Celebrating Nursing: Perspectives on the Profession

Celebrating Nursing: Perspectives on the Profession


(bell rings) – We have only an hour. So I don’t wanna minimize
one single moment of our time with our extraordinary panel. My name is Pat Cloonan and it is my really
exceptional honor to serve as Dean of the School of
Nursing and health studies. As we head towards national nurses’ week, we really are just delighted
to welcome you to Georgetown for this celebration of nursing. We have distinguished colleagues
from many different venues and many different organizations. And frankly, as I looked
at the respondent list, I was kind of blown away by
the extraordinary talents, the breadth of expertise and
the breadth of experience that you all bring. We have people from schools of nursing, professional associations, foundations, community based organizations,
hospitals, local and federal government,
just to name a few. So it is really a humbling
experience for us to begin to think about ways in
which we engage together, to advance the profession
that we all love. I’m very grateful for the
opportunity to welcome our esteemed panel to this
beautiful venue at Georgetown. This is Gaston Hall and
many have graced this stage. President Bill Clinton
and Secretary Clinton, President Barack Obama,
Congresswoman Shirley Chisholm, First Lady Laura Bush and
of course Bradley Cooper, (laughing) and now you our extraordinary panel. So we’re just grateful for
your presence with us today. It’s a special pleasure
of course to welcome the honorable Lauren Underwood who represents Illinois
14th Congressional district in the United States
House of Representatives. As most of you know the
congresswoman who was elected this past November to
serve in the 116th congress is a nurse. In fact, yay.
(crowd applauding) Sometimes all you have to do
is write RN next to your name and (laughs) sweet. But I also wanna point
out that among her many pre-congress achievements,
she actually taught Health Policy to our graduate
students here at Georgetown and I’m looking at heads nodding, I’m assuming that some
of her former students are in the room. As her official bio reads,
congresswoman Underwood is the forest woman, the
first person of color and the first millennial to represent her community in Congress. She’s also the youngest
African American woman to serve in the United States
House of Representatives. Within the house, she’s a member (crowd applauding) Her work in the house includes membership on several key committees
including education and Labor, Homeland Security and Veterans Affairs. Additionally, she’s a member
of the House Democratic Steering and Policy Committee and is co-founder of the
Black Maternal Health Caucus. Congresswoman Underwood completed
her Bachelor’s of Science in Nursing at the University of Michigan and her Ms MPH at the
Johns Hopkins University whose Dean and faculty are with us today. (crowd applauding)
Yay. Congresswoman Underwood began her career as a public health nurse in Chicago then went on to work as a senior advisor at the US Department of
Health and Human Services, which she worked on the implementation of the Affordable Care Act. So I could go on and on,
but I also am reminded that we really are blessed with a robust and extraordinary group of
nurse leaders on our panel. So let me take a moment and introduce them and then we’ll begin the conversation. To my immediate left, we have
Miss Eileen Brennan Ferrell, a double Georgetown
graduate, who’s the chief Yes.
(crowd applauding) Eileen is the Chief Nursing Officer and Senior Vice President at Medstar Georgetown University Hospital. And I will say that Eileen
leads an absolutely exceptional team of nurses, many
of whom are here today. And of note, that team
was recently recognized with the magnet designation for
the fourth consecutive time. (crowd applauding) I should also say that only 50 hospitals in the United States have earned that designation four consecutive times. And it really is a testament, I think to Eileen’s great leadership
that Medstar Georgetown is one of them. Next to Eileen, we have Maria Gomez, a Georgetown nursing graduates (crowd applauding)
(laughs) who is founder, president
and CEO of the Neri Center, which is truly an extraordinary
community health center that serves the residents
of the district of Columbia for over 30 years. Maria has been recognized for
her exceptional contributions to health and wellbeing of
literally thousands of Americans, particularly among the community
of immigrants in the city. In 2012 President Obama awarded her the presidential citizens metal, the second highest civilian
honor in the United States. (crowd applauding) That’s just humbling to have you with us. Next we have Dr. Pat Grady,
also a Georgetown Grad. (crowd applauding) Who, I just can’t help myself really, who led the National
Institutes of nursing research with distinction from 1995
until her retirement last year. Pat, who is an outstanding
scientist in neuroscience in her own right is a fellow
of the American Academy of Nursing and an elected member of the National
Academy of Medicine. And last but certainly not least, is our beloved Dr. Mary Wakefield. (crowd applauding) Who served in the Obama administration, as acting Deputy Secretary
of the US Department of Health and Human Services as well as administrator
of the Health Resources and Services Administration. As an export in rural
health and health policy Mary is also a fellow of the
American Academy of Nursing and an elected member of the
National Academy of Medicine. And I can’t resist but quickly
adding that Mary, Maria and Pat have all been in
service to our community as visiting distinguished
professors for the past year. (crowd applauding) And Eileen is an invaluable member of our school’s board of advisors. So we’re grateful for
all of their service, their contributions to
our learning community and it’s an honor to have you here. So the structure of today’s
panel will be a moderated discussion with our guests,
followed by some time hopefully, with a question and answer
period for the audience. So let me begin with our distinguished representative Lauren Underwood. I’d like to ask you to
reflect on two key areas. First, I know that many of us in the room have had the opportunity to read about your path to Congress. Some of us have had the
pleasure of actually hearing you talk about
that, but I was hoping that you could spend a
few minutes, particularly for our students and our
early careerists to talk about your personal story and to
highlight how your education in nursing has really
led you to where we are. And second, reflecting on
today’s celebration of nursing, which is really what
this event is all about, it would be interesting
for us to hear from you about what you see is the priorities in the profession as well as
in healthcare more broadly. So I’ll let you take
it away and I sit down. – Well, thank you for
having me this afternoon. I’m so excited to be back on campus, to be here at Georgetown and
to have an opportunity to chat with these legends on the stage today. This is a real treat. I was diagnosed with a heart condition when I was in elementary school. I have an accelerated heartbeat and had to see a cardiologist quarterly. And so the care that I
received from those providers inspired me to go into health care. And once I picked nursing,
I felt pretty comfortable that I have found what I wanted to do. Now, when I was in high school, my mayor, appointed for the first
time high school students to local boards and commissions. And so I applied and got appointed to the Fair Housing Commission
in the city of Naperville. A city that’s mostly owner occupied homes but for the small percentage
of folks that rented it turned out that they were experiencing a lot of discrimination. And so got a chance to investigate it and make recommendations to City Council for how to improve our
community and I loved it. I was like, you all
are letting me do this? This is fantastic. And so for two years I had an opportunity to serve my local community and then one off to the
University of Michigan, not knowing what I was going to make of that local government experience, but knowing that I wanted
to go into healthcare. Well, second semester, freshman
year at 8:00 AM on a Monday, we had this honors course,
Policy and Politics in Nursing and Healthcare. No one was excited about it except for me. And that class changed my
life because I found out about a field called health policy where I was able to combine
my clinical interests and this government interest and knew that I could have
a whole career in that area. So, I spent a summer
after my sophomore year interning on the hill, I
worked for Senator Obama. After my junior year, I went down to CDC and did an internship. And so when I graduated,
went right to Hopkins and ended up doing some
clinical rotations, doing the MSN portion of my degree, working with an association that works with schools of nursing to
advocate for nursing education during the shaping of
the Affordable Care Act and the Stimulus Bill. So nursing was a real grounding for me and beginning of my health
policy career at that time, I also was a fellow at NIH. That was my first job, working in the nursing research service as a newly minted RN and
helping them run a study. And so upon graduation went to HHS, the US Department of
Health and Human Services as a career federal employee, I worked for the American people. And I had my dream job at
23 able to help implement the Affordable Care Act. I worked in private insurance
reform, healthcare quality and Medicare and preventive
services, the screenings, the vaccines and the
contraceptive coverage, everything the Obama
administration was getting sued on. (laughing) I had in my portfolio in terms
of the things the secretary would sign, I had an opportunity to work with Dr. Wakefield in
that role and to learn from her experience and I loved it. And then got a call the
week that Mr. Duncan had a bowl in Dallas and they
asked if I wanted to join the president’s team to help
them with that response. And I said yes, and ended up
staying in the administration until the very last day. So you can imagine, right? You work all these years
to help provide health care coverage to 23 million Americans. We all thought election
was gonna go a certain way that didn’t happen and
the Trump team came in and they were immediately like, we’re gonna take away health care coverage from the American people immediately. And I wasn’t into that, not a shocker. And so I decided to move home. It sounds like you all know
the story of how I decided to run for Congress. But this was a long shot, right? This was not a race that people thought was necessarily going to flip, but I knew that we could be
successful and healthcare ended up being the number
one issue in our election. So to the question about what
does the agenda look like? I think health is at the very top of our national policy agenda, I believe healthcare is a human right. That’s been foundational
to my nursing practice. And I think, but that’s probably a value (crowd applauding) a value that’s shared among this room. However, our current
policies don’t always express it in that way. Most egregiously because
healthcare remains out of reach for so many individuals because it’s so expensive. And so we have a lot of work
to do in terms of premium affordability and drug
price affordability, expanding access to coverage. There’s no reason that in
2019 we should have tens of millions of people uninsured
in our country, and we do. And so we’re working on
all these issues every day. And we need to hear from you. We need to hear from the
clinicians and from the students and the experts in this field, right? Because we hear from the lawyers, we hear from the economist, we hear
from all these other folks, but we don’t always hear your voices. And that’s what’s, I think,
probably most important to help shape the way that we’re
gonna transform our healthcare system in the coming year. So that’s number one. I think number two, we do have a really robust nursing agenda. And there’s only two
nurses in the house now. There’s me and Eddie Bernice Johnson, chairwoman Eddie Bernice Johnson, who chairs the Science Space
and Technology Committee. How amazing is it that we
have a nurse that chairs the Science Committee. And so (crowd applauding) in an era where we have a
president that’s completely dismissive of facts,
right, doesn’t see science as something worth investing
in and certainly doesn’t have a commitment to evidence based data-driven policymaking
to have two strong nurses in Congress is important, but we need others to
help us move this agenda so that we can have more
dollars for nursing research. So we can have more funding
for nursing education, so that we can inspire
future generations, right? Because the nursing shortage
that we saw at the end of that first, the two thousands decade we are not completely insulated from those workforce shortages. And so we have to be aggressive about the full planning
for our profession. There are a variety of
workplace safety issues, right? We know that nurses are
continually being attacked and threatened on their job and there’s a lot of work
that we can do in that space. And so, I think that many
of us are so comfortable advocating for our patients. We’re so comfortable
advocating for our communities, but we don’t often advocate for ourselves and certainly not on Capitol Hill. And so it was a real honor
in my career to be able to teach in a program
here that taught nurses how to do this. And I commend Georgetown
for continuing to make that a requirement in
the Master’s program. But I also think that
it’s up to us, right, if we wanna see some
advancements for our profession, we have to be willing to do the work. And so I’m gonna encourage
all of you to think about what you can do, to help
our profession move forward in that way. – Great, everybody got the job now everybody know the action plan. Sounds good. So you’ve talked about costs,
you’ve talked about access, you’ve talked about nursing
education and research and safety is overall
priorities for the profession and more broadly healthcare. Do the other panelists have
anything that they wanted to contribute to that particular
question around priorities for the profession and
priorities for healthcare? Now it would be the moment. – To respond to Congresswoman
Underwood’s plea to get involved because I would like to say that nurses compose the largest and most trusted component
of the health care team. And they are trained to do research and to improve clinical care and policy. So I think we should
take what she’s asking us to do very seriously and act on it the minute we get home. – Maybe even before.
