NRS 440VN Grand Canyon University Health Care Delivery Questions

Question 1 – Choose a legislator on the state or federal level who a nurse is also and discuss the importance of the legislator/nurse’s role as advocate for improving health care delivery. What specific bills has the legislator/nurse sponsored or supported that have influenced health care. Gino Martelli – 1 – According to John Quincy Adams “If your actions inspire others to dream more, learn more, do more, and become more, you are a leader.” It is not necessary that all leaders hold titles, some of this leaders might be you teacher, your supervisor and many more. Nursing and advocacy work hand in hand. As nurse we promote our patient’s advocacy. It is necessary the nurses be “politically active and skillful to influence health reforms and safeguard nursing profession from unhealthy policies and laws” (Alhassan, Kume-Kyereme, Wombeogo and Fuseini, 2019). Eddie Bernice Johnson was the first nurse to be elected to the US Congress in 1992. She is now serving her 14thterm representing the District of Texas. Eddie is a registered nurse who studied at St. Mary’s college. She earned a BSN from the Christian University, where is specialized in healthcare, immigration and veterans. Since finishing her education in 1967, Eddie Bernice Johnson has been very active in politics and advancing healthcare policies. In her job as a congress representative. Eddie Bernice Johnson has been supporting and securing the passing of the bills such as: National Suicide Prevention Hotline Improvement Act of 2019 End of Stigma around Psychiatric Illness. Eddie Bernice Johnson has contributed a lot in the nursing practice, given that the bills she supports are very crucial, for example suicide and stigma (Staebler et al., 2017). Being a nurse, she understands the importance of advocacy through legislation is important in order to deliver high quality patient care. It does not end there; she seems to be in terms with only issues facing nurses at her area of her specialty but also barriers to patient care. Since she was elected to the US Congress, she has supported or influenced many bills such as: HRe316 – that seeks to address the health issues of minorities and the different health disparities HR4704 – a bill that seeks to advance research to prevent acts of suicide, specifically focusing on grants and research to reduce the prevalence. These are few among many examples of bills supported/ influenced by Eddie Bernice Johnson. With more nurses venturing into politics, advocacy through legislation will bring many health benefits. It is therefore important that as the closest to the consumer of healthcare services, and most times the primary witness of inadequacies and inequalities within the healthcare delivery, nurses must be keen about politics to influence positively to the advantage of patients and nursing profession federal and state laws and regulations. Reference Alhassan, A., Kume-Kyereme, A., Wombeogo M., and Fuseini A. (2019). Nurse participation in political activities: Level and practices of registered nurses in Tamale, Ghana. _The Online Journal of Issues in Nursing_ Vol. 24, No. 2. **DOI:** 10.3912/OJIN.Vol24No02PPT63 Duncan, R. (2018, August 27). Titles Don’t Make Leaders. Retrieved January 18, 2021, from https://www.forbes.com/sites/rodgerdeanduncan/2018… Health care. (n.d). retrieved from https://bass.house.gov/issues/health-care Staebler, S., Campbell, J., Cornelius, P., Fallin-Bennett, A., Fry-Bowers, E., Kung, Y. M., … & Miller, J. (2017). Policy and political advocacy: Comparison study of nursing faculty to determine current practices, perceptions, and barriers to teaching health policy. _Journal of Professional Nursing_ , _33_ (5), 350-355. Cara Harris 2- _Shirley Nathan-Pulliam, RN, BSN, MAS is both a Nurse and a Legislator in Baltimore, Maryland. She completed her education in England. Shirley is a big proponent for helping those who are unable to care for themselves, those who are uninsured, and those from many demographic backgrounds. She has spent over 20 years in the State’s House of Delegates. Shirley help sponsor a bill that was signed into law called Health in All Policies in 2017._ On May 4, Maryland Governor Larry Hogan signed into law a bill that engages the University of Maryland School of Public Health’s Center for Health Equity (M-CHE) in advising state lawmakers on healthy public policy. The law directs M-CHE to convene a workgroup that will make recommendations to state and local legislators to inform laws and policies that will promote health equity and have a positive impact on the life of Maryland’s residents. ( ASPPH, 2017) Legislation was introduced by a group of Maryland lawmakers including Senator Shirley Nathan-Pulliam, who is a member of the Education, Health and Environmental Affairs Committee. ( ASPPH,2017) The goal with this bill was to support areas of affordable housing, access to healthcare, education, workforce opportunities and many other areas to assist with bridging the gaps that existed. Shirley has also been very influential in developing access to funds that were created for those inflicted with cancer. In an article where Shirley was asked about her greatest accomplishments Shirley responded “we secured $500,000 towards oral cancer diagnosis and treatment for men living on the street and underserved. Fast forward to 2003, my bill created a plan to address racial and ethnic disparities in the State of Maryland, and, in 2004, my bill, House Bill 86, created the Office of Minority Health and Health Disparities within the Maryland Department of Health”( Campaign for Action ,2018) Shirley is noted by saying some of her most important calls to action have a direct correlation and similarity to her nursing education and experience. She is very focused and task oriented and has utilized her nursing experience in life to assist in changing the lives of others on a much larger scale to impact lives. References Association of Schools and Programs of Public Health (ASPHH). 