Safe and Sound Week – August 10-16

  

What makes a nurse safe at work? The American Nurses Association (ANA) supports and promotes nurse safety in its many aspects, which include use of personal protective equipment (PPE), preventing workplace violence, avoiding injury in handling patients, and having staff capacity that is appropriate for quality outcomes and nurse safety.

To draw attention to safety in healthcare settings, ANA partners every August with the Occupational Safety and Health Administration (OSHA) during Safe and Sound Week, which is now under way (August 10-16). The national week of activity is meant to recognize the successes of workplace health and safety programs, and share ideas on how to keep America’s workers safe.

This year, the COVID-19 pandemic has shown dramatically that nurse safety needs to be a priority 24/7, 52 weeks a year. The pandemic has tragically taken lives, including nurses’ lives, and challenged all corners of the healthcare system. ANA has been active in public and behind the scenes to advocate for all possible steps to ensure nurses are Safe and Sound at work, so they can continue to care for patients and educate the public about the pandemic. We must safeguard nurses’ and other frontline providers’ well-being and heed their invaluable insights so that the nation can recover faster and stronger.

As ANA President Ernest Grant said recently in impassioned testimony before Congress, “It is both a moral and strategic imperative for our nation’s leaders to do everything possible to arm and protect nurses and other critical responders as we work to combat the pandemic and prepare for future public health crises.”

For Safe and Sound Week in the year of COVID-19, PPE and workplace violence are of special concern to ANA.

Personal Protective Equipment. Access to appropriate PPE has been one of ANA’s main legislative priorities during COVID-19. Below are some talking points we have made to legislators and thought leaders, that you can also share with your elected officials:

  • PPE shortages continue to persist throughout the healthcare system. At one point this year, three out of four nurses said they are required to reuse their N95 respirators, or are encouraged to do so.
  • Many nurses have reported they do not feel safe using PPE that has been through a decontamination process.
  • Decontaminated respirators may not fit properly or may have other deficiencies.
  • When nurses voice their concerns about unsafe PPE, they should not be subject to retaliation. At ANA’s urging OSHA encourages workers to report such incidences.
  • A solution to addressing safety issues with PPE is to return to OSHA standards and pre-COVID guidelines as soon as possible.
  • ANA also supports creation of an OSHA standard specifically addressing risks of infection disease transmission.

For more information about ANA advocacy on PPE, visit the COVID-19 resources on Nursing World and share your voice with congress to let them know that more PPE is needed immediately.

Workplace Violence. Workplace violence by patients, family members, peers, and external individuals, including intimate partners, is a serious safety issue in healthcare settings, affecting nurses and patients. Yet violence and other abuses toward nurses are not well tracked and analyzed. One reason is that many nurses do not report incidents of violence, perhaps in the belief that their experience will not be acted upon effectively. The COVID-19 emergency has revealed unique threats that could arise in future emergency or high-stress periods, posing risks to nurses and to patient care. For instance, there have been times when family frustration about patient isolation has led to threats and violence. Nurses and other healthcare workers have also felt unsafe in their own communities, because of stigma and unfounded fears about exposure to the virus from healthcare workers specifically.

ANA believes workplace violence can and must be addressed. Our #End Nurse Abuse campaign is raising awareness about risks as well as ways to prevent violence and abuse in healthcare settings. ANA supports legislative and regulatory reform, such as OSHA standards for prevention programs, and collecting national data with effective reporting systems.

Safe and Sound Week is a good reminder that nurse safety is the responsibility of policymakers, employers, the nursing profession, and nurses themselves. Here are more ANA resources that can help keep nurses safe at work:

Safe Patient Handling and Mobility. In the HealthyNurse Survey 58 percent of nurses said they have experienced musculoskeletal pain at work in the past year. This pain is typically caused by the repetitive motions of transporting, mobilizing, repositioning, or ambulating patients. Musculoskeletal pain is not new to healthcare workers, and for the past 20 years ANA has advocated for safer practices and eliminating injuries for all professionals across the care continuum. For critically ill COVID-19 patients, proning procedures have been used to reposition patients, adding patient-handling risks for nurses.

