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Washington Watch

American Journal of Nursing - February, 2002 - Volume 102, Issue 2

The Nationwide State Legislative Agenda
The ANA and state nurses' associations address the nursing shortage.

By Susan Whittaker, MSN, RN

In 2001, the ANA and its state constituent member associations (CMAs) developed a comprehensive, coordinated federal and state legislative agenda to address the current nurse staffing crisis and emerging nursing shortage. While ANA lobbyists have been working with Congress to pass legislation to prohibit mandatory overtime, protect whistleblowers, increase funding for nursing education, and provide incentives for hospitals to improve nurses' working conditions, CMAs have been working in tandem to promote similar legislation at the state level. The 2001 Nationwide State Legislative Agenda on Staffing was accomplished by the ANA and its CMAs working together to develop and secure introduction of state legislation, holding coordinated press conferences on the national and state levels, sharing strategies and resources, and promoting the agenda at national meetings of state legislators.

"This landmark strategy marked the first time the ANA and the CMAs have combined forces to implement legislation in a coordinated manner across the nation," notes ANA president Mary Foley, MS, RN. "The ANA is the only national nursing organization that has the structure, resources, and national clout to carry out such an agenda."

The Nationwide State Legislative Agenda on Staffing is already reaping results. The following are state legislative victories that were won through joint ANA-CMA efforts in 2001:

Regislation to prevent or limit mandatory overtime and prevent employers from discriminating against nurses who refuse overtime was introduced in California, Connecticut, Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Ohio, Pennsylvanias Rhode Island, Washington, Wisconsin, and West Virginia. Legislation was enacted in Maine, Oregon, and New Jersey.

Whistleblower legislation that protects nurses who speak out on behalf of patients was passed in Oregon and West Virginia and introduced in Hawaii, Illinois, Missouri, New York, Pennsylvania, and Rhode Island. In addition, New York and Oregon legislation would prevent employers from retaliating against any employee who refuses to participate in an activity that poses a risk to the health, safety, or welfare of a patient.

Legislation that would require hospitals to develop and implement nurse staffing systems that accurately reflect the number of nurses necessary to provide safe, high-quality patient care, and to be accountable for staffing effectiveness was introduced in Illinois, Maine, New York, Ohio, and Pennsylvania and enacted in Oregon.

Legislation was introduced in Georgia, Hawaii, New Jersey, and Minnesota and enacted in Florida, Mississippi, North Dakota, Tennessee, Texas, and Wisconsin that would require the collection of nursing supply-and-demand data by an entity to be identified by the state.

Bills were introduced in Connecticut, Maine, Minnesota, New Jersey, New Mexico, New York, and Pennsylvania to increase the number of students who graduate from nursing programs by offering student loan forgiveness options, grants and scholarships, and funding to schools of nursing to expand nursing programs, staff, and faculty. Legislation was signed into law in California, Florida, Illinois, Nebraska, Nevada, Rhode Island, Texas, and Virginia.

Building upon the 2001 Nationwide State Legislative Agenda on Staffing, CMA
lobbyists and ANA staff have developed a 2002 nationwide legislative strategy with the following priorities:

• Secure passage of legislation that incorporates valid, safe, and appropriate staffing levels nationally. This includes legislative initiatives introduced in 2001, such as bills on mandatory overtime and whistleblower protections.

• Obtain increased funding for nursing education.

• Explore legislative approaches that provide incentives to facilities that achieve Magnet status, as awarded by the American Nurses Credentialing Center.

• Advocate the provision of resources to increase the capacity of nursing to respond to national disasters, including biological, chemical, and nuclear attacks.

Susan Whittaker is an associate director in the ANA's Department of Government Affairs. .

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