The Nursing Voice: Board of Directors Report On Future of ANA\California

The Nursing Voice is a quarterly publication produced to update you on ANA\California's directives and the future of your association.

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Dr. Marketa Houskova, DNP, MAIA, BA, RN

Executive Director, ANA\California

HIGHER LOVE

An important missive from your Executive Director during this global pandemic.

"We live in interesting times...

The Year of Nurse and Midwife came in, both fists swinging.

Coronavirus, global pandemic, borders closed, planes grounded, schools shut, state of emergency activated, sports arenas converted into alternate care sites, shops and businesses locked, restaurants and 7-Eleven's boarded up, USNS Mercy gliding into the L.A. Harbor, MASH units throughout CA, extended shelter-in-place orders, curfews, and L.A. freeways empty... few have seen this in their lifetime.

I will never forget the sight of camouflaged Humvees, unlicensed vehicles, and armed federal troops in balaclavas without insignia or ID numbers in our streets and at civil protests, while my defiant inner voice kept screaming...

‘This isn't Fallujah, we aren't your enemy, we aren't an insurgency. We are your citizenry!’. This is Manifest Destiny. This is Land of the Free and Brave. This is America 2020. And we are only halfway through!

"Nurses feel like they carry the weight of the broken healthcare system on their shoulders.

Global society was reminded, yet again, how fundamental, selfless, caring, passionate, dedicated, capable, and compassionate nurses are and how it feels like they carry the weight of the broken healthcare system on their shoulders.

This pandemic saw families separated, nurses sleeping in garages, sheds, home offices, physically distancing form their loved ones to keep them safe and returning to work every day to serve their communities.

Moreover, this pandemic showed how difficult public health is as a discipline, why public health departments, staff, officers and nurses are so crucial to our health and well-being, and how we must invest in it.

We also got to know and admire the indomitable and always kind Dr. Anthony Fauci, and exhaled a big sigh of relief knowing we don’t have the hardest job in America, he does.

On the other hand, this pandemic also showed something that was normally hidden from the public. When faced with an unknown threat, nurses showed true grit, bravery, dedication, professionalism, ingenuity, and steel determination by caring for those needing it most, from Washington to New York, and from China to Italy.

"Honorably, nurses met the moment without missing a beat... 

Twelve-hour shifts, layers of PPE, the only constant their patients see all day, calling and FaceTiming patients’ family members so they could say goodbye, taping pictures of themselves over their gowned chests so their patients know who they are, working inside negative pressure rooms, waving hands hoping for a colleague to see and bring the one thing you forgot...

Honorably, nurses - many in unsatisfactory PPEs - met the moment without missing a beat by diligently caring for the sick during their shifts and by joining street EMS teams and providing first aid to injured protesters during their time off.

That is the fiber we are made of. That is who we are. That is Nursing. There is no higher love than that.

Now, with a heart full of gratitude and appreciation, I present to you our new and improved publication: The Nursing Voice - Enjoy!"

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IN THIS ISSUE

• Reactive To Proactive
• Legislation On A Deadline
• Innovation Out Of Necessity
• To Remain Silent Is To Be Complicit
• Nursing Education Relies On A Pivot
• Breaking Nursing's Glass Ceiling
• Building An Army
• Operating In the Black
• Recognizing Special Volunteers

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Dr. Anita Girard, DNP, RN, CPHQ, NEA-BC

President, ANA\California

REACTIVE TO PROACTIVE

"The Coronavirus pandemic highlighted the importance of professional nursing organizations' ability to be agile and proactive.

Working in coalitions, developing solutions, advocating for PPE and safe work environment, educating elected officials, and leading inside and outside of facilities, nurses met the moment."

Shifting Gears

While the pandemic forced many institutions to be reactive out of the sheer amount of new information produced every day, ANA\California took this as an opportunity to be proactive instead.

We reduced the time to respond to new issues from a few weeks to a few days, all the while maintaining an internal office team of just three (wonderful) staff members.

To do this we focused on our core business: advocacy.

Creating new opportunities for our members to engage is synonymous with our ability to grow nursing's influence. One-click advocacy messages, public statements, new coalitions, investing in resources and tools - these are all areas we're actively managing to influence the future of nursing.

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Lindsay Sandberg Duggan MS, BSN, RN, CPHRM, CPPS 

Legislative Director, ANA\California

LEGISLATION ON A DEADLINE

"COVID-19 has severely disrupted the 2020 legislative session.

