513711
research-article2013
NASXXX10.1177/1942602X13513711NASN School NurseNASN School Nurse
President’s Letter
Advocacy, A Strategic Priority for NASN Carolyn L. Duff, MS, RN, NCSN
Welcome to the 15th year of the 21st century! Happy New Year, School Nurses! The wonderful thing about the new calendar year beginning in the middle of the academic year is that we have the opportunity to have two fresh starts, one in the fall when school begins, and one in January, when we get that second wind to support our students to a flourishing finish. It is all so very satisfying! NASN begins 2014 with approval of a NASN Strategic Plan that will set the direction of the organization through January 2017. The NASN board of directors has been engaged in a year-long planning process and used information gathered through the annual school nurse survey to select the strategic priorities. In 2013, the response to the survey was tremendous, with participation of NASN members and nonmembers from all 50 states. Ninetytwo percent of school nurses rated “advocacy on behalf of school nurses” as the activity they expect, above all other
expectations, from their professional organization. Of course, advocacy is one of the five strategic priorities in the NASN Strategic Plan, and it is the theme for this issue of School Nurse News. Advocacy is a standard and a competency for school nursing practice and the Scope and Standards of Practice include advocacy in the basic tenets of school nursing, the roles and responsibilities of school nursing, and the ethics of school nurse practice (American Nurses Association & National Association of School Nurses, 2011). As school nurses, we use the nursing process to advocate for health care consumers, and we must advocate for our profession to fulfill that responsibility. It stands to reason that school nurses expect NASN to advocate for school nurses. NASN is committed to strongly influence stakeholder support of school nursing, and with 92% of school nurses as members, the power of the influence can be phenomenal. An influencer motivates individuals to change behavior and gives them the knowledge and skills to make the change. According to the authors of Influencer: The Power to Change Anything, there are six sources of influence: individual motivation and individual ability, social motivation and social ability, and structural motivation and structural ability (Patterson, Grenny, Maxfield, McMillan, & Switzler, 2008). Case studies in the book illustrate that successful influence efforts address each source of influence, all at the same time
DOI: 10.1177/1942602X13513711 For reprints and permission queries visit SAGE’s Web site, http://www.sagepub.com/journalsPermissions.nav. © 2013 The Author(s)
and with the same intention and intensity. NASN influence begins with NASN members and expands from there. Independent Sector, a nonpartisan coalition of 600 nonprofits, foundations, and corporate giving programs, completed a study in 2012 to identify which approaches and strategies make successful advocacy efforts and to determine how well organizations perform in sector-wide advocacy (Independent Sector, 2012). The focus of advocacy in the study is at the federal level, but lessons can be applied at the grassroots level. A comprehensive literature review pointed to five internal factors of an organization that influence advocacy outcomes: •• “Staying power,” a focused presence in the policy arena for the long haul •• Issue expertise •• Proactive approach •• Partnership development •• Investment in staff and resources to support advocacy efforts (Independent Sector, 2012) The literature review also identified five external factors that impact advocacy outcomes: •• Policymakers hesitate to act on “high-conflict issues.” •• Institutional influences have an impact, such as congressional polarization. •• The more resources behind a policy, the more likely it will succeed.
