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Tuesday, March 25, 2008

Getting Ready for NSNA Convention 2008

“Apprehension, uncertainty, waiting, expectation, fear of surprise, do a patient more harm than any exertion.”
Florence Nightingale

This week a resolution in support of endorsing legislation to establish the Office of the National Nurse, voted on and passed by the Oregon Student Nurses Association during their February 23, 2008 convention, is being introduced into the National Student Nurses Association House of Delegates. The National Nursing Network Organization is committed to making sure students in attendance who will be considering this resolution have the most accurate and up to date information as they make their decision to support or oppose.

Thus, we are reprinting a post that was published on November 8, 2007 on

Concerns Expressed About the Office of the National Nurse Initiative

We continue our attempts to dialogue with stakeholders and to work towards consensus, understanding, and compromise. Our Board of Director’s current thinking is very much aligned with the Quad Council (ANA, ASTDN, ACHNE, and APHA) and members of the US Public Health Service and their concerns are being addressed.

The working draft from August 2007 contains the edits of a ranking member of the COA, who directs the Medical Reserve Corps. We are grateful to have his expertise and advice. The draft and mission statements can be found at

Recognize and Strengthen The Chief Nurse Officer (CNO)

We believe that it is essential to strengthen and make the position of the Chief Nurse Officer of the USPHS more visible, and to not create an entity that would require new funding and possibly replicate services. Therefore, it is our recommendation that the CNO becomes the Office of the National Nurse. The title of National Nurse would give the CNO of the USPHS the authority, impetus, and recognition needed on a national level to promote prevention. This would also place a nurse in a leadership position to help educate the public about the critical role nurses play, not what the media chooses to portray.

In the American Nurses Association/Quad Council letter of concern to our Board, they too state, “A stronger and more visible CNO would better highlight the roles of public health nurses, which could serve as a valuable recruitment tool.”

Bolster the Existing Public Health Nursing Network

The NNNO BOD, like many others, is committed to seeing that existing programs are strengthened, and therefore we are recommending that the ONN promote volunteerism within the Medical Reserve Corps, instead of establishing ‘new’ teams of volunteers. “MRC units are community-based and function as a way to locally organize and utilize volunteers who want to donate their time and expertise to prepare for and respond to emergencies and promote healthy living throughout the year. MRC volunteers supplement existing emergency and public health resources.” Retrieved on November 2, 2007 from

Invest in Public Health Education

We have heard concern expressed about whether the ONN would use best evidence-based practices. This is assured as the Office will be filled by a ranking member and leader of the USPHS and will be located within the Office of Public Health and Science.

Further evidence to support the ONN initiative comes from Dr. Susan B. Bastable. Bastable’s book is the first recommended text to be used by nurse educators preparing to take the elite Certified Nurse Educator (CNE) exam offered by the National League for Nursing:

“There is a belief on the part of nurses and other healthcare providers, which is supported by research, that patient education improves compliance and hence, health and well-being. Better understanding by clients of their treatment plans can lead to increased cooperation with therapeutic regimens. Patient education will enable them to independently solve problems encountered outside the protected care environments of hospitals, thereby increasing their independence.” (Bastable, 2003, p. 8)
Bastable, S. B. (2003). Nurse as educator: Principles of teaching and learning for nursing practice (2nd ed.). Sudbury, MA: Jones & Bartlett Publishers.

Unintended Consequences

Finally, there is fear of unintended consequences. For instance, if a National Nurse were established, would politicians and others perceive this individual in the healthcare arena as the sole leader for every nursing issue of the country? Would the National Nurse usurp the power and duties of the nation’s national nursing organizations and nurse leaders? The NNNO Board believes that although the CNO’s position would be perceived differently in that the National Nurse will be recognized as the point of symbolic national leadership for a new philosophy and cultural shift to prevention in US healthcare, the actual level of authority, duties and responsibilities held by the CNO will remain consistent. We do have an excellent example of an existing position within a decentralized healthcare system to examine, and that is the Office of the Surgeon General. Clearly, the OSG does not hold rank over the AMA and other physician led groups, but rather he has his own subset of goals and objectives to accomplish, just as the proposed ONN would have.

We are not asking for other services in nursing to be disrupted, nor are we asking for new funding for the ONN or funding cuts for other programs. As a checks and balance system, much like we have within our government, we have proposed in our working draft the following language:
“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. This would provide formal opportunity for key nursing organizations to suggest topics and influence strategies for activities.”

This list could be easily expanded to include the National League for Nursing, the American Organization of Nurse Executives, The American Association of Nurse Attorneys and the remaining nursing organizations that so diligently and thoroughly compiled Nursing’s Agenda for the Future (2002). We propose representative liaison members of these organizations be structured as a formal "Advisory Board" to serve the ONN.

It is true we cannot control every obstacle that might be on the horizon, but through dialogue and open and honest communication, we can find solutions for overcoming these.

Final Words

It is important that we are all clear that the Office of the National Nurse initiative continues to evolve, based on the feedback and suggestions we have received. It is therefore imperative that organizations seek out the most current information so they know what it is they are supporting or opposing.

Prevention is in the forefront of the national debate on health care reform. Through the ONN initiative, nurses are saying they want to take a lead role in these efforts. Nursing needs to be proactive on this issue, not reactive. As report after report continues to be published about the demise of our healthcare system, let’s remember that the nursing profession has the power, the expertise, the knowledge, and the caring to shift the tide towards prevention and improve our nation’s health.

The National Nursing Network Organization Team—Tuesday, March 25, 2008  

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