California's legislative process changed overnight, from a plethora of bills and a lengthy timeline of advocacy efforts to unknown schedules, last-minute statements, and limited public testimonies.

The legislative process has become a faster and more efficient system for California legislators, which, conversely, has been disadvantageous for advocacy associations and the public wishing to render support or opposition on important issues. This cannot be the new status quo.

As the needs of nurses in California and their patients evolve, ANA\California will continue to innovate in the new legislative environment to ensure nurses' voices are heard."

How We're Adapting

Our lobbyist, Roxanne Gould, creates daily updates summarizing Governor Newsom's briefings, legislation movement, COVID-19 updates, and more. These emails are sent to the ANA\California's Legislative Committee - if you're not on this email list, you should be... email Teresa to be added.

We constantly monitor a daily file of legislative bills for last-minute changes. Roxanne has joined many hearings with less than an hour notice to offer support or opposition on key nursing and healthcare bills.

ANA\California has also increased the number of public statements released in recent months to inform the State Legislature and our members where we stand on important issues. We continually ask our members and coalition partners to share these statements. You can find the statements on our website, COVID-19 Resources page, and our LinkedIn posts.

To further our reach and influence on key bills, ANA\California is receiving quotes for paid-media, which would offer quick, targeted messages to mobilize nurses across California.

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Dr. Chris Tarver, DNP, RN, CNS, NEA-BC

Nursing Practice Director, ANA\California

INNOVATION OUT OF NECESSITY

"The long term effects on nursing practice are still unknown, however, the short term effects are being realized.

Staggering growth in telehealth, nurse and NP-led clinics to serve and support a stressed healthcare system, leap forward in full scope practice, new depths of compassion as nurses managed "no visitor" restrictions, and rapid implementation of innovations leveraging the art and science of nursing over the harsh realities of a pandemic...

The long term effects on nursing practice are still unknown, however, the short term effects are being realized.

Through it all, our nursing practice has never faltered in our commitment: to deliver excellent care and save the human race.

And that is exactly what professional nursing associations must continue to focus on; helping nurses adapt and respond to new trends through communication and connection."

Looking To The Future

What was still ten years off, is here today. COVID-19 has spurred innovation and forced technology adoption overnight...

Watching this spike, ANA\California has been making new connections with innovators in nursing, artificial intelligence, simulation, business and more. These topics are changing the way we operate as an industry today, and some are already affecting the legislation, regulation, and policies of tomorrow.

Mental health and burnout continue to plague the nursing profession... How long can we settle for blogs telling us to be more resilient, to do yoga, to breathe? While these tips and tricks can help, fundamental change is needed. ANA\California is connecting with nurses and business leaders to figure out the long term affects of new models - some of which could put nurses in the driver's seat.

It is also important to support innovation at the bedside, not just at the executive level. Taofiki Gafar-Schaner and his partner's invention, SafeSeizure, was just recognized by one of ANA's Innovation Awards. Working on an idea? Tell us about it!

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Phillip Bautista, BSN, RN, PHN

Vice President, ANA\California

TO REMAIN SILENT IS TO BE COMPLICIT

"Nurses have an ethical obligation to provide care without discrimination.

We have a unique opportunity to identify the impact of racism as a public health crisis in our society and to engage others to stand up to racism.

That's because we come from, and are a part of, the community we live in. When protests run high in media, when every channel seems to have some sort of coverage, some sort of angle, we stand on the front line as a common voice against racism. And we're being recognized for this.

At ANA\California we've been engaging nurse leaders across the state to open the dialogue about racism's resurgence within our society.

By identifying where these opportunities exist, and utilizing our trusted voices, we can provide solutions to influence the direction of our industry for years to come."

Creating Accountability

ANA\California is spearheading the conversation on racism in healthcare with California's top nursing and healthcare leaders. The goal is to provide solutions that influence nursing and healthcare's response to this systemic issue with one key word in mind, "accountability."

ANA\California and eleven leaders are setting deadlines to produce a series resources, including research, toolkits, whitepapers, and guidance with monthly goals.

Before we coordinated the leaders, we began by recording a Racism in Healthcare Dialogue Forum. This forum discussed the findings of many conversations with nurses throughout California and summarized barriers to constructive conversations and a working reporting system.