January 2014 | NASN School Nurse 5
•• The more voices behind a policy, the more likely it will be adopted. •• New policies that change the status quo are more difficult to initiate. (Independent Sector, 2012) Internal factors have to do with building capacity and external factors have to do with the context for action. NASN, you and I, have prioritized building the essential elements for advancing our advocacy agenda. We moved to Washington, D.C., and our issue experts have a daily presence in the policy arena. We develop partners with aligned missions and nurture those partnerships. We scan the environment to be proactive on issues. We invest in staff and resources to our limit, but I believe we must increase our limit and invest more. NASN, you and I, must grow our membership to strengthen advocacy and to take advantage of the transformation in health care to advance our mission. The external factors, the context, are favorable to our mission. School health services to support education and advance health are not a “high-conflict” issue, and it is not a new initiative. It is a priority issue that has the attention of many. The stakeholders at the three Health in Mind convenings in Washington, D.C., gathered to focus on the health-education connection (Davis & Levi, 2012). Charles Basch, a distinguished educator, leader, and advocate for school health, tells superintendents, you cannot accomplish your mission without school health services (Basch, 2013). Susan Hassmiller, director of the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine, said,
6 NASN School Nurse | January 2014
“Nurses are the lynchpin when it comes to quality and safety [in health care]. You have to make the link between nurses’ roles and their contributions in addressing cost, quality, and access” (Kovner & Spetz, 2011). School health and health care are in transformation. According to Robert Gass, internationally known organizational consultant, “Transformational change is distinguished by radical breakthroughs in paradigms, beliefs and behavior. In transformational change, what was seen as obstacles may morph into opportunities, apparently irreconcilable opposites may come to be seen as creative tension, and change that seemed improbable or requiring long development may quickly come into being” (Gass, 2010). NASN intends to lead the transformation of school health and is eager to show that school nurses count in a big way. That is what you will hear from the school nurse advocates and authors in this issue. The evidence is clear—there is strength in numbers. Please join your professional school nurse organization. As always, thank you for the work that you do every day to support education and advance student health. ■
References American Nurses Association & National Association of School Nurses. (2011). School nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Association. Basch, C. (2013). Investing in healthier students. School Administrator, 70(7), 18-26. Retrieved from http://www.aasa.org/content .aspx?id=28930 Davis, R., & Levi, J. (Eds.). (2012, May). Health in mind: Improving education through wellness. Washington, DC: Healthy Schools Campaign and Trust for America’s Health. Retrieved from http://healthyamericans.org/ assets/files/Health_in_Mind_Report.pdf Gass, R. (2010). What is transformational change? transform. vision & practice for transformative social change. Retrieved from http://transform.transformativechange .org/2010/06/robertgass/ Independent Sector. (2012). Beyond the cause: The art and science of advocacy. Retrieved from http://www.independentsector.org/ uploads/advocacystudy/IS-BeyondtheCauseFull.pdf Kovner, C., & Spetz, J. (2011). The future of nursing: An interview with Susan B. Hassmiller. Nursing Economics, 29(1), 32-34. Retrieved from http://www .nursingeconomics.net/necfiles/news/JF_11_ Kovner.pdf Patterson, K., Grenny, J., Maxfield, D., McMillan, R., & Switzler, A. (2008). Influencer: The power to change anything. New York: McGraw-Hill.
research-article2013
NASXXX10.1177/1942602X13513711NASN School NurseNASN School Nurse
President’s Letter
Advocacy, A Strategic Priority for NASN Carolyn L. Duff, MS, RN, NCSN
Welcome to the 15th year of the 21st century! Happy New Year, School Nurses! The wonderful thing about the new calendar year beginning in the middle of the academic year is that we have the opportunity to have two fresh starts, one in the fall when school begins, and one in January, when we get that second wind to support our students to a flourishing finish. It is all so very satisfying! NASN begins 2014 with approval of a NASN Strategic Plan that will set the direction of the organization through January 2017. The NASN board of directors has been engaged in a year-long planning process and used information gathered through the annual school nurse survey to select the strategic priorities. In 2013, the response to the survey was tremendous, with participation of NASN members and nonmembers from all 50 states. Ninetytwo percent of school nurses rated “advocacy on behalf of school nurses” as the activity they expect, above all other
