American Nurses Association Delegates Take Action to Improve
Health Care, Protect the Vulnerable and Advance Nursing
Silver Spring, MD - Achieving universal access to health care, ensuring registered nurses' (RNs) vital role in providing care in community-based settings, changing workplace practices that lead to dangerous levels of fatigue among nurses and protecting the rights of prisoners and detainees were some of the many issues that nurse leaders acted on during the American Nurses Association's (ANA) House of Delegates (HOD) June meeting.
The HOD, composed of more than 600 nurse leaders from ANA's 54 constituent member associations (CMAs) and organizational affiliates, was held June 17-19 in Washington, DC. As a result of ANA's 2003 bylaws amendments, organizational affiliates have both voice and vote in the HOD.
"The House of Delegates took bold action on behalf of the profession, approving reports that advocate for Americans' right to quality health care, nurses' rights and welfare, the well-being of children and human rights," said ANA President Barbara A. Blakeney, MS, RN.
Advancing Health Care Reform
In a wide-reaching measure, delegates overwhelmingly approved an HOD resolution on health care reform that will improve consumer access and reduce costs.
The report noted that every year since 1965, health care expenditures have risen at rates generally two to four times the rate of economy-wide inflation. Further, 44 million persons are uninsured and tens of millions are significantly underinsured, which impedes their access to adequate health care services.
The HOD-approved measure asks ANA to use its leadership role to work with other health care organizations and citizen action groups to carry out the goals outlined in the association's updated blueprint for health care reform, called ANA's Health Care Agenda 2005. In that document, ANA states that health care is a basic human right and calls for an emphasis on preventive, community-based care and universal health coverage.
The HOD resolution also directs ANA to work toward shaping the national debate in advance of the 2008 national election cycle and disseminate ANA's Health Care Agenda 2005 to elected officials and policymakers.
In a related action, the HOD passed a measure aimed at protecting RNs' vital role in providing patient care in community-based or ambulatory care settings. The measure asks ANA to update relevant position statements on the replacement of RNs in these settings, as well as to evaluate recent trends, such as unlicensed assistive personnel being allowed to administer medications.
Taking on RN Fatigue
Extensive research has been published on the effect of prolonged work hours on employees' ability to perform safely in many industries, and that work has led to limiting work hours among railroad, trucking and airline employees. In 2004, the Institute of Medicine targeted the health care industry with its report, Keeping Patients Safe: Transforming the Work Environment of Nurses.
The comprehensive HOD resolution asks ANA to disseminate information detailing the impact of nurses' fatigue, rotating shifts, long work hours and insufficient break time on patient safety, quality of care and the personal safety of RNs so that these effects are taken into account when scheduling decisions are made.
The HOD action also asks ANA to provide information on the legal and ethical obligations that RNs and employers have when RNs' work hours extend beyond what constitutes a safe environment for nurses and patients. In addition, the measure asks that ANA advocate for research that looks at the financial impact of nurses' fatigue on institutions, as well as on nurses, when RNs work differing shift lengths and total hours in a given time period.
Beyond providing information, delegates want ANA to urge all stakeholders to implement measures that ensure patients and nurses aren't put at risk when RNs work long hours or when they are fatigued.
Other Patient Safety and Advocacy Actions
Delegates also backed a measure prompted by recent world events. The ANA and other nursing and health care organizations have voiced concerns about the abuse and torture of prisoners and detainees from Iraq and Afghanistan. For example, ANA sent a letter to U.S. Secretary of Defense Donald Rumsfeld Feb. 3, 2005, detailing RNs' ethical responsibility to report prisoner abuse and advocate for the care of all patients.
The HOD requests that ANA adopt principles that advocate for prisoners' and detainees' right to health care and humane treatment, ensure that RNs do not voluntarily participate in any deliberate infliction of physical or mental suffering, and hold the Code of Ethics for Nurses as a set of precepts that encompass all nursing activities and that may supersede specific policies of institutions or employers.
The resolution also asks for ANA to condemn interrogation procedures that are harmful to mental and physical health and to advocate for counseling and support for RNs who speak out about acts of torture and abuse.
Protecting Children
To prevent the deaths of an estimated 85 abandoned newborns each year, the HOD approved a resolution that promotes public awareness of "safe haven" laws. Forty-five states currently have programs that allow parents to take unwanted infants to a safe place without fear of exposing their identities or being charged with the crime of child abandonment.
The resolution asks ANA to join with its CMAs and other state-based organizations to develop a public awareness campaign aimed at health care providers and the general public.
In addition, the HOD approved another resolution that focuses on children's safety.
Between July 2000 and June 2001, at least 78 children under the age of 14 died and nearly 9,200 were injured when they were left unattended in and around motor vehicles, according to a 2002 national report. Dangers that children are exposed to include being inadvertently backed over in a driveway or parking lot, being left in a vehicle where temperatures can reach deadly levels within minutes and strangulation by a power window or sun roof.
To keep children safe, the HOD approved the resolution, which calls for ANA to collaborate with other national nursing and child advocacy organizations to request a nationwide Ad Council campaign to educate parents and others about the dangers of leaving children unattended in and around motor vehicles.
RN Tribute
The HOD welcomed a program, called "The Nightingale Tribute," that honors deceased nurses. Delegates specifically want ANA to promote the availability of the tribute nationwide, including working with the National Funeral Home Directors Association.
The tribute, developed by the Kansas State Nurses Association, is a structured honor given to an RN at the funeral service, and it includes a short synopsis of the nurse's career, a reading about the nursing profession, and the presentation of white roses by colleagues to symbolize their appreciation for the nurse. The HOD implemented this ceremony during its meeting and agreed to make it a part of future meetings.
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The ANA is the only full-service professional organization representing the nation's 2.7 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.