Representing and working for the members - Health Policy Issues

Frederick P. Franko

Each month, a staff member from AORN's Government Affairs Department writes this AORN Journal column about issues of importance to AORN members. This month's article highlights more activities that the Government Affairs Department and the Center for Nursing Practice undertake on members' behalf.

NATIONAL REPRESENTATION

AORN Congress. AORN members who have never attended the annual AORN Congress are missing a special event. Last year, more than 6,000 members gathered in Chicago to learn, teach, and discuss topics of concern and interest to perioperative nurses. For several years, the booths for AORN's staff departments were located in different spots inside and outside the exhibitor's hall, so conference attendees sometimes had to walk some distance to Fred the staff members for whom they were looking. Last year, for the first time, the Association brought together its various departments into a convenient centralized location--the AORN Resource Center. Attendees again will have the opportunity to visit the Government Affairs Department booth in the resource center at the 2004 AORN Congress in San Diego.

Congress provides the best opportunity for Government Affairs Department personnel to learn the problems that members are confronting on the front lines and determine whether these problems are public policy issues that require the attention of the department. Attending AORN's Congress is a good way for members to share their experiences first hand and to find out in more detail the issues AORN is tracking and promoting. Members are encouraged to visit the AORN Resource Center in San Diego and stop by the Government Affairs Department desk.

This year, as in previous years, Government Affairs staff members will present an education session at Congress: "Advocacy at AORN--Review and Preview." The objective of this session is to update members on current state and federal legislation and regulations that relate to AORN's legislative priorities. During part of the session, presenters will discuss opportunities for perioperative nurses to become involved in legislative activities and public policy.

National Conference of State Legislatures. Every year, Government Affairs Department staff members attend the National Conference of State Legislatures annual meeting and exhibition as exhibitors. Attending this annual meeting affords AORN staff members the opportunity to interact with thousands of state legislators, as well as legislative and administrative staff members, at the largest meeting of its kind in the nation. At the exhibitor's booth, Government Affairs staff members share with legislators and their aides important background information about AORN as a professional membership Association for perioperative RNs (Figure 1). Typically, when Government Affairs Department representatives strike up a conversation with legislators or their aides, they have to define the name AORN by explaining what a perioperative nurse is. The brochures and displays at the booth are designed to describe, in layman's terms, perioperative nurses' professional preparation, the professional association that supports them, their various roles and responsibilities, and the public policy issues that face the profession.

[FIGURE 1 OMITTED]

Work with other organizations. AORN staff members and volunteers represent AORN outside the Association in many other ways. Although these activities are not functions of the Government Affairs Department exclusively, they represent AORN's positions on improving patient safety, positive patient outcomes, and file perioperative nursing profession. AOICN's Center for Nursing Practice specialists, for example, are involved intimately in supporting perioperative nursing through their interaction with other associations and organizations. The Center for Nursing Practice works closely with the Government Affairs Department to address member questions, examine legislation or regulations, and review content in government affairs publications.

Some of the organizations that the Center for Nursing Practice experts work with include file

* Joint Commission on Accreditation of Healthcare Organizations' Hospital Professional and Technical Advisory Committee (JCAHO's Hospital PTAC),

* JCAHO's Ambulatory PTAC,

* Association for the Advancement of Medical Instrumentation,

* American Institute of Architects, Health Guidelines Committee

* American Association for Accreditation of Ambulatory Surgery Facilities, and

* Centers for Disease Control and Prevention Healthcare Infection Control Practices Advisory Committee.

Although much of the work that the Center for Nursing Practice staff members perform does not fit neatly under the umbrella of government affairs, some of their work influences or intersects with public policy. For example, state boards of nursing and state boards of medicine are interested in JCAHO standards because the federal government holds the power to accredit health care organizations for participation in its Medicare programs. Through their work in the PTACs, AORN's nursing specialists advise the Joint Commission on standards development and survey procedure changes.

National Council of State Boards of Nursing. Providing input to the National Council of State Boards of Nursing, Inc (NCSBN) is one example of a collaborative effort between AORN's Government Affairs Department and the Center for Nursing Practice on an issue that involved both nursing practice and public policy concerns. In July of 2003, NCSBN asked AORN to submit comments on the Draft Model Nursing Practice Act and Administrative Rules. The two departments worked closely in reviewing proposed revisions to the Draft Model Nursing Practice Act and Administrative Rules models. AORN provided input on further differentiating between RNs and licensed practical nurses, providing increased exposure to specialty areas of nursing, emphasizing that nursing care be directed by an RN, modifying faculty members' qualifications, and expanding the definitions section.

Lobby Day. For several years, AORN has held a federal lobby day in Washington, DC, to advocate on behalf of national issues important to perioperative nursing. Members enthusiastically have responded to this call to visit with their representatives in Congress. More than 100 participants converged on Capitol Hill to lobby for AORN's legislative priorities, particularly the Nurse Reinvestment Act and the Medicare Certified Registered Nurse First Assistant Direct Reimbursement Act of 2003 (HR 1388).

WORKING AT THE STATE LEVEL

Chapter visits. Periodically, local AORN chapters ask Government Affairs Department staff members to update their members on current legislation and regulations relating to AORN's legislative priorities. Other topics that have been covered in these presentations include occupational and professional regulations and the issues surrounding credentialing, political advocacy on behalf of perioperative nursing, and staying connected and informed. These chapter visits are another way for Government Affairs Department employees to stay in touch with members and to hear and understand the critical issues that members face every day.

State visits. AORN is fortunate to have dedicated volunteers in all 50 states willing to work on AORN's behalf on important legislative and regulatory issues. In each state, the AORN President or President-elect selects an AORN member to serve as state legislative coordinator. AORN Government Affairs Department personnel work closely with the volunteer state coordinators to shape the future of perioperative nursing through legislative and regulatory efforts. Advancements in technology during the past 10 years have provided Headquarters personnel with the means of gathering information and communicating with members to a degree and at a pace that typically does not require personal visits to a particular state.

There are instances, however, when face-to-face meetings are necessary for discussing issues and developing strategies that do not lend themselves to fax, telephone, or e-mail communication. Every year, Government Affairs Department staff members visit several states to discuss and carefully plan AORN's strategies for dealing with current or pending legislation or proposed regulations. Their visits sometimes include meetings with AORN members, legislative staff members, state administrators, representatives of other associations, and lobbyists hired to represent AORN's interests.

IN THE SERVICE OF AORN MEMBERS

Part of the Government Affairs Department's work involves maintaining a level of visibility ha the perioperative community and the public affairs arena. They continue to seek venues to inform public policy makers and devise other means of working with organizations ha support of perioperative nursing and safe patient care.

FREDERICK P. FRANKO DIRECTOR OF STATE PUBLIC AFFAIRS GOVERNMENT AFFAIRS DEPARTMENT

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