A Life Changing Event Leads to Nurse Advocacy



I am very excited to announce that I recently joined the Policy and Government Affairs team at the American Nurses Association. By way of getting to know me and my background, my career started on Capitol Hill where I worked in the House of Representatives for several years, and most recently, I had the privilege of working at the American Physical Therapy Association.

I do not think landing at ANA is purely coincidental. Just a couple of years ago my family went through a deeply terrifying time. One day my mother was healthy and happy and overnight everything changed. She developed hematomas on her brain and wound up in a weeks-long coma. As readers of this blog uniquely know, my family was terrified. We were in ICU for a very long time and developed relationships with many hospital workers.

We would not have made it through each day without the nurses we met. When we didn’t understand something (which happened frequently!), the nurses would break it down and explain what it meant. When we needed something for my mother, they would get it as soon as they could. Of course, there were also the moments where we didn’t see hope, and as busy as ICU nurses are, they would take a moment and were there for us.

This fall my family celebrates three years since that time. I couldn’t be happier to share that my mother is awake, at home, and she recently went to Orlando with her children and grandkids and had the vacation of a lifetime.

While we are so grateful to be past that stage, we are forever thankful to those nurses who not only helped my mom but helped our entire family. We have even gone back to the hospital to see the team and show off how well their former patient is doing!

Working in this role is what I can do to try and repay all of the nurses around the country that have done so much.

Here at ANA I am leading our legislative efforts on issues that include: Title VIII funding; safe staffing; workplace violence; health care transformation; and U.S. Nurse Cadet Corp. legislation. I encourage you to get in touch with your Members of Congress and tell them your stories about why it is so important they support these issues.

I look forward to working together to move forward sound policy that helps advance the nursing profession across the country.

Ending HIV/AIDS – Nurses on the Frontline as Administration Ramps Up New Initiative


Nurses are indispensable to ending HIV/AIDS in the U.S., the ANA reminded a federal stakeholder group advising the Department of Health and Human Services (HHS). The Administration has ramped up HIV prevention efforts, announcing plans to reduce the number of new HIV infections by 90 percent in the next decade. HHS will need nurses, including APRNs, to reach that target and improve the lives of people who are now living with HIV/AIDS (PLWHA).

In a letter to the CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment, ANA made the case to ensure nurses’ participation in new HIV initiatives. Lead agencies include the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) within HHS. HHS is seeking an HIV budget increase of $291 million, for CDC and HRSA to invest in local HealthForces that will target communities where HIV cases are the fastest growing.

Since the early 1980s when the U.S. health care system began to confront HIV and its enormous impact, nurses have been on the frontlines on many levels – creating new patient care models, conducting research, educating the community, and addressing workplace safety. Now, and over the decades since life-saving anti-retroviral therapies (ART) have been available, nurses are central to the care coordination that supports many PLWHA in life-saving treatment to stay virally suppressed.

Viral suppression, when viral load is no longer detectable, also significantly reduces risks of HIV transmission, so much so that advocates have coined the phrase “U=U”: Undetectable means untransmittable. Effective HIV treatment, then, is also critical to HIV prevention.

In the President’s 2019 State of the Union address and following months, the Administration has made bold commitments to dramatically reduce new HIV infections. According to the Kaiser Family Foundation, the U.S. lags other comparable countries in HIV suppression rates, at 54 percent compared to 84 percent in the United Kingdom, for example. And while HIV incidence had been falling in the United States in the early part of this decade, that progress has slowed in recent years.

Research and epidemiology clearly show that HIV incidence in the U.S. is now highly concentrated in a relatively small number of geographic areas. HIV in those areas is especially prevalent in Black/African-American communities, which have historically confronted negative social determinants of health and inequitable barriers to health care. Of all PLWHA in the U.S., 50 percent live in five states, primarily southern states.

The Administration has proposed a response that would invest in new HIV prevention in the geographic areas where infection rates continue to be among the highest. At the local level, health departments and other stakeholders would be given more resources to identify new HIV cases. Community health centers would play a lead role in delivering appropriate care so that PLWHA achieve viral suppression. There would also be an emphasis on reaching people who are at high risk of becoming HIV positive, and encouraging use of ART prophylactically for prevention.

ANA will continue advocating for nurses as the Administration pursues its agenda to prevent HIV. For more information about this effort, visit the CDC’s resources for providers in the Act Against AIDS campaign. To learn more about ANA’s advocacy, read our comments on updates to the National HIV/AIDS Strategy, and our letter to the CDC/HRSA Advisory Committee.

ANA works to ensure nurses are equipped to treat their patients’ pain effectively


As the largest healthcare provider group in the country, nurses are no strangers to treating pain, including chronic, acute, and emotional pain. Nurses are also subject to their own personal pain, and they are not alone. Today, there are approximately 50 million adults in the US living with chronic pain and over a third of those adults’ pain interferes with their daily activities. ANA is monitoring and advocating along with our nursing partners, around the Department of Health and Human Services Pain Management report due to be finalized later this year, that promises to help providers use evidence based treatments to manage their patients’ pain while considering the nationwide opioid epidemic.

In 2011, the Institute of Medicine recommended that pain and relieving pain should be a national priority. The report goes on to say that pain is a chief driver for visits to physicians and other healthcare providers, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. We have all experienced pain and for many, if not all nurses, we have had to decide how and to what degree to treat that pain.

The Code of Ethics for Nurses with Interpretative Statements (the Code) mandates that nurses have an ethical obligation to treat their patients’ pain without bias. To minimize biases, the nurse must identify the influences and intentionally set them aside. However, the Code does not say how they must treat pain. For many what first comes to mind is treatment that involves opioids. For some diagnoses, opioids are part of the best clinical practices for treatment; for others, it may be a combination of pharmacological, restorative, and alternative therapies. Patient adherence, access, coverage, and social determinants may all affect the best option for the individual.

More recently, there has been a renewed interest in the role of pain with regards to the opioid epidemic. Pain is a separate disease from the addiction and dependence that can come from opioid use, a fact which has been recognized by the Department of Health and Human Services Pain Management Best Practices Inter-Agency task force. Encouraging to nurses, the task force recommends an individualized and multidisciplinary approach to chronic pain that also includes increased insurance coverage for Complex Management Situations. It also calls for safer opioid stewardship through a risk assessment based on the patients’ medical, social, and family history.

Nurses are also positioned to provide care coordination activities for improved patient outcomes to patients and their families suffering from chronic pain conditions and associated co-morbidities. ANA commented on the draft pain management report and will continue to advocate the role of nursing in treating chronic pain to the task force and agency. The task force will meet on May 9th and 10th to vote on final recommendations.

Recognizing pain as not just a symptom, but rather a disease for some patients, may help shape the patient-provider relationship and higher quality outcomes of care. Pain can have devastating personal, financial and social consequences. Reshaping how nurses talk about pain with their patients and taking the time to learn about and advocate for alternative therapies available in the community, can help in the immediate care of a patient and the long-term ability to complete activities of daily living.