– Well that’s right. – And actually I just love
the congresswoman’s comments. As a matter of fact, I
felt like throw this away because she just, she’s so succinctly and beautifully made the points that I want you to, I want to come in and right behind Lauren’s comments and behind yours as well Pat and say that there is the
obviously nurses play a critical role in health care. Nurses have tremendous
expertise in deploying that role in healthcare as educators, clinicians, nurse exacts researchers. And in addition to all of that expertise and the the delivery of that expertise to patients care, we have a lot going on as congresswoman Underwood indicated in the health policy arena. That very much shapes
what happens to patients, what happens to their families, what happens to our entire communities. And I would say one of our
highest priorities right now is to ensure that the work that nurses do embraces engagement in health policy. I say that to brand new nurses. I say that to nursing
faculty, to nurse researchers, to all nurses as we
all have a role in that because that area is so influential in terms of impacting who
has access to healthcare, what kinds of quality care delivery, what is the affordability of healthcare, how do we manage under chronic conditions? And so we’re very much about strengthening and improving health as
a nursing profession, but we can’t achieve that aim without also impacting one
of the most impactful areas. And that is the health policy arena. Sharing our expertise there. And I just wanna stay
on the back end of this. This doesn’t start today, this
didn’t start 10 years ago. This started all actually all the way back to Florence Nightingale. Really when you look at that leader of our shared profession, she was active in clinical care, she was an incredible researcher. We’ve got another one here, but she was an incredible researcher and she was also a nurse
executive and not instead of, but and she also engaged
with policy makers to inform their thinking, not just about nursing, but
to inform their thinking about health and healthcare delivery. Think of that in the 1860s. So what you would have heard
her talked about up here isn’t a new concept, but I think we’ve got an opportunity to leverage much more robustly than we have been historically. And we’ve got great nursing associations, American Nurses Association,
American Academy of Nursing who are advancing this
agenda, others as well, but they can’t do it
without rank and fall nurses without nursing faculty, without nurse researchers and so on. So thanks so much. I sped it up on the back end. (audience laughs) – I just said. I think there’s a couple
of things and I echo, I mean it’s tremendous and I would add that there’s a lot of opportunities we see it play out and the health center where innovators of technology, right, nurses would be perfect as
innovators of technology. We have researchers to come
in when try a new gadget and they want to know, whether
it works on the community. And so nurses can actually
talk about the affordability and the accessibility and
the cultural competence of those technologies
for those individuals. And I think pharmaceuticals,
we work with pharmaceuticals all the time and they’re all, they’re gonna
be there forever and ever. We’re not gonna get rid of
pharmaceutical companies. And so I think nurses have
such an amazing ability to inform, again, about culture again, about affordability and actually
also about accountability and responsibility of the
pharmaceutical companies. In the last one I would just
say is I think we need to elect or get our first Secretary
of Education to be a nurse and chancellors of public
school systems to be nurses because that’s what
we’re gonna find nurses that are gonna bring education, healthcare and all of the social determinants
all into one department if we elect the first secretary and so (crowd applauding) – I would just say that, obviously agree with all these wonderful comments, but just to showcase, we
do recruit at Georgetown from all over the country and we actually as a Magnate Hospital have a very, very detailed shared governance program, which includes a legislative council. To our knowledge we’re really
the only one in this region and according to Magnate that has that. So we are trying to bring
all of these young nurses from around the nation to
come and Capitol Hill’s down the street, see what it
is, how can we make change? And I think there’s probably
some of our legislative council here, oh a bunch of them here today, that are very interested and focused, not just on nursing issues
but health care in general. So they’re really quite a wonderful group and I hope that you’ll
get to meet some of them. – Great, so now I’m
gonna shift a little bit and get down to the granular perspective that each of you bring from your particular forecast and domain. And I’m gonna start with you Eileen. As I mentioned, Eileen is the Chief Nurse at Medstar Georgetown University Hospital. And even as a public health
nurse, I’m well aware of trends that seem to be effecting
the acute care of environment and frankly, somewhat alarming ways. When I look at the increased
need for mental health services and simultaneously, at
least here in Washington DC the closure of certain
services and the closer of certain hospitals,
it’s deeply concerning, regarding how it is that our
system can continue to provide the needed care for people
who so desperately need it. So I’d be interested in your
perspective as a Chief Nurse of acute care facility for how hospitals and frankly the nursing
workforce in particular should be thinking about
preparing for these trends. – Sure.
– A small question. – A small question and a
brief answer as instructed. So and I do wanna say
that we recruit heavily at the University of
Michigan and at Hopkins and we’d love that. Always producing amazing grads. So I just made kind of a list of things that obviously acute,
academic centers are feeling. It just was at a conference
with Jesse Knowles from Academic Centers where
we all have the same issues. And I’m sure they’re just as many of these that reflect community
hospitals, rural hospitals, and of course critical access hospitals. But, so I sort of have
about nine quick things that you can think about. Our patients are getting way more acute, they’re very complex
every day, it’s amazing. Our case mix index is skyrocketing. Even in our future
planning, we never dreamed that it would be at this level. Hospital closures, whether they’re locally or they’re nationally, they’re unexpected and they’re very difficult to manage. In the district right now we
have two really serious issues going where there just are not
enough health care services available to the communities
in which these people live. We are very worried about
our maternity population and our psychiatric
mental health patients. And it’s not just for adults,
it’s geriatric mental health issues are huge and our
pediatric population locally and nationally, there’s
not enough services available for them. We’re feeling it dramatically
in the acute setting as well. And just local community placements, there’s just such a shortage, whether it’s you need acute
care, you need longterm, you need rehab, you need home health, there just aren’t enough
places for patients to go. And as a result of that, our
length of stay in a hospital like ours is dramatically
increasing, which you can say, well, what’s the big deal about that? The big deal is, there lots of
patients that need to come in for really serious acute care
needs and we can’t meet them because we have patients boarding in the ED patients
boarding in the pack use and just no movement whatsoever
because the community is not providing areas for
us to place these people. And of course there’s plenty
of financial pressures as we all know in no matter
what area of healthcare you’re working in. And then as you mentioned,
workplace violence is such a significant problem for us. We are being very aggressive about that, but it’s not only
patients being aggressive, it’s their family
member, it’s their guests that’s in our hospital, the
visitors that are coming to us it is a major, major concern. Again reflecting on this other
meeting I was at with CNOs from academic centers,
it’s pervasive throughout the hospital system in this
country and it is getting worse and we are not addressing it correctly. We are putting our healthcare providers at risk in our hospital environments. It’s very, very concerning. And then of course we are
always looking for more funding for nursing education and research. And the big question
is who is going to care for the patients of the future? Who is that person who
provide care to them? So I think those are
just a few of the things that we’re feeling pretty dramatically in the acute care setting. And we’d love to have lots
of great answers for those. – So you don’t have the answers? – No
– We have a pen ready. – Next time.
