Action taken on range of workplace and patient care issues at ANA's House of Delegates

Connecticut Nursing News, Sep-Nov 2003

CNA delegates joined nurse leaders representing the American Nurses Association's (ANA) 54 constituent member associations (CMAs) to 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 on 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. (see story pages 1, 4)

PROTECTING THE WORKFORCE

Workplace issues of HIV-Positive Nurses

The number of nurses with HIV in the United States or globally is not known. There is also 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.

CDC Control and Prevention's Plan to Prevent Emerging Infectious Diseases.

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, delegates passed a resolution for ANA to support the dissemination of the Centers for Disease Control and Prevention's Plan to Prevent Emerging Infectious Diseases. The ANA will also advocate for timely, ongoing education for RNs regarding appropriate mechanisms to protect themselves and their patients from infectious diseases.

Supporting public health nurses and their role in strengthening the public health infrastructure

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.

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. ANA should also 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. Delegates also called on ANA to work to further develop and implement quality indicators that capture public health nursing functions.

Insurance coverage for injuries or illnesses from acts of terrorism

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. ANA will also collaborate with CMAs to ensure that workers' compensation covers injured employees who are exposed to harm while traveling and assisting in employment-related duties and will urge the insurance industry to detail specific coverage for biological contamination caused by terrorist acts.