ANNA Member Lucy Todd Reflects on 2014 Nurse In Washington Internship Program

ANNA member Lucy Todd participated in the Nurse in Washington Internship (NIWI) program in Washington, DC, March 30 through April 1, 2014. Sponsored by the Nursing Organizations Alliance, the NIWI program provides nurses the opportunity to learn how to influence health care through the legislative and regulatory processes. Participants learn from health policy experts and government officials, network with other nurses, and visit members of Congress. Read below to learn more about her NIWI experience.

PhotoI attended the NIWI program funded by ANNA as an incoming member of the Health Policy Committee. Each NIWI attendee was given four specific “asks” to address during the scheduled visits with both Congressional and Senate members and/or their staffers. Each attendee scheduled their own Congressional visit and was accompanied by other attendees residing in the same Congressional district. Senate visits were scheduled by the planning organization for all attendees from the represented state.

I first met with a staffer from Senator Kay Hagan’s (D-NC) office, who was very receptive to each of the “asks.” The entire delegation from North Carolina met with no resistance of any nature from this office. Senator Hagan is up for re-election this year and is considered vulnerable. Her office was delightful, friendly, open, and helpful. I then met with Congressman Patrick McHenry (R-NC-10). He was not open, let alone interested in any of the “asks.” When approached on the request for Title VIII money, at budget neutral levels, to impact nursing workforce development, his response was, “Let me tell you what I tell the docs. I don’t care about you. I care about access.” It is unclear how access to health care is sustained when there is no funding or attention to educating more providers.

The four “asks” are:

  • Nursing Workforce Development – to sign the Dear Colleague Letter requesting strong support for the Nursing Workforce Development Programs (Title VIII, Public Health Service Act) in FY 2015 through the Labor, Health and Human Services, and Education Appropriations bill. The Nursing Community, a coalition of 60 national nursing organizations, is requesting that these programs be funded at $251 million in Fiscal Year (FY) 2015. ANNA is a member of this community.
  • Nursing Research – to support $150 million for the National Institute of Nursing Research (NINR) in the list of FY 2015 programmatic priorities. NINR funds research that establishes the scientific basis for quality patient care. The requested increase in funding for NINR would help expand the nurse scientist community and the number of research initiatives while allowing for more complex studies focused on health promotion and disease prevention.
  • Nursing Practice – to support $20 million for Nurse-Managed Health Clinics (NMHCs) in the list of FY 2015 programmatic priorities. NMHCs provide essential services and are operated by APRNs. For many patients in medically underserved areas, NMHCs and APRNs are the area’s only primary care providers. These critical access points provide care to patients regardless of their ability to pay or insurance status and keep patients out of the emergency room, which saves the health care system millions of dollars annually.
  • Ensure Veterans Access to High Quality Care – to contact the VA to express support for the modernization of the VHA Nursing Handbook and urge the agency to finalize and implement it. Do not support efforts to oppose modernization of the VHA Nursing Handbook. The Veterans Health Administration’s modernization of its Nursing Handbook specifically recognizes APRNs (including NPs, certified nurse-midwives, CRNAs, and CNSs) as Full Practice Providers. This will further facilitate timely delivery of high-quality health care to our nation’s service men and women.

The NIWI experience was outstanding, but the question is how to use it within ANNA. Change occurs most effectively from the ground up. Senator Hagan and her office already understood the issues and the need to support requested funding. Those who do not grasp the need for requested funding will require effective education from their constituents to begin the mind-set change. How does this occur? Each chapter can identify their members of Congress opposed to funding requests, especially those specific to nephrology, and target them for letters, phone calls, Virtual Lobby Day contacts, and invitations to visit to clinics. The more specific the information that is shared with legislators illustrating how patients are suffering, quality care is declining, etc., will bolster the value of the education. No one in Congress will respond to a generic request for more funding, but rather to targeted issues with real-life examples for support. Our legislators need to understand their votes can help or harm lives. We need to ensure they “get it.”

As a member of the Health Policy Committee, I am tasked with specific chapters to mentor. I will focus my energies on those chapters to help them identify key legislators in their districts to target for change. I know the process is slow, but every step counts on the path to change.

I want to thank ANNA for funding me to NIWI. I am grateful for the opportunity and eager to move forward.

Lucy Todd, MSN, ACNP-BC, CNN
ANNA Health Policy Advisor
Blue Ridge Chapter #262