The POWER Of ONE VOICE

  1. Power of One Voice
    Newly elected ANA president shares her thoughts about nursing-and her hope
    By Kay Bensing, MA, RN
    Advance For Nurses

    When you throw your hat into the ring as a candidate for president of the American Nurses Association (ANA), it's not a decision you make on a whim. Why would you aspire to lead the profession now, as it grapples with the most critical national nursing shortage ever, when uniting 2.7 million nurses toward a common goal is no easier than it's ever been, and when the organization's membership is declining steadily? To take on these challenges, you would need a strong sense of self, proven leadership skills, years of experience and an understanding of the daily struggles of your colleagues. You would have to believe that you can rally the troops to have renewed pride in their profession, thus motivating them to get involved in issues that affect their patients, their practice and the future of nursing.

    Expert in Public Policy Barbara A. Blakeney, MS, APRN,BC, ANP, elected ANA president in June, believes she is well suited for the job. Recently, ADVANCE posed a number of questions to the leader who represents the largest group of health care professionals in the country. She spoke candidly about the membership issue and how to attract more nurses to join their professional organization.

    A practicing nurse for 32 years, Blakeney most recently served as director of health services for the homeless at the Boston Public Health Commission. Previously, she was the principal public health nurse for homeless services and addiction services at the Division of Public Health, Department of Health and Hospitals in Boston. Additionally, she was primary care nurse practitioner with Amherst (MA) Medical Associates and at Boston City Hospital. Blakeney, an expert in public health, health care policy and leadership development, has been active in ANA for years, serving on national committees and holding the offices of first and second vice president. She has received numerous awards for her leadership abilities and public health contributions from ANA, other nursing associations and community groups that she has served.

    Seeking Common Ground:

    In its annual listing of the top 100 most powerful people in health care today, Modern Healthcare recently ranked Blakeney No. 34 on the list. Then, after being on the job just a few weeks, she traveled to President Bush's recent economic summit in Waco, TX. There, she shared the spotlight with other experts in discussing implementation of the recently passed Nurse Reinvestment Act and key factors ANA believes will help to mitigate the shortage-access to academic opportunities, scholarship and loan repayment programs, plus scholarships for nurses who want to earn advanced degrees that would qualify them to teach. Asked which of her many transferable skills would be most helpful in her new position, Blakeney didn't hesitate for a moment.

    While she credits her experience in providing population-based programs for those in need to be a plus, she sees her ability to bring people together as her strongest suit. "I always look for a common ground," she said. "Too often, we look at what's different in people, instead of looking at what we have in common." She explained that looking for similarities doesn't negate the need for diversity in nursing. "There's a lot of common ground in nursing. There are many issues that all of us have tremendous stakes in and I would like to see us focus on these. The reality is we have a galvanizing issue in front of us-the crisis in nurse staffing and the nursing shortage. We need to focus a great deal of our time to find short-term and long-term solutions to these problems."

    The ANA:

    A Generational Concern Addressing the subject of ANA's declining membership, Blakeney doesn't hedge. She believes that one of the reasons for nurses not joining their professional organization is generational. "I don't know that nursing organizations or any organizations in general have begun the process of refining their message and how they do business to attract younger members of our society. This is certainly an issue with nursing. "ANA is always interested in making sure our message is current and relevant. But to be relevant, you have to demonstrate it. If no one knows what you're doing, then you're irrelevant." Blakeney believes ANA needs to strengthen its communication ability with the state affiliates, then support them to do the same with their members. "We need to give people information that they can look at in a few minutes and then give them the resources where they can explore issues more deeply," she said. "Rethinking how we get information out to nurses is critical."

    Broadest-Based Organization:

    Another issue related to ANA's declining membership, according to the president, is that when nurses in specialty practice consider how much time and resources they have to devote to nursing organizations, they choose to support their specialty. "We want to continue to encourage nurses to support their specialty organization, but we also want people to recognize that the work of the profession as opposed to practice issues gets done in organizational frameworks. ANA is the broadest-based organization in the country, representing the broadest-based thinking on issues," Blakeney said. "It's great to support your specialty, but we want you to support your profession as a whole-and that means ANA," she concluded. Is it puzzling to Blakeney that only 6 percent of practicing nurses have gotten the message that ANA is their voice, speaking on behalf of their interests? "It is surprising, but it's also a recognition that nurses are struggling every day to do practice well, and at the end of the day they know in their hearts that they haven't been able to do the right thing for their patients," she reflected.

