The post-election party confetti has fallen and, thankfully, partisan attack ads have disappeared from the airwaves. Expectations for action by the 113th Congress are rising in the hearts and minds of the American people, who wait to see what will come from the promises and platitudes of the fall campaigns.
We want you to know that nurses are passionate about assuring affordable health care, and we’re ready to help. We support the testing and implementation of innovative delivery and payment models that focus on the patient and family and provide higher value. Many innovative delivery models have registered nurses and, in particular, nurse practitioners at their foundation. We know many Americans already are benefiting from the Affordable Care Act passed by Congress in 2010. Going forward, nurses want to be liberated from the archaic rules that restrain our practice so we can best serve the American people, no matter where we live and work. We want to make sure you realize nurses are game changers.
Nurses also know about ratings and rankings—and in that area, you could use some help. The September Gallup poll revealed only 13% of your constituents approved of the way Congress is handling its job. Nurses, on the other hand, have enjoyed a consistent top spot as the most trusted profession in the annual Gallup Honesty and Ethics survey. Let’s help each other by working together to transform health care. We offer you the opportunity to hitch your wagon to many stars—nurses.
We’ve always brought a patient-centered approach to care in homes throughout our communities and in hospitals and other care facilities. We work tirelessly to keep people healthy or rescue them from harm’s way. These are the day-to-day heroic nursing efforts already familiar to you. We’d also like you to know the impact of advanced practice nurses in delivering a wide array of services that expand access to and the reach of health care in primary care and specialty services, such as midwifery and anesthesia. These services bring excellent outcomes and, in many cases, lower costs.
Nurses are in the direct line of care activities that keep patients safe and prevent harmful complications. We also manage patients with chronic conditions using creative techniques and technology to achieve medication and lifestyle adherence, and we work with children, teens, and adults to lessen the burden of illness through prevention and counseling. What’s more, we ease suffering, sorrow, and sadness at the end of life by honoring choices for a peaceful ending. And we are the backbone of healthcare services for the poor and underserved throughout urban and rural communities. We can show you the evidence—studies that confirm the effectiveness of nursing care. You can trust us.
We urge you to leverage the knowledge, skills, and abilities of nurses—the stars—to bring order to a chaotic healthcare system. A 2009 Gallup survey of industry-wide opinion leaders reinforced that nurses are an underused resource and should have more influence in health care through service on boards and in other leadership positions. (See “Taking the first steps to serving on a board” in this issue.) We believe it’s crucial to advance the focus on team-based care (including interprofessional education and practice). Nurses embraced these approaches early, and today we lead the movement to take full advantage of each discipline’s education, scope, and abilities in delivering care—without wasting time bickering over who should deliver which service based on a code or payment (the albatross of current payment systems). This means more than just supporting the structure of team-based care, which allows the most appropriately prepared provider to deliver services based on a patient’s needs and preferences, at the right time and in the right place. It means aligning payment systems to reward multiple disciplines in a way that recognizes appropriate treatment with effective outcomes.
Making the changes needed to transform health care also means making additional investments in nursing education and workforce development. It requires intense listening and acknowledging the evidence of the positive impact nurses have on care, recovery, health, and cost effectiveness—followed by action to promote more opportunities for nurses to engage as providers who can practice unfettered and share in reimbursement programs on a level playing field.
Members of Congress—we ask you to take advantage of nurses’ scientific and emotional wisdom. We will continue to shine, no matter how long it takes to gain the advantages the American people deserve from health care. We would like you to shine with us.
Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN