Nurses Can Advocate for Federal Policy Changes—Even With Social Distancing

Nurses are experts in advocating for their patients’ care. Taking those skills to Washington, DC, and speaking out for changes in federal health policy can have just as much impact. Even in an era of social distancing and travel restrictions, oncology nurses can bring (https://campaignforaction.org/nurses-how-to-advocate-for-federal-policy-change/) their message to the local, state, and federal leaders to bring about change.  

Programs like the Annual ONS Hill Days (a virtual event in 2020), Nurse in Washington Internship, and Robert Wood Johnson Foundation (RWJF) Health Policy Fellowship (https://www.healthpolicyfellows.org/) give nurses the training and opportunity to raise their voices and share their stories directly with policymakers. And when nurses speak, people listen—especially in today’s world.

“This is an unprecedented crisis and there’s no operating manual for how to proceed,” Ellen Kurtzman, PhD, RN, FAAN, associate professor at the George Washington University School of Nursing and past RWJF fellow, said (https://campaignforaction.org/nurses-how-to-advocate-for-federal-policy-change/). Kurtzman was placed in Speaker of the U.S. House of Representatives Nancy Pelosi’s (D-CA) office for nine months following her fellowship training and shared lessons for nurses about advocating under social distancing.

 “I’ve been told that most Hill offices are working from home. Because face-to-face meetings won’t be possible for a while, nurse advocates may need to hone their abilities to communicate remotely through emails, phone calls, letter writing, and video conferences,” Kurtzman explained.

Principles that participants learn during ONS Hill Days apply to virtual visits, too. Hill Days teaches that reframing the conversation—especially with lawmakers and elected officials—is a critical skill. Oncology nurses have the unique perspective needed to overcome misunderstanding and share vital information that can transform the future of cancer care.

ONS member Candace Schiffer, NP, AOCNP^®, a nurse practitioner at the Monter Cancer Center in North New Hyde Park, NY, was a participant in ONS’s 2018 Hill Days, where she met (https://voice.ons.org/stories/oncology-nurses-make-impact-during-onss-hill-days) with U.S. Representative Peter King (R-NY), among other lawmakers. And she inevitably was asked the age-old question: “Cancer is heavy stuff—death and dying. How do you do what you do every day?”

“Oncology isn’t about death and dying, it’s about life and living beyond cancer,” Schiffer said (https://voice.ons.org/stories/oncology-nurses-make-impact-during-onss-hill-days), using the opportunity to promote ONS’s advocacy for a palliative care bill. “That’s why we’re here—to talk about palliative care and survivorship initiatives. Palliative care is the supportive care needed to get patients through their cancer treatment, and survivorship care planning and implementation is the ongoing care, surveillance, and communication from one healthcare provider to another. Oncology nurses are educated caregivers, patient advocates and cheerleaders, family supporters, and evidence-based practitioners, and when we get down to it, we’re seeing cancer survivorship rise year after year.”

King went on to sign on (https://www.congress.gov/bill/116th-congress/house-bill/647/cosponsors?searchResultViewType=expanded) as a cosponsor of the bill.

Oncology nurses who want to refine health policy like Kurtzman and Schiffer don’t have to wait until the pandemic is over. To learn more about ONS advocacy or get involved, visit the ONS Center for Advocacy and Health Policy (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy).   

FDA Releases Centralized PPE Shortage List 

Since the start of the COVID-19 coronavirus pandemic, healthcare institutions have lacked (https://voice.ons.org/advocacy/provider-groups-announce-campaign-urging-public-to-wearamask) adequate personal protective equipment (PPE). In response, the a section of the Coronavirus Aid, Relief, and Economic Security (CARES) Act authorized the U.S. Food and Drug Administration (FDA) to prevent or mitigate medical supply shortages during public health emergencies. To meet a provision of that authority, on August 21, 2020, FDA released (https://thehill.com/policy/healthcare/512129-fda-creates-first-ever-medical-supply-shortage-list-including-masks-swabs) a medical supply shortage list (https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency), which lists current PPE in short supply. FDA also released (https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency#discontinuance) a list of permanently discontinued PPE products that it will update regularly.

