AAN President's Pages
A public health crisis: Recommendations to reduce gun violence in America
The Academy Board of Directors has identified five areas of priority including:Reducing toxic stress experienced by children living in poverty
In my last President's Message I shared the five policy areas set by the Academy Board of Directors. They are:Mindfulness and the work of the academy
Mindfulness has become an important concept to help ensure the safety and high reliability of the clinical practice of healthcare professionals. Mindfulness based interventions have been used successfully to decrease stress and burnout in nurses and physicians. The Institute for Healthcare Improvement (IHI) describes mindfulness as assuming an aware, non-judgmental, present state of mind. It is the habit or practice of being in the moment.May you live in interesting times!
At this year's policy conference, as in past years, we highlighted nursing initiatives that are transforming health, leading change, influencing policy, and ultimately improving the health of our nation. It is no accident that the conference focused heavily on social justice given the fact that our nation and the world continue to face ongoing challenges to human rights. Those challenges sadly come in all too familiar expressions—racism, threats to immigrants, limiting women's access to reproductive services, underestimating the impact of climate change on global health, injury, death and psychological impact of gun violence, and many others.Access to a healthy future
What if we decided to weed through the rhetoric and ideology that has dominated the crafting of a health plan and examined the basis for why it is in our country's best interest to assure a pathway for accessing and then gaining high-quality and affordable health care? While we are at it, we might want to examine the equally important premise that how healthy we are is predominantly the result of resilient communities, clean and safe environments, adequate housing, living wage employment, genetics, behavioral choices, and a host of other determinants of health.Valuing Science
I just experienced one of my favorite times of the year; the week we graduate our students. I admit that I like a little of the pomp and circumstance that comes from a long tradition within academic environments. I like donning the cap and gown that spent the last 12 months hanging on the back of my office door. I love seeing students transition to colleagues; almost overnight! I admire the commitment of faculty to students and the pride they take in collective success. I am somewhat envious of the opportunities today's education affords our students: mentorship, clinical and research opportunities, rigorous and challenging courses, high expectations of their mentors and peers, opportunities to explore cultures across the globe, preclinical simulation scenarios that reduce the anxiety of their first clinical engagement with an individual; all designed to ignite a love for the practice of nursing.What nurses are fighting for: The elevator briefing
I recently attended a very stimulating 2-day meeting at the Robert Wood Johnson Foundation (RWJF) to engage in a dialogue about the future of nursing's role in population health. RWJF convened the dialogue to explore the opportunities and challenges related to the roles and leaderships in population health and how we, as nurses, can impact the health of populations. The interdisciplinary group of individuals focused on how population health was defined, practiced, taught, studied, and utilized in policy within the nursing profession.Shaping policy in an antipolicy environment
As the president of the American Academy of Nursing, I try to limit sharing my personal sentiments about politics and politicians in the pages of Nursing Outlook or Fellows of the American Academy of Nursing Mail. I feel quite comfortable sharing my thoughts on policy, but I do not assume that we all feel the same about our leaders and their style of governing. However, because the academy is primarily a policy focused organization and has integrated the policy process into our mission and vision I feel compelled to share with you that I believe our vision is in peril.Registered nurses in primary care: A value proposition
I feel as if we are finally acting on evidence that has been known for some time; there is significant value to enhancing the contributions of registered nurses practicing in primary care. The outcome of increased efforts to engage RNs in primary care practice could be gains in the health status of patients, reduced dissatisfaction of providers (physicians, nurse practitioners, and physician assistants), and an improved value proposition for primary care. Redesigning primary care through new models that utilize teams of primary care practitioners and high functioning registered nurses could change a dynamic that has plagued primary care for some time.Culture, practice, science and leadership: Natural partners
The Academy is committed to the critical role that social determinants of health play in creating healthier people and healthier communities. We positioned the social determinants of health as one of three strategic goals in our 2014 to 2017 strategic plan. The Academy Board is currently engaged in refreshing our strategic plan for 2017 to 2020. A commitment to the health of populations and to health equity is threaded throughout our focus on policy, practice, and leadership and it is evident in the Academy's signature initiatives, policy briefs, position statements, and engagement with partners.Lost in the shuffle
What is it like for an individual with complicated health care needs to navigate our modern, technologically sophisticated and highly complex care environments? What is it like for their families when efforts to access information and assistance necessary to manage care at home are lost in the shuffle? Those questions have prompted health systems, governmental agencies, academia, and scholars to investigate the burden and poor health outcomes that patients and families may experience during the transition within and across care environments.Valuing primary care practice
