ANA Membership Assembly reaffirms support for hospital staffing ratios

WSNA, with 12 voting representatives, had the largest delegation at the annual meeting of the American Nurses Association (ANA) Membership Assembly in Washington, D.C., June 28-29.

The Membership Assembly—including 200 voting representatives elected from each constituent/state nurses’ association and the Individual Member Division—sets policy for ANA and elects members to the ANA board.

In her opening address, ANA President Jennifer Mensik Kennedy, PhD, RN, FAAN, reviewed progress on ANA’s strategic initiatives, emphasizing nurse staffing as a major priority. She reaffirmed ANA’s position—adopted at the 2022 Membership Assembly—supporting staffing ratios as a means of addressing the staffing crisis. ANA has endorsed federal legislation that would require nurse staffing ratios in hospitals. Mensik Kennedy, a member of the Oregon Nurses Association, focused on ANA’s ongoing initiatives on Diversity, Equity, Inclusion, Belonging, and Accessibility. She also outlined national efforts to confront the growing problem of workplace violence against nurses and other healthcare workers.

Resolutions adopted

Delegates acted on two topics after discussions during Dialogue Forums on the first day: mental health stigma and veterans’ healthcare.

The Membership Assembly adopted recommendations to remove barriers that prohibit nurses from receiving appropriate mental health and well-being support, including stigma reduction. The Assembly also voted to accelerate changes to mental health reporting requirements, encouraging employers to foster an organizational culture that prioritizes health workers’ well-being.

Representatives also approved recommendations regarding access to veterans’ healthcare, including working to improve nursing knowledge about this population’s unique healthcare needs and continuing efforts to allow nurses to practice to the full extent of their licensure.

Code of Ethics controversy

An additional Dialogue Forum considered plans to revise and update the Code of Ethics for Nurses with Interpretive Statements. ANA periodically updates the Code of Ethics to reflect ongoing changes in nursing, the practice environment, and society. The last revision was in 2015. The Code of Ethics for Nurses Revision Panel developed a draft of the revised code, with a goal of implementing it in 2025. The draft was sent to voting representatives prior to the Assembly.

Among a wide range of topics addressed by the Code of Ethics discussion, one part drew concern: The draft of Interpretive Statement 2.4, Issues of Safety in the Nurse-Patient Relationship, discusses avenues for advocacy and included this sentence:

“When a strike is deemed the most viable option, nurse organizers ought to examine the structure of the systems in place at their organization or within their state and ensure there is a process in place to care for patients.”

While this statement acknowledges that strikes are an avenue of advocacy for nurses’ rights and patient safety, it has the effect of placing responsibility for patient care during a strike on the union, not on the employer, where it belongs.

During the discussion, Susan King, MS, RN, CEN, FAAN of the Oregon Nurses Association, and Edna Cortez, RN, chair of WSNA’s Labor Executive Council, urged that this sentence be removed from future drafts. WSNA and the Oregon Nurses Association also provided written comments and public statements on the issue.

As the Code undergoes further revision, it appears that our concerns have been heard and this language will not be included in the final version.

Presidential endorsement declined

Delegates also debated the question of whether ANA should endorse a candidate in the 2024 U.S. presidential election.

ANA endorsed presidential candidates in every election from 1984 to 2016.

In 2019, the Membership Assembly revised ANA policy so that it no longer required that ANA endorse candidates. Instead, decisions could be made based on each election’s circumstances. In 2020, ANA’s board declined to make an endorsement.

On behalf of WSNA, Oregon Nurses Association, Montana Nurses Association, and the Minnesota Organization of Registered Nurses, WSNA President Justin Gill, DNP, FNP, RN, introduced a motion that strongly urged the ANA Board of Directors to endorse a candidate for president in the 2024 election.

The motion was opposed vigorously, primarily by delegates representing Southern states. These delegates argued that an ANA endorsement would be divisive and controversial, and politically isolate them.

Supporters of the motion emphasized the need for ANA to stand up for its principles. They also argued that taking a clear stand is important for ANA to demonstrate its relevance, especially as it seeks to expand membership among younger nurses. Ultimately, the motion was defeated.

(Despite ANA deciding not to endorse, the WSNA Board of Directors subsequently voted to endorse Kamala Harris for president based on her record of advancing healthcare, among other issues.

Delegates also re-elected Mensik Kennedy as ANA’s president.

Hill Day

The Membership Assembly was preceded by ANA’s Hill Day, during which almost 500 nurses and nursing students met with their members of Congress and staff at the capitol. Priority issues were restricting mandatory overtime for nursing, addressing the nurse faculty shortage, easing restrictions on advanced practice nursing, and protecting recent federal regulations requiring staffing standards in long-term care.