In 2013, ANA developed the Safe Patient Handling and Mobility (SPHM) Interprofessional National Standards to assist organizations in creating SPHM policies and implementing and sustaining SPHM programs. Creating a culture of safety is the foundation for the standards. Without a commitment from staff and leadership, as well as the necessary financial resources, a successful SPHM policy cannot happen, and an SPHM program cannot be maintained. Other aspects of patient care are also addressed by safely handling patients including falls, pressure ulcers, skin injuries, and aggression among patients.

Mental Health.  Some nurses have become sick with COVID-19, but many others will suffer from anxiety, fear, anger, loss, isolation, loneliness, depression, stress, grief, or bereavement because of the pandemic. This is especially true for those who had pre-existing mental health conditions, or those serving on the front line. For all of us, mental health screenings, learning to build resilience, and getting the mental help needed immediately are key. Please see this blog and these webpages on nurse mental health and combating stress for further resources.

Self-Care. An empty plate has nothing to offer. If nurses are not rested, safe, well-nourished, fit, and satisfied with their work-life balance, then they may suffer personally and not be able to give the best care to their patients and families. That’s why self-care is so important. As difficult as this might be in the era of COVID-19 work and meal breaks, at least 7 hours of sleep daily, physical exercise, healthy food, and restorative “down time” need to be non-negotiable items in nurses’ routines. Healthy Nurses Healthy Nation has a plethora of blogs on self-care and stories of inspirational nurses.

Now more than ever, nurses, alongside other health professionals and their employers, need to focus on wellness and occupational health and safety. Nurses cannot do it alone; safe, respectful, and just workplace cultures are everyone’s responsibility. To learn more about occupational health and safety for nurses and health professionals, including immunizations, COVID-19, (see also CDC COVID-19 HCP guidance) staffing and more, visit www.nursingworld.org. For additional resources on self-care and nurse wellness, visit www.hnhn.org.

ANA Advocacy – Transforming Nursing’s Voice on the National Stage

  

Last week, I represented the American Nurses Association (ANA) before the United States Senate Finance Committee to reiterate the urgent need to provide nurses a sufficient supply of personal protective equipment (PPE), safeguard the mental health and well-being of nurses, and address the racial health disparities exacerbated by COVID-19. Participating in a Senate hearing for the first time was an eye-opening experience. It was evident that senators unanimously respect and appreciate the significant sacrifices being made by nurses in response to COVID-19. What came to light during the hearing was that ANA’s bi-partisan approach to advocacy is working –as both sides of the aisle were interested in hearing our message and ensuring that the nation’s 4 million registered nurses are at the witness table as Congressional debate continues over access to PPE. More needs to be done to ensure nurses have access to PPE – therefore I urge each of you to help amplify our collective voice by taking ANA’s latest PPE survey and contacting your members of Congress today.

As ANA president, I am determined to ensure that ANA continues to be at the table to advance the voices of nurses and the patients they serve. This means the association representing the nation’s registered nurses needs to work with those who are elected regardless of political affiliation. Having good working relationships with the Administration and Congress allows for productive conversations even when we disagree. This approach has provided ANA’s leadership, including me, the opportunity to proactively discuss the threats our nurses face on the frontlines of the pandemic while voicing our opposition over the Administration’s defunding of the World Health Organization or the lack of action in authorizing the Defense Production Act. Despite these differences, ANA is recognized on Capitol Hill and within the Administration as the voice of nursing. This has allowed ANA additional opportunities to meet with influential decision makers.

In 2019, ANA’s highest governing body – its Membership Assembly – voted to move away from endorsing presidential candidates. In this presidential election cycle, ANA is focused on equipping nurses with information about the candidates to better engage in the 2020 elections. While ANA is not supporting a specific presidential candidate, I encourage every nurse and nurse advocate to actively participate in the political process, and vote on November 3. The decision not to endorse was based on recommendations of a bi-partisan task force made up of influential nursing leaders. ANA has developed NursesVote to help nurses activate, educate, support and vote for the political candidate of their choice. The ANA-PAC stands by its long history of endorsing pro-nursing Congressional candidates who typically have strong relationships with our Policy and Government Affairs staff and our Constituent/State Nurses Associations.

