By Lisette Hilton
October 15, 2012
Pat Barnett, RN, JD, felt compelled to get involved in the legislative process as a young nurse working for a state psychiatric hospital in Illinois. It was 1976, and Barnett said she couldn’t stand by and watch the injustices of deinstitutionalization, an attempt by the state to move people from state facilities into the community.
"There was no place for these patients to go," Barnett said. "They would be discharged and there were no community homes because nobody wanted one in their backyard. [Patients] were given very little support, so you would see people end up in the No. 1 institution for the mentally ill — jail."
Barnett, who today is CEO of the New Jersey State Nurses Association, testified along with other nurses before a legislative committee about how deinstitutionalization was impacting her patients. While the volunteer advocates weren’t able to stop deinstitutionalization, they were, according to Barnett, able to get more funding for the mental health system, and some facilities remained open.
Nurses need to become active and engaged politically purely because of the nature of the highly regulated profession, according to Barnett.
"Nurses are extremely regulated by state law statutes, regulations before the board of nursing, hospital regulations, ambulatory care regulations, long-term-care regulations," she said.
Politics and policy affect every area of nursing, whether it’s education, practice or research, according to Connie Vance, RN, EdD, FAAN, professor, College of New Rochelle (N.Y.). "Healthcare is political," Vance said.
Current events, such as the tumultuous state of healthcare and the upcoming presidential election, add to the urgency for nurses to become involved in political action, according to Barnett.
"I think one of the challenges that all nurses have now is under the Affordable Care Act, where there will be 900,000 new patients in the state of New Jersey that will have health insurance coverage of some sort," Barnett said. "Right now, we have a serious shortage of primary care doctors. There are 1,400 too few right now in the state of New Jersey."
The possible savior? None other than nurses, according to Barnett.
"We have 5,000 advanced practice nurses, 80% of whom actually practice in primary care, and many of those take Medicaid and Medicare patients," Barnett said. "So I think nurses need to be involved because the Affordable Care Act creates opportunity for nurses, whether or not they are advanced practice nurses. Also, there is money in the Affordable Care Act to create nurse-run clinics — and money for nursing education. That happened only because the American Nurses Association, other nursing associations and individual nurses lobbied the legislature and their individual legislators to make that happen."
The Institute of Medicine weighed in on the importance of nursing input in its October 2010 report, "The Future of Nursing: Leading Change, Advancing Health." According to the IOM, nursing is at a pivotal point.
"Nurses’ roles, responsibilities and education should change significantly to meet the increased demand for care that will be created by healthcare reform and to advance improvements in America’s increasingly complex health system," the IOM announced after releasing its report.
Even as the largest healthcare profession, nursing’s voices often are silent or ignored, according to Vance.
"I believe our values and concerns should be heard to help our patients and our profession," she said. "We have to decide whether we want to make our voices heard, [and have] input in the decision-making around our practice. Or, they’ll make these decisions without our input."
Many nurses, like a number of Americans, think politics is a dirty word, according to Linda Parry-Carney, RN-BC, MA, education specialist at Hackensack (N.J.) University Medical Center.
Parry-Carney is a former president of the New Jersey State Nurses Association and the current chairwoman of the board for the New Jersey Collaborating Center for Nursing.
What nurses might not realize, she said, is they already are politicians, whether they’re negotiating with patients at the bedside, with employers, on hospital committees or as members of organizations.
Legislators don’t act alone. They make decisions based on what their constituents want, according to Parry-Carney.
"[As NJSNA president,] when I needed to talk to the Governor’s staff, an assemblyperson, senator or the commissioner of health, it wasn’t just me sitting in front of him," she said. "He knew I represented the interests of all the people who were members of our organization, and, in fact, all nurses in New Jersey."
One nurse sharing his or her perspective helps formulate strategies that groups use in an effort to influence policy and make changes.
"Every nurse should be a 'political’ nurse because we are such a caring, large constituency for people," Vance said. "We are important to society. We’re important to people. So we have to take our practice beyond the bedside, beyond the school, beyond our research, and set it in a larger way into community involvement, which means being an activist, being a volunteer, being an informed citizen."