    Short-Term Solutions:

    In a recently published study, researcher Julie Sochalski, PhD, RN, documented that new nurses are leaving the profession much faster than their predecessors and men are leaving twice as fast as women. ANA's Nursing's Agenda for the Future is a comprehensive plan to develop long-term strategies that deal with the many facets of the problem. However, as the exodus of new nurses continues, does ANA have short-term solutions? "One of the short-term solutions that we need to continue to support and push is Magnet recognition," the highest recognition for nursing excellence awarded by the American Nurses Credentialing Center (ANCC). "The number of hospitals applying for this recognition is skyrocketing these days. "We believe that hospitals that not only meet the ANCC guidelines but implement them as well are good places for nurses to work.

    These facilities empower nurses and they have a significant say in how practice occurs. We know that turnover rates are lower in Magnet hospitals, and that the environment in general is better." Better Mentoring Programs Critical to retaining new graduate nurses is how young people are mentored, according to Blakeney. "This mentoring should not only be directed to new grads but to young people who are looking for second careers. We have an opportunity to build a new cadre of nurses who come from different disciplines. They have career skills and life experiences that make them valuable to the profession. "We have a variety of folks who might value a career in nursing. There are traditional and non-traditional students, and we need to focus on both groups simultaneously," she acknowledged.

    Grading the Media:

    Grading the media on its efforts to educate the public about nursing and the shortage, Blakeney candidly noted that to some extent media coverage of the shortage has been uneven. "In some cases, the experts that the media identifies are not the real experts-nurses," she said, adding that the so-called experts sometimes featured in coverage tend to speak only on the economic issues related to the shortage. "The bottom line is that when nurses look at what they need to practice well, you will hear the vast majority of them talking about their practice environment and the difficulties in it. "Sure, they'll be talking about money, but they're going to be talking about physicians who can sometimes be outrageous; how they have to deal with violence in the workplace; the reality of mandatory overtime; and being floated to clinical areas where their expertise is not where it should be to provide safe care."

    The Invisible Nurse:

    "Money has to do with attracting and retaining competent nurses. But the bottom line is if the nurse isn't there, it's almost like Jimmy Stewart in It's a Wonderful Life. His character had the opportunity to see what his life would have been like if he hadn't been there. If a nurse isn't at the bedside, then she doesn't see the ventilator patient getting into trouble and she can't fix it before it becomes an incident. "Much of what a nurse does is invisible, in that she prevents something from happening. Because she's at the bedside, incidents don't happen. We take this for granted. Take the nurse out of the equation, and things do happen," said Blakeney, who believes nurses need to educate the media about these reality-based issues.

    The new ANA president praised the recent Johnson & Johnson marketing campaign that highlighted diversity in nursing. However, she believes that more community outreach programs that introduce junior and senior high school students to nursing and provide academic counseling are needed to fulfill this goal. High on Blakeney's wish list for ANA-sponsored programs is that district associations, within the state organizations, will take on projects that encourage young people to become nurses.

    Power of One Voice:

    "I would like to leave as my legacy what I call the power of one voice," she summarized. "This means one strong voice for nursing. It doesn't mean that we all agree and that we are all in lockstep. It means that our common ground is so powerful and so clearly recognized that we speak with one common voice. It means that we have a common frame of reference to address the problems nursing faces."........... http://www.advancefornurses.com/NWoe_1.html
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  2. 20 Comments

  3. by   Jenny P
    Thank you, -jt for posting this here. Maybe it should also be posted under the General Nursing and Off Topic forums also so everyone will read it! I think Barbara Blakeney is the voice all nurses need today.
  4. by   lee1
    "Another issue related to ANA's declining membership, according to the president, is that when nurses in specialty practice consider how much time and resources they have to devote to nursing organizations, they choose to support their specialty. "We want to continue to encourage nurses to support their specialty organization, but we also want people to recognize that the work of the profession as opposed to practice issues gets done in organizational frameworks. ANA is the broadest-based organization in the country, representing the broadest-based thinking on issues," Blakeney said. "It's great to support your specialty, but we want you to support your profession as a whole-and that means ANA," she concluded. Is it puzzling to Blakeney that only 6 percent of practicing nurses have gotten the message that ANA is their voice, speaking on behalf of their interests? "It is surprising, but it's also a recognition that nurses are struggling every day to do practice well, and at the end of the day they know in their hearts that they haven't been able to do the right thing for their patients," she reflected. "

