Making a difference and what a difference communications can make!

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• Joan L. Shaver, PhD, RN, FAAN, AAN President

I write this message near the end of my Presidency and will reflect on the “dynamism” of the American Academy of Nursing (AAN). Our mission is to serve the public and nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. But we can only make a difference in shaping policy and practice if we are facile at communicating such knowledge, for ourselves and others. Communication is a “rate limiting” factor in how we view our organization and how others view us. During my time on the AAN Board, we have come a long way in communicating across our fellowship but of course, it is never enough. Even more challenging is our need, desire, and efforts to communicate what we stand for to those outside the fellowship. Here I summarize some of our important points of productivity and communications advances and challenges.

An extraordinary and robust program of leadership development exquisitely aligned with emerging societal needs is the John A. Hartford Building Academic Geriatric Nursing Capacity. Accelerating the education of pre- and post-doctoral scholars is foundational to fostering a nursing influence for shaping new health policy and innovative practice related to promoting healthy aging. We are entering a renewal phase of this multimillion dollar program and are grateful to the leaders at the J. A. Hartford Foundation, most particularly Corinne Rieder, PhD, Executive Director and Treasurer for her foresight and trust in our partnership. This initiative now is guided by Fellow Pat Archbold, who recently accepted the leadership reins from founding Director, Fellow Clair Fagin. Capably facilitated by Patricia Franklin, with operational back-up through the AAN main office, and along with other partners, our AAN presence is broadened and enhanced. An ongoing communication challenge is how to leverage the visibility of this transformative endeavor.

We are innovatively addressing a pressing societal issue, the growing nursing workforce shortage. While most solutions have been addressed to nurse supply, the fellows comprising our Commission on the Nursing Workforce have steadily envisioned and tested within the practice environment ways through new technologies to impact nursing efficiencies. Currently, they are forging partnerships for next phase research and development resources. New AAN staff member, Amy Stone, Director of Development and Programs is coordinating necessary grant proposal writing. Communications are ongoing through conferences, proceeding publications, proposals, and presentations.

While the strength of the workforce is key to enhancing the quality of health and nursing care, we have intensified our interface with the National Quality Forum, an interdisciplinary body that coordinates review of quality healthcare indicators through a public vetting process. The importance of a nursing voice in this process is obvious. We have appointed Bonnie Jennings and Carole Hudgings (AAN Board member) as representatives and we partner with ANA on communications. As the Board, we are puzzling how to involve the expert panels in communications to and from the National Quality Forum.

Much of AAN expert panel work is oriented to improving health and nursing care quality, raising needs for communication to the outside world. Our Family and Child panel has derived guidelines for parents in assessing the healthcare available to their children. They are tracking related congressional legislation. For example, they have urged AAN support of the Compassionate Care for Children Act of 2005, Senate bill 174. Our Global Health expert panel has formulated a statement related to international health issues. A consortium of the Acute and Critical Care, Aging and Quality panels received a small ANA grant related to quality of care for older adults in acute care settings. We are challenged to influentially communicate these important AAN activities and outcomes.

As I scan our environments, I see other dynamics that could guide future AAN agendas. I have participated in recent discussions sponsored by the Commission on Graduates of Foreign Nursing Schools regarding global nurse migration. In the interest of improving patient safety, we co-sponsored a recent meeting hosted by the Joint Commission on Accreditation of Healthcare Organizations related to health professions education. The American Association of Colleges of Nursing is pushing the boundaries of education as data emerges supporting the need for nursing clinicians that have higher levels of clinical decision making and care competencies, eg, clinical nurse leaders and clinical practice doctorates. Most of the health science disciplines through their leadership are calling for transformation of education. The AAN Special Interest group on nursing education met this July and will be forging further dialogue at our annual conference and meetings. At a meeting I attended to discuss the diffusion of standards for genetics practice, held at American Nurses Association headquarters, we were represented by the chair of our Genetics Expert Panel, Fellow Kate Potempa. While clearly poised to be influencing healthcare in a huge way, we in nursing have not incorporated genetics and genomics into our educational or practice cultures in any mainstream way as of yet. How should these issues play into the work of the AAN?

As nursing leaders and a profession that has often filled the gaps in access to healthcare for the underserved, our focus on reducing health disparities & inequalities is a “hand in glove” fit with nursing ideology. Although this label connotes a broad scope of possible strategies and tactics, it is rich for us to consider. Envisioning meaningful initiatives matched to the mission, the capacity of the AAN and assessment of possible outside resources are in the hands of a small group of impassioned fellows. Moreover, through facilitation by the American Nurses Foundation, the AAN concern is communicated through the Gloria Smith guest lectureships, which serve a provocative purpose.

In spite of receiving inadequate attention in mainstream healthcare dialogues, our newest emphases deserve the voice of the AAN because of their close match with nursing ideology. We, as nurse leaders, are the ones to appreciate that the majority of diseases exist in chronic form and much of prevention lies in lifestyle modifications—a huge opportunity for health communication. Our public health contingent knows it all too well and while our healthcare system and financing is oriented to acute care and medical treatment, a loud voice for disease prevention and health promotion would best be ours. I trust that our 2005 annual meeting will provide further directions for the AAN to pursue for shaping healthier behaviors and environments. Further, we know well that mental health/illness have been stigmatized, that good primary physical care often eludes those with mental health challenges and that it is through the integration of services that we will best optimize mental/behavioral healthcare. No voice in policy circles would be better than ours in calling for transformation and integration of physical and mental healthcare at a primary level.

We are communicating our value of research for improving healthcare through the Council for the Advancement of Nursing Science (CANS), the open membership council of the AAN. Spearheading the State of the Nursing Science Congress every 2 years, holding a special topics conference on alternative years, representing us at the Nursing Research Roundtable, and establishing a nursing seed money scholarship, the CANS is communicating a leadership identity that reflects well on us. Guided by representatives of the 4 regional nursing research societies plus 2 general organizations seeding nursing research (Sigma Theta Tau International and the American Nurses Foundation) and in partnership with the National Institute for Nursing Research, with business support from our head office, the CANS (currently chaired by Marilyn Sommers) extends a national voice for nursing research.

The challenges to effective, informative communications are many but good communications make such a difference. During my tenure as President-elect and President, I advocated for our transition to a management company and this unleashed our potential to communicate in more contemporary ways. In addition to a thriving print journal (Nursing Outlook, chief editor Marion Broome), we now have an e-newsletter (chief editor Donna Zazworsky), broadcast e-mails, and an interactive Web site with online voting, polling, and commerce. We have great staff support to write grants, make brochures, advertise conferences, write scripts, help us publish paper, write letters to policy makers, coordinate communications with partners, craft strategic messages, and generally profile the productivity of the AAN. In all these areas, I am grateful to our head office staff Annette Hess, Carina Tran, Becky Gade, and now Amy Stone as well as Kay Whalen (President of EDI Inc.). Their bench strength in design, information technologies, and business practices means we can focus on strategic programming and ever broadened communications. Because of our strengthened infrastructure, I believe that our strategic programming has unlimited potential for the AAN to grow in stature and influence. As I prepare to leave the AAN Presidency, the future looks terrific for communicating to ourselves and others the power of the AAN—and it stands to make such a difference to us making a difference!