– Next time. Well, I mean it strikes me that your work with your legislative council
and in many of the issues that you raised, it seems to
me really do lend themselves to policy solutions and research solutions and the ways in which we
collectively need to be thinking about preparing the health
workforce on our end and engaging them in
sort of the full breadth of nursing practice on your end. Particularly as we look at
what seems to be teeing up into the future. So lots of interesting
things to be thinking about. – Yes. – I’m gonna switch a little bit again to talk to Maria who really,
her work at the Mary’s Center is really exemplified by
quite magnificent partnerships I think that you’ve developed over time, whether it’s partnerships
with schools, with payers, with hospitals, with health systems. And I’m wondering if you
can talk a little bit about your experience in
developing partnerships because it seems to me that
our ability to move out of our silos and to engage
across not only disciplines but organizational structures is something we all could begin to think
about as we look at addressing some of the acute care issues
that Eileen just raised. – Yeah. – Well first of all, I just
wanna first of all say thank you to my team that’s here. There are government is one of our, she’s a Chief Nursing Officer. (crowd applauding) I’m sure there are other people here, Linda who is our Head of Communications and I can’t see what all this lights, but I know I see them, but
all of you who are here, but thank you so much. I think that what we have
found with partnerships is that Mary’s Center
could have never started without those partnerships. It started with the
partnerships in the beginning when we first started with
the hospital, the one hospital that closed, was our partner. But I think that it’s looking
to see at a community level who can see what kind
of partnerships really are not just, addressing the needs that we have as a center. But also what is happening
and what’s happening in the community and to
look forward into the future to see what are the needs
so that we can start working with those partners in the beginning. So I think that I would
just say for instance, the basic ones that we
have to always partner with is basic housing and food. Food and healthcare
definitely are other ones that we are actually
everyday struggling with. We struggle a lot with
the issues of trying to, if we’re gonna even have housing and have food for people on a table, we have to make sure that
they have representation. So working with law centers
to make sure that people are represented, to
make sure that they keep their housing as opposed
to losing their housing and having to go through that process. I’m working with the city. We were very instrumental Mary’s Center who was very instrumental way back in 2001 when the this district got
a DC Healthcare Alliance, which is an equivalent of DC Medicaid that now helps folks who are undocumented or otherwise not able to be
part of the Medicaid or the ACA. So it’s that is being
involved in that level, I think in partnering with them,
we pushed and really fought to be a partner with PEPCO because we were seeing
a lot of our clients who are losing electricity, losing gas, losing their utilities
because they are working in too many jobs and the
other priorities besides that, you had to pay the rent even
if you don’t have electricity. And so pushing PEPCO for
us to become their partner and their, what they call their
energy assistance program. So we have the energy assistance program in Prince George’s
county, which is really, we have one case for instance,
of a kid who was home on a respirator and lost electricity and we were able to get
the electricity back on. People say, well, why do we
have right now as we speak, we have a whole of a parking
place where the boxes and boxes of car seats. Why car seats? Because our families are
not going to make the trip all the way to the department
of motor medical vehicles to get a car seat. So we do the car seat, the city comes in, they get the car seat,
they get the instructions, they get the whole thing done. I think we moved out of our own four walls to go into the school system
and provide behavioral health care because we were
seeing again, so much violence. And behavioral health to us is not, I mean, one of the things that we struggle with to try to fund, but we do it on a daily
basis is over 20 schools that we actually are
not just seeing the kid, but we also are seeing the
administrators and teachers because sometimes they are the problem. They are the reason why this
kids are behaving so terribly. Or they themselves are coming
with, a lot of our teachers are coming with a lot of
stress and a lot of issues that need to be resolved. So dealing with the
teachers, the administrators and then with the parents
and the child really is at the bottom of the list. Although that’s why we’re in there. But I’m dealing with
that, those partnerships and those are not easy to bring on all the ones
that I just mentioned they seem like, Oh yes, like why shouldn’t there be a partnership? Get in the city to actually come and do the car seats way back, like almost 28 years ago was a struggle, but we were seeing so many
people that had their kids killed because of that not having car seats. And then managed care
organizations, really, really establishing and be an innovative. And there are our chief nursing
officer as a great example of bringing telemedicine and
saying to the managed care organizations, you’re struggling to meet the quality outcomes, how can we help you? But also again, keeping
the community in mind. And that is saying, what
does the community need for the home bound person? What does somebody who
is a medical assistants, who are some opioids we can’t
get into, how can we get them through telemedicine being
in their home and so forth. And I think I would say
that the hardest thing that we have had and partnering
with and we’ve on and off it has been hospitals and
the departments of health. And I think, it’s because
in many times I’ve heard the department of Health tell me, just like what do you think you’re, you think you’re the department of Health and no, I’m not the Department of Health. That’s exactly, we wanna be your partner. And so and so did you know from doing the community assessment is
a struggle to include us. It’s a struggle for us
to lead on certain pieces that we know we’re in the community and we’re better to knowing. And in the same thing with hospitals, I think because of the whole thing of being so acute and so many issues, I think it’s hard for people to get out of those four walls of the hospital right and look and see what
are those partnerships. So I’m looking forward to, I think there’s some great opportunities for that to happen and I’m
looking forward to that. – Right, and it seems to me
as someone who thinks a lot about social determinants of
