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An Office of the National Nurse would:
- Elevate the Chief Nurse Officer (CNO) of the US Public Health Service to full time status within the Office of the Surgeon General to become the National Nurse to enhance prevention efforts in all communities.
- Complement the work of the US Surgeon General.
- Promote involvement in the Medical Reserve Corps to improve the health and safety of the community.
- Incorporate proven evidence-based public health education when delivering prevention.
Wednesday, August 01, 2007
Latest Version of Policy to Create an Office of the National Nurse
Thank you to the leadership of the Medical Reserve Corps for providing feedback for the working draft of the policy to establish an Office of the National Nurse. The following is the very latest version of the working draft:
National Nurse Proposal-Working Draft-August 1, 2007
Purpose:
Why establish an Office of the National Nurse?
• To establish symbolic national leadership for a new philosophy and cultural shift to prevention in US Healthcare
• To raise visibility, enhance prestige and support recruitment to nursing and other healthcare professions.
• To provide guidance for state and local leadership that can mobilize nurse volunteers and other healthcare providers at the local level to enhance prevention and improve health outcomes.
Complementing the work of the US Surgeon General
The role of the Office of the National Nurse would be to provide a visible symbol of the nursing profession at the national level. The NN would provide symbolic leadership to build partnerships and support the development of a philosophy and culture to promote disease prevention and health promotion.
To assure local autonomy, legislative guidelines that create the Office of the National Nurse will be general, not prescriptive, and result in policies and practices that build on existing partnerships and allow local PH jurisdictions to determine local actions. The Office of the National Nurse would offer guidance based on authoritative resources such as the CDC and NIH, and may suggest specific focus topics and/or activities that complement the work of the Surgeon General. However, decisions on which strategies to adopt would be determined at the grassroots level.
Promoting volunteerism to improve health and safety in local communities
A key strategy of the NN Campaign would be to promote nursing involvement in local volunteer efforts. These activities will focus on strengthening health related linkages and creating a culture of prevention. The goal is to improve health outcomes by teaching and promoting healthier living. Nurse volunteers could engage community partners to introduce, emphasize and reinforce prevention concepts and establish best practices to change behaviors. Some key focus areas would include exercise, better nutrition, tobacco cessation, and mental health. These efforts would also seek to reduce health disparities, which is consistent with the Surgeon General’s priorities and Healthy People 2020 goals.
The NN would particularly promote involvement with the Medical Reserve Corps (MRC) (www.medicalreservecorps.gov). Local MRC units improve the health and safety of their communities by organizing and utilizing public health, medical and other volunteers. MRC volunteers not only donate their time and expertise to prepare for and respond to emergencies; they also promote healthy living throughout the year through a variety of public health activities. While over 30,000 nurses are currently involved with their local MRC units, many more are needed.
Local Leadership
Because public health is traditionally addressed at the local level, each state and
public health jurisdiction will be encouraged to engage nurses on unique activities to best address their identified needs. The Surgeon General may advise and offer guidance, but does not have a direct line of authority over the physicians in the nation. An Office of the National Nurse would parallel these concepts and provide structure, guidance and leadership. This model will allow a focus on local issues, and build partnerships that strengthen existing linkages to best serve local communities.
Why Nurses?
Nursing is strategically positioned to become the driving force for prevention efforts in US healthcare. Nurses are the largest group of healthcare workers in the US, numbering nearly 3 million. Nurses are in the trenches at the frontline assessing need and delivering healthcare 24/7 in every community. Gallup polls repeatedly find the public rates nurses as the most trusted profession. The nurse workforce is educated, licensed, skilled, experienced and rich in cultural diversity and bi-lingual skills. Nurses are used to coordinating multidisciplinary team efforts. These facts make nurses the logical existing resource to mobilize for prevention efforts. Nurses are ubiquitous; they work in a variety of community settings including hospitals, home health, public health, community clinics, K-12 schools, occupational health wellness programs and other provider agencies. Universities enroll thousands of nursing students every year that could earn community service hours and play active roles with local voluntary organizations such as the MRC.
