state levels? What do we, as leaders of the association, need to do to make this association a more effective vehicle for advancing nursing and protecting the public? Dr Malone served as moderator for the committee of the whole and encouraged delegates to speak. She said, “We are not about playing it safe. We are challenged about looking at ourselves critically. This is a time of constructive debate and creative thinking.” The delegates’ responses were many and varied and included the following. ANA’s representation of nurses must continue to grow. Promote membership activities. Trust leaders. Increase communication between members and leaders. Mentor new nurses. Strengthen advocacy efforts. Strengthen cultural diversity programs. Address quality care.
.
399 AORN JOURNAL
SEPTEMBER 1997, VOL 66. NO 3 A N A HOUSE OF DELEGATES
AMERICAN NURSES ASSOCIATION VISION AND GOALS
Standards of Clinical Nursing Practice were to them. “Managed Care: Barriers and Opportunities for Nursing,” which provided attendees an overview of managed care issues and regulation designed as the first step in an ANA initiative called “Nursing’s Blueprint for Managed Care.”
than 96% of the delegates voted to accept 1\11 ore the following short-term vision and two-year goals and priorities. The ANA short-term vision states: Quality health care for all people is assured by protecting and enhancing professional nursing practice in all environments. The goals and priorities for 1998-1999 follow. The American Nurses Association and state nurses associations will assure that the registered nurse is an essential provider in all practice settings through education, research, collective bargaining, workplace advocacy, legislation, and regulation. The American Nurses Association and state nurses associations will collectively and collaboratively advocate for access to comprehensive quality health care. affordable for all people. The American Nurses Association and state nurses associations as multipurpose organizations will continue to be strong and effective at the state, national, and international levels.
FORUMS
I
n addition to the items voted on in the house of delegates, three forums were presented for ANA delegates. “Code of Ethics: Guidance for a New Millennium,” which reported on proposed revisions to the 1985 Code for Nurses with Interpretive Statements. “Getting Your Say: Help Mold the Standards of Clinical Practice,” which reported on the results of two surveys in which 695 RNs responded to questions about how often and how relevant ANA’s
SPECIAL GUEST
F
irst Lady Hillary Rodham Clinton spoke at a luncheon with more than 300 attendees and credited nurses with much of the progress made in improving the quality of health care. She acknowledged the important role nurses played in the passage of the Health Care Insurance Portability and Accountability Act and the Mothers and Newborn Protection Act by saying, “Your work has been paying off over the past several years-we’re changing the climate.” Clinton also praised the nursing profession for alerting the public to the health care changes that threaten patient safety. Refemng to the trend in hospitals to cut costs by reducing nurse staffing and replacing RNs with UAP, Clinton said, “I believe [these things] will have an adverse effect on the care patients receive.” The First Lady concluded by saying, “The voices of nurses will be heard even more as consumers see these changes. You are really doing work that needs to be done.”
NEXT YEAKS MEETING he ANA house of delegates meets annually to T vote on issues important to the nursing profession. The next meeting will be held in San Diego, as part of ANA‘s biennial convention, June 26 to July 1, 1998. JENIFER F. WALKER MANAGING EDITOR
Shark Cartilage as Anticancer Agent Debated According to the June 19, 1997. Medical Trihirn~. new data negate health food store claims that shark cartilage is an effective anticancer agent. The article reports the largest study to date, which involved 60 patients with advanced cancers-primarily of the breast. colon, lung. and prostate. These patients were followed for up to 10 months and were taking no standard anticancer medication. Although they ate large quantities of powdered shark cartilage,
results showed no benefit of this therapy. The amount of powdered shark cartilage taken dissolved in juice or flavored water three times per day would cost the consumer $1,000each month. In capsule fonn, a person would have to take 100 or more 500mg capsules per day. “New data challenge anti-cancer claims for shark cartiluge, ”Medical Tribune 38 (June 19, 7997) 29. 400
.-\OR% J0L;RNAL