health, that really being able to do partnership with the Martha’s table and with the school system and engage sort of the legal community as well. It seems like the way
in which we should begin to be thinking about moving forward. So Dr Grady, I think there’s
been a few research questions that perhaps have arisen as a
result of this conversation. There’s absolutely no shortage of domains that really need the
attention of neuroscientists. And I’m wondering if you could
spend a couple of minutes and lay out for us the areas of research that you think it’s important
for nursing to focus on, into the future. – What else did you say (mumbles) There’s no dearth of
questions to be addressed and information we need to have, but although we have a
critical mass of nurses, we have fewer nurses who are
actively engaged in research. So it’s really critical that they address the most challenging and
important health care issues so that we can have an
impact and be able to come up with those answers. Nursing research has been
instrumental in developing programs to decrease premature
births, to help teens manage their diabetes, to help prevent the spread of HIV AIDS. And as our population ages
many people are living with chronic illness and
nursing research helps people to manage those symptoms and
help our seniors to continue to live productive lives
and to age in place and live independently. Many of these successful research programs have been translated into
patient care or into policy, to help improve the lives of our citizens, including the Affordable Care Act and which two of our esteemed panelists have worked very hard on. But it’s really important, it’s essential that we grow on the foundation of work that has been done and continue to direct the efforts of nursing research to improve the lives of all of our
citizens every single one. Particular areas of focus
include maternal child health, addressing the health of
our underserved populations, and also creating and
testing new models of care that take into account a
variety of care settings. Some of these issues having
been already mentioned by Eileen and Maria. But also to be able to
include community health care delivery and assisted living
in a variety of settings that are population is gonna
be and as we move forward. Our infant mortality
rate is alarmingly high for a developed nation. And this disproportionately
affects our minority populations our young adults are showing
a higher incidence of obesity and a higher incidence
of type two diabetes what we used to call adult onset diabetes. And also increasing
mental health challenges with the type of society
that we’re developing. Our seniors need strategies
to age successfully while remaining active and
the majority of these seniors, as time goes on are going to be women. So this is a really strong
women’s health issue. Nursing research studies
can address these issues by exploring behavioral modifications and also ways to live healthier lifestyles and to change as well as increasing access to health professionals and health care through interventions on many
of which you may have heard about some of the anticipatory
discharge planning and follow up. Things that we used to do
that are not done as well. But we can do these better
if we test out systems to show us the way to go. Then these advances can be translated into improve patient care, and also policy that can guide our legislators. Because they’ll be able to use real data to make these decisions. They have to make the
decisions moving forward in the absence or the
presence of the data. And so we want to be vigilant and being able to end
responsible to provide that data as we fast forward a
future of increasingly complex health challenges. So that’s in a nutshell. – So if anybody’s looking
for a PHD dissertation ideas that we’ve got a few for you here. (laughing) And through this, the recurring
theme of policy solutions I guess is a logical
place for us to move next. In your perspective,
Mary, what do you think the opportunities are at
hand to leverage nurses, particular expertise that
may be weren’t present five years ago? To bring, what characteristics
do nurses in particular bring to the policy arena to make
their voices as they represent an advocate for people who are
vulnerable and marginalized? How is it that we should be thinking about moving those ideas forward
from a nursing perspective? – I think first of all that
nurses don’t always feel incredibly confident in their ability to inform health policy
and yet they are in my mind some of the perfect packages
of expertise, knowledge, skill to advance policies
that are ultimately supportive of the aim of our profession, which is to strengthen and
improve health of individuals and families and communities. And I wanna just make a side comment about Pat’s prioritizing,
not prioritizing necessarily, but identifying a number of different research areas of focus. I could take every one
of the areas of research that she mentioned from HIV
prevention and on down her list and I could have a conversation
with her about thinking through the policy implications,
how we advanced policy and informed federal and state programs for each of the populations
that she mentioned. So when we think about policy,
it’s really part and parcel of what we do. And so what does nursing bring to that? Nursing brings I think
first of all, evidence. We have a much deeper evidence
based for our profession we wouldn’t think about
practicing except to be informed by contemporary research, no
matter where we’re practicing if we’re in public health
or if we’re working in an intensive care. So bringing evidence to informing policy is also incredibly important. So there’s much greater
comfort level, I think between nurses and evidence
that undergrads are practicing. And I’m suggesting taking that
orientation and remembering that it’s that very
evidence we want to lift up and put in front of policy
makers to inform their thinking about the needs of a
particular population, how to better manage more
efficiently the delivery of healthcare through health systems. Wherever nurses are researching,
there’s just a direct tie in my mind in almost all
areas to taking that research and that evidence, lifting it up and using it to inform policy. And I think we’re in a much
stronger position today than we were when I was
graduating, for example, from school to do just that. And I would also say
that in this day and age, much to my Chagrin, we don’t always have everyone, accepting evidence. That I think is part of
nursing’s responsibility too because we have a special
place in terms of recognition of the public and our relationship, is an important and unique relationship with the American public. And I think it’s time for nurses to think about how we take evidence
and talk about evidence informing for example,
vaccinations to better manage diseases like measles,
help the public understand and also inform policy
makers about what else they could be doing based on evidence. And I’m not suggesting we only pivot from nurses generated evidence. There’s a lot of other
