What Has ANA Done for Me Lately?

pattyjo, MSN, RN · Sep 8, 2002

sjoe,

Just to clarify: ANA has a branch which is union, the UAN, affiliated with AFL-CIO. I am going to plead ignorance here, since I am not a member of that part of the organization. Perhaps jt will respond, with much more knowledge of this than I have. ANA itself is not a union, nor is PSNA.

You can look on ANA's website for more information

http://www.nursingworld.org and then click on the UAN link.

Patty

-jt · Sep 8, 2002

Why is that surprising? She IS a member of the ANA. She is NOT a member of a union. You dont need to do one in order to do the other.

Thats about it in a nutshell but the longer explanation is below:

Theres a misconception that may be contributing to your confusion. The ANA is NOT a union. It is the national professional organization for Registered Nurses in the same way the AMA is one for doctors. The AMA is not a labor union either. Doctors who are unionized with a labor union still can be members of their professional organization - the AMA - and are. But not all doctors who are members of the AMA are unionized. So there are some doctor members of the AMA that are also in a labor union & some who are not. Same thing happens in the ANA.

The work of the American Nurses Association is in Washington DC, in the government, & in the media, to name just a few, to educate the public --- speaking & fighting at the federal level for the rights of ALL nurses & pt safety, working to advance the position of the nursing profession & all nurses.

The ANA also writes & lobbies national laws to address the issues of RNs in all kinds of settings, monitors other healthcare groups like the AHA & AMA, monitors & counteracts proposed legislations that would adversely affect RNs, their practice, & their pts, & fights the efforts of non-RN groups like the AHA that are lobbying for laws & trying to make decisions for RNs. (remember the AMAs attempt to have Congress pass a law to create Registered Care Technicians - basically a LICENSED UAP - to replace RNs in the 80's nursing shortage. There would be no such thing as a staff RN if the AMA had had its way back then. The ANAs role as watchdog & RN advocate prevented that). Thats what the ANA does - its not a union. The ANA is its members - the majority of whom are staff RNs.

The ANA, as an organization, recommends & is supportive of the concept of collective bargaining for RNs & identifies collective bargaining for RNs as being a "professional imperative" to be able to have a measure of control over your practice, rights to determine your working conditions, and ability to provide safe pt care. (see the collective bargaining page at http://www.ana.org) But the ANA itself is not a labor union & does not do collective bargaining. So you dont have to be a unionized staff RN to be a part of the ANA.

There are 54 state associations that are members of the ANA - one for every state (including California), plus DC & the USVI. Of these 54 state associations, 27 are also RN labor unions themselves or offer collective bargaining services or are developing such a program. But those are the individual state associationsthat do it - not the ANA.

Since every state association is a member of the ANA, your membership in your state association makes you a part of the ANA, but whether or not you are a union nurse depends on whether or not your state association is a union.

STAFF RNs who join their state association in states like NY, which has the largest collective bargaining program of all the state associations, become unionized RNs who are part of the ANA. Non-staff RNs in NY who join our state association would not be members of our states union branch but would also be part of the ANA, same as our states union members. So there are even union RNs & non-union RNs from the same state association in the ANA working together to make national changes. Just as they do locally in their own states, as Pattyjo described. Staff RNs or any other kinds of RNs who join state associations like Pennsylvania, which does not provide collective bargaining services, would also be non-union RNs who are part of the ANA - right alongside the union RNs from collective bargaining states. It makes no difference. We're all still working to improve the situation for nurses in this country.

Case in point: I am a unionized staff RN member of the New York State Nurses Association & a part of the ANA. NursKaren is a NON-union RN member of the Pennsylvania State Association & also a part of the ANA. For anyone who knows us here, even though I am union & she is not, are we not fighting the same fight together in the same organization & speaking the same language? :)

Its not about unions. Its about NURSES.

That said, there is a new Staff RN ONLY national labor union branch within the ANA & made up of those 27 state associations that provide collective bargaining. These ANA state associations that are also RN labor unions (or want to become such) & their members got together from around the country & formed their own labor union for staff RNs, but rather than break away from the ANA to do it, they chose to keep their union affiliated with the ANA. And then last year affiliated with the AFL-CIO as a full charter member in the House of Labor with a seat on the AFL-CIO executive board. Thats a very powerful position in this country & it's held by these staff RNs.

This RN union is called the United American Nurses (UAN), it's the national RN labor union, & is now the largest RN union in the country. The UAN is made up of & is controlled by & for staff RNs only. The focus is on the staff RN's workplace & labor issues - locally at their place of employment, statewide & nationally. The RNs of the UAN believe that ALL RNs should be able to determine the conditions of their employment thru collective bargaining if they so choose, so the members have directed the UAN to work to offering collective bargaining services to all staff RNs in the nation - wherever the RNs want it - even if those RNs are in a right-to-work-state and even if they arent members of their own state association, & even if their own state's nurses association is non-union like in Texas.

