Nurses: An Action Plan for Quality
Re-design, "patient-focused care," threats to regulation, proposals to reduce nurse jobs by one-third, the closure of nursing schools and the rise of for-profit medicine — all are risks to the nurse's role as patient advocate.
Understanding the forces which affect nurses' ability to practice their profession is an essential first step and one key goal of this manual. The end goal is to translate understanding into action. Because only by acting now — individually as patient advocates and collectively as members of UNA/AFSCME — can nurses weigh in on the changes affecting their profession and meet the future challenges to come.
"The New Health Care System: A Guide For Nurses" has attempted to detail the hows, whats and whys of where we are in American health care today, and we hope you find this information useful in your individual practice setting. More importantly, we hope it spurs you to act.
Changes will continue to occur, whether or not nurses choose to engage themselves in the debate. But in the new world of profit-driven health care, nurses stand as the strongest sentinel in defense of quality patient care. As such, we have no choice but to act: You must speak out, you must be heard — patient care quality cannot be allowed to deteriorate further.
All across the country, nurses are mobilizing, organizing, giving voice to concerns about the negative changes in the health care industry. UNA/AFSCME has been, and will continue to be, an aggressive advocate for nurse issues and nurse concerns; we encourage you to join this effort by coordinating activities at your facility or institution.
As the servicing arm for more than 40,000 RNs, LPNs and LVNs, UNA/AFSCME has been tackling the issue of quality on the front lines where nurses work. To assist nurses in implementing the "Rights of Quality," UNA/AFSCME has developed the following definition:
"Quality will be maintained in an environment of barrier-free and accountable nursing practiced in a safe and supportive setting resulting in optimal outcomes for clients and families from an appropriate mix of professional, technical and support staff."
The first step involves taking a critical look at your facility to analyze the challenges and barriers in your own work environment. Please use the Action Plan Form at the end of the manual to initiate a problem-solving process for your local or affiliate at work. The components of this process are summarized as symptoms, prescriptions and treatments:
Sx
What are the symptoms? What is going on at your facility? How involved is the union in decision-making? Is TQM or another form of self-governance present? How effective is it? Is redesign or privatization on the horizon? Is patient-focused care, multi-skilling or downsizing likely? How competitive is the market? Are their mergers/consolidations? How strong is your facility? What is the political climate? Do you have allies?
Rx
A ANALYZE the health care marketplace, the community standard of care, the number of Medicare/Medicaid clients in your facility and the community, state and local regulations, risks to the Nurse Practice Act, community health needs, the strengths and weaknesses of your local or affiliate.
F FAMILIARIZE (or understand and integrate) the information, educate your membership, assess the community for coalitions and allies.
S STRATEGIZE and identify goals, develop a plan, involve the membership, formulate a message(s), reach out to allies.
C COMMUNICATE by developing an internal plan for your facility and your local or affiliate, using surveys, focus groups, brown bags and written communications. Develop a community outreach plan to advocacy and consumer groups, the religious and labor communities, political leaders and the media.
M MOBILIZE and define "doable" tasks for activists, reach to what motivates members and consumers, develop a focused and working committee.
E ENERGIZE by evaluating often to keep your plan focused and in motion.
Tx
What is the treatment? Is maintaining the status quo an option? Is your plan realistic? What modifications do you need to make? What is the timeline? How will you measure success?
