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Nurse Reinvestment Act; contacting elected officials; legislative priorities; Perioperative Nurse Week
OCTOBER 2002, VOL 76, NO 4 HEALTH POLICY ISSUES
Nurse Reinvestment Act; contacting elected officials; legislative priorities; Perioperative Nurse Week his month’s column covers several subjects of interest to perioperative nurses. These topics include the recent passage of the Nurse Reinvestment Act, effective ways to communicate with elected representatives, AORN’s revised legislative priorities, and tying political activism to Perioperative Nurse Week. THE NURSE REINVESTMENT ACT President Bush signed the Nurse Reinvestment Act into law on Aug 1, 2002. This legislation will provide various programs to address the nursing shortage, such as nursing scholarships and grants to health care facilities for nurse retention activities. The new law authorizes these programs, but Congress still must appropriate funding. The House version of the act was introduced by Rep Lois Capps (D-Calif), an RN. David Broder, a nationally syndicated columnist for the Washington Post, offered the following observation about the act’s passage. . . . this legislation was remarkable,for t ~ ’ reasons. o More than almost any bill in this session, it bore the imprint of women legislators. And more than such well-publicized but never,finished measures as the “patients’ bill of rights,” it has the potential to bring sarbstantial benefits to untold millions ofpeople during the decades ahead.
AORN, working with its federal lobbyist, is collaborating with other nursing organizations and health care associations to discuss funding levels for the Nurse Reinvestment Act and to determine legislative strategies for achieving these funding levels. The latest developments will be posted on the “What’s New” section of AORN Online at http:llwww.aorn.org and communicated to members through the monthly Legislative News! updates distributed to chapters by the Department of Government Affairs. As always, members are encouraged to stay in close contact with their congressional representatives. CONTACTING ELECTED OFFICIALS Members of Congress and state legislators can become overwhelmed with public awareness campaign efforts, requests for assistance, and pleas from constituents regarding particular bills. Joel Blackwell, a political consultant who has worked with AORN in the past, describes information overload as a public policy disease and states that “the antidote is the anecdote.”? In other words, a personal story or individual account is the most effective part of any communication with an elected official. How an issue affects you as a constituent ultimately affects your legislator. Most political consultants agree that the most effective mechanisms for communicating 692 AORN JOURNAL
with elected ofiicials, in order of importance, are I a personal visit with your legislator or his or her staff members, 5s a polite but direct letter, and m a telephone call.’ The most important component of each of these methods is your name. Whether you schedule a meeting, sign a letter, or speak with someone on the telephone, this communication will have the most impact if the person on the receiving end knows who you are. Name recognition occurs as a result of advocacy and active involvement in the legislative process. Many people have an aversion to legislative activity because they consider it “dirty politics.” In reality, legislative action is about building relationships, forming coalitions, and presenting a consistent message. Democracy in the United States is designed to belong to everyone-“We, the people.”4 There is no shortage of suggestions from political advisors who offer how-to tactics for contacting representatives in the US Congress and the state legislatures; however, the better question is when, not how. Right now, just weeks before federal and state elections, is an ideal time to be in touch with elected officials as well as other candidates for public office who would like to become elected officials. These candidates are on the campaign trail in their home
OCTOBER 2002, VOL 76,")
3
GOVERNMENTAFFAIRS TOOLBOX AORN legislative priorities, 2002-2003
Patient safety AORN advocates for perioperative RNs who are working to put patient safety first. Perioperative Nurse Week is November 10-16, 2002. AORN members are encouraged to promote awareness of this week as an immediate follow-up to state and federal elections in November, establishing a base of contact with elected officials, community leaders, and public policy makers.
AORN opposes Itcensure of STs and SAs
Professional nursing environment AORN acknowledges the national nursing shortage as a public health crisis and collaborates with other organizations and nursing associations (eg, Americans for Nursing Shortage Relief [ANSR]) to establish corrective strategies, especially as they pertain to perioperative settings. A focus for the ANSR coalition is research by specialty nursing organizations. Copies of the current ANSR consensus statement are available upon request from the AORN Department of Government Affairs.
AORN supports federal legislation to improve potient safeiv. AORN identifies, monitors, supports, and introduces state and federal legislation, as appropriate, to address the needs of perioperative nurses pertaining to correct site surgery, reducing medical errors in perioperative settings, smoke evacuation, needlesticks, and additional emerging concerns.
AORN supports progress of the federal Nurse Reinvestment Act. This measure provides nursing scholarships and grants to health care facilities for nurse retention programs. Congress has passed this legislation, but funding still must be appropriated.
AORN maintains that every surgical patient deserves a perioperative nurse and actively works to keep the RN in the OR.