evidence from a public health, other disciplines that
nurses can be packaging and using again to inform policy makers. And that’s a comfort
zone we’ve gotten out. The second, the third
thing, areas that I think that we bring is that personal interaction with individuals who are
experiencing healthcare challenges. We know it. We don’t know what in a vacuum
because we’ve read about it. We know it because we’ve practiced. We’ve worked with individuals. We’ve worked with communities
that are facing serious sustained challenges with their health. That’s why we’re often
interfacing with them. We work with them to manage their, to help them to manage wellness, and mitigate against symptoms associated with chronic illness. So that’s an area that
we’re so familiar with, that needs, priorities, etc of
patients, people, communities with whom we work and who we serve. It’s that firsthand
experience that’s so important to informing policy as well. So it’s the evidence and it’s the story. It’s the anecdote. And I can speak to that,
I’ve practiced and trust me, I’ve reached back a hundred times. If I reached back once
to the thinking about and lifting forward my interactions with the needs of individuals and saying, and this was my experience
and this is why this policy is one that needs to be advanced now. Literature and evidence
as I said, and also that personal experience
of professional expertise that we acquire over time. And third, nursing brings an
incredible set of core values. I am so proud of the values that are our profession embraces. It is first and foremost about the people for whom we care always
and every time, every time. That is our north star in our work. And that means our values are grounded in a humanitarian approach,
in a person centered approach. It’s very much about the
people for whom we care. It isn’t about their genetic code, their zip code, their country code. It’s about what can we do to help ensure that they are as healthy and
as safe as they can possibly be in terms of their own healthcare, regardless of any of the other
static in the environment. We’re focused like a laser
as a discipline on that. And I’m hopeful that every
bit is true for generation x, for millennials, for baby boomers, for the nurses that came before us, the nurses that are gonna come after us. That is our core. It’s the core that we operate from. And I think that that’s to what we bring to informing health policy. It is not about us. This is about what’s in the best interests of the health of Americans. And that’s what US nurses,
what United States nurses have always been about as
what we’re about today, that’s what we’re gonna
be about 15 years from now and 50 years from now. And that means taking that
orientation and saying, this policy compromises
the health of Americans or this policy compromises my
states, population’s health or a subset of my state’s population. This policy advances health. And we do that not because of us, but because of this disciplines,
our deep seeded values that are so, that provide
us with the guidance I think that is so incredibly important. So I think that’s bottom line why we need to engage in this space. It’s not the only place to
advance health from the country that is in the public policy arena, but it is unbelievably deep and wide. I can influence the health
of seven patients on a shift. I can influence 70
students in a classroom. I can influence the health
of 70 million Americans if I weigh in along with
hundreds of my other colleagues on a health policy issue. That’s the impact
(audience applauding) Now, what was the question you ask me? (laughing) Anyway you get the point.
– Yeah. (laughing) – And you get my point that we
as a community are so blessed to have the perspectives,
the energy, the commitment. Really, you almost sound
like a Georgetown Grad, Mary, (laughing) – Listen, I don’t think you
would have taken me, trust me. (laughing) Oh well. – So let me now circle
back to the congresswoman based upon this sort of array
of really interesting ideas that have been brought
forward, other dimensions that you’d like to add
or the things you’d like to expand upon. – Well the only other thing I would say is we can’t ignore the politics of it. One of the things that
I learned pretty quickly in teaching my course here is that, nurses sometimes come into this work with a certain set of political views. Maybe they are raised that way
or culturally we’re expected to assume those political views. And then as they started
expanding their worldview to consider what was
best for their patients or what was best for their community or what was best for their profession, they found themselves considering a different set of political views. And that’s okay. It’s really necessary. I think that a lot of what
we’re discussing up here today, whether we’re talking
about research dollars and a research agenda and
really pushing forward, to actual advancements,
that’s not partisan. It’s not. Making sure that we can
actually pay for health care, making sure that we can
actually deliver services in the communities that people
live in, that’s not partisan. It’s not. And so, so much of the work
that I do gets stuck in the mud of this partisanship,
but the actual problems and the actual solutions themselves do not end up being partisan. And so please do not let
that gridlock stop you from engaging, right? Because we have the ability as America’s most trusted profession. We have the ability as
true experts, no matter if you just be gone your nursing education or it’s whether you’re
the post doctorate fellow with 200 publications or
whether you’re one of the folks on the panel today who
have considerable expertise in your line of work. We all bring deep rich knowledge that has nothing to do with politics. But if we sit out or
we don’t engage someone who’s in decision making role because we don’t agree
with their politics, then we failed.
(crowd applauding) We haven’t shown up for our communities, we haven’t shown up for our patients and we’ve let each other down. And so I think that in
these conversations, we can be United on a policy agenda, just like we can be United
on a research agenda or ways and partnerships and advancements or what we can do in
individual institutions. We can unite around those visions. But sometimes we ended up being fractured by the political lens. And I’m just gonna urge
everybody to keep it in mind, but don’t let it keep
you out of the arena. – Great Point, great Point. Well now I’d actually
like to open it up to you. We have about 10 minutes left. And so if there are people
here that have questions, our panel would be more than
happy to engage in them. What I’d like you to do is to go to a mic and tell us your name and your
affiliation and to the extent that you can ask the question briefly so we can get as many questions
and that would be terrific. Oh, people are lining up. – [Man] To this mic.
