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FOR IMMEDIATE RELEASE July 8, 2003 CONTACT:
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Nurse Leaders Take Action On Range Of Workplace And Patient Care Issues At ANA's House Of Delegates
Washington, DC --Nurse leaders representing the American Nurses Association's (ANA) 54 constituent member associations (CMAs) set policy on a range of issues important to the profession, including protecting the rights of nurses, supporting the critical role of public health nurses and the public health system and promoting ANA's role in shaping the current debate on health care system reform to ensure access to care for all.
Nearly 600 delegates passed several key resolutions at ANA's House of Delegates (HOD) held in Washington, DC, June 25 to 27. Nurse delegates also approved bylaws amendments that significantly change the structure of the association, creating several new membership options for individuals and organizations.
Between annual meeting sessions, delegates also had the opportunity to participate in several events, from a nursing shortage forum to ANA-PAC and American Nurses Foundation (ANF) fund-raising events. The fund-raising events netted ANA-PAC more than $73,000 and ANF more than $7,600.
Protecting the workforce
The number of nurses with HIV in the United States or globally is not known. Further, there is little scientific evidence regarding health care workers transmitting HIV to their patients during care.
What is known, however, is that the use of highly active, antiretroviral therapy has dramatically improved the health of HIV-positive persons, which has led to HIV being viewed as a chronic condition and not a terminal disease. Although this shift in prognosis is good news, it has created new workplace concerns, including HIV-positive nurses fearing the loss of their jobs due to employer discrimination and/or patient concerns.
To address these workplace concerns, delegates approved a resolution requiring ANA to work with other nursing organizations to develop policies that will ensure equitable practice guidelines for HIV-positive nurses, without undue limitations on their practice. ANA also will collaborate with specialty organizations to educate patients and the public about the safety of HIV-infected nurses in the health care workplace. Further, ANA will collaborate with the International Council of Nurses to create consistent policies regarding workplace rights of HIV-positive nurses in all global settings, with a particular focus on the negative impact of compulsory HIV testing as a pre-employment requirement.
In a separate action, nurse leaders supported a corollary measure for ANA to work in concert with other organizations to develop policies on the workplace rights of nurses infected with other bloodborne diseases, such as hepatitis.
Despite scientific advances, new infections continue to emerge. In addition, existing infectious diseases that were thought to be under control are reemerging, and common bacteria are rapidly developing resistance to antibiotics.
To address these issues, nurse leaders passed a resolution for ANA to support the dissemination of the Centers for Disease Control and Prevention's Plan to Prevent Emerging Infectious Diseases. Further, ANA will advocate for timely, ongoing education of RNs regarding appropriate mechanisms to protect themselves and their patients from infectious diseases.
In another measure, delegates looked toward protecting the public health nurse role and the system's infrastructure. The number of RNs identified as "public health nurse" in the National Sample Survey of Registered Nurses has decreased from 39 percent in 1980 to just 17.6 percent in 2000. Meanwhile, demands on these nurses and the entire public health structure have continued to increase, particularly in relation to preparedness requirements for anthrax, smallpox and other biological threats.
Therefore, delegates want ANA, in part, to advocate for the acknowledgement of the critical nature of the public health nurse's role in promoting and protecting the health of individuals, families and communities. Further, ANA should advocate for information systems technology and training to strengthen the public health infrastructure, as well as federal funding to health departments to attract, retain and enhance the role and compensation of public health nurses. Also, ANA will work to further develop and implement quality indicators that capture public health nursing functions.
In another workplace rights issue, delegates passed a resolution seeking the protection of nurses who become ill or injured as the result of terrorist attacks.
Since the events of Sept. 11, 2001, many insurance carriers publicly stated they would not deny claims arising from such attacks under the "war risks" exclusions. Recently, however, there have been media and industry reports about insurance carriers adding specific terrorism and bioterrorism exclusions to a variety of insurance policies.
Because RNs and other health care workers can potentially be the targets of terrorism or harmed while they provide services following attacks, delegates passed a resolution calling for ANA to advocate that carriers of all types of insurance offer specific policy coverage protecting nurses harmed by acts of terrorism and bioterrorism. Further, ANA will collaborate with CMAs to ensure that workers' compensation covers injured employees who are exposed to harm while traveling and assisting in employment-related duties. ANA also will urge the insurance industry to detail specific coverage for biological contamination caused by terrorist acts.
Protecting patients
Cannabis was widely prescribed in the United States until 1937 when federal legislation was passed prohibiting its use. A 1970 measure completely banned all therapeutic, medicinal use of marijuana by making it a Schedule I drug. And in 1992, the U.S. Department of Health and Human Services secretary terminated access to legal marijuana through a federal Investigational New Drug Program.
However, a 1999 Institute of Medicine report and other research suggest that marijuana has a significant margin of safety when used under a practitioner's supervision and when all of the patient's medications are considered in the therapeutic regimen. So far, nine states and the District of Columbia have passed medical marijuana laws.
While controversy and conflicting opinions on the safety and efficacy of marijuana for medical purposes continue, including at the HOD, delegates agreed to pass a resolution that addresses this patient-care issue.
In part, they want ANA to support the education of RNs regarding current, evidence-based therapeutic uses of marijuana, as well as back controlled investigational trials of the therapeutic efficacy of marijuana, including alternative methods of administration. ANA also was asked to support the right of patients to have safe access to therapeutic marijuana under appropriate prescriber supervision.
Delegates also passed a resolution that addresses nursing issues related to therapeutic and reproductive applications in genetics science.
The emerging science of theoretical and applied genetics has the potential to impact the care of clients and the profession of nursing, particularly in the areas of gene therapy, stem-cell research, human cloning and genetic counseling. Therefore, the HOD resolution specifically calls for ANA, in part, to commit to expanding the study of the ethical, moral, clinical, psychosocial, cultural and spiritual implications involved in the care of patients receiving services. Delegates also want ANA to promote nursing's voice in the international and national debate on these issues. And, they want to ensure that nurses are knowledgeable on genetics science, so RNs can properly educate, counsel and support patients and their significant others.
Other actions
Concerned with even greater gaps in the health care system, delegates passed a motion calling for ANA, in part, to commit itself to be an active force in shaping current debate on health care system reform to ensure access to care for all. Delegates also requested that ANA investigate and evaluate current proposals for universal health care and the validity of claims regarding cost containment and the effect on nursing practice and its workforce.
After lengthy discussion, delegates passed a resolution that broadens existing ANA policy requiring the association to post an anti-discriminatory notice when accepting advertising or exhibits from any organization or employer with policies that conflict with ANA's policy opposing discrimination.
The HOD asked ANA to send letters each session to all members of Congress, the President and Joint Chiefs of Staff urging the military to abandon discrimination against lesbians and gays. The resolution also puts ANA on record of being proud of all men and women risking their lives to serve in the military.
This compromise resolution continues ANA's opposition to the military's discriminatory "don't ask, don't tell" policy, while maintaining its support for nurses in the military.
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ANA is the only full-service professional organization representing the nation's 2.7 million Registered Nurses through its 54 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 by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.
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