The UAN is the union. Not the ANA. Every one of the 100,000plus staff RN union members of the UAN is also part of the ANA. But not every RN in the ANA is part of the union. There is a synergistic relationship between the 2 organizations.

Home Health Columnist / Guide · Sep 8, 2002

Well said, JT!

Always a pleasure to work together on behalf of the PROFESSION of NURSING.

-jt · Sep 8, 2002

The influence locally in a particular state should come from the state nurses association. Mine is 98% made up of staff RNs & we are active in it, so I see a huge influence on my job directly. Since its the members who direct their state association & the work it does, & its the members that make the decisions, the issues that are important to the members of that association are the ones that will be addressed. And those who are there are the ones who decide what that will be.

If staff RNs are not in it, & there are no staff RN members there to make their voices heard, their needs known, or to make the decisions and direct their state association to staff RN issues, how will their issues ever get addressed???

I dont know how to answer bedside nurses in states where bedside nurses dont join their state association, & are not involved in its direction or decision making, and then find that it isnt doing enough for the problems of bedside nurses in that state.

If your state association membership is full of all kinds of other RNs EXCEPT staff RNs working at the bedside, what is that associations focus going to be? Its sure not going to be the staff RN. Its going to be the squeeky wheel that gets oiled. Especially since the ones who are there are the ones who decide.

If everybody else is in there speaking up for themselves & making the decisions & we arent there to speak at all, can we really be surprised when everybody elses issues are addressed before our own?

The state association is looked to by the legislative & media powers that be as being the voice of nurses in that state. Each association is individual - not directed or controlled by the ANA - but directed & controlled by its own members. Its a member-driven organization. If we arent in there speaking up for ourselves, making the decisions, & working for our own best interests, who will be?

Nurses in all fields of the profession join their professional state nurses associations but many times bedside nurses dont because they feel theirs doesnt do enough for bedside nurses in their state. Yet its the nurses who DO join the state association that get to decide what work that association will do & what issues it will focus on. Theres a solution there right in the problem.

Bluebarn · Sep 30, 2002

I've been wanting to sign on to the ANA since college. But now the pricey dues have made we wince and delay membership.

It would be great to feel more direct results from ANA lobbying, it would encourage me to sign up sooner. But then I feel guilty to ask for more results without putting my dues and name behind the efforts in the first place.

So the next paycheck will fund my first ANA dues. I'd like to put my effort where I want improvement for the profession.

kmchugh · Oct 3, 2002

OK, so my last post on this topic was pretty short. I've watched a while, and this thread has had few responses, and those mostly seem to come from people who either are members, or plan to become members. With your kind permission, I'll explain my viewpoint on the ANA.

I graduated nursing school in 1996, and fully planned on becoming a member of the ANA though the Kansas nurses organization. I contacted the organization, and low and behold, my first year's dues were nearly half a month's salary! I thought then (and believe now) that if they were truly representing me both at the state level and nationally, the fees might be worth it. I looked into the ANA, and my first thought was "what a disorganized, timid, non-representative organization!" My belief, at that time as well as now, was that the ANA was so busy trying to represent every faction, every splinter group, every wacko theory, the core values and concerns of all nurses were being ignored. I also felt the ANA was so busy fawning over the AMA, that if nursing interests conflicted with the interests of the AMA, well, lets just say physicians had another lobby group in their corner.

A few years later, I went back, and got my master's degree as a CRNA. I am a member of the AANA, and will continue as a member. They truly are an effective organization, who represents the interests, the core values of all CRNA's. They are not afraid to take on physicians, and have done so, particularly with the ASA on a number of issues.

So, what are the core issues that affect nurses? Here's a short list:

-Inadequate pay (which in large part accounts for the nursing shortage).

-Nursing shortage. (I put pay ahead of this because I really believe if you solve pay problems, the shortage will take care of itself.)

-Excessive hours, with some states still allowed to mandate overtime.

-Abuse of nurses by physicians, employers, and patients.

-Lack of respect for nurses.

-Identification of the appropriate level of education for all nurses. (Solution here will go a long way towards resolving respect issues.)

-Identification of nursing as a profession.

In the ANA's haste to be looked on benevolently by the AMA, in its haste to promote whatever theory the "professors" are currently enamored of, the ANA has forgotten the staff nurse. The message I received, loud and clear, from the ANA, was you are a nurse, you must join. Send us your money, then shut up. We, who have not been at the bedside in years, will decide what's best for you.