    AND how many times have we told the ANA that their yearly dues are way too high. $275/hr is absolutely rediculous, which I just paid however!!! I pay only $78/yr to AACN which also lobbies (don't understand why though if ANA is so powerful) for me in Washington. For the average nurse who for too many years did NOT see any benefit coming their way to the down in the trenches staff RN it is not a puzzle to see why they didn't elect to belong as the leadership of nurses sat paralyzed while the staff nurses were given to the wolves-----overworked, deplorable working conditions, etc. This has been going on for more than 10 years. Why didn't the ANA stop it before it got out of hand???? They did not advocate to prevent the complications of their own !!! They were too busy creating another level of nurse instead.
  5. by   l.rae
    Lee, my sentiments exactly...and even with the nurse reinvestment act.....what has it done to keep the bedside nurse at the bedside?....l see plenty of opportunities to get away from the bedside by furthering education, teaching etc......l still maintain that there is no shortage of nurses...just nurses willing to stay at the bedside and work under deplorable conditions. When will they EVER learn?..........LR
  6. by   sjoe
    lee1--You got it right (and said it much more politely than I usually do).
  7. by   Jenny P
    "For the average nurse who for too many years did NOT see any benefit coming their way to the down in the trenches staff RN it is not a puzzle to see why they didn't elect to belong as the leadership of nurses sat paralyzed while the staff nurses were given to the wolves-----overworked, deplorable working conditions, etc. This has been going on for more than 10 years. Why didn't the ANA stop it before it got out of hand???? They did not advocate to prevent the complications of their own;...." (quoted from Lee1)

    Okay, I'm a member of both ANA and AACN, and MY dues to belong to ANA/State/ and my district Association are TWICE as much as yours, Lee.

    I personally think both memberships are bargains to me. I have to rant a bit here, because I feel like I'm beating my head against a brick wall sometimes. I AM involved in all 3 levels of the ANA and have learned so much from it.

    If the "average nurse" did not belong to ANA , why do you suppose that ANA didn't speak for them? BUT there were lots of "average nurses" in ANA; just NOT ENOUGH of them to make the difference that was needed! Sometimes I don't understand the logic involved here; ANA works as a MEMBER-DRIVEN NURSING ORGANIZATION! What they HAVE accomplished in the past 10-15 years HAS made a big difference in the nursing profession today; but the NON-MEMBERS keep saying that the ANA hasn't done enough for THEM! DUH!! Those that complain should join and get INVOLVED, okay? Even just paying membership dues and attending a few meetings per year can help educate you and change the organization.

    "They were too busy creating another level of nurse instead."(Quoted from Lee1)
    I don't understand this phrase at all. ANA has never tried to create another level of nurse; way back in the 70's and early 80'sthere was a proposal called BEL (Basic Entry Level) where ANA was saying that the BSN should be the entry level for the professional nurse (and all current RN's would be "grandfathered in" at this level), while the ADN should be the entry level for the technical nurse (and that all the current LPN's would be "grandfathered in" at this level). The uproar that occured from nurses who did not understand that concept was heard loud and clear, and this proposal was withdrawn. But, it is still misunderstood and thrown up as an arguement by non-members 20+ years later. Lee1, I see that you are a member of ANA; how about reading up on what is going on in the ANA? ANA and AACN are sister organizations and some of the lobbying that AACN does may use ANA's lobbyists and ANA's Washington DC offices annd staff.

    I don't mean to pick on you in particular, Lee1, I have the flu right now, plus I've argued this point with many people over the years. I have co-workers who belong (we are in a union with our state association doing the collective bargaining), but won't lift a finger to do anything for their profession-- they just complain, complain, complain about what THEY are NOT getting from the ANA. When it comes time for them to do anything (even READING the newsletters about what is happening), they refuse.
    Last edit by Jenny P on Nov 2, '02
  8. by   l.rae
    Jenny, sorry you have the flu..hope you feel better soon!...l still think if the ANA wants membership of ''average nurses''(bedside nurses), then they must have something to offer them...if they are member driven and the average member is NOT the average nurse....how can they possibly be attractive to the average nurse?....to pay those dues is kind of like taking a blind leap and hoping your get the representation you "paid for"...it's too much like voting for the polititian that may or may not deliver the goods....Why didn't they turn their attn to bedside nursing first where the most critical changes are needed...for the nurse and the patient?....seems their priorities are turned upsidedown....as for their dues....well, l guess more advanced and higher degreed nurses who make more money can afford that , so it just makes sence that that is where they focus their efforts....l think bedside nurses need their own voice...ANA doesn't even seem to want to make themselves more attractive to the average nurse.....for me, it would be like joining a tennis club when l don't play tennis...l might get a few fringe benifits, but not be able to participate in the main purpose......The nursing crisis is primarily at the bedside and l haven't seen as much concern for this problem as l have for our titles and technicalities that do not impact direct health care delivery to the patient...l confess that l gave up keeping up with news on ANA quite some time ago because of these sentiments so l may be incorrect in some of my views....What big differences have they made in the nursing profession today?...l admit l am not well informed in that area any longer...l will say, l have been a nurse for 22 yrs and l sure can't say l have experienced any major improvements...quite to the contrary l must say....l work more consistantly short staffed now than l did even 3 yrs ago.............LR
  9. by   l.rae
    l just re-read my above post....not sure it made sense....sincerely looking for update.....cause like l said l am not up to date on ANA
  10. by   lee1
    "Okay, I'm a member of both ANA and AACN, and MY dues to belong to ANA/State/ and my district Association are TWICE as much as yours, Lee. "

