Vital Signs

Saying Good-bye

I know I leave the ANA in good hands.

by Geri Marullo, MSN, RN

On a cold and dreary evening three years ago this month, I arrived in Washington, DC, with my family from Honolulu to become the executive director of the American Nurses Association. Since that time, the ANA, like the nursing profession it serves, has sustained its share of ups and downs. But also like the profession, it has persevered and become a force to be reckoned with in the health care industry and on Capitol Hill, a force that has done much to ensure the safety and quality of patient care in this country.

And so it's with a heavy heart that I've made the decision to leave my position at the ANA and journey back to Hawaii. While I am excited at the wonderful opportunities ahead for me--watching my four-year-old daughter, Maya, conquer her own worlds, and finishing my doctorate--I am saddened to relinquish the opportunity to lead the ANA to even more triumphs.

In these three years, the ANA has led our profession through disappointing defeats to unparalleled achievements. Reflecting the core spirit of nursing, the ANA turned the demise of health care reform into a spark for change through legislation, publicity and public education campaigns, and groundbreaking research studies. I am most proud of the dedicated staff and state nurses association members with whom we've achieved so much. Their consistent dedication enables the association to protect individual nurses and to ensure patient safety.

The ANA and SNAs have gone far in protecting individual nurses by getting more dedicated professional nurses involved in collective bargaining, negotiating better contracts, and advocating better measures to protect nurses' health and safety. We have sparked sweeping reform in Medicare reimbursement for advanced practice registered nurses and are working toward similar goals with Medicaid , thus changing the care available to the country's elderly and indigent. Through precedent-setting research, the ANA has proved that a higher nursing skill mix prevents hospital-acquired infections and leads to better patient outcomes.

Much of what the ANA has achieved in the past three years has resulted from its growing partnership with consumers. When the ANA launched its "Every Patient Deserves a Nurse" campaign in 1994, many patients were unaware of the cutbacks in nurse staffing and the growing use of unlicensed assistive personnel. More important, they were unaware of the danger these measures posed to their care. Since then, the ANA has educated the media, legislators, and consumers on the crucial role RNs play in health care delivery. The introduction and growing support -- 40 cosponsors -- of the ANA's Patient Safety Act shows that our message is being heard.

These are the big accomplishments that I look back on with pride. But much of what is significant lies in the day-to-day work of the association and its SNAs. The many elected ANA leaders, along with nurses, other nursing organizations, and the 210 dedicated employees of the ANA, advance the nursing profession day by day, step by step. The ANA staff, in particular, has served as the backbone of the association's many achievements. As a result of their hard work, for example, we have won national awards for our Nursing World Web site, our Customer Care Center, and our official newspaper, The American Nurse. In 1995, the ANA was recognized as the second most successful association in the Washington, DC, area.

Because of the ANA and SNA elected leaders, the SNA and ANA staffs, and the countless others dedicated to our mission, I know I leave the association in good hands. During the past three years, we have, through strategic, business, and operational planning, created the resources for the ANA Board of Directors to set a bold course into the next millennium. Already the board is investing in an aggressive labor and workplace advocacy program, fast-tracking the quality indicator work that measures nursing outcomes into the service setting of the community, and articulating the ANA's policy and political expertise through its revolutionary Blueprint for Health Care Change.

As I leave, there are lessons I take with me. I have learned that even the most powerful groups are fragile in the challenging environment of membership model organizations, unpredictable business and economic climates, and brutal competition. I have seen how critical the checks and balances of representation, resources, and power in any organization are to thoughtful policy and ongoing stability. Thus, serving the ANA has been an honor with deep responsibilities and long-term significance for me.

What I have learned the most, though, is how much my love for the nursing profession continues to grow as time goes on. The best part about working as executive director of the American Nurses Association was spending these last three years with those who feel the same.

Geri Marullo was the executive director of the American Nurses Association from January 1995 to December 1997.