Nope. No way.

Kevin McHugh, CRNA

-jt · Oct 3, 2002

Maybe you havent looked at it in all the years since your first research but the majority of the ANA membership IS staff RNs, the current legislative agenda is by staff RNs, has been written for staff RNs, & the focus, especially over the past 3 yrs has been on staff RNs. In fact the ANAs safe staffing package in Congress right now encompasses every item you just listed & more - & the RNs of the ANA have developed workable solutions to all of them. An email to your congressman & senator in support of our RN bills would go a long way to solving the core issue problems you mention. You can get updated by reviewing this legislative material on the governmental affairs page at http://www.ANA.org

Staff RNs are on the ANA board of directors, staff RNs developed the legislative agenda, staff RNs are lobbying, staff RNs developed a union branch, etc. I dont know where you get the idea that we are trying to be lovey dovey with the AMA - when we are fighting them tooth & nail to prevent them from creating other categories of workers to fill in for RNs rather than address the reasons that staff RNs are fleeing from bedside jobs.

Besides that, hasnt it been the ANA & its members, working along with its affiliate, the AANA, all pushing to advance the independent practice of CRNAs & NPs, lobby for their independence, & fight against the AMA who is trying to keep MD control over these RNs?

Also, ANA has called together over 70 national nursing organizations to unite around "a shared vision for the future of the profession and they have developed a strategic plan to address the complex, interrelated factors that have created a growing shortage of nurses". "The plan reflects the brain trust of nursing and includes strategies to address basic issues, such as recruitment, as well as more complex issues, such as the economic value of nursing". See "Nursings Agenda for the Future"

http://nursingworld.org/pressrel/2002/pr0404.htm

As a CRNA, you might be interested to know that your specialty organization, the AANA is part of the 19-member steering committee that will guide this agenda with the ANA. In this way, as an active member in your specialty organization, you can have a hand in directing nursings entire future right now.

kmchugh · Oct 4, 2002

Forgive me, JT, but as you can see, I tend to be argumentative, and can be passionate about some subjects. To me, "bedside nurses" does not mean nurses who worked there 10 or 15 years ago, and have since moved on to other things. It means people actively involved, today, in bedside nursing. In the AANA, the officers are ALL currently practicing CRNA's. They know what CRNA's are facing TODAY, not ten years ago.

I have long held that the ANA, like some other nursing organizations, has been taken over by the "academic" nurses, who teach at universities, rather than work at the bedside. I would be hard pressed to believe that active, bedside nurses have become ANA officers. Academia simply would not stand for it. The current president of the ANA is an MS, RN, CS, ANP, who works at managerial levels in public health. More than half of the board of directors are Master's and PhD nurses, who have long since left bedside care of patients. All this information is available from the website to which you directed me. Please don't try to tell me that the ANA is run by staff nurses. That simply is not true.

Please don't read this to believe that I am putting academia or advanced degree nurses down, I'm not. But most advanced degree nurses have left hospital nursing behind, and don't have the foggiest idea what the staff nurse is doing or facing. If they did, they'd know, for example, what a staff nurse makes, and would know that ANA membership dues are exhorbitant for most RN's. And that is just one example. I'm sorry, I don't wish to be negative, but I still believe that the ANA is out of touch with its grassroots members.

And, by the way, the fight to maintain CRNA's independent practice has been fought primarily by the AANA. At last report, the ANA had issued statements of support, and not much else. The financial support for current court cases and for lobbying has come from CRNA's, through the AANA. If you, as a member of the ANA were more familiar with this, you would know that the fight is not to obtain independence for CRNA's, which we already have. The fight is with the ASA to keep that independence.

Kevin McHugh

booboo · Oct 12, 2002

One question - If the ANA is

so great, why are things so bad now? Why is there such a shortage?

When I looked into it, I saw expensive dues and I saw a group who came out AGAINST mandatory staff-patient ratios - an issue which I believe is at the core of the poor working conditions of nurses.

It's like no one can see the forest for the trees!! If we have a reasonable number of patients to care for, we will be able to do ALL of the things expected of us and taught to us in nursing school - instead of teaching us fantasyland and sending us into combat!!

-jt · Oct 12, 2002

Only against the GOVERNMENT mandating a NUMBER -- because they have no idea what is needed & because the number that works in one place may be inadequate in another. That does not mean that the ANA is against safe staffing ratios. The ANA's position is that there must be a standard acuity measurement and that the NURSES, together with their employers, not the government, should be the ones to decide which numbers are safe for them, based on the standard acuity measurement of the pts they care for in their individual facilities. And that if the employers fail to do this & fail to provide the adequate number of nurses & ratios required, they forfeit medicare & medicaid reimbursements. Look a little closer.