Must Reads:

• ‘This Is Not a Patient, This Is Property of the State’: Nursing,ethics, and the immigrant detention apparatus by Danisha Jenkins, MSN, RN, CCRN, NEA-BC
• A Reason for Hope... a personal story from Michelle DeCoux Hampton's, RN, PhD, MS, experiences with racism.

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Dr. Robyn Nelson, PhD, MS, RN

Nursing Education Director, ANA\California

NURSING EDUCATION RELIES ON A PIVOT

"Should nursing programs delay the progression and graduation of students who worked so hard to achieve their professional goal?

There were two very big changes that nursing education programs confronted since COVID-19:

1. Face-to-face classroom instruction pivoted "overnight" to virtual learning.
2. Cancellation of direct care experience in the clinical settings delayed nursing students' entrance into the workforce.

This has raised many questions, such as:

• Did all students have adequate technical support at home? What were the distractions to studying at home?
• Should nursing programs delay the progression and graduation of students who have worked so hard to achieve their professional goal?
• Will our healthcare partners be prepared to offer a longer orientation for new graduates who may not have had the same clinical experiences as pre-COVID?"

What We Did

To support nursing students, ANA\California worked diligently with coalition partners across the state to issue joint public statements, provide resources, and advocate for the timely graduation of thousands of nursing students in California.

This included a 2,700 advocacy messages sent to Governor Newsom, Speaker of the Assembly, Senate Pro Tem, Chairs of Assembly and Senate Health Committees, and the Director of the DCA.

At the request of the Office of Governor to better understand how to increase the nursing workforce, ANA\California co-chaired the COVID-19 California Practice Group, led by HealthImpact, which focused on processes and steps to bring nurses and nursing students to hospitals and community care settings so they may provide care during the pandemic.

The COVID-19 California Practice Group created four documents to suggest resources and guidance for clinical agencies.

Next Steps

Will as many Fall 2020 nursing graduates be able to graduate? Spring 2021? What is the continued impact of COVID-19 on nursing student's clinical requirements?

ANA\California has been actively conversing with nurse educators and nursing workforce experts to quantify the pandemic's impact on the future of nursing. AB 2288 (Low) is a key legislative priority to give nurse educators the flexibility they need to help students graduate when clinical placements have dried up from COVID-19.

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Dr. Ruth K. Rosenblum DNP, RN, PNP-BC, CNS

Secretary, ANA\California

BREAKING NURSING'S GLASS CEILING

"Nurses communicate with transparency and accountability that is often not present from other professions.

As we have seen, the Year of the Nurse and Midwife became more than we have anticipated.

Nurses have been highlighted in media, fighting on the front lines of the epidemic, responding to casualties and deaths of patients and colleagues alike, displaying resilience amid lack of appropriate PPE and staffing, etc.

While it is unfortunate that it took a worldwide pandemic to highlight nurses and the challenges that we face on a daily basis, media has magnified our voice ten-fold.

But will the media continue to look to nurses in the future?

As leaders in our field, we need to identify expert nurses, train them to speak to the media, and pitch them to Public Relations staff at hospitals, universities, clinics and other appropriate places.

Nurses communicate with transparency and accountability that is often not present coming from other professions. In an ever-partisan world, this voice, our voice, is needed!"

Nurses In Media

ANA\California is proud to be an investor and joint partner with UCSF School of Nursing faculty to develop a media training program to increase nurses' visibility. Read our public statement to learn more about the program.

By now everyone has heard nurses are cited as sources in media only 2% of the time compared to our physician counterparts. We're changing that.

Here is a recent list of media opportunities ANA\California and its members have participated in:

[PODCAST] What The California Legislature Can Do Now To Help Nurses On The COVID Frontlines by Neptune Ops. Dr. Marketa Houskova DNP, MAIA, BA, RN, ANA\California's Executive Director, discussed history, insights, and 'political will' behind some of 2020's most important nursing legislation and laws.

[MAGAZINE] What Now for California Nursing Organizations by The Working Nurse. ANA\California joined other nursing associations in discussing how "work as we know it" changed and how it will never be the same. Read their insights to stay up-to-date.

San Diego Nurses Care For COVID Patients By Day, Protesters By Night by KPBS. ANA\California's San Diego Task Force to date has joined more than 70 protests fighting against discrimination. See their latest update here, and join their efforts by reaching out to Laura or Danisha.

[VIDEO] Nursing in Policy and Politics by Nurses Outside the Box. Dr. Houskova also joined Annemarie Toleman to discuss the status and process of nursing advocacy in policy and politics, and how to get more involved in innovative ways.