The critical shortage of manpower in the nursing profession remains a challenge. Nursing needs a visible boost in recognition and prestige via an Office of the National Nurse, because recruitment of youth into nursing is critical to continue quality health services for our nation. In addition, volunteering would allow continued involvement and draw on the experience of the boomers in the aging nurse workforce.
Assuring Support of Nursing Organizations
To assure inclusion and seek input from all nursing specialties, the Office of the National Nurse could periodically survey professional nursing organizations such as those in the Quad Council (ANA, ASTDN, APHA, and ACHNE). This would provide formal opportunity for key nursing organizations to suggest topics and influence strategies for activities.
National Nurse as a Visible Symbol of Nursing - Staff Support
The position of Chief Nurse of the USPHS is uniquely qualified to become the first National Nurse, our nation's visible symbol of nursing.
The USPHS Chief Nurse Officer currently has several major areas of responsibility:
• Chief of USPHS Commissioned Corps nurses (the Commissioned Corps has approximately 6000 members, of which 1360 are nurses).
• Advisor for issues affecting nurses in the US Department of Health and Human Services and the agencies it supports with nursing services
• Government representative to the World Health Organization for nursing issues
• Member of the federal nursing service chief council which includes the chief nurses of the American Red Cross, Veteran's Administration, Public Health Army, Navy and Air Force
• Works with educational and professional nursing organizations including ASTDN and the ANA.
It is suggested that logistically a dedicated staffer would likely be assigned as the day-to-day liaison for the ONN.
Funding and Sustaining National Nurse Efforts
Funding for the NN Project would be a small investment considering the potential return on investment (ROI) via the healthcare cost savings that can result from creating a culture of prevention. Nationally, the ONN would be created from the existing USPHS Chief Nurse with only a few if any new staff assignments. At the state level, it may be feasible to create a new, or designate an existing state nurse, position to be the official "state coordinator" of ONN efforts.
Seeking grants for community based volunteer organizations, such as the MRC, could result in creative partnerships to fund the teams and/or provide stipends or salary to sustain leadership for team activity. There are a large number of both public and private grants that may be applicable for funding the educational activities. Grants that focus on preventing obesity via improved nutrition and increasing physical activity are a good example. An evaluation component will be a critical element of the National Nurse Campaign efforts. Healthcare foundations are likely to adopt and fund efforts once data can demonstrate evidence of their positive impact on health behaviors. Establishing best practices to improve community health outcomes can be validated via the research.
Partnerships with other existing organizations like March of Dimes or The American Cancer Society would enhance activity based on that organization's programs and educational materials. Volunteers may also become involved as "presenters" for a variety of organizations with different healthcare focus issues. These nurses could develop strong liaisons between those organizations, schools, businesses and their community's public health planners. The potential rewards for our communities are obvious, and may only be outweighed by the satisfaction that could be experienced by the volunteers in this win-win concept.
- posted by Teri Mills @ 6:45 AM 5 comments
Tuesday, July 03, 2007
Draft Policy to Establish Office of the National Nurse
This is a "working draft" of the latest suggested policy to create an Office of the National Nurse. This comes as a result of numerous meetings and communications with leadership of national nursing organizations, leaders in the USPHS, legislative policy aides, and others. The Board of Directors is open to hearing your thoughts too. Please email Teri .
A manuscript, Office of the National Nurse: Leadership for A New Era of Prevention, is also available in the February 2007 issue of Policy, Politics, and Nursing Practice.
Working Draft: Policy to Establish an Office of the National Nurse
Purpose:
Why establish an Office of the National Nurse?
To establish symbolic national leadership for a new philosophy and cultural shift to prevention in US Healthcare.
To raise visibility, enhance prestige and support recruitment to nursing and other healthcare professions.
To provide guidance for state and local leadership that can mobilize nurse volunteers and other healthcare providers at the local level to enhance prevention and improve health outcomes.
