HR 4601 Chief Nurse Officer
- from http://www.medscape.com
Medscape: What is HR 4601?
Ms. Schneider: HR (stands for House of Representatives) 4601 is a bill to elevate and recognize the Chief Nurse Officer position of the US Public Health Service (USPHS) and that position will be the National Nurse. That person would then be responsible for kicking off a nationwide focus on illness prevention and health promotion and deliver that message across the nation through the Office of the National Nurse and volunteer networks of nurses in every state.
Medscape: Why do we need a National Nurse?
Ms. Schneider: We have a Surgeon General and the Centers for Disease Control and Prevention, and from those offices and others we get a huge amount of health-related information -- really important information about health concerns in our country and what should be done about them. What we don't have, though, is a good mechanism to deliver those messages on a broader scale. Just as the nurse at the bedside delivers messages about health and illness prevention to individual patients, the Office of the National Nurse would deliver similar messages to the population as a whole.
We see the Office of the National Nurse as providing that missing delivery mechanism. Nurses aren't just care providers, they are also health educators. The National Nurse would be a tangible, recognizable role model for what nurses do and do well -- which is educate people about their health.
Medscape: Who would be the National Nurse?
Ms. Schneider: When we developed the bill, we really tried to emphasize that the National Nurse needs to be someone who is experienced and knowledgeable from within the USPHS. The current Chief Nurse Officer is just such a nurse -- someone who has come up through the ranks of the USPHS. That system is already in place, and we want to retain that, so the National Nurse is not just the person who campaigns the hardest but someone who is truly right for the position. We already have a Chief Nurse Officer, and we want to see an elevation and recognition of this role.
Medscape: How do you see the Office of the National Nurse as benefiting healthcare?
Ms. Schneider: The vision is that this role would help change healthcare by reducing the need for sick care. That is a lofty goal, and we are well aware that prevention of health issues is not a quick fix -- it can take a long time to see results. A great deal of evidence is out there, however, proving that prevention programs save not only dollars but also suffering. We are hoping the Office of the National Nurse will kick off and spearhead a real change of focus for the nation, and take us away from the patchwork "sick care" focus that we currently have.
As our elected officials look into healthcare reform, they are struggling with how to pay for our current system of healthcare. HR 4601 would be one way of focusing our attention on the prevention of those expensive chronic conditions, so we don't have to continue to look for ways to pay for more sick care.
Medscape: How will having a National Nurse benefit nursing?
Ms. Schneider: We certainly don't see this as a cure-all for either healthcare reform or the nursing profession, but it is a step toward getting recognizable, respected leadership at the national level. For our more than 3 million nurses, the National Nurse would be that identifiable role model.
The National Nurse is not intended to be "the nurse over all nurses" just as the Surgeon General is not the leader of all physicians. It will not be the role of the National Nurse to make decisions about the nursing profession. But, naturally, a side benefit of having a nurse in such an elevated position is that our young people will see someone that they respect and might want to emulate. More young people might choose nursing as a profession when they see the role model of a nurse who is valued and admired by the nation. We may see nurses coming into nursing school actually thinking about public health nursing -- something we rarely see now -- and they may leave school wanting to become public health nurses. This would address the critical shortage of public health nurses that we have in this country.
The Office of the National Nurse will also open up tremendous opportunities for nurses in all sectors -- active, retired, and students -- to volunteer by participating in the delivery of messages of health to the public.
Medscape: Would all nurses be required to volunteer?
Ms. Schneider: Not at all. But we've been seeing many calls for volunteers lately, from many quarters including President Obama, who is asking the country to become more active in volunteerism. The Office of the National Nurse would provide a way for nurses who want to volunteer to do so in their professional capacity. A network of volunteer nurses would be encouraged to participate in a nationwide health promotion and education effort in their own communities, using the resources of the Office of the National Nurse.
Medscape: Why has it taken so long to get a National Nurse?
Ms. Schneider: Nurses have a long history of not speaking up for themselves and their profession, although we do very well speaking out for the needs of patients and populations. As a nurse educator, I see that the next generation of nurses is interested in making a change and moving forward the legitimacy of the profession.
The nursing shortage highlights how important nurses are. Although the government has been willing to devote money to nursing education, we need to continue to educate them about what we do. We need more national recognition of the role we play as part of the team and our unique role as patient educators.
Medscape: Is there any opposition to creating an Office of the National Nurse? If so, what is the source of the opposition?
Ms. Schneider: Opposition has been voiced, and surprisingly it has come from within nursing itself. Throughout the years, the NNNO has made concerted efforts to communicate with nurses, nurse leaders, and nursing organizations across the country about the vision for the Office of the National Nurse. We have had several discussions with the leadership in the USPHS, including the past and present Chief Nurse Officers of the USPHS. But in our efforts to share ideas with others, we faced refusals to discuss the initiative. We found that the order of the day for some nursing organizations was to spread misinformation about the initiative, much like what we are seeing with attempts to launch healthcare reform.
I am unclear, at this point, what the opposition is, but without the opportunity of dialogue, I can only assume that the basis for it is a misunderstanding of the change we are advocating. Or perhaps it's because the Office of the National Nurse effort comes from "grassroot nurses," and opponents are displeased that policy decisions are being attempted by a coalition of frustrated nurses working across the country with sick and dying patients who could have benefited from greater access to accurate health information and services.
HR 4601 is the second go-round for the Office of the National Nurse initiative, but it contains very different language from previous legislation. We worked hard with Representative Blumenauer's office to craft a bill that addresses the needs and concerns of the USPHS, the American Nurses Association , the Quad Council, and the US Congress. We do not want to legislate a new office or agency, but we are asking for the elevation and parity ranking of the Chief Nurse Officer with other CNOs. We are asking for the very things nurse leaders in the Quad Council requested in their letter last year to Secretary Leavitt, and we are asking Congress to enact the change so that it is not dependent on each new administration's appointment of the position.
There will always be opposition in any discussion of change, and in policy making you simply cannot devise a solution for every problem. HR 4601 seeks to elevate a nurse leader within the USPHS, to provide a publicly recognized title, and for the active engagement of that position in the fight against preventable illness, health disparity, and poor health literacy.
Medscape: What can nurses do to support the bill for an Office of the National Nurse?
Ms. Schneider: We have some great "Take Action" links on the Nationalnurse.org Web site. We need to get some cosponsorship for the bill in the House of Representatives. The first step is for nurses to find out who their House representative is, and the Web site walks you through this. It is very easy to contact your representative, and the process is explained on the Web site along with tools to help, such as sample letters, sample telephone messages, and ways to get groups of nurses involved.