[VIDEO] Dr. Nadine Burke Harris Interview by SheShares. ANA\California sponsored this important conversation between SheShares, an organization highlighting women leaders in California, and Dr. Nadine Burke Harris, California's Surgeon General. Supporters were recognized in the video and advertising.

CNBC asked, you nominated: Recognizing the selfless heroes of the coronavirus pandemic by CNBC. Danisha Jenkins, MSN, RN, CCRN, NEA-BC was nominated for going above and beyond in educating nurses in California and Mexico. Tamara AL-Yassin, RN, BSN, CEN, PHN was also nominated for her creating a COVID-19 Warrior Pin for essential workers... so cool by the way, check them out @essentialwarriors... All proceeds go to Feeding America.

National Nurses Week: Celebrations Put On Hold by COVID-19 Pandemic by The Epoch Times. Dr. Marketa Houskova was asked to comment about cancelling Lobby Day - one of nursing's biggest days to visit the State Capitol, speak with legislators, and network.

Upcoming Media

NBC News segment featuring Dr. Anita Girard, DNP, RN, CPHQ, NEA-BC. The story is about the rising coronavirus cases in Southern California, and how this is impacting their work as nurses.

Nursing & Healthcare 2020 Webinar: Stress in COVID-19 featuring Dr. Chris Tarver, DNP, RN, CNS, NEA-BC. This is an international conference and we're honored to highlight Dr. Chris Tarver to represent nursing and ANA\California.

The Handoff Podcast by Trusted Health featuring Dr. Marketa Houskova. Looking to the future of nursing advocacy and leadership.

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Zack Huddleston, BSN, RN, PHN

Membership Director, ANA\California

BUILDING AN ARMY

"Although the COVID-19 pandemic has hindered us in some ways, it has also inspired us to innovate our approach in reaching our membership.

ANA\C has increased its communication with membership, greatly increased our social media presence, and increased the number of advocacy messages our members can send to their representatives.

We have seen a 10% increase in members month over month, but I feel we can do better by helping our members to become more involved in advocacy within the first month of joining ANA\California."

Grassroots From The Ground Up

While the Advocacy Institute Fellowship has been delayed until 2021, we've been adding "layers to the onion" to further expand upon the program's offerings. The key concept here is: Organizations thrive off a well-educated, well-coordinated membership. We're developing the Advocacy Institute to, first and foremost, give you the skills and knowledge to create the change you want to see.

Our 'Who Do You Wear A Mask For' #MaskUp campaign showed that we can coordinate 35+ nursing and healthcare organizations in a very short time period. And while many nurses joined to share their stories during the campaign, there is still room for growth in engagement.

We started Advocacy Hour to increase our direct connection to motivated nurse advocates and give us a way to keep our "ears on the ground." We also adapted The Pioneer newsletter to promote calls-to-action and advocacy on topics discussed during Advocacy Hour.

Since January, we launched on LinkedIn and relaunched on Instagram. Today, we have over 750 LinkedIn connections with nursing and healthcare leaders and about 1,000 Instragram followers - primarily consisting of the next generation of nursing students.

Want to know more about the Advocacy Institute, join the Advocacy Hour, or learn advocacy skills? Message Jared.

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Kelly Bell, MSN, RN

Treasurer, ANA\California

OPERATING IN THE BLACK

"In trying times such as these, the opportunity exists to reevaluate our investments and expenditures to make sure we continue to be fiscally responsible.

Our investments are in line with our policies, which means they lack volatility and are relatively protected against huge losses in the market. In fact, our portfolio hasn't changed much since the beginning of 2020, reassuring us that we're invested wisely.

Additionally, we took this time to visit and secure new office space, which provides more space for future growth at a lower cost."

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RECOGNIZING SPECIAL VOLUNTEERS

Brooke Newman BSN, RN

Brooke is an MSN bridged, DNP student with a focus on nursing leadership. She helped facilitate many connections, coordinated research on important campaigns, helped write advocacy messages and is responsible for the initial idea that led to our #MaskUp campaign.

Brooke is extremely driven and is showing her stripes as a true connector in nursing leadership.

Chris Cinkowski BSN, RN, CCRN

Chris is an MSN student and emergency critical care nurse at Stanford Healthcare.

He worked diligently to provide sources and write advocacy statements with ANA\California in the initial months of the pandemic.