I become more mindful every day of our educational and practice imperative in nursing to assure that our workforce is robust, well prepared, relevant, and timely. How educators and clinicians translate that to practice is often a complex cooperative approach to seek strategies that align education and practice priorities, assure that faculty and clinicians are current and competent in clinical and research skills, attend to trends in health systems, and engage in health policy. It's a tall order! My enthusiasm for our future in nursing is fueled by my knowledge that our Academy fellows are experts and leaders in these competencies.Driving change in population health
My first message as the new President of the American Academy of Nursing continues the conversation Diana Mason began in her July/August President's Message “Building Healthy Communities”. If you attended the policy dialogue on “Leveraging Community Benefit to Reduce the Prevalence of Violence, Poor Nutrition, and Adverse Childhood Events” at the Academy's Policy Conference in October you participated in a discussion about how “Community Benefit” can act as a powerful tool to help engage communities in assessing their collective health.A mission-driven organization
This is the last President's Message that I will write for Nursing Outlook, so I want to highlight some evidence of our progress on our strategic plan. Much of what I have to report builds on the work of prior presidents, boards, and staff that laid the foundation for a strong organization and launched some of the initiatives that the current board and staff have moved forward as we focus on our mission of transforming policy and practice through nursing knowledge.Building healthy communities
The Academy's second strategic goal focuses on addressing the broad range of factors that shape the health of individual, families, and communities. I want to share with you three recent developments that align with this goal in the areas of nutrition, violence, and toxic stress in childhood—the three priority areas identified by the board for 2014-2015.Getting what we pay for
One of my favorite Edge Runner stories was told to me by board member Eileen Sullivan-Marx, PhD, RN, FAAN, now Dean at the College of Nursing at New York University. At the time, she headed the University of Pennsylvania School of Nursing's LIFE program called Living Independently For Elders, a Program for All-Inclusive Care of Elders (PACE; Medicare.gov, n.d.), with capitated payments by Medicare and Medicaid. Designed to keep older adults living independently in their homes rather than in nursing homes, PACE was first developed by Jennie Chinn Hansen, PhD, RN, FAAN, another fellow and Edge Runner who founded On Lok in San Francisco.Creativity in policy
At the October 2014 annual meeting of the Academy, Stephanie Ferguson went to the microphone and challenged the fellows in attendance to be more visibly involved in some of the most important issues of our day, including the expansion of Medicaid and continuation of the Children's Health Insurance Program (CHIP). Her call is timely, given the continuing need for reforming health care and the changing political landscape.Wisdom and will
In 2013, the National Research Council confirmed what had become evident to those who conduct comparative analyses of nations' health care systems—the United States ranks poorly on most indicators of health and systems' outcomes but leads other developed nations in health care spending. No wise person would design the health care system we have now. The challenge is whether we have both the wisdom and will to transform our health care system.Toxic stress in childhood: Why we all should be concerned
Karen Cox is the outgoing Secretary and co-lead of an Academy task force on Strategic Goal #2 that addresses the “upstream factors” that affect the health of people. She is an expert in toxic stress in childhood and is leading the Academy's workgroup on this factor. I invited her to coauthor this President's Message with me.Ask not, what have you done for me lately?
I am borrowing from John F. Kennedy's famous line, “Ask not what the Academy can do for you. Ask what you can do for the Academy.” It is a bit of a cliché now but still relevant. The members of the Academy board, committees, and expert panels are contributing their time and talents to advancing the mission of the organization, and most also make annual gifts to the Rheba de Tornyay Fund, recognizing that we are a small but visionary organization that needs more resources than dues provide to move forward on our strategic plan.Looking upstream
In the last issue of this journal, I wrote about the imperative for the Academy's second strategic goal—lead efforts, in partnership with others, to address the broad range of factors affecting the health of populations. Although there are data supporting the fact that our nation outperforms other developed nations on health care spending, we trail behind on most leading health indicators (Organisation of Economic Co-operation and Development, 2013). The need to create healthy communities is not new to nursing.Where and how is health created?
Reforming our health care system is necessary but not sufficient for improving the health of the nation.Diverse voices
The American Academy of Nursing seeks to be a model organization on diversity and inclusivity. How are we doing? I asked myself that recently when I received feedback from two fellows that gave me pause.Think globally, act locally
Last year, the board of directors appointed a task force headed by Living Legend Barbara Nichols to examine the Academy's approach to international fellows. Specifically, the board was responding to concerns about how nominations for international fellowship were evaluated, their fellowship fees (which have been at a reduced rate), and membership status that restricted their right to full involvement in the academy (international fellows could not run for office or vote in our elections).Coming of Age
Since becoming a fellow in the American Academy of Nursing, both it and I have matured. In 1991, Loretta Sweet-Jemmott and I were supposed to be standing quietly in place in a hallway while we awaited our turn to take the stage of the hotel ballroom to be inducted as new fellows. Instead, we were reconnecting (we had worked at the same university for a short time) and laughing hysterically about Loretta's enhanced presentation in a gorgeous dress that hid a “wonder” garment. The then chief executive officer (CEO) Janet Heinrich had to come by and tell us to be quiet.