– I hope they’re lining up. – I hope that they’re lining up (mumbles). – Yes, my name is Herald Christian Kim. I’m the new vice president of
Graduate Students Government at Georgetown University,
which is a student government for all graduate students
in the Medical School, Nursing School, Business
School, Public Policy School, Graduate School and
School of Foreign Service and other graduate programs here. And my question to you is,
what do you feel about, health care insurance that is nationalized in the model of United Kingdom, where taxes are paid into the system and everyone receives the same healthcare, whether they’re billionaires
or they’re homeless and they do not have to pay any co-payment when receiving care. Because right now the problem that I see with Obamacare and the Democratic Party and the Republican Party’s models is the fact that money has to be paid. And that just is not an
equitable healthcare system that pertains to human rights. Because public school system, you don’t have to pay anything. So healthcare system that is associated with human rights, a
fundamental human rights must not require any payment of any kind when receiving service. So what do you feel about that? – Great question. – Okay, I assume that’s to me. And so thanks for your question. So I believe healthcare is a human rights that’s been foundational. I think that we are in the
middle of having this really open brainstorm about what we want our healthcare system to look like. And as we think about
transitioning from this fee for service model to
something else potentially, I think that, there’s
been a lot of activity and enthusiasm around the
Medicare for all proposals, which is not the same thing necessarily as universal coverage. It’s not the same thing
necessarily a single payer, it’s a version of that. And in my community when I talk to people and I say Medicare for
all, and they’re like, oh yeah, yeah, yeah, I’m like, well what does that mean to you? And I get 200 different answers, right? For everyone it means something different. And so I think it’s great that right now around kitchen tables,
all around our country, people are talking about what
do they want their healthcare system to look like and
how should it function. And it has reached this level of activity where people are engaging
in this conversation and that’s great. It’s gonna be an issue
in this election in 2020 and then we’ll see what the
outcome of that election is in terms of where we can transition. For me representing a community that is, has some resources, folks
are upper middle class and we think about
transforming our tax system, it impacts my community directly. So a really important
question for my constituents is how much would that cost
and how do we pay for it? And just because there
is a cost does not mean that we don’t do it. But I do think that that’s a
really important part of the conversation because we are
transforming a system, right? We’re not walking in
today with an already done and sort of builtin culturally. I will also say that
inherent in your comments was a binary approach. Medicare for all or the
affordable care act, medicare for all or the current system, and I reject that binary approach. We have got to be able to
do both because guess what, if you pursue a framework
where we just are completely dismissive of the affordable care act and completely dismissive of the system that we have now we’re talking
about 23 million people who would not have
coverage, who would not. And that’s just the realities of our health care system right now. And so we’re in a political environment where folks are very
unsure and very uncertain that they’ll even have coverage
by the end of this year. Because just last week,
the president stood in front of the NRA and he
said, yeah, let’s rip it up. Let’s get rid of the rest
of the Affordable Care Act. Let’s just go all the way and do it right. And so people hear that and they say, Oh God, I need to be able
to afford my insulin. I need to be able to
go and see my provider. And so I wanna just be very careful about how we framed this conversation because I think that we’re
gonna be able to transform our healthcare system. We’re gonna be able to pay for it, do it in an inclusive way, but
we can do so without taking away coverage from people
who desperately need it. (crowd applauding)
Thank you. – Next question. – Hi, my name is Lou. I’m actually part of the hospital and I’m in stem cell transplant. So many patients and I’m
wondering nurses today, talk about nurses to stand up basically and Senator Murkowski actually once said, you have to, nurses need to
show up, stand up and speak up. So it’s easy to do that,
but nurses need to know how to do it and exactly what’s the way of doing it and the correct way. And I think some of these oncology care is so expensive today, but people need to, the government needs to realize, okay, how can we help to lower these costs with these pharmaceutical companies and not just the pharmaceutical companies, but also some other coverage
that can bridge the gap for them to actually
receive this treatment. Many people may only have medicare, so what’s their other option when they don’t have enough
money or a secondary insurance to pay for something
that’s millions of dollars to actually have them live. And from a physician standpoint,
or a nurses’ standpoint, just tell someone that’s maybe
the same age of their parent or their grandparent that
this is your only option and you don’t have enough money or you don’t have the insurance
to actually pay for this. That’s kind of hard to say when you think of that could be your own family member. And I think sometimes some
of the people in politics need to realize that and
stand, take a stand back and like kinda pay attention
to it from that standpoint. Then just the overall. So we’ll, do you think,
– Thank you for your comment. – So what do you think
that could actually be done as far as nurses to like kinda help us? – Well, I think we
heard Dr Wakefield’s say that we have to share our stories. – And even if you don’t know
all the facts about a bill, even if you don’t know the exact details of an upcoming proposal,
you know the impact that you’re seeing on your floor on your unit, in your
clinic or in your community. And telling that story with the sincerity and fidelity and
authenticity that you bring ’cause it’s inherent in yourself. And so it’s really important. I mean, honestly, when
I think about the way that I spend my days and my
colleagues spend their days were not hearing from
regular people, right? Like normal people who are
doing this work every day, we’re just not. That’s not how the congress is set up. I’m sorry if this is shocking to you. (laughing) But and so that perspective
is incredibly important. That’s also why it’s
incredibly important to, I mean, you all are in
the District of Columbia, but I’m sure that many of you, this is not where you’re from from, right? And so for folks who are
from other communities, like we have to go home to
our districts every week. When I go home to my district every week, that is my opportunity to
talk to my constituents, my neighbors, and hear the
directly and super clearly. And people should not be
scared to offer those stories when they have the opportunity to engage an elected official. – Great, thank you. Next question, Oh, I’m sorry. – I would just add that
what I said earlier too. I think being even lower in the startup of this whole pharmaceutical
when drugs cost that much, we should be at the front
end of saying this is not, should not be tolerated. That pharmaceutical
shouldn’t be that expensive and out of reach of so many people. So we should be way back when this pharmaceuticals are being made. We for instance at Mary’s
Center people complain and get upset because I have conversations with some of the pharmaceuticals and we don’t take the money
to kind of do research, but we do allow them to
have a conversation with us and for us to go to their
basis of pharmaceuticals and talk to folks who don’t, and I mean there’s folks,
the scientists have no idea how the pharmaceuticals effect poor people and people with low resource
and people who are uninsured. So it is our duty I think as nurses and I spent quite a bit of time traveling to do those kinds of conversations. So we have to be in the beginning. – Thank you, we’ve time probably
for just one more question. So that’s all right and – Well, thank you so much
for this incredible panel of nurse leaders. It’s so great to see such
distinguished guests today. My name is Alison Sierra
and I work at the hospital. I’m the leader of the Health Advocacy and Legislative Counsel there and it’s been a real
honor probate privilege to be a part of that council. A lot of you have spoken
