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Monday, July 20, 2009

NNNO Sends Letter to Congressman Waxman

Health care reform remains this summer's hot topic in Congress and throughout the nation. Below is the letter that the NNNO wrote to Congressman Henry Waxman, Chair of the Energy and Commerce Committee in support of the Division C (public health) provisions.

July 9, 2009

Dear Congressman Waxman and Distinguished Members of the Energy and Commerce Committee,

The Board of Directors of the National Nursing Network Organization proudly stands with you in your recognition of the integral role prevention has within our public health system. We agree with many who have testified and written letters affirming that our healthcare system has failed to provide Americans, beginning with school age children, messages of prevention aimed at keeping them well.

In addition to providing the necessary funding to replicate successful programs of prevention, we urge you to closely examine the Office of the National Nurse initiative.

The National Nursing Network Organization proposes there be an Office of the National Nurse (ONN) established with a highly visible national nurse spokesperson to encourage prevention efforts by communities, families and individuals. The ONN would serve to mobilize interested nurses, students and retirees to become activists for prevention and health promotion in their local communities. It is proposed that the United States Congress enact legislation to initially create an ONN by designating the existing Chief Nurse Officer (CNO) of the United States Public Health Service (USPHS) to serve in this unique nursing leadership role. This would avoid unnecessary cost and duplication of services (Mills & Schneider, 2009).

Nurses, as both providers and consumers, see all too often how our healthcare system is faltering with increasing epidemics of chronic preventable diseases. Poor health literacy and continuing health disparities will be better addressed with a shift to focus on prevention in our communities. Eighteen other countries do better than the US at reducing preventable deaths (Dunham, 2008) and the US ranks 29th among all industrialized countries in infant mortality (Harris, 2008). Every year 1.3 trillion dollars is spent on managing the impact of the 7 most common chronic diseases, most are preventable (DeVol, 2007).

These figures speak volumes about our healthcare system, a system that is based on sick care not health care. A philosophical and cultural shift to focus on wellness at the national level and reinforced by nurses in every community would go a long way in promoting health, reducing costs and saving lives. Growing epidemics of obesity and diabetes resulting from dietary intake and sedentary lifestyles can be curbed only with a concentrated effort, inspired nationally and implemented locally.

The intent of creating an ONN is to have nurses, under the leadership of a National Nurse within the USPHS, support health promotion and deliver interventions to prevent illness in their own communities. By delivering broad-based, educationally sound messages on the national level and then reinforcing them in local communities, improvements in health literacy and the ability to reach across a broad and diverse population will be realized. Such health enhancing actions would be accomplished through involvement to strengthen existing service delivery such as the Office of the Surgeon General, the Medical Reserve Corps, the American Red Cross and others.

Nurses are well positioned to initiate this much needed shift in that they are 2.9 million strong, traditionally serve as advocates for those in need and are highly trusted by the public. They are the largest segment of the healthcare workforce, span all cultures, are present in all communities, and are skilled at assessment, education and implementation of evidence based interventions. Add to this number the thousands of student nurses in all levels of nursing programs and hundreds of active retired nurses who maintain licensure, and there is a huge resource pool from which to draw volunteers and contributors for community health promotion.

With guidance from the ONN, sanctioned by Congress to spearhead prevention, available nurses would be encouraged to participate with existing health organizations (American Heart Association, Diabetes Association, Cancer Society, MRCs) local schools, and community organizations with programs that can add a focus on delivering health promotion information. Nurse volunteers would 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 issues. The goal is to create a culture of prevention to improve health outcomes through national social marketing and local activism. Nursing efforts can promote both healthier behaviors and environments at both the systems level and the community level, as well as with families and individuals.

In a Robert Wood Johnson Foundation September 2007 newsletter, Dr. Susan Hassmiller, Senior Program Officer, states, "Nurses have a pivotal role in promoting preventive care since they spend more time with patients than any other health care professional. By educating and counseling patients about the importance of simple preventive measures, nurses can have a significant impact on improving health and extending lives. The health care system needs to empower and encourage nurses for them to be effectively engaged in this role." This statement represents the foundation of the proposal for an Office of the National Nurse.

Nurses realize our healthcare system is in serious trouble and needs revision. Dozens of nursing organizations recognize the strong merit in the vision of a National Nurse to shift us to prevention and have endorsed this proposal. Nurses know preventive medicine is better than reactive medicine. In addition, the Office of the National Nurse would enhance recruitment and integrate Nursing’s Agenda for the Future (American Nurses Foundation, 2002) that called for an improvement of the image and value of the nursing profession. The activities of the ONN will help fulfill this objective by portraying leadership for this key role in nursing, and allowing youth to view both hospital and community nursing as a nationally respected and valued careers.

We appreciate and support your endeavors to include prevention and wellness funding in health care reform legislation that will ultimately save lives and alleviate unnecessary suffering.


Teri Mills, RN, MS, CNE
President, National Nursing Network Organization
Office of the National Nurse

Terri Polick, RN
Vice-President, National Nursing Network Organization

Alisa Schneider, RN, MSN
Secretary, National Nursing Network Organization

Susan Sullivan, RN, PHN, MSN
Board Member, National Nursing Network Organization


American Nurses Foundation. Nursings Agenda for the Future. (2002). Washington D.C.

DeVol, R., et. al (2007) An unhealthy America: The economic burden of chronic disease-charting a new course to save lives and increase productivity and Economic growth. Retrieved June 1, 2009 from

Dunham, W. (2008). France best, U.S. worst in preventable death ranking. Reuters. Retrieved June 1, 2009 from http://

Harris, G. (2008). Infant deaths drop in U.S., but rates still high. The New York Times. Retrieved June 16, 2009 from

Mills, T., & Schneider, A. (2009). The office of the national nurse. Journal of nursing law, 13, (1), 13-18.

The National Nursing Network Organization Team—Monday, July 20, 2009  

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