NBNA SPECIAL ISSUE ON THE FUTURE OF NURSING

16 — NBNA.org
Raise the Voice!
Joanne Disch, PhD, RN, FAAN
cAre iN AmericA today is inaccessible to many,
expensive for most and fragmented for all.”
“HeAltH 1 in January
2012, the institute of medicine published Living Well with
Chronic Illness: A Call for Public Health Action2 , outlining the
‘epidemic’ of chronic disease which represents 75% of the $2
trillion spent annually on health care. the report emphasized the
numerous determinants affecting health, such as genes, biology,
behavior, coping responses, the role of peers and family, the
social-cultural context, and the physical environment. None of
this is new to us as nurses: We have always worked with the
patient in the context of the family, environment, community and
socioeconomic considerations. in fact, while health care systems
have created monumental structures that perpetuate the
physician-dominant, acuity-oriented, hospital-based care model
evident today, nursing innovators have quietly gone about developing
new models of care that are cost-effective, personalized,
convenient and successful in helping individuals and families deal
with chronic illness. Perhaps too quietly.
this is why the American Academy of Nursing, under the leadership
of then-president linda Burnes Bolton, launched the raise
the Voice! campaign to educate the public and policymakers
about the creative approaches that nurses are taking to assure
that people, often the under- and un-insured, receive the care
that they need and minimize the complications of chronic disease.
over the past six years, 49 nurses have been identified as edge
runners, or practical innovators who have developed new care
models that achieve significant clinical and financial outcomes.
Here are profiles of a few edge runners and their work:
n 11th Street Family Health Services is a community-based
center that provides access to not only clinical services but to a
wide range of health promotion and disease prevention services
to inner-city Philadelphia residents. employing a broad transdisciplinary
team of health professionals, it also has a strong
educational and research component, serving as a clinical site
for many health professions’ students. in addition to more than
25,000 clinical visits, it has made 1650+ home visits to pregnant
or new mothers, and thousands of wellness and health encounter
sessions. in 2011, the center reduced pre-term births to 2.5% in
African American for their women, compared to 15.6% in the city.
(Patty Gerrity, PhD, rN, fAAN)
n The St. Francis Health Center improves access to quality
primary health care services for the poor and uninsured, integrating
both physical and mental health assessment, treatment and
follow-up services, regardless of employment status or income.
founded and managed by a team of nurse practitioners and
clinical nurse specialists in Joliet il, they use weekly team meetings
to discuss case management and approaches to care. their
patient base includes place-bound elderly and disabled, victims
of domestic violence, the working poor and uninsured. since
their opening, they have provided services to more than 6,500
nBnA nurse LeAdershIp
patients. they offer services daily, with some evening hours and
weekend coverage by NPs. (carol Jo Wilson, PhD, rN, cNP)
n INSIGHTS help parents and teachers recognize children’s
temperaments so that they can deal effectively with minor behavioral
problems, help them learn self-regulation strategies and
enhance their interpersonal relationships with families, teachers
and friends. this 10-week intervention, developed in partnership
with African American and Hispanic community members, has
helped children with ADHD without using medication, reduced
the behavior problems of children with serious disruptive behaviors,
enhanced parents’ ability to handle their children’s behavior;
and reduced aggressive behavioral episodes in the classroom.
(sandee mcclowry, PhD, rN, fAAN)
the Academy website (http://www.aannet.org/raisethevoice)
offers details on these innovators and other edge runners. Also
on the website are the criteria for becoming an edge runner.
consider applying for this designation or nominating colleagues
if you or they have developed an innovative care model that has
made a measurable difference in health care outcomes. Nominees
need not be fellows in the American Academy of Nursing.
Here are the criteria:
n Nominations support the innovative work of nurses and demonstrate
the holistic and integrated philosophy underlying
nursing care.
n the nomination demonstrates how an innovative solution
(intervention or model of care) remedied a problem in the delivery
of health care or an unmet health need of a population.
n Although single demonstrations are acceptable, data that
substantiate the success and impact of the project must be
included with the nomination.
n there is evidence that the original work has been replicated or
has the promise of leading to replications in other settings.
in conclusion, nurses have historically understood what the
public wants from health care, and have generated creative solutions
for delivering it. it’s time to showcase the important work
that nurses are doing, and raise the Voice! on the significant contributions
that nurses are making to achieve a reformed health
care system.
Dr. Joanne Disch is a clinical Professor and Director of the
katharine J. Densford international center for Nursing leadership,
and the katherine r and c Walton lillehei chair in Nursing
leadership at the University of minnesota school of Nursing. she
is currently the President of the American Academy of Nursing.
REFERENCES:
American Academy of Nursing (2011). edge runners. retrieved february
25, 2012 from http://www.aannet.org/edgerunners.
institute of medicine (2012). living well with chronic illness: A call for
public health action. retrieved february 25, 2012 from http://www.
iom.edu/~/media/files/report%20files/2012/living-Well-withchronic-illness/livingwell_chronicillness_reportbrief.pdf.