AORN affirms, as stated in the 'AORN statement on nurse-to-patient ratios":
Scope of practice AORN ensures the supervisory presence of the professional RN in the perioperative arena with laws and regulations requiring RNs in the circulator role. AORN regularly communicates this position to the Centers for Medicare and Medicaid Services (CMS). The CMS rules require that ORs must be supervised by an experienced RN, medical doctor, or osteopathic doctor. AORN promotes basic educational standards for assistive personnel, such as surgical technologists (STs) and surgical assistants (SAs).
. . . whenever invasive procedures are performed, the minimum nurse-to-patientratio is one professional perioperative registered nurse dedicated to each patient during that patient's entire intraoperative experience. Reimbursement AORN supports the Medicare Certified Registered Nurse First Assistant Direct Reimbursement Act of 2001 (ie, HR 822). This federal bill, introduced by Rep Mac Collins (R-Ga), now has extensive bipartisan support in Congress with more than 100 cosponsors. AORN seeks sponsorship for a companion bill in the US Senate. AORN supports third-parly reimbursement for RN first assistants in the states. Close to 20% of the states currently have this legislation.
AORN supports the registration or certification of STs and SAs that is under the authority of the state board of nursing or its equivalent.
NOTE 1 , "AORN statement on nurse-to-patient ratios" in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2002) 128.
694 AORN JOURNAL
OCTOBER 2002, VOL 76,NO 4
districts, and they are highly motivated to talk with constituents and listen to concerns. Attending candidate forums and town hall meetings, filling out e-mail feedback forms on campaign web sites, writing letters to the editors of newspapers that make endorsements, and volunteering for a candidate all are excellent ways for AORN members to interact with public policy makers. Identify your opportunity to be part of the process, and get involved. This is the best time to promote perioperative nursing as a profession and communicateAOR”s legislative priorities. AORNS LEGISLATIVE PRIORITIES AORN’s Legislative Committee is charged with recommending revisions to the organization’s legislative priorities. The Committee met in April 2002 and again in May 2002 to develop a recommendation that
was sent to the AORN Board of Directors. The recommendation included emphasizing patient safety and addressing the nursing shortage. The Board discussed the recommendation during its July 2002 meeting in Denver, after a presentation from the Legislative Committee chair. The Board directed the Committee to hrther expand on the recommendation, and a formal revision was approved by the Board in mid-August. The updated legislative priorities are listed in the “Legislative Toolbox.” PERIOPERATIVE NURSE WEEK AORN is proud to honor perioperative RNs throughout the year, but especially during PerioperativeNurse Week. Perioperative Nurse Week highlights the history, current opportunities, and future challenges of perioperative nursing. This time
of recognition also provides a forum for public awareness. This year’s PerioperativeNurse Week is Nov 10 to 16, and the theme focuses on patient safety. Members are encouraged to promote Perioperative Nurse Week as an immediate follow-up to state and federal elections on Nov 5. Having your governor or mayor proclaim Perioperative Nurse Week in his or her jurisdiction gives credibility to your observance, and this action can be of interest to local media. A sample proclamation is available on AORN Online at http://www.aorn .org/about/pmlamation.htm. In 2001, Arizona, Hawaii, and Washington were among those states whose governors issued Perioperative Nurse Week proclamations in response to grassroots outreach efforts by AORN members. BURKEBEU AORN LEQISIATM ANALYST
3. M D Lord, “Grassroots strategy and tactics: What works, what doesn’t, and why,” in Knning at the
NOTES 1. D S Broder, “The nursing bill: A quiet triumph,” Washington Post, 7 August 2002, A21. 2. J Blackwell, Personal Political Power: How Ordinary People Get What They Wantfim the Government (Issue Management Co LLC, 2001) 76.
Grassroots:A ComprehensiveManual For Corporations And Associations (Washington, DC:Public Affairs Council, 2000) 242. 4. US Constitution, preamble.
Changes Improve AORNJourszal Home Study Programs Beginning with the July issue of the AORN Journal, some changes were made to the Home Study Programs, in accordance with revised American Nurses Credentialing Center’s Commission on Accreditation criteria. The revised criteria allows for more creativity in the development of Home Studies, participant interactivity,and evaluation. The number of examination questions has been reduced; however, this will not affect the number of contact hours AORN typically offers for Home Studies. Also, more learner input is being sought via the learner evaluation. We hope to use this information to improve the Home Study Programs and bring you
articles that are relevant to your practice. We would like your feedback on these changes. Please send any comments to Editorial Assistant, AORN Journal, 2 170 S Parker Rd, Suite 300, Denver, CO 8023 15711, or send via fax to (303) 750-3441. Also, all currently valid Home Studies now are available on AORN Online http://www.aorn.org(jour nayhomestudy. After printing the Home Study you wish to take, complete the examination and mail the answer sheet, learner evaluation, and payment to AORN Customer Service, c/o Home Study Program, 2170 S Parker Rd, Suite 300, Denver, CO 8023 15711, or send via fax to (303) 750-3212.