Complementing work of the US Surgeon General - via least prescriptive model
The role of the Office of the National Nurse would be to provide a visible symbol of the nursing profession at the national level. The NN would provide symbolic leadership to build partnerships and support the development of a philosophy and culture to promote disease prevention and health promotion.
To assure local autonomy, legislative guidelines that create the Office of the National Nurse will be general, not prescriptive, and result in policies and practices that build on existing partnerships and allow local PH jurisdictions to determine local actions. The Office of the National Nurse would offer guidance based on authoritative resources such as the CDC and NIH, and may suggest specific focus topics and/or activities that complement the work of the Surgeon General to promote 2010 goals. However, decisions on which strategies to adopt would be determined at the grassroots level.
Volunteer teams in local communities
A key strategy of the NN Campaign would generate Community-based National Nurse Teams to promote Prevention efforts. These teams would be comprised locally of volunteer nurses and other healthcare providers. Team activities will focus on strengthening health related linkages and creating a culture of prevention. The goal is to improve health outcomes by teaching and promoting healthier living. Teams will engage community partners to introduce, emphasize and reinforce prevention concepts and establish best practices to change behaviors. Some key focus areas would include exercise, better nutrition, tobacco cessation, and mental health. Community-based National Nurse Prevention Team goals would include reducing health disparities consistent with Healthy People 2010 goals. The teams would interface with schools, businesses, community based agencies as well as local public health leadership.
Local Leadership
Because public health is traditionally addressed at the local level, each state and public health jurisdiction will be encouraged to implement unique Community-based National Nurse Team activities to best address their identified needs. The Surgeon General may advise and offer guidance, but does not have a direct line of authority over the physicians in the nation. An Office of the National Nurse would parallel these concepts and provide structure, guidance and leadership yet allow that Community-based National Nurse Teams be responsive to local PH leadership. This model will allow a focus on local issues, and build partnerships that strengthen existing linkages to best serve local communities.
Why Nurses?
Nursing is strategically positioned to become the driving force for prevention efforts in US healthcare. Nurses are the largest group of healthcare workers in the US, numbering nearly 3 million. Nurses are in the trenches at the frontline assessing need and delivering healthcare 24/7 in every community. Gallup polls repeatedly find the public rates nurses as the most trusted profession. The nurse workforce is educated, licensed, skilled, experienced and rich in cultural diversity and bi-lingual skills. Nurses are used to coordinating multidisciplinary team efforts. These facts make nurses the logical existing resource to mobilize for prevention efforts. Nurses are ubiquitous; they work in a variety of community settings including hospitals, home health, public health, community clinics, K-12 schools, occupational health wellness programs and other provider agencies. Universities enroll thousands of nursing students every year that could earn community service hours and play active roles on the CNNTs.
The critical shortage of manpower in the nursing profession remains a challenge. Nursing needs a visible boost in recognition and prestige via an Office of the National Nurse, because recruitment of youth into nursing is critical to continue quality health services for our nation. CNNTs would allow continued involvement and draw on the experience of the boomers in the aging nurse workforce.
Assuring Support of Nursing Organizations
To assure inclusion and seek input from all nursing specialties, the Office of the National Nurse could periodically survey professional nursing organizations such as those in the Quad Council (ANA, ASTDN, APHA, and ACHNE). This would provide formal opportunity for key nursing organizations to suggest topics and influence strategies for Community-based National Nurse Team activities.
National Nurse as a Visible Symbol of Nursing - Staff Support
The position of Chief Nurse of the USPHS is uniquely qualified to become the first National Nurse, our nation's visible symbol of nursing. The USPHS Chief Nurse Officer currently has at least six major areas of responsibility:
Chief of USPHS commissioned corps with 6000 members including 1360 nurses.
Member of the US Health and Human Services
Liaison to the World Health Organization for international PH issues
Representative to the federal nursing services including American Red Cross Nurses, Veteran's Administration Nurses and Nurses on active duty in all branches of the military.
Works with professional nursing organizations including ASTDN and the ANA.
