Op-ed by David Keepnews, PhD, JD, RN, FAAN: ​‘Now is a time to be courageous’

The American Nurses Association (ANA), nursing’s national professional association, held its annual Membership Assembly in Washington, D.C., on June 16 and 17, 2023.

The Membership Assembly is ANA’s highest decision-making body, bringing together 200 voting representatives of constituent/state nurses associations, the Individual Member Division, representatives of ANA’s organizational affiliates, and members of the ANA Board of Directors. WSNA, ANA’s affiliate in Washington state, had the largest voting strength of any delegation at the assembly.

The day before the Membership Assembly, more than 400 nurses from around the country participated in ANA’s Hill Day, meeting with their members of Congress to advance ANA’s federal priorities — addressing the nurse staffing crisis, removing barriers to advanced registered nurse practitioner full practice authority, preventing workplace violence, and increasing support for nursing workforce research.

ANA President Jennifer Mensik-Kennedy, a member of the Oregon Nurses Association, opened the Membership Assembly and emphasized ANA’s continuing priority of addressing the nurse staffing crisis. At the 2022 Membership Assembly, the ANA adopted a clear position to support safe staffing standards, including enforceable ratios. President Mensik-Kennedy noted that this position is regarded as controversial by some groups within nursing, but the ANA remains committed to it because employers are not taking meaningful action to address the worsening nurse staffing crisis.

As she said, “Like many others who are pursuing real structural changes, now is a time to be courageous.”

The Membership Assembly adopted three resolutions.

GUN SAFETY — One focused on the need for legislation to address gun safety by increasing funding for mental health services and research on gun violence and prevention, including gun violence directed against healthcare workers. This point resonated strongly with WSNA representatives, considering the murder of WSNA member Doug Brant during a home health visit in Spokane, WSNA President Lynnette Vehrs explained.

Representatives also voted to endorse the American Academy of Nursing’s Statement on Firearm Safety and Violence Prevention and to update the ANA’s Statement on Incivility, Bullying, and Workplace Violence. These statements address gun violence and prevention in healthcare settings.

VIRTUAL NURSING — Another resolution addressed the role of virtual nursing in acute-care settings. The resolution called for the development of a national policy to address the standardization of virtual nursing practice, along with funding models for virtual nursing and its implications for licensure, regulation, and liability.

There are examples of virtual nursing — in which an off-site nurse is electronically present —providing support to bedside nurses, such as mentoring newer nurses. However, some models have sought to use virtual nursing to reduce the use of bedside nurses.

The Membership Assembly adopted an amendment by Oregon Nurses Association representatives, developed in collaboration with WSNA, that emphasized that virtual nursing can be useful in providing support for nurses at the point of care but that “[v]irtual nurses should support, but not supplant nursing staff in nursing ratios, matrices, or other measures of staffing levels.”

NURSING DOCUMENTATION — A third resolution addressed reducing the burden of nursing documentation during times of crisis. While recognizing the need to address the documentation burden, WSNA representatives proposed an amendment calling for involving experts on nursing professional liability and state regulation to ensure that revised standards of documentation do not expose nurses to additional legal or regulatory risks. The Membership Assembly adopted this amendment.

Bylaws amendment on disaffiliation

The Membership Assembly adopted several amendments to the ANA bylaws. WSNA, together with the Oregon Nurses Association, Montana Nurses Association, and Minnesota Organization of Registered Nurses, proposed a bylaws amendment providing parameters for the ANA Board of Directors in developing a policy on the disaffiliation of ANA affiliates. This amendment sought to ensure the principles of due process by supplying an impartial investigation, informing the affiliate of any charges, providing an opportunity to respond, requiring a two-thirds majority for the board to disaffiliate, and an opportunity to appeal. Compromise language proposed by the ANA Board, which maintained these principles, was adopted overwhelmingly.

Workshops

The Membership Assembly also included workshops on nurses’ roles in advancing health equity, current developments in federal policy, and upcoming revisions in the Nursing Leadership Scope and Standards of Practice as well as the Code of Ethics for Nurses.

Elections

Representatives elected four new officers and board members: Anita Girard of California as Vice President, Joan Widmer of New Hampshire as Treasurer, Khaliah Fisher-Grace of the Individual Member Division as Director-at-Large, and Nikule Abel of Minnesota as Director-at-Large (recent graduate). They join five continuing officers and board members, including David Jacob Garcia of Washington.