695 AORN JOURNAL
Nurse Reinvestment Act; contacting elected officials; legislative priorities; Perioperative Nurse Week his month’s column covers several subjects of interest to perioperative nurses. These topics include the recent passage of the Nurse Reinvestment Act, effective ways to communicate with elected representatives, AORN’s revised legislative priorities, and tying political activism to Perioperative Nurse Week. THE NURSE REINVESTMENT ACT President Bush signed the Nurse Reinvestment Act into law on Aug 1, 2002. This legislation will provide various programs to address the nursing shortage, such as nursing scholarships and grants to health care facilities for nurse retention activities. The new law authorizes these programs, but Congress still must appropriate funding. The House version of the act was introduced by Rep Lois Capps (D-Calif), an RN. David Broder, a nationally syndicated columnist for the Washington Post, offered the following observation about the act’s passage. . . . this legislation was remarkable,for t ~ ’ reasons. o More than almost any bill in this session, it bore the imprint of women legislators. And more than such well-publicized but never,finished measures as the “patients’ bill of rights,” it has the potential to bring sarbstantial benefits to untold millions ofpeople during the decades ahead.
AORN, working with its federal lobbyist, is collaborating with other nursing organizations and health care associations to discuss funding levels for the Nurse Reinvestment Act and to determine legislative strategies for achieving these funding levels. The latest developments will be posted on the “What’s New” section of AORN Online at http:llwww.aorn.org and communicated to members through the monthly Legislative News! updates distributed to chapters by the Department of Government Affairs. As always, members are encouraged to stay in close contact with their congressional representatives. CONTACTING ELECTED OFFICIALS Members of Congress and state legislators can become overwhelmed with public awareness campaign efforts, requests for assistance, and pleas from constituents regarding particular bills. Joel Blackwell, a political consultant who has worked with AORN in the past, describes information overload as a public policy disease and states that “the antidote is the anecdote.”? In other words, a personal story or individual account is the most effective part of any communication with an elected official. How an issue affects you as a constituent ultimately affects your legislator. Most political consultants agree that the most effective mechanisms for communicating 692 AORN JOURNAL
with elected ofiicials, in order of importance, are I a personal visit with your legislator or his or her staff members, 5s a polite but direct letter, and m a telephone call.’ The most important component of each of these methods is your name. Whether you schedule a meeting, sign a letter, or speak with someone on the telephone, this communication will have the most impact if the person on the receiving end knows who you are. Name recognition occurs as a result of advocacy and active involvement in the legislative process. Many people have an aversion to legislative activity because they consider it “dirty politics.” In reality, legislative action is about building relationships, forming coalitions, and presenting a consistent message. Democracy in the United States is designed to belong to everyone-“We, the people.”4 There is no shortage of suggestions from political advisors who offer how-to tactics for contacting representatives in the US Congress and the state legislatures; however, the better question is when, not how. Right now, just weeks before federal and state elections, is an ideal time to be in touch with elected officials as well as other candidates for public office who would like to become elected officials. These candidates are on the campaign trail in their home
OCTOBER 2002, VOL 76,")
3
GOVERNMENTAFFAIRS TOOLBOX AORN legislative priorities, 2002-2003
Patient safety AORN advocates for perioperative RNs who are working to put patient safety first. Perioperative Nurse Week is November 10-16, 2002. AORN members are encouraged to promote awareness of this week as an immediate follow-up to state and federal elections in November, establishing a base of contact with elected officials, community leaders, and public policy makers.
AORN opposes Itcensure of STs and SAs
Professional nursing environment AORN acknowledges the national nursing shortage as a public health crisis and collaborates with other organizations and nursing associations (eg, Americans for Nursing Shortage Relief [ANSR]) to establish corrective strategies, especially as they pertain to perioperative settings. A focus for the ANSR coalition is research by specialty nursing organizations. Copies of the current ANSR consensus statement are available upon request from the AORN Department of Government Affairs.
AORN supports federal legislation to improve potient safeiv. AORN identifies, monitors, supports, and introduces state and federal legislation, as appropriate, to address the needs of perioperative nurses pertaining to correct site surgery, reducing medical errors in perioperative settings, smoke evacuation, needlesticks, and additional emerging concerns.
AORN supports progress of the federal Nurse Reinvestment Act. This measure provides nursing scholarships and grants to health care facilities for nurse retention programs. Congress has passed this legislation, but funding still must be appropriated.
AORN maintains that every surgical patient deserves a perioperative nurse and actively works to keep the RN in the OR.
