HR 4601 Chief Nurse Officer

[Guest guest]

from http://www.medscape.com

Interview

Medscape: What is HR 4601?

Ms. Schneider: HR (stands for House of Representatives) 4601 is a bill to

elevate and recognize the Chief Nurse Officer position of the US Public Health

Service (USPHS) and that position will be the National Nurse. That person would

then be responsible for kicking off a nationwide focus on illness prevention and

health promotion and deliver that message across the nation through the Office

of the National Nurse and volunteer networks of nurses in every state.

Medscape: Why do we need a National Nurse?

Ms. Schneider: We have a Surgeon General and the Centers for Disease Control and

Prevention, and from those offices and others we get a huge amount of

health-related information -- really important information about health concerns

in our country and what should be done about them. What we don't have, though,

is a good mechanism to deliver those messages on a broader scale. Just as the

nurse at the bedside delivers messages about health and illness prevention to

individual patients, the Office of the National Nurse would deliver similar

messages to the population as a whole.

We see the Office of the National Nurse as providing that missing delivery

mechanism. Nurses aren't just care providers, they are also health educators.

The National Nurse would be a tangible, recognizable role model for what nurses

do and do well -- which is educate people about their health.

Medscape: Who would be the National Nurse?

Ms. Schneider: When we developed the bill, we really tried to emphasize that the

National Nurse needs to be someone who is experienced and knowledgeable from

within the USPHS. The current Chief Nurse Officer is just such a nurse --

someone who has come up through the ranks of the USPHS. That system is already

in place, and we want to retain that, so the National Nurse is not just the

person who campaigns the hardest but someone who is truly right for the

position. We already have a Chief Nurse Officer, and we want to see an elevation

and recognition of this role.

Medscape: How do you see the Office of the National Nurse as benefiting

healthcare?

Ms. Schneider: The vision is that this role would help change healthcare by

reducing the need for sick care. That is a lofty goal, and we are well aware

that prevention of health issues is not a quick fix -- it can take a long time

to see results. A great deal of evidence is out there, however, proving that

prevention programs save not only dollars but also suffering.[4] We are hoping

the Office of the National Nurse will kick off and spearhead a real change of

focus for the nation, and take us away from the patchwork " sick care " focus that

we currently have.

As our elected officials look into healthcare reform, they are struggling with

how to pay for our current system of healthcare. HR 4601 would be one way of

focusing our attention on the prevention of those expensive chronic conditions,

so we don't have to continue to look for ways to pay for more sick care.

Medscape: How will having a National Nurse benefit nursing?

Ms. Schneider: We certainly don't see this as a cure-all for either healthcare

reform or the nursing profession, but it is a step toward getting recognizable,

respected leadership at the national level. For our more than 3 million nurses,

the National Nurse would be that identifiable role model.

The National Nurse is not intended to be " the nurse over all nurses " just as the

Surgeon General is not the leader of all physicians. It will not be the role of

the National Nurse to make decisions about the nursing profession. But,

naturally, a side benefit of having a nurse in such an elevated position is that

our young people will see someone that they respect and might want to emulate.

More young people might choose nursing as a profession when they see the role

model of a nurse who is valued and admired by the nation. We may see nurses

coming into nursing school actually thinking about public health nursing --

something we rarely see now -- and they may leave school wanting to become

public health nurses. This would address the critical shortage of public health

nurses that we have in this country.[5]

The Office of the National Nurse will also open up tremendous opportunities for

nurses in all sectors -- active, retired, and students -- to volunteer by

participating in the delivery of messages of health to the public.

Medscape: Would all nurses be required to volunteer?

Ms. Schneider: Not at all. But we've been seeing many calls for volunteers

lately, from many quarters including President Obama, who is asking the country

to become more active in volunteerism. The Office of the National Nurse would

provide a way for nurses who want to volunteer to do so in their professional

capacity. A network of volunteer nurses would be encouraged to participate in a

nationwide health promotion and education effort in their own communities, using

the resources of the Office of the National Nurse.

Medscape: Why has it taken so long to get a National Nurse?

Ms. Schneider: Nurses have a long history of not speaking up for themselves and

their profession, although we do very well speaking out for the needs of

patients and populations. As a nurse educator, I see that the next generation of

nurses is interested in making a change and moving forward the legitimacy of the

profession.

The nursing shortage highlights how important nurses are. Although the

government has been willing to devote money to nursing education, we need to

continue to educate them about what we do. We need more national recognition of

the role we play as part of the team and our unique role as patient educators.

Medscape: Is there any opposition to creating an Office of the National Nurse?

If so, what is the source of the opposition?

Ms. Schneider: Opposition has been voiced, and surprisingly it has come from

within nursing itself. Throughout the years, the NNNO has made concerted efforts

to communicate with nurses, nurse leaders, and nursing organizations across the

country about the vision for the Office of the National Nurse. We have had

several discussions with the leadership in the USPHS, including the past and

present Chief Nurse Officers of the USPHS. But in our efforts to share ideas

with others, we faced refusals to discuss the initiative. We found that the

order of the day for some nursing organizations was to spread misinformation

about the initiative, much like what we are seeing with attempts to launch

healthcare reform.

I am unclear, at this point, what the opposition is, but without the opportunity

of dialogue, I can only assume that the basis for it is a misunderstanding of

the change we are advocating. Or perhaps it's because the Office of the National

Nurse effort comes from " grassroot nurses, " and opponents are displeased that

policy decisions are being attempted by a coalition of frustrated nurses working

across the country with sick and dying patients who could have benefited from

greater access to accurate health information and services.

HR 4601 is the second go-round for the Office of the National Nurse initiative,

but it contains very different language from previous legislation. We worked

hard with Representative Blumenauer's office to craft a bill that addresses the

needs and concerns of the USPHS, the American Nurses Association , the Quad

Council, and the US Congress. We do not want to legislate a new office or

agency, but we are asking for the elevation and parity ranking of the Chief

Nurse Officer with other CNOs. We are asking for the very things nurse leaders

in the Quad Council requested in their letter last year to Secretary Leavitt,[6]

and we are asking Congress to enact the change so that it is not dependent on

each new administration's appointment of the position.

There will always be opposition in any discussion of change, and in policy

making you simply cannot devise a solution for every problem. HR 4601 seeks to

elevate a nurse leader within the USPHS, to provide a publicly recognized title,

and for the active engagement of that position in the fight against preventable

illness, health disparity, and poor health literacy.[7]

Medscape: What can nurses do to support the bill for an Office of the National

Nurse?

Ms. Schneider: We have some great " Take Action " links on the Nationalnurse.org

Web site.[8] We need to get some cosponsorship for the bill in the House of

Representatives. The first step is for nurses to find out who their House

representative is, and the Web site walks you through this. It is very easy to

contact your representative, and the process is explained on the Web site along

with tools to help, such as sample letters, sample telephone messages, and ways

to get groups of nurses involved.