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ANA AFFIRMS COMMITMENT TO SAFE, HIGH QUALITY, COMPETENT NURSING CARE AS PEW COMMISSION RELEASES SWEEPING RECOMMENDATIONS ON HEALTH CARE PROVIDERSWashington, DC -- The American Nurses Association (ANA) today affirmed its historic commitment to the delivery of safe, high quality, competent nursing care, as the Pew Health Professions Commission released sweeping recommendations on changing the provision of health care and oversight of the health care professions. "We applaud many of the report’s emphases," said Argene Carswell, JD, RN, Executive Director (Interim) of the ANA. "ANA has always believed that registered nurses should be permitted to provide care up to the full scope of their practice. We agree that ‘turf wars’ should not interfere with health professionals’ ability to provide the highest quality of care. Specific recommendations of the Pew report, released today, will require further analysis." ANA is concerned that sweeping documents such as the just-released Pew report fail to take fully into account the current health care environment and the very real constraints on provision of the highest quality, safest care facing providers, including RNs. "The environment is key," said Carswell. Pew Health Professions Commission Executive Director Edward H. O’Neil, PhD, questioned by a nurse on this issue at today’s media briefing, responded that investigators were not asked to look at health systems in this report. Carswell notes that gross understaffing of RNs and health care organizations’ delegation of professional nursing responsibilities to unlicensed staff are examples of core factors that inevitably impact on the safety and quality of care, and on patient outcomes. This has been demonstrated by research showing that when more RNs are at the bedside, patients contract fewer infections, have fewer bedsores, and leave the hospital sooner. "Therefore," she states, "Continued competency must not be judged on nurses’ ability to do the impossible -- we are already at that limit, as concerned hospital RNs across the country attested to in a recent barrage of letters to Ann Landers -- but on nurses’ ability to do the possible. Competency can be expressed fully only in the environment of the possible. ANA’s focus is on making it possible for RNs to do their jobs so patients can get the safest, highest quality care." Carswell notes that any report that fails to take into account the environment in which health care is delivered risks delivering reductionist conclusions and recommendations. "We are in an environment where the quality of care is clearly determined by a multitude of factors, one of which, of course, is continued competency. In that regard, ANA is in full agreement that health professionals should be required to demonstrate their continued competence beyond meeting professional licensure requirements." ANA, the only full-service national professional nursing organization representing RNs, the nation’s largest health care profession, was not asked by Pew investigators to engage in an ongoing substantive information liaison as the Pew report and recommendations were being developed. Carswell says, "A substantive engagement with the information and perspectives of the ANA would have helped avoid such pitfalls as inadequate attention to the environment in which nursing care is delivered." While ANA agrees with the commission’s stated concern that professional licensure boards must be open and responsible to the public, we believe that the nature of the composition of those boards is critically important. While non-RNs certainly can participate in the oversight of nursing care, just as non-physicians can participate in the oversight of physicians’ care, we believe that a professional understanding of the nature of nursing practice is required before a fair judgment can be rendered and fair -- or productive -- discipline can be imposed. The Pew Commission report outlines many more specifics, including the establishment of statewide oversight boards to address scope of practice disputes and the creation of a national board to set national scope of practice standards. ANA will review these proposals with our mission clearly in mind: to improve the quality of health care and ensure access to health care for all Americans, and to support professional nurses in their important work of caring for the sick, the injured, and the dying. The American Nurses Association is the only full-service
professional organization representing the nation's 2.6 million Registered
Nurses through its 53 constituent associations. ANA advances the nursing
profession by fostering high standards of nursing practice, promoting the
economic and general welfare of nurses in the workplace, projecting a positive
and realistic view of nursing, and lobbying the Congress and regulatory
agencies on health care issues affecting nurses and the public.
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