It is suggested that logistically a dedicated staffer would likely be assigned as the day-to-day liaison for the ONN and Community-based National Nurse Teams.
Multidisciplinary Collaboration with Medical Reserve Corps
The focus on health promotion will present many opportunities for multidisciplinary collaboration. Inclusive multi-disciplinary efforts will maximize support for prevention among public health agencies. The growing volunteer base in our Medical Reserve Corps (MRCs). The Medical Reserve Corps may be a likely partner for Community NN Teams. MRCs deal with emergency preparedness and hands-on care in disasters. Existing MRCs are designed to avoid having to assemble and mobilize emergency workers at the time of a disaster, and require a lengthy online application and formal orientation. In contrast, the focus of volunteers on Community-based National Nurse Teams is to enhance prevention efforts and educate the public to promote wellness. Compared to MRCs, Community-based National Nurse Teams (CNNT) will have a simpler, more stream-lined on-line application process and require only minimal orientation and training. Some volunteers may choose to become active in both programs, while others may select one program over the other based on their availability to volunteer, the different focus and simple vs. complex application and training process.
Funding and Sustaining Community National Nurse Teams
Funding for the NN Project would be a small investment considering the potential return on investment (ROI) via the healthcare cost savings that can result from creating a culture of prevention. Nationally, the ONN would be created from the existing USPHS with only a few if any new staff assignments. At the state level, it may be feasible to create a new or designate an existing state nurse position to be the official "state coordinator" of CNNT efforts. Some states may designate an existing nurse leader to be the "Lead Volunteer" for a statewide network of CNNTs.
While CNNTs are envisioned to initially be "volunteer," seeking grants for community based organizations could result in creative partnerships to fund the teams and/or provide stipends or salary to sustain leadership for team activity. There are a large number of both public and private grants that may be applicable for funding the CNNT educational activities. Grants that focus on preventing obesity via improved nutrition and increasing physical activity are a good example. An evaluation component will be a critical element of the National Nurse Campaign efforts. Healthcare foundations are likely to adopt and fund CNNTs once data can demonstrate evidence of their positive impact on health behaviors. Establishing best practices to improve community health outcomes can be validated via the research.
Some CNNT members might have a personal "favorite issue" and choose to partner with certain organizations like March of Dimes or The American Cancer Society and promote activity based on that organization's programs and educational materials. Others may be open to become involved as "presenters" for a variety of organizations with different healthcare focus issues. These CNNT nurses could develop strong liaisons between those organizations, schools, businesses and their community's public health planners. The potential rewards for our communities are obvious, and may only be outweighed by the satisfaction that could be experienced by the volunteers in this win-win concept.
- posted by Teri Mills @ 7:34 AM 2 comments
Tuesday, October 31, 2006
Original Proposal Submitted to Congress August 2005
Create an Office of the National Nurse to Advocate for, Educate and Empower American Health Care Consumers
Request: Create an Office of the National Nurse to focus on providing all Americans with preventive health care resources.
The office is necessary to acknowledge the critical role nurses play in hands-on patient care and education. The Office of the National Nurse would provide Americans with the tools to prevent disease and effectively manage chronic illness thereby reducing utilization of health care resources. The National Nurse will oversee state coordinators who will assemble nurse teams to provide screening, education and referral services in their communities.
Nurses treat people in their response to wellness, disease or injury and do this through collaboration with physicians and other health care service providers. The Office of the National Nurse will function similarly in a complementary role with the Office of the Surgeon General and other current agencies providing health care services.
Background: There are 44 million uninsured Americans and millions more are underinsured, leaving large gaps in people's access to primary and preventive care services. Americans who are insured may have limited understanding of the importance of primary or preventive health care services. Nurses know the importance of outreach and integrating patient and family education into their care for every patient. Studies demonstrate that when nurses provide early intervention, educate and work closely with patients, patients require fewer hospital and emergency care visits. (Palmer, Appleton, Rodrigues, 2003; Cherry, Moffatt, Rodriguez & Dryden, 2002) Nurses overseeing and promoting preventative care will decrease the need for hospitalizations, thereby reducing utilization of Medicare and Medicaid dollars. (Collins & Wadhwa, 2005) Ultimately, fewer nurses would be needed to provide "sick care" at the hospital or nursing home bedside, thus lessening the impact of the current nursing shortage.