today about using our voices and telling our stories and
using our expertise as bedside nurses or as nurse educators
and nurse managers to convey to scientists and researchers and policy makers to
inform these decisions. But my question comes to
how do we bridge that gap? That sounds like a really great idea, but what are some concrete ways
that we as nurses can engage in those conversations
and get to those tables where those discussions are being made? If someone could have, many of you could provide specific examples
where we could engage and use our voices, I
would love to hear them. – We’ll do a little lightning round. – Oh rats. (laughing)
– Just kidding. Sorry Mary. – So I’ll just mention a couple of things because the Dean has
suggests they can all say a couple of things. And so maybe I’ll say two,
I don’t know if you saw it, but there was a really
interesting experience in the State of Washington recently. Okay, fine, you know the story. I wasn’t gonna say it ’cause
I don’t have the time. But the point is there’s
a state legislator who made a comment about
nurses who practice in rural critical access hospitals and it wasn’t particularly
a helpful comment in terms of reflecting on the profession. It was stunning to see how
quickly the nursing community responded to that on social
media, Twitter Feeds, public statements from
professional organizations, CEOs, individual nurses
from across the country. And what did they do? They took it upon themselves
individually to lift up photos and some case of their work environments to share an anecdote about
their work environment from all across the country. Inject a little bit of humor, which I actually found
kind of entertaining. Personally and I thought that was fine too ’cause it was done in good taste. So there didn’t need to be for a lot, for thousands of nurses
across the country. Any other vehicle other than, listen, let me help educate you. This is a teachable moment
about what my profession does, even in small rural hospitals a distraction in my own
personal background. So it was incredibly effective. It was so effective that you
could have heard about it. If you’re listening on
CNN, in health trade press, in political outlets
out here in Washington and across the country,
it’s swept like wildfire across this country. It’s that voltage. It’s that energy that’s bottled
up within the profession that periodically it
needs to be lifted up. Individual nurses did it on their own. Some cases there were
suggested it was suggested to them by some of their
State Nurses Associations. I know I’m a member of
my state association and I saw the email coming through, etc. So some of it’s organized,
some of it is isn’t, but the point is it was a
powerful response and it’s that, that we need to harness
in other environments too. And it’s also the pre for the voltage. It’s also a membership and
professional organizations. So it’s as a function as
an individual and be sure that you are a part of
organizations that advocate. Not organizations that
do lots of other things, but nurses or nursing organizations
and other organizations that also have an advocacy
branch and engage it. When they’re suggesting you need to email, you need to respond, you
need to have a conversation. When your state legislator comes home, you take the time to do it. You don’t have to be a lawyer,
a congresswoman Underwood, but boy, it’d be great if
there are a thousand more folks who did that absolutely. But,
(crowd applauding) But you do. I think it is incumbent
upon all of us to engage. The question isn’t I do that instead of, it’s in addition to what I already do. It might be an hour or a month, it might be a five hours a month, but I absolutely engaged, particularly when my
professional association is asking for that because
there’s sort of a feeder. So you can engage
individually and have impact. You can also engage with your National
Professional Association. I tried to talk as fast as I could. (laughing) – Well we’re actually
getting a signal from afar. – Okay. – I think
– It’s God. – It’s close to being up. – So just quickly, I would say piggy back and watch and marriages (mumbles), – That’s all right. – So belonging to the
organizations, speaking to them, speaking out whenever
you have an opportunity, whether it’s in your neighborhood to the Chamber of Commerce,
whether it’s the PTA, whatever, use your voice to speak out. The biggest challenge I find
is it’s not being informed. You have to be informed, but
to be able to communicate in plain language. We all have our sort of guilds
of what we know the initials and are sort of special
language that we use with each other, people
who are in our particular, subset of nursing or whatever,
so don’t use that language. Use plain language and
figure out how to communicate to people so that they
understand what you’re saying. That’s, in my many years trying to communicate Health Science. That is the biggest challenge. It’s plain language. Make sure that they understand and also find out what does your audience, what does the legislator need
to be able to move forward? What are they looking for? What is it that you have to say to them that they’re gonna be the most interested? Or any other audience,
what do they wanna hear that you have to say and
find that common ground? – Okay, so a few things. One, I would encourage you to
write letters to the editor and op eds. Really important ’cause
whatever issue you have, it’s likely gonna be a
community or locally based and you’re going to need
to have a group of people to support your endeavor,
your advocacy goal. So that’s one area. The second thing that I would
suggest is even at the most basic like fundamental
local level of government, you need to know that person. So who is in charge of your
county health department? And who is the person on the
county board that supervises that person on your
county health department? You all should be besties. Depending on what your
clinical area of expertise is, you might wanna know your clerk
or your recorder of deeds. You might wanna know the
coroner and understand what they do and have a good
working relationship there. Just at the local level. Then as you go up, I would
encourage each of you who has an area that
you really care about, get to know the staffer
for your representative, on the state level for your governor, if it’s something going on statewide or for your member of Congress, and get to know each
other and be a resource, you can send information. My team is always reaching
out to folks that we’ve gotten to know in the community. We’ve called over to Hopkins
when we have questions like we call it because we
like to hear from the experts. And you wanna be that
source, that resource or the the policy maker, but it might not be the
member themselves, right. SAP does a lot of work and that’s a really great entry point a to get to
know in terms of the members’ priorities and your expertise. – Great, other comments? – I would say a big piece that
I think is really important that you actually read the
newspaper online of course. But I think that
sometimes we get caught up in everything else that we do, but we’re not really educating
ourselves well enough on actually what’s really happening. And I think that it’s
key to really learning who all these people are
and how the game is played. And I think that maybe
being more up to date on what’s really happening
on a day to day basis on Capitol Hill or on your home legislative front is really important. – I would just say also
don’t forget the power. And I learned this from my
director of communications. Don’t forget the power
of the communications. Like if you’re passionate about something, call the media and say, look, this is an issue in my community, this is an issue in my
hospital, this is an issue with whatever the issue might be. And get on that media or blogging. Blogging is amazing, although I don’t have
to tell young people, but there’s very powerful
and we’re getting some expertise this morning, but another one is just the YouTube. Getting YouTube, because all those media would get to Congresswoman
Underwood and her staff and everyone who says, oh
my God, that’s an issue. They can’t know it all. There’s no way. We get called all the time
from places and Congress from places in City Council for all because they need our expertise. So I think getting yourself
and you know the issues much better and like very,
as they’re happening. And you should be the one to alert. – So thank you for asking that
wonderful question really. We’re very proud and pleased. (crowd applauding) And I’d like to you to join me in thanking our extraordinary, panel really and truly. It’s been a wonderful,
wonderful, wonderful opportunity. (crowd applauding)

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