Since the beginning of the pandemic, ANA has met with the White House and has interacted with a number of federal agencies: the Department of Health and Human Services, the Department of Labor and the Federal Emergency Management Agency to raise concerns about a lack of PPE among other pressing issues. This is in addition to political advocacy efforts on Capitol Hill, which have already resulted in wins for nurses, outlined here in a June Capitol Beat blog. Nurses are at the table – and making a difference.

ANA’s advocacy focus is to ensure our ability to expand and promote nursing’s agenda and to fight for the profession and the patients they serve. We make our concerns known both publicly and in personal meetings with elected officials and their staff. ANA will not remain silent. We continue to lead the charge for nurses.

House LHHS-ED Appropriations Committee Recognizes Nursing Priorities in Legislation

  

Each spring starts the annual appropriations process in the U.S. House and Senate. Both the U.S. House and Senate Appropriations Committees have 12 subcommittees that are tasked with compiling legislative bills that provides funding for operations, personnel, equipment, and activities.  

ANA monitors the entire appropriations process and advocates for nursing priorities to be inserted into the Labor Health and Human Services (LHHS-ED) legislation. The LHHS-ED Subcommittee has jurisdiction under the following: the U.S. Department of Education; the U.S. Department of Health and Human Services; the U.S. Department of Labor; and many related agencies.

The House LHHS-ED released its Fiscal Year (FY) 2021 Report and the Full Committee Markup is this week. Upon reviewing the information, ANA was pleased to see several items, including:

  • $10 million increase to Title VIII Nursing Workforce Development Programs for a total of almost $270 million. 
  • $1.454 million increase to National Institute of Nursing Research for a total of $170.567 million in FY 2021.  
  • In January 2017, the Occupational Safety and Health Administration (OSHA) committed to developing and issuing a workplace violence standard, but the agency has not yet completed a required small business review, and there is no estimated date for the issuance of a proposed or final rule. The Committee believes issuing a workplace violence standard to protect workers in health care and social services should be a top priority for the Department of Labor. It has required for OSHA to report to Congress on its progress within 90 days of passage of the appropriations legislation.
  • The Committee provides $5 million to make grants to establish or expand optional community-based nurse practitioner fellowship programs that are accredited for practicing postgraduate nurse practitioner in primary care or behavioral health.  
  • The Committee included $41.7 million for the Mental and Substance Use Disorder Workforce Training Demonstration program – a $15 million increase. This program supports training for medical residents and fellows in psychiatry and addiction medicine, nurse practitioners, physician assistants, and others, to provide SUD treatment in underserved communities. It includes an additional $15,000,000 for new grants to expand the number of nurse practitioners, physician assistants, health service psychologists, and social workers trained to provide mental and substance use disorder services in underserved community-based settings 
  • The Committee asked the Substance Abuse and Mental Health Services Administration (SAMHSA), with the Department of Education, develop a standard for providing all school-based teachers and nurses with suicide prevention training to treat mental health challenges experienced by younger Americans.  
  • Provides funding to strengthen Historically Black Colleges and Universities (HBCUs). This program provides grants to specified colleges and universities making a substantial contribution to graduate education opportunities at the Master’s level in mathematics, engineering, the physical or natural sciences, computer science, information technology, nursing, allied health, or other scientific disciplines.  
  • $2 million dollar increase is included for the Minority Fellowship Program (MFP), for a total of $16.169 million in both the Center for Mental Heath Services and the Center for Substance Abuse Treatment. The MFP aims to improve behavioral health care outcomes for racial and ethnic populations by growing the number of racial and ethnic minorities in the nation’s behavioral health workforce. The program also seeks to train and better prepare behavioral health practitioners to more effectively treat and serve people of different cultural and ethnic backgrounds.

As appropriations work continues in the U.S. House and Senate this summer, ANA Government Affairs staff will continue to monitor its progress and will keep you updated.