Community based nurse led health services focusing on identification and early intervention have been shown to prevent unnecessary admissions to hospitals, reduce length of stay of necessary hospital admissions, and improve patients' ability to function while enjoying a higher quality of life. (Young, 2005)
There are 2.7 million nurses who work on the front lines in the United States health care system. Even though they are one of the largest groups of health care service providers in the nation, nurses hold too few positions of influence to have a national large-scale impact on the nation's health. The Office of the National Nurse integrates Nursing's Agenda for the Future (2002) as proposed by nineteen national nursing associations and organizations that call for an improvement of the image and value of the nursing profession. The activities of the Office, as well as the National Nurse, will fulfill this objective by portraying nursing as a nationally respected and valued career.
Also in Nursing's Agenda for the Future (2002)one of the objectives calls for achieving nursing's desired future state by creating "a process that provides for ongoing communication, collaboration, support and monitoring of the overall plan activities within the nursing community and among other health professions, the health care industry, and health care consumers."(p.9)
Plan: Create an Office of the National Nurse to promote and coordinate opportunities for the nation's registered nurses and licensed practical nurses to collaborate in community-based Nurse Teams. Nurse Teams will utilize the traditional nursing approach that focuses on assessing the individual's overall physical and mental state of health and working with the patient to achieve a positive outcome in accessing health services.
The Nurse Teams will be responsible for the implementation of four educational programs per year which have been identified by the National Nurse through collaboration with the Surgeon General's office and other members of the health professions, including but not limited to members of the nursing and medical professions, pharmacists, nutritionists, health educators, the Center for Medicare and Medicaid Services, pharmaceutical companies and hospital associations.
These programs will occur nationwide simultaneously to raise awareness and increase participation. For instance, if obesity/diabetes screening is the top national health priority, then the National Nurse would direct the State Coordinators who would direct their Nursing Teams in presenting the educational program in churches, supermarkets, schools, senior centers, libraries and other accessible locations in their communities. Any licensed nurse in the country would be allowed to receive training to participate and these educational programs will be designed to reach every American instead of a targeted population.
State Nurse Teams will include nurses prepared at all educational levels and will represent diverse populations. Programs will foremost focus on keeping Americans healthy by providing education about how identify their individual wellness needs, understand how to access available health services, and how to navigate the myriad of choices to better care for themselves.
Programs will improve quality of care by helping identify the special needs of communities including but not limited to geriatric and culturally diverse populations. As members of their community, nurses are better able to identify and target the diverse needs of the patients they serve.
The Office of the National Nurse, as a center, will share and disseminate information and collect data from the Nursing Teams to assist government agencies such as the CDC with their ongoing research. The Nurse Teams will focus on educating Americans using "best practices" to improve their health while reducing costs.
Nurses identified as "experts" from the National Nurse Teams will present one health education topic to the American people each week. The expert is defined as a nurse who has the educational background and practice experience to represent the health topic information to be delivered. These weekly educational pieces will be available for broadcast and on the Internet in different languages to reach America's diverse population. The goal is to create the most massive community outreach ever conducted by nurses.
Role:
The National Nurse will serve as spokesperson, publicizing the distinct role of nursing, and encouraging nurses to become involved in grassroots activities and educating the American public about the services provided by the Office. Educating the public about nursing's pivotal role in health care will be basic to involving nurses in health care policy formulation and in key business decisions that affect nursing's future." (Nursing's Agenda for the Future, 2002, p 10)
The National Nurse will be responsible for collaborating with members of the nursing community and other health care providers to determine priorities for the National Nurse Teams' community-based programs.
The National Nurse will identify state coordinators for each of the states that will be responsible for ensuring the volunteer activity is disseminated to the grassroots level.