2017. Maryland “Health in All Policies” Bill Becomes Law. Retrieved from https://www.aspph.org/maryland-health-in-all-policies-bill-becomes- law/#:~:text=The%20bill%20emphasizes%20the%20%E2%80%9CHealth,across%20sectors%20and%20policy%20areas. Campaign for Action. 2018. Shirley Nathan-Pulliam: A Nurse Turned Maryland Legislator. Retrieved from https://campaignforaction.org/shirley-nathan- pulliam-a-nurse-turned-maryland-legislator/ Chinonye E 3- Diane Lynn Black (January 16, 1959) a nurse by trade, business woman and a former Republican member of the U.S. House of Representatives from the state of Tennessee, representing Tennessee’s 6th Congressional Districtfrom 2011 to 2019 (Muruiki, 2021). Black ran for Governor of Tennessee in 2018 but she lost the primary on August 2, 2018. Black’s real-world experiences as a nurse for 40 years have uniquely positioned her as a credible and effective leader on health care policy in Congress. Diane Black is a dedicated leader in the pro-life movement, and has championed legislation that will save lives, including the Pain-Capable Unborn Child Protection Act and the Born Alive Abortion Survivors Protection Act. HR 4978, Rep. Diane Black, Chronic Disease Management Act amends the Internal Revenue Code, with respect to health savings accounts (HSAs), to allow the high deductible health plans required for an HSA to provide care for chronic conditions with no deductible. The bill introduced Feb. 8, 2018 covers care and prescription medicines related to the treatment of medically complex chronic conditions which: (1) are substantially disabling or life threatening, (2) have a high risk of hospitalization or other significant adverse health outcomes, and (3) require specialized delivery systems across domains of care (The Alliance, 2018). H.R. 5719, the Reducing Overprescribing Opioids in Treatment (ROOT) Act, Introduced by Rep. Diane Black (R-TN) and Rep. Tom O’Halleran (D-AZ) in 2018. It improves provider prescribing practices by eliminating pain questions from the current patient satisfaction survey used to determine a hospital’s eligibility for bonus payments. It reduces the incentive for doctors to overprescribe pain medicine (House.gov, 2018). References House.gov, (2018). President Trump signs O’Halleran provisions into law. Retrieved from https://ohalleran.house.gov/newsroom/press-releases/president- trump-signs-ohalleran-provisions-law Muruiki, W., (2021). Diane Black Net Worth 2021: Age, Height, Weight, Husband, Kids, Bio-Wiki. Retrieved from https://www.wealthypersons.com/diane-black-net- worth The Alliance, (2018). The Alliance seeks input on employer health care benefit priorities from congress. Retrieved from https://benefitslink.com/cgi- bin/pr/index.cgi?rm=p… Laura Garcia 4- Nursing practice is a process that has actually facilitated better advancement in the process of patient care in the health care organization. Nurse advocates are individuals who basically are responsible of making sure that they address and present the suffering that patients go through in the health care organization. Through better advocacy process nurses must make sure that they treat and care for all the patients in the health center with equal comparison and respect so that the provision of care can be easy for each person. Nurses are responsible of enabling better advocacy of equal access to care. Each and every individual in the health care unit deserves the same level of attention and comparison (Stamps et al., 2020). So that they can actually improve health care delivery system, nurse advocates should promote health equality and should always include encouraging others not to be involved in discriminating instead they should familiarize with the included model. The legislator involved in this process has actually served as a nurse for a period of 20 years. There are many and various achievements that she has actually promoted and she is proud of their successfulness. One accomplishment that was well received and improved was about the secure of many women who required better attention of the issue of breast cancer. There were more free screening processes which were actually offered to the community to enable better knowledge and awareness of those at great risk for fast attention. She also was involved in the process of promoting nursing education on other nurses so that there can be better understanding of the importance of advancing in nursing education. References Stamps, D. C., Foley, S. M., Gales, J., Lovetro, C., Alley, R., Opett, K., Glessner, T., & Faggiano, S. (2020). Nurse leaders advocate for nurses across a health care system. _Nurse Leader_. https://doi.org/10.1016/j.mnl.2020.07.011 Question 2 – Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue? Responses Cara Harris 5 – ne of the more encouraging legislative moves as a result of excellent nurse advocacy is the Palliative Care and Hospice Education and Training Act. This Act is also referred to as H.R. 647. To further explain is to first differentiate that Hospice care is end of life care which is usually diagnosed when someone has a life expectancy of six months or less. Hospice care, in contrast, provides comfort care and support, but there is no attempt to cure the patient’s terminal illness. It is not tied to a specific place and can occur in any setting, whether a hospital or a home. Death is estimated to be in six months or less, depending on the natural course of the illness (Nurse.com, 2020) Palliative Care is part of Hospice Care, however Hospice Care is not part of Palliative Care. Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family. (CAPC) The fundamental parts of the proposed H.R. 647 is to provide education and training to both the clinical nursing environment, the clinical interdisciplinary team, physicians, and most importantly educating the public to awareness of death and dying and the very important aspect of ensuring a quality of life at end of life. This is in part of the continuous change in the healthcare system moving away from chronic disease management to a platform of early access to care, quality education, and wellness awareness. As of current, there are too many individuals that are living with very compromised diseases that will only continue to need complex care. About 90 million Americans live with a serious illness, such as diabetes, renal disease, stroke and dementia. (Nurse.com, 2020) Chronic disease state management is a burden on our healthcare system, nursing services, and overall healthcare management. As we move to a better platform, nursing has been very instrumental in support of and management of change. As we begin this paradigm shift in healthcare we are challenged with those who are very sick and sometimes without good support systems to assist with making choices such as Hospice Care and Palliative Care which provide excellent options for those who are faced with irreversible complex clinical issues. If the healthcare bill is passed, H.R. 647 intends to amend the Public Health Service Act to increase the number of permanent palliative care faculty in schools of nursing and promote education and research in both palliative and hospice care. (Nurse.com, 2020) Moving the burden of care when there are not any more heroic options to good quality end of life options allows the care delivery system to work in a more preventable environment and assist with preventing onset of avoidable diseases and the costs and times incurred attempting to manage these ever challenging and ongoing challenges. References CAPC. N.d. About Palliative Care. Retrieved from https://www.capc.org/about/palliative-care/ Nurse.com. 2020. This year, make your voice heard on a healthcare bill. Retrieved from https://www.nurse.com/blog/2020/01/02/this-year-make-voice-heard-healthcare- bill/ Shanon Bolin 6 – n March of 2020, the U. S Congress passed three monumental bills, which were intended to provide immediate support in the Unites State’s fight against the Corona Virus (Stone, 2020). With a $2.5 trillion cost, the U.S. government showed their willingness and commitment to the country that it was dedicated to supporting the treatment, hardships and the cure of the virus. The Coronavirus Preparedness and Response Supplemental Appropriates Act provided emergency funding for research and development to several agencies like the Centers for Disease Control and Prevention (CDC) and the U. S. Food and Drug Administration (Stone, 2020). The families First Coronavirus Response Act targeted the American people who jobs, and lives were affected by the massive shutdowns and provided assistance with paid sick leave, insurance, COVID-19 testing and unemployment benefits (Stone, 2020). The third bill, the Coronavirus Aid, Relief and Economic Security (CARES) Act provided assistance for obtaining appropriate personal protective equipment (PPE), vaccine development, support for research from the National Institute of Health, CDC and the Centers for Medicare and Medicaid for nursing home support (Stone, 2020). With this massive piece of legislation came help to the nursing profession and health care in the country as well. These bills included legislation that waived or lightened the requirement for nurses to create and maintain a current care plan when appropriate (Stone, 2020). This was meant to allow nurse to spend more time at the bedside and less time documenting and in specific cases, allow the nurse to increase patient load as a result of lightened documentation requirements. The second provision allowed for the nurse practitioners (NP) and nurse midwives to provide more patient care independently by lightening the required time the NP must be in direct communication with the ordering physician (Stone, 2020). The third change was also addressed the role of the NP by altering the scope of practice and encouraged and supported states in allowing the NP to practice to their fullest extent which allowed the physicians to focus their efforts on the more critical patients. The COVID-19 virus has and will continue to affect the world and as legislation is introduced as record speed, the nursing profession will need to continue to advocate not only for their patients but for themselves as well. As frontline workers, nurses have once again been given the opportunity to show the world how essential the nurse is to the health of their patients and their community. In years to come when history looks back at the “Year of the Nurse 2020” they will find a selfless group of individuals that continued their work at a time when others stayed home. Law and policy makers must continue to find ways to support the nursing profession, which has committed itself to the health and well-being of all they care for. Stone, A., (2020). How the CARES act and other COVID-19 laws affect nursing and health care. _ONS Voice: News, views and advocacy from the oncology nursing society._ Retrieved from https://voice.ons.org/advocacy/how-the-cares- act-a…

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