    Interesting. $275 is the NATIONAL ANA dues including my state dues. How is yours higher?? I do not pay extra dues for the state chapter I belong to.
    $78 is the NATIONAL AACN dues, $20 is for the local chaper???
    How are yours so much higher???
  11. by   lee1
    "They were too busy creating another level of nurse instead."(Quoted from Lee1)
    I don't understand this phrase at all. ANA has never tried to create another level of nurse;

    Then what is the APN, NP or whatever you call them locally?
    Advanced Nurse Practicioner. I have belonged to the ANA for many years and this is the focus of what I saw them concentrating on over the last decade. The staff nurse's problems seemed to be just that-----their own-----
    Middle managers did nothing to help them, made them worse
    ANA allowed the problems to escalate. Only now, do they seem to be making them a priority. BUT, a little to late, I am afraid.
  12. by   oramar
    Seems to me that orginazations like PSNAP and CNA have the momentum right now. These are after all splinter orginizations. ANA has to do more soul searching to find out why they left. PSNAP and CNA dues are sooo reasonable and their membership is increasing, does anyone get that message? I think that in the future PSNA will see the light and try to get PSNAP back in the fold. It is plain as the nose on your face that ANA will have to become more radical. That process has already begun. The numbers lie with the bedside nurse so if they want to increase membership they have to go there and find out what it is these nurses want. They have to put bedside nurse in places of power in their organization. They have to stifle the insulting voices that put down ADN and Diploma grads. Promote education by all means but be careful of rhetoric that even whispers that these nurses are somehow inferior. Pay and working conditions are really the issue. PSNAP and CNA are actively pushing for nurse to patient ratios and bedside nurses are leading the charge.
  13. by   Jenny P
    Originally posted by lee1

    Interesting. $275 is the NATIONAL ANA dues including my state dues. How is yours higher?? I do not pay extra dues for the state chapter I belong to.
    $78 is the NATIONAL AACN dues, $20 is for the local chaper???
    How are yours so much higher???
    Lee1, I was referring to the $571 I pay yearly to be a member of ANA/MNA/and my district association. This amount breaks down to $55/year for my district dues; $376 for MNA dues; and $120 for ANA dues. We also have a $20 dues option which we can designate for any of the following funds: a strike fund (for those of us that are part of the union), a scholarship fund; the general fund; and the last choice is MNAF (our foundation fund). I pay extra because I belong to a state that does collective bargaining for us(we are part of a union FOR nurses BY nurses). Because of this UNION, I AM eligible to retire in 3 more years with a pension, I have health insurance, and I can use my unions' strength to make my workplace safe.
    My District Nurses Association has over 5000 members, and I am on the Board of Directors of it; my state has 13 Disticts, which are geographical areas across the state. 3 of these Districts are in metropolitan areas and my district is one of those 3. My district association has had its' own lobbyist for our state legislature, we have our own Exec. Director, we offer many CEU classes (even independant study), we have our own professional practice group, awards committee, a group for night nurses, an advanced practice group, and many other groups and committes, according to the different interests of our members.
    My State Association has over 16,000 members. We have 4 very active areas: the E&GW (economic and general welfare --usually refers to the UNION part of the association- deals with our contracts and negotiates with the hospitals, etc.; deals with unsafe staffing); the Commission on Nursing Practice (this group deals with general workplace issues which are found in ALL practice areas; there are excellent documents on Supervision and Delegation, Nursing Quality Indicators, Concerns for Practice Forms (which are different from Unsafe staffing forms),etc. Then there is our governmental affairs branch and also our Education branch. I'm losing steam here; maybe the easiest thing I can tell you to do is to go to MNA's website and browse through the site a while. It's at www.mnnurses.org. You won't be able to read the individual contracts (sorry, I did try); but maybe compare our state association with yours and see if I am right: it IS a bargain at this price.
    I'm going to go to bed (I worked my 12 hr night shift last night) now and will address more questions when I get up.
  14. by   Jenny P
    BTW, when you look at MNA's Board of Directors, please note that 10 out of the 12 board members are STAFF NURSES. Our President is a CNP who once lost her job for her union activites when she was a staff nurse. She still fully supports staff nurses; and she went on in nursing to earn her CNP thanks to a scholarship (or maybe more than 1) from MNA. The other board member is an educator. Because of MNA's collective bargaining arm, we do not have managers on our BOD.

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