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Monday, May 10, 2010

An Overview of HR 4601 The National Nurse Act of 2010

The passage of the healthcare reform package brings a unique window of opportunity to strengthen the delivery of prevention education and highlight the nurse's role in our healthcare system. We are excited to hear leaders of the Public Health and Prevention subgroups for healthcare reform who share this vision. HR 4601 The National Nurse Act of 2010, introduced by Oregon Congressman Earl Blumenauer on February 4th and now supported 11 esteemed members of Congress, brings nurses to the forefront as the deliverers of the message of prevention to every American. Four state legislative bodies (Massachusetts, New York, Oregon, and Vermont) and over 100 organizations and prominent individuals have also endorsed this bill.

In a Robert Wood Johnson Foundation newsletter, Susan B. Hassmiller, Senior Advisor for Nursing states, “ Nurses have a pivotal role to play 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.”

The rise in numbers of people struggling with chronic disease threatens the population like never before. Reports of low health literacy, coupled with the increasing numbers of chronic conditions that are preventable, current efforts are proving to be insufficient. Based on the ubiquitous presence of nurses in all communities and the high degree of trust bestowed on them, an adequate nursing workforce can play a major role in prevention, thus reducing both morbidity and costs related to chronic disease.

By designating the Chief Nurse Officer of the US Public Health Service to be officially known as the country's National Nurse, Congress will provide an impetus for promoting the Medical Reserve Corps and strengthening existing public health infrastructure and resources, through which nurses and other health workers within each community would deliver and reinforce messages of prevention.

Developing this "Prevention Promotion" network would have a huge impact on reduction of preventable disease. This strategy would help shift our nation to focus on prevention, and along with other health care reform initiatives has potential for tremendous positive impact. The ANA social policy statement includes a call for nurses to be involved in health promotion and prevention strategies and HR 4601 accomplishes this in actions.

The current bill language is different from a bill introduced into Congress in 2006 and is based on feedback members of the National Nursing Network Organization received after four years of meetings with the USPHS, nursing leadership, and key stake holders. In fact, the American Nurses Association played a key role- it was their letter that they and the Quad Council sent to HHS Secretary Leavitt that formed the basis for this legislation. This letter stated “ Many of us in the nursing community firmly believe that the PHS Chief Nurse Officer is already the “National Nurse.” We feel it would be counterproductive to establish a separate office or re-title the current position which would ultimately compete with the PHS Chief Nurse Officer for authority, recognition, and already scarce resources.”

Supporters agree and HR 4601 asks for the Chief Nurse Officer position to be KNOWN as the National Nurse, there is NO title change requested in the bill language. Please read this two page bill that is easy to understand. The title of National Nurse is necessary because we have found that too few nurses let alone members of the public can name the CNO of the USPHS. You may be asking yourself right now, who is the current Chief Nurse Officer of the USPHS?

One goal of this legislation is to have a visible nurse leader who has the skills, knowledge, expertise and years of experience to help lead our country into a culture of prevention. So when First Lady Michelle Obama is speaking in front of the nation about childhood obesity, imagine the impact the CNO/National Nurse would have in inspiring and engaging the public to participate in health promotion activities. And because this position is currently funded, federal dollars would not be competed for that could go towards nursing education and improvement of the nursing workforce.

The bill language is carefully crafted so as NOT to politicize the position of the CNO. The CNO/National Nurse appointment and successors would be chosen through the same nominating process currently used (this is not a Cabinet position, nor is it a Presidential appointment like the Surgeon General).

Furthermore, the current duties of the CNO are retained. The position is being increased to full time; as presently the CNO works half time as the CNO and half time in the department of the HHS where the CNO previously worked full time. Doubling the CNO hours will allow more time to interface with the Federal Nurse Council and more time to direct the USPHS interdisciplinary staff. It is appropriate for the CNO to be known as the National Nurse because the reality is nurses are the largest segment of the US Public Health Service workforce as well as the largest sector of the healthcare workforce.

A review of the literature has shown that health education coupled with social marketing strategies works-this is exactly what is being asked for in HR 4601. One example is Tobacco Free California. With aggressive advertising and public relations campaigns, along with community programs, the state has made significant advances in achieving a tobacco free California. As a result, California has the second lowest adult smoking rate in the nation; only Utah is lower.

Once HR 4601 is explained, most rank and file nurses see this as a real opportunity, a rare opportunity, to unite nurses across all specialty areas, to help showcase public health and community nursing roles, and to do a very positive action for society- to help reduce preventable conditions.

There are many ways to help promote the passage of HR 4601 The National Nurse Act of 2010. If you too are inspired to make a difference and want to take part in this grassroots campaign please email the National Nursing Network Organization's Board of Directors and we will provide you with ways to help.

The National Nursing Network Organization Team—Monday, May 10, 2010  

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Anonymous Patti Ashland 
As a pediatric nurse, nursing teacher, and former public health nurse I wholeheartedly agree the CNO position should be full time and more visible. Folks do trust nurses so we should have more say in public health education and awareness./Patti Ashland, MSN, RN