d. Formulate strategies that respond to policy changes that impact health and education.
With the change in health care systems, the aging population, and the nursing shortage, emphasis has been placed on demands for public policy to create change and bring more members to the nursing workforce. The growing nursing shortage is negatively impacting how health care is delivered to the patient population. “The contributions made by the practice and science of nursing are significant, and in collaboration with other healthcare professionals, improve the quality of America’s healthcare system” (Nursing Community, 2009, p. 2). Title VIII is a public policy developed in 1964 that provides funding for the Nursing Workforce Development Programs under the Public Service Health Act. The policy was amended and expanded into the Nurse Reinvestment Act (P.L. 107-205, 2002) in which Nurse Education, Practice, and Retention grants became priority (Reyes-Akinbileje, 2005). In the Policy Statement paper, I reviewed the purpose and magnitude of the policy, the stakeholders and power players, and discuss windows of opportunities for nursing professionals to create solutions.
This artifact is a journal reflection of an experience attending the Nebraska Action Coalition meeting in January 2016 as part of my practicum hours for NRS 524. The Nebraska Action Coalition is a group organziation who works with policies and creates initiatives to impact public health and spread education accoriding to the public's needs. This reflection will disuss the agenda and current and past initiatives of the organization as well as what I learned from the experience that I will utilize in my career as a nurse educator.
Health Services Advisory Committee Meeting
2/11/16 Practicum Experience
What: During this practicum experience, I attended a Health Services Advisory Committee meeting with my preceptor Echo at the early Learning Center at Skinner Elementary. The agenda for this meeting included welcome and introductions for announcements, as well as a discussion on current concerns and trends affecting Head Start and Early Head Start children in the community. The biggest concern at this point is the lack of lead screenings among children without convenient access to healthcare. There is no longer point of care testing in the community in Nebraska. Lead screening is required for all children who enter Head Start and Early Head Start programs but the access to getting these screenings completed is increasingly difficult. The screenings are recommended at 12 and 24 months. Throughout this meeting, we discussed how public health nursing and Nebraska Methodist College could work to provide more access. The purpose for our attendance to this meeting was to update the committee on the future plan for a collaborative to implement point of care testing for children in the community.
So What: This concern is important to address because of the dangers of toxicity and exposure that lead places on our children in the public. This is an enormous public health concern and the lack of early screenings leads to delayed intervention. High lead levels are correlated with neurological development delays among children. Currently there is no community point of care testing which means unless children have access to a regular, primary care physician they are likely not being tested for lead exposure. This is again highly concerning because those living near the superfund site are part of the lower socioeconomic status and likely do not have access to healthcare. Nebraska Methodist College has collaborated with Douglas County health department and Head start to offer screenings free of cost to the families. This collaborative group has purchased a machine to screen at community events to open a point of care testing area. Cowen & Moorehead (2011) discussed the benefits of partnerships in public health nursing. The benefits include access to no-cost capacity in data management and analysis, experts in clinical data interpretation, and access to evidence-based services. The partnership is ensuring quality access to health screenings as well as education and advancement of the public health knowledge on the dangers of lead and how to reduce exposure. This education overall will likely help reduce the exposure and high lead levels in children for the future.
What else: The implementation of this project is critical. Pilot tests are needed to evaluate the implementation process and effectiveness, as well as make necessary adjustments. The plan to pilot this process will be at two different events this spring. The first event will be at the Omaha Black Families community event and the other will be at the Minne Lusa health fair, in which the Nebraska Methodist College students host for children who attend this school and their families. The nurse’s role is diverse in these public health experiences, including leader, educator, researcher, and manager (Cowen & Moorehead, 2011). Support and contribution from both partners during the pilot and implementation is crucial to the overall success and effectiveness. According to Billings & Halstead (2016), partnerships between the community and schools of nursing are beneficial for both creating excellent clinical experiences for students but also for addressing local health care needs. The population’s health disparity needs can be addressed while students are able to participate in the development of policy, leadership, and change which will benefit their future vision of the nursing profession. These experiences teach nurses about caring for a population, creating change, and continuously advancing the nursing profession.
Now what: As a former emergency room nurse, I witnessed the impact of a lack of healthcare access for low socioeconomic groups. Children of low socioeconomic groups did not receive primary or preventative health care, as they should. This impact affects their everyday health leading to nutrition, exercise, and health deficits. Lead intoxication and exposure from living in high-risk areas further increases their risk of health disparities. I have observed through this experience the effect that partnerships and education can have on a community. Now as a nurse educator, I will use my experiences and knowledge to make a change and work towards a community involvement that leads to prevention of health disparities, rather than treating the disparity after it exists. This experience has given more meaning to the concept of education and service. I will utilize this experience as a foundation for future service learning and community involvement experiences for both the students with whom I work as well as the community at risk.
Nebraska Action Coalition Meeting
1/11/16 Practicum Experience
What: The Nebraska Action Coalition (NAC) is comprised of several businesses, nursing associations, and individuals all of whom are key stakeholders in the health care environment. The agenda of the meeting included reviewing the previous meeting’s minutes and then conducting the present business. The nurse’s day at the legislature was discussed as well as the plans for the next year for the coalition. Most interestingly, the public health needs were discussed and the plans on how to approach public education on suicide and mental illness and school health disparities. The purpose of this coalition is to discuss the needs for the future of nursing practice. Other than focusing on the pubic health needs, some of the focus was placed on advancing nursing education over the next several years. Individuals are empowered to make change and be leaders when they create a vision and are able to work toward their goal.
So what: Because of the recent challenges facing the health care system, the NAC has been working hard to create initiatives to advance nursing professionals and provide quality, diverse access to healthcare. I learned the coalition is now working toward an action campaign for the future of nursing. This is important because suicide rates are increasing, especially among adolescents and the importance of providing access to resources and education for the public was stressed. The stakeholders for the NAC discussed that the number one need in Douglas and Sarpy County was education on increased bullying and suicide in the adolescent community. An initiative was created of how to make the local communities aware. I learned from this meeting that the goal for Nebraska is to have 80 percent of nursing graduates have their BSN by the year 2020. The data from 2014 showed that 61 percent of nurses had their bachelor’s degree. According to Benner, et. al., (2010) nursing professionals should continue their education to Bachelor’s, Master’s, and Doctoral degree programs.
What else: Other agenda items that were discussed were the toolkit online to create a Vote and Vax program to utilize the public health election voting locations to provide convenient vaccination booths for the public health. Therefore, the community that attends voting polls will also be able to get their influenza vaccinations in a key timeframe. A toolkit was loaded to the Nebraska Action Coalition website to provide health care providers and the public with the resources to start a vote and vax clinic. I also was exposed to conferences and nursing legislative opportunities that are up-coming, including nurse’s day at the legislature and the Global Health Conference at Creighton hospital this February.
Now what: The plans for the current year were summarized at the end of the meeting. I learned the primary goal and focus for the following year is implementation of the mental health and suicide initiative as well as continuing to increase the amount of BSN graduates in Nebraska. Attending the NAC meeting was an informative experience. I learned how I can promote quality health care access and educate other healthcare professionals as well as members of the public on matters that are affecting the public and most importantly how to be a change agent. The next step for myself is to allow my voice to be heard. After attending the NAC meeting, I have developed a more diverse view of what the future of nursing involves and I will use my voice to communicate to other healthcare professionals how we can most promote better public health and advanced education for the nursing practice. I, as a nurse educator, can be a key leader because I can utilize my creative skills and vision to encourage others to learn and ultimately create an influential, desired nursing profession.