MAKING ADVOCACY
HAPPEN The Role of the Association in Representing Nurses in Statewide Collaborations By Cindy Zolnierek, PhD, RN, CAE Chief Executive Officer of TNA
ADVOCACY RESONATES with nurses as a duty owed to their patients—to ensure they represent their patients’ wishes, speak out for their patients’ needs, and are responsive to changes in clinical status as required by our Code of Ethics. Some nurses also engage in individual advocacy efforts in the policy realm— voting in elections, developing relationships with policy makers, participating in nursing associations, and responding to prompts to engage legislators on immediate issues. The importance of the individual voice of a citizen, a voter, a nurse cannot be underestimated. However, it is very difficult to launch policy initiatives or policy change as one person. The most effective equation for policy influence involves uniting individual voices with an organized message, such as through a professional association. Texas Nurses Association (TNA) has positioned itself as the voice of Texas Nurses in the policy arena with a mission of empowering nurses to advance the profession. During the current COVID-19 pandemic, nurses have faced unprecedented challenges, and TNA has stepped in to make sure their concerns are heard statewide, particularly by collaborating with other organizations in Texas. From TNA’s longstanding engagement in policy—through representation on many governmental advisory groups as well as engagement with other stakeholder associations during legislative sessions—
TNA is recognized as the predominant representative for nurses in the state. Having this groundwork already established helped TNA pull together quickly with other Texas organizations.
The most effective equation for policy influence involves uniting individual voices with an organized message, such as through a professional association. TNA was one of 14 organizations invited to participate in the Texas Health Care Industry Strike Force on COVID-19; the only nursing organization invited to the table. In addition to health care associations, university systems, the Department of State Health Services, and representatives from the Governor’s office participate in meetings. This Strike Force has convened every Saturday morning since March 21 to address three goals: 1.
Enhance statewide cross-sectorial COVID-19 health care response collaboration
2.
Identify critical vulnerabilities that need to be urgently addressed
3.
Identify state regulations that need to be modified
Discussion topics related to these goals
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have included testing, supplies (personal protective equipment [PPE], ventilators, medications), supply acquisition and distribution processes, capacity issues (acute, critical, and long-term care), workforce and shortages, vulnerable populations (residential facilities and prisons), mass critical care guidelines, economic viability issues, and recovery phase considerations. The Strike Force has made two requests of the Governor: 1.
March 29: Request to adopt mass critical care guidelines based on standards and suspend penalties for following guidelines and permitting APRNs to prescribe CSIIs and sign DNAR orders (still pending action by Governor)
2.
April 4: Request to waive enforcement of some HIPAA provisions related to telehealth
Provider groups, including TNA, have been staunch advocates of the need for PPE at every meeting. In addition, TNA and Texas Hospital Association have collaborated on efforts to ensure the focus on bed capacity includes a corresponding focus on staff capacity to ensure patients occupying available beds have necessary human resources to provide care. TNA’s purpose has always been to listen to and respond to the needs of nurses. During this crisis, as providers are asked to work with limited PPE or even reuse