First of all, the ANA is its members. As an active member involved in the work being done on RN staffing & mandatory ot state by state & nationally, I know these issues are both THE top priority. Our association & members are fighting hard at state capitols & in DC for safe staffing & to ban mandatory ot.

And we're doing it with our own funds - our state nurses association membership dues.... $185/yr of which goes to support the work of the ANA.

Incidentally, it is the MEMBERS who decide what the dues will be & we VOTED to make it this amount.

It costs money for the overhead we need like office space & electricity, and it costs money for the resources we need like hiring staff, legal experts, professional lobbyists, and to do the research & other work to support our claims & demands, & back up our efforts. In most everything in life, there is always the few doing the work for the many..... and getting all the criticism and complaints for their efforts as well.

My dues that are now paying for the work we ALL want done would be a lot less if there were more helping out, rather than just complaining that Im not doing enough for them.

And the work would get done a lot quicker too.

Excerpts from the ANA webpage:

Message to Congress

acute care staffing:

The most reliable and cost-effective way to ensure high-quality inpatient care is to provide an adequate number of registered nurses (RNs) at the bedside. ANA urges Members of Congress to support efforts to:

*Support the Patient Safety Act of 2001 (H.R.1804, S. 863) which would require Medicare providers to publically report nurse staffing levels and mix, and patient outcomes, bringing market pressure to bear in improving those levels.

*Require acute care facilities to develop and implement valid and reliable staffing methodologies and improve RN staffing as a condition of participation in Medicare and Medicaid and in receiving those reimbursements.

For issues surrounding acute care RN Staffing:

http://nursingworld.org/gova/federal/legis/107/rnacute.htm

Message to Congress

long term care staffing:

The ANA supports the immediate enactment of upwardly adjustable, minimum skilled nursing facility (SNF) nurse staffing ratios as a condition of participation in Medicare and Medicaid and receiving those reimbursements.

Issues Surrounding Registered Nurse Staffing in Long Term Care: http://nursingworld.org/gova/federal/legis/107/rnltc.htm

Message to Congress

ANA OPPOSES THE USE OF MANDATORY OVERTIME as a staffing tool. We urge you to support legislation that would BAN THE USE OF MANDATORY OVERTIME through Medicare and Medicaid law.

Nurses must be given the opportunity to refuse overtime if we believe that we are too fatigued to provide quality care. Research shows that sleep loss influences several aspects of performance, leading to slowed reaction time, delayed responses, failure to respond when appropriate, false responses, slowed thinking, diminished memory and others.

In fact, 1997 research by Dawson and Reid at the University of Australia showed that work performance is more likely to be impaired by moderate fatigue than by alcohol consumption. Their research shows that significant safety risks are posed by workers staying awake for long periods.

Federal regulations have used transportation law to place limits on the amount of time that can be worked in aviation and trucking. Certainly, nursing has as much of an impact on public health and safety as these professions. Therefore, it is appropriate for Congress to place a ban on the use of mandatory overtime in nursing through health law.

ANA maintains that the deterioration in the working conditions for nurses is the primary cause for the staff vacancies being reported by hospitals and nursing facilities - not a systemic nursing shortage. Nurses are opting not to take these nursing jobs because they are not attracted to positions where they will be confronted by mandatory overtime and short staffing. This staffing methodology - deemed "mandation" by health care facilities - is having a negative impact on patient care, increasing the chances for medical errors, and driving nurses away from the bedside.

ANA maintains that no matter how many resources are placed into increasing educational opportunities for nurses, the nursing shortage will remain and likely worsen if changes in the workplace are not also addressed. Improvements in the environment of nursing care, combined with aggressive and innovative recruitment efforts will help avert the impending nursing shortage. We must begin by improving the environment for nursing.

http://nursingworld.org/gova/federal/legis/107/ovrtme.htm

Selected ANA RN Testimonies to Congress Addressing Direct Care Staffing Shortages:

http://nursingworld.org/gova/federal/legis/testimon/index.htm

Finding a Cure to Keep Nurses on the Job

ANA Congressional Testimony

http://nursingworld.org/gova/federal/legis/testimon/2001/govaref.htm

Nurse Staffing - Causes, Impact & Remedies

ANA Congressional Testimony

http://nursingworld.org/gova/federal/legis/testimon/2001/edwork.htm

Patient Safety - Appropriate Staffing and Mandatory Overtime

ANA Congressional Testimony

http://nursingworld.org/gova/federal/legis/testimon/2002/safety.htm