The PPE shortage list includes (https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency#shortage) 20 items in limited supply, broken up into three categories:

• PPE
• Testing supplies and equipment
• Ventilation-related products

Under the CARES Act, manufacturers are required to inform FDA of discontinued products or delays in manufacturing that could potentially lead to a shortage.

To build the lists, FDA analyzes (https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/medical-device-shortages-during-covid-19-public-health-emergency) each submission; evaluates device supply and demand; determines whether there are adequate, approved, and available alternatives (based on Emergency Use Authorizations requirements (https://www.fda.gov/regulatory-information/search-fda-guidance-documents/emergency-use-authorization-medical-products-and-related-authorities)); and works with other federal partners to reach a conclusion. The lists don’t include supplies accrued in the Strategic National Stockpile (https://www.phe.gov/about/sns/Pages/default.aspx). 

Americans are starting to understand what oncology nurses have recognized for decades—PPE, whether to protect them from hazardous drugs (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/ensuring-healthcare) or deadly infections—is essential (https://voice.ons.org/advocacy/provider-groups-announce-campaign-urging-public-to-wearamask) for healthcare workers. Current events have spotlighted the dire need for national preparedness, driving policy makers to look forward on supply chains (https://voice.ons.org/news-and-views/how-to-manage-ppe-supply-shortages-related-to-covid-19) and seek to prevent shortages before they occur. Find out more about ONS’s interim PPE guidelines during COVID-19  (https://www.ons.org/covid-19-interim-guidelines?ref=HP)and lend your voice (https://voice.ons.org/advocacy/covid-19-reminds-us-that-nurses-are-health-diplomats-for-humanity) to the advocacy conversation.    

Nurse Uncovers Error in COVID-19 Database

Dana Jones (https://uihc.org/dana-jones), DNP, ARNP, CBN, a nurse practitioner in Iowa City, IA, discovered a glitch (https://apnews.com/c15b742f95a73ba2a45f7e7bf7d7255d) in the state's COVID-19 coronavirus website (https://coronavirus.iowa.gov/), which caused the site to mistakenly report lower numbers of new cases and a smaller percentage of daily positive tests. The error is of particular concern because school districts are using current state data to determine whether they will offer in-person instruction at the start of the school year. 

Potentially thousands of new infections from the recent weeks and month were instead erroneously recorded (https://apnews.com/c15b742f95a73ba2a45f7e7bf7d7255d) as happening in March, April, May, and June.

“It’s just horrifying. We have no idea what’s going on, really,” Jones said (https://apnews.com/c15b742f95a73ba2a45f7e7bf7d7255d).

The state credits the glitch to the cases in which people originally tested negative but later tested positive. Iowa’s system was recording (https://apnews.com/c15b742f95a73ba2a45f7e7bf7d7255d) the new positive results as having happened when the original negative results were first reported.

“It’s one of the worst data errors that could be happening right now,” Megan Srinivas, MD, MPH, an infectious disease physician (https://www.doximity.com/pub/megan-srinivas-md) in Fort Dodge, IA, said (https://apnews.com/c15b742f95a73ba2a45f7e7bf7d7255d). “We are making these policy calls based on completely flawed numbers and that needs to be acknowledged.”

Nurses are valued members of any healthcare team, whether it’s patient-facing or research-based to build the evidence. Nurses like Jones are demonstrating the power of nursing science (https://www.ons.org/podcasts/episode-71-power-nursing-science) and serving as a real-life example of how nurse innovation makes a difference (https://www.ons.org/podcasts/episode-44-how-nurses-innovate-practice-every-day-ons-congress) in the lives of potentially millions of people. Or as nurses know it, “Tuesday.”