Through the Office of the National Nurse, nurses from around the country will sign up indicating the state they are licensed from and their willingness to serve on a Nurse Team in their community.
The National Nurse will choose an expert nurse to address the nation via a public service announcement on pertinent health care topics.
The National Nurse will actively recruit qualified individuals into the profession and encourage nurses to become nurse educators through media campaigns and public appearances.
The National Nurse will work with other interested persons and departments to promote policy that would improve the nation's health.
The Office of the National Nurse will collect data to demonstrate the success of the National Nurse Team activities.
References
American Nurses Association. (2005). ANAs health care agenda 2005.
American Nurses Association. (2005). American Nurses Association delegates take action to improve health care, protect the vulnerable and advance nursing. Retreived July 1, 2005 from: http:// www.nursingworld.org/2005/pr0627.htm
Cherry, J.C., Moffatt, T.P., Rodriguez, C., Dryden, K. (2002). Diabetes disease management program for an indigent population empowered by telemedicine technology. Diabetes Technology Therapy 4(6),p. 783-91.
Collins, M. & Wadhwa, S. (2005). Nurse first logs long miles in Montana. Policy & Practice, June issue, p. 31.
Nursings Agenda for the Future. (2002). American Nurses Foundation. Washington DC.
Palmer, N.D., Appleton, B., Rodriquez, E.A. (2003). Specialist nurse-led intervention in outpatients with congestive heart failure: Impact on clinical and economic outcomes. Disease Manage Health Outcomes 11(11), p. 693-698.
Young, L.(2005). Supporting people with long term conditions. Primary Health Care 15(2), p.12-13.
- posted by Teri Mills @ 5:13 AM 5 comments
Saturday, June 17, 2006
Sample National Nurse Phone Script (Revised on October 20, 2007)
Hello, my name is __________________. I am a constituent calling from (City) in support of establishing an Office of the National Nurse.
An Office of the National Nurse is needed to:
Establish symbolic national leadership by elevating and strengthening the Chief Nurse Officer of the USPHS to make this position visible to the nursing profession and the public.
Complement the work of the US Surgeon General.
Promote involvement in the Medical Reserve Corps to improve the health and safety of the community.
Incorporate proven evidence-based public health education when promoting prevention.
Finally, studies show that when nurses are involved early on in a patient's care, they require fewer emergency room visits and hospitalizations.
Legislation was introduced in the 109th Congress, and reintroduction is anticipated. I wanted US Representative _____ or US Senator _____ to be aware.
Thank you for taking my call.
- posted by Teri Mills @ 7:00 AM 0 comments
Sample Letter to Your U.S. Representative and/or Senator (Revised on October 20, 2007)
Dear Representative _______,
Thank you for your concern for our nation's health.
I am writing today to encourage you to support legislation to establish the Office of the National Nurse.
I believe the nation needs a National Nurse to lead the public to better health through preventive health measures.
Obesity, diabetes, cancer, and heart disease are primary culprits for our nation's declining health. But these diseases can be prevented. The primary job of the National Nurse is to educate the public about how to prevent these diseases and lead healthier lives.
We in the United States are fortunate to have many choices in the foods we eat, in our means of transportation, and in recreational options. While these industries have contributed positively to the economy of our country, the less obvious yet equally important outcome has been disastrous, mainly the demise of our nation's health. This progress has resulted in a growing obese, highly stressed, and sedentary population.
Unhealthy people become a liability to corporations when sick employees are unable to work; to governments overwhelmed by the costs of health care; and they become a burden to themselves and their families.
With the overwhelming concern for communicable epidemics we are overlooking the preventable epidemics destroying our nation's health. A National Nurse is a means by which to address this problem. The Office of the National Nurse and nurses with other disciplinaries would be responsible for educating individuals, families, and communities about being healthy and preventing disease.
We urge you to show your support for establishing an Office of the National Nurse.
Thank you for your consideration.
- posted by Teri Mills @ 7:00 AM 5 comments