AORN affirms, as stated in the 'AORN statement on nurse-to-patient ratios":
Scope of practice AORN ensures the supervisory presence of the professional RN in the perioperative arena with laws and regulations requiring RNs in the circulator role. AORN regularly communicates this position to the Centers for Medicare and Medicaid Services (CMS). The CMS rules require that ORs must be supervised by an experienced RN, medical doctor, or osteopathic doctor. AORN promotes basic educational standards for assistive personnel, such as surgical technologists (STs) and surgical assistants (SAs).
. . . whenever invasive procedures are performed, the minimum nurse-to-patientratio is one professional perioperative registered nurse dedicated to each patient during that patient's entire intraoperative experience. Reimbursement AORN supports the Medicare Certified Registered Nurse First Assistant Direct Reimbursement Act of 2001 (ie, HR 822). This federal bill, introduced by Rep Mac Collins (R-Ga), now has extensive bipartisan support in Congress with more than 100 cosponsors. AORN seeks sponsorship for a companion bill in the US Senate. AORN supports third-parly reimbursement for RN first assistants in the states. Close to 20% of the states currently have this legislation.
AORN supports the registration or certification of STs and SAs that is under the authority of the state board of nursing or its equivalent.
NOTE 1 , "AORN statement on nurse-to-patient ratios" in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2002) 128.
694 AORN JOURNAL
OCTOBER 2002, VOL 76,NO 4
districts, and they are highly motivated to talk with constituents and listen to concerns. Attending candidate forums and town hall meetings, filling out e-mail feedback forms on campaign web sites, writing letters to the editors of newspapers that make endorsements, and volunteering for a candidate all are excellent ways for AORN members to interact with public policy makers. Identify your opportunity to be part of the process, and get involved. This is the best time to promote perioperative nursing as a profession and communicateAOR”s legislative priorities. AORNS LEGISLATIVE PRIORITIES AORN’s Legislative Committee is charged with recommending revisions to the organization’s legislative priorities. The Committee met in April 2002 and again in May 2002 to develop a recommendation that
was sent to the AORN Board of Directors. The recommendation included emphasizing patient safety and addressing the nursing shortage. The Board discussed the recommendation during its July 2002 meeting in Denver, after a presentation from the Legislative Committee chair. The Board directed the Committee to hrther expand on the recommendation, and a formal revision was approved by the Board in mid-August. The updated legislative priorities are listed in the “Legislative Toolbox.” PERIOPERATIVE NURSE WEEK AORN is proud to honor perioperative RNs throughout the year, but especially during PerioperativeNurse Week. Perioperative Nurse Week highlights the history, current opportunities, and future challenges of perioperative nursing. This time
of recognition also provides a forum for public awareness. This year’s PerioperativeNurse Week is Nov 10 to 16, and the theme focuses on patient safety. Members are encouraged to promote Perioperative Nurse Week as an immediate follow-up to state and federal elections on Nov 5. Having your governor or mayor proclaim Perioperative Nurse Week in his or her jurisdiction gives credibility to your observance, and this action can be of interest to local media. A sample proclamation is available on AORN Online at http://www.aorn .org/about/pmlamation.htm. In 2001, Arizona, Hawaii, and Washington were among those states whose governors issued Perioperative Nurse Week proclamations in response to grassroots outreach efforts by AORN members. BURKEBEU AORN LEQISIATM ANALYST
3. M D Lord, “Grassroots strategy and tactics: What works, what doesn’t, and why,” in Knning at the
NOTES 1. D S Broder, “The nursing bill: A quiet triumph,” Washington Post, 7 August 2002, A21. 2. J Blackwell, Personal Political Power: How Ordinary People Get What They Wantfim the Government (Issue Management Co LLC, 2001) 76.
Grassroots:A ComprehensiveManual For Corporations And Associations (Washington, DC:Public Affairs Council, 2000) 242. 4. US Constitution, preamble.
Changes Improve AORNJourszal Home Study Programs Beginning with the July issue of the AORN Journal, some changes were made to the Home Study Programs, in accordance with revised American Nurses Credentialing Center’s Commission on Accreditation criteria. The revised criteria allows for more creativity in the development of Home Studies, participant interactivity,and evaluation. The number of examination questions has been reduced; however, this will not affect the number of contact hours AORN typically offers for Home Studies. Also, more learner input is being sought via the learner evaluation. We hope to use this information to improve the Home Study Programs and bring you
articles that are relevant to your practice. We would like your feedback on these changes. Please send any comments to Editorial Assistant, AORN Journal, 2 170 S Parker Rd, Suite 300, Denver, CO 8023 15711, or send via fax to (303) 750-3441. Also, all currently valid Home Studies now are available on AORN Online http://www.aorn.org(jour nayhomestudy. After printing the Home Study you wish to take, complete the examination and mail the answer sheet, learner evaluation, and payment to AORN Customer Service, c/o Home Study Program, 2170 S Parker Rd, Suite 300, Denver, CO 8023 15711, or send via fax to (303) 750-3212.
695 AORN JOURNAL