Advocacy and Nursing

Welcome to Heart to Heart Nurses, brought to you by the Preventive Cardiovascular Nurses Association. PCNA's mission is to promote nurses as leaders in cardiovascular disease prevention and management.  

Geralyn Warfield (host): We are so excited today to have the opportunity to speak with Laura Hayman, who's going to be in conversation with us about advocacy. Laura, would you mind giving a brief introduction to yourself for our audience? 

Laura Hayman (guest): Thank you so much and I'm delighted to have this opportunity to talk about advocacy. So, my name is Laura Hayman. I'm a Professor of Nursing in the Manning College of Nursing and Health Sciences at UMass Boston, and I'm an Adjunct Professor in the Division of Preventive and Behavioral Medicine in the Department of Population and Quantitative Health Sciences at UMass Chan Medical School. 

Geralyn Warfield (host): Well, we are, again, so excited to have you at the table today talking with us, and I want to [00:01:00] start off with a question about why it's important for nurses and for nursing to be involved in advocacy initiatives. So, could you discuss that a little bit for us?  

Laura Hayman (guest): Sure. An excellent question. So, there is no universal standard definition of advocacy. So, I've given that a lot of thought with my work within nurses; with nurses, nursing, and within PCNA. And so, one definition I would elaborate is that advocacy is individual and collective action designed to guide and inform policies on many levels.  

And of note, I will insert here, Ernest Grant, who is the current President of the American Nurses Association, had a one pager on advocacy in the March [2022] issue of American Nurse, and he was advocating for advocacy by nurses and nursing more on the population level. And he [00:02:00] just said it's a process of influencing policy on multiple levels, and governmental levels: local, national, even global, and really encouraged nurses to get involved in advocacy efforts.  

So, on an individual level, we, nurses, are advocates for our patients with the aim of providing evidence-based quality care and with patients’ input in decision making about that care. 

But collectively, collectively, I think we could do a better job. We could be more engaged. As we know, as many national surveys have shown over the last several decades, nurses are the most trusted healthcare professionals. Therefore, we have a mandate. We have a mandate to advocate for policies that are designed to improve health, enhance healthcare, healthcare [00:03:00] systems, with the overall goal of improving the health of the public. 

Geralyn Warfield (host): Thank you so very much for that great information. We're going to take a quick break and then we will be back with more information about advocacy and nurses.  

Geralyn Warfield (host): We're back with Laura Hayman, a discussion that we're having about advocacy and nurses. And my next question for you is, what is PCNA doing in this space of advocacy? 

Laura Hayman (guest): An excellent question. Well, PCNA has had an Advocacy Committee for at least 10 years. I've had the opportunity to participate in the committee. We meet every four to six weeks, and in so doing, we review issues and legislation that's pending, that has implications for policy on multiple levels. PCNA, as you may know, is recognized by many groups nationally as the premier nursing [00:04:00] organization focused on prevention as well as management of cardiovascular disease. 

So PCNA is often asked to comment on pending legislation, issues, guidelines. For example, the US Preventive Services Task Force issues recommendations, which are important for all of us because what ultimately ends up in those recommendations will guide the care that's given in that area, such as in cholesterol screening, weight management for children—weight, obesity screening and management for children. 

And so, we've been asked to comment on several of their documents, pending recommendations for risk behaviors, health behaviors that are central to cardiovascular health promotion and disease prevention, [00:05:00] as well as on CVD risk factors like cholesterol screening and management.  

Also, the American Heart Association calls on us to comment on their pending statements and guidelines. And many of us within PCNA have been involved in statements and advisories that are produced by the American Heart Association.  

Another very important piece is that we feature. and we promote, specific types of legislation. So, every year—over the last 10, I believe—at least eight, we have a virtual Lobby Day where we are supporting and endorsing pieces of pending legislation. We have in the past supported many of the initiatives [00:06:00] focused on cardiac rehab, enabling cardiac rehab for all, including diverse populations, advocating for more nurse involvement in the whole cardiac rehab process, which we know is critically important in secondary prevention. And so that was one of our major initiatives over time. 

This year, we focused on the Black Maternal Health Momnibus Act, which has recently, it has passed the House. However, it’s going to the Senate and it's critically important because as we heard here at the [2022 PCNA] Annual Symposium, and we know from data from several sources, that Black mothers have a higher rate of morbidity and mortality, certainly than their white counterparts, which is due to a variety, [00:07:00] a number of issues. So, the bill is designed to make critical investments in the social determinants of health that influence maternal health outcomes. 

That's one of the major parts of that bill. As well as to provide funding for community-based organizations that are working to improve maternal health outcomes and promote equity, and to support moms with mental health conditions and substance use disorders, among other suggestions or recommendations in that bill--there are actually 12 points.  

So, we are lobbying virtually, and what we have done is disseminated the information to our membership, and asking them to go online. We have a form for ease of, of submission that they can connect with their local legislators, [00:08:00] their representatives, and their senators, and say, please support the Black Maternal Health Momnibus Act, and we say why, and why it's so critically important.  

And this has emerged across disciplines nationally as really an important issue because the health outcomes for both Black moms and their children, their babies, are much less than optimal.  

Geralyn Warfield (host): So, you've charged us with a mandate of providing advocacy, not just for our patients, but for our profession. So, outside of joining Lobby Day, what might you suggest for an individual nurse who's interested in becoming more active as an advocate for his, her or their career?  

Laura Hayman (guest): Well, very good question. I would say that, first of all, they need to stay tuned with what is pending in terms of legislation that would affect their area, if it's in the [00:09:00] cardiovascular arena, from, from primordial to primary to secondary prevention. And in other areas as well. For example, in legislation that's important in improving the social determinants of health, and improving access and affordability to healthcare, and as well as some of our, the safety net programs. 

I think in general—I teach social determinants of health to PhD students and communicate with an array of nurses nationally for different reasons. And I would say that more information, they need more information. They need to be, first you need to be aware. This is an important part of nursing armamentarium and mandate. 

And then you need the knowledge, right? And then the skillsets. And, of course, on the local…national…organizational level, excuse [00:10:00] me, I would say involvement in PCNA because we are extending our, you know, our advocacy initiatives. And, as I mentioned earlier, our American Nurses Association just came out with action for advocacy and so I think they have several initiatives that will be launched shortly, some in place and some forthcoming. 

Geralyn Warfield (host): You have provided excellent information for us to get involved for daily interactions on advocacy, but also longer-term advocacy actions. Laura Hayman, it has been a delight to spend time with you today. This is Geralyn Warfield, your host, and we will see you soon. 

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