expectations, from their professional organization. Of course, advocacy is one of the five strategic priorities in the NASN Strategic Plan, and it is the theme for this issue of School Nurse News. Advocacy is a standard and a competency for school nursing practice and the Scope and Standards of Practice include advocacy in the basic tenets of school nursing, the roles and responsibilities of school nursing, and the ethics of school nurse practice (American Nurses Association & National Association of School Nurses, 2011). As school nurses, we use the nursing process to advocate for health care consumers, and we must advocate for our profession to fulfill that responsibility. It stands to reason that school nurses expect NASN to advocate for school nurses. NASN is committed to strongly influence stakeholder support of school nursing, and with 92% of school nurses as members, the power of the influence can be phenomenal. An influencer motivates individuals to change behavior and gives them the knowledge and skills to make the change. According to the authors of Influencer: The Power to Change Anything, there are six sources of influence: individual motivation and individual ability, social motivation and social ability, and structural motivation and structural ability (Patterson, Grenny, Maxfield, McMillan, & Switzler, 2008). Case studies in the book illustrate that successful influence efforts address each source of influence, all at the same time
DOI: 10.1177/1942602X13513711 For reprints and permission queries visit SAGE’s Web site, http://www.sagepub.com/journalsPermissions.nav. © 2013 The Author(s)
and with the same intention and intensity. NASN influence begins with NASN members and expands from there. Independent Sector, a nonpartisan coalition of 600 nonprofits, foundations, and corporate giving programs, completed a study in 2012 to identify which approaches and strategies make successful advocacy efforts and to determine how well organizations perform in sector-wide advocacy (Independent Sector, 2012). The focus of advocacy in the study is at the federal level, but lessons can be applied at the grassroots level. A comprehensive literature review pointed to five internal factors of an organization that influence advocacy outcomes: •• “Staying power,” a focused presence in the policy arena for the long haul •• Issue expertise •• Proactive approach •• Partnership development •• Investment in staff and resources to support advocacy efforts (Independent Sector, 2012) The literature review also identified five external factors that impact advocacy outcomes: •• Policymakers hesitate to act on “high-conflict issues.” •• Institutional influences have an impact, such as congressional polarization. •• The more resources behind a policy, the more likely it will succeed.
January 2014 | NASN School Nurse 5
•• The more voices behind a policy, the more likely it will be adopted. •• New policies that change the status quo are more difficult to initiate. (Independent Sector, 2012) Internal factors have to do with building capacity and external factors have to do with the context for action. NASN, you and I, have prioritized building the essential elements for advancing our advocacy agenda. We moved to Washington, D.C., and our issue experts have a daily presence in the policy arena. We develop partners with aligned missions and nurture those partnerships. We scan the environment to be proactive on issues. We invest in staff and resources to our limit, but I believe we must increase our limit and invest more. NASN, you and I, must grow our membership to strengthen advocacy and to take advantage of the transformation in health care to advance our mission. The external factors, the context, are favorable to our mission. School health services to support education and advance health are not a “high-conflict” issue, and it is not a new initiative. It is a priority issue that has the attention of many. The stakeholders at the three Health in Mind convenings in Washington, D.C., gathered to focus on the health-education connection (Davis & Levi, 2012). Charles Basch, a distinguished educator, leader, and advocate for school health, tells superintendents, you cannot accomplish your mission without school health services (Basch, 2013). Susan Hassmiller, director of the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine, said,
6 NASN School Nurse | January 2014
“Nurses are the lynchpin when it comes to quality and safety [in health care]. You have to make the link between nurses’ roles and their contributions in addressing cost, quality, and access” (Kovner & Spetz, 2011). School health and health care are in transformation. According to Robert Gass, internationally known organizational consultant, “Transformational change is distinguished by radical breakthroughs in paradigms, beliefs and behavior. In transformational change, what was seen as obstacles may morph into opportunities, apparently irreconcilable opposites may come to be seen as creative tension, and change that seemed improbable or requiring long development may quickly come into being” (Gass, 2010). NASN intends to lead the transformation of school health and is eager to show that school nurses count in a big way. That is what you will hear from the school nurse advocates and authors in this issue. The evidence is clear—there is strength in numbers. Please join your professional school nurse organization. As always, thank you for the work that you do every day to support education and advance student health. ■
References American Nurses Association & National Association of School Nurses. (2011). School nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: American Nurses Association. Basch, C. (2013). Investing in healthier students. School Administrator, 70(7), 18-26. Retrieved from http://www.aasa.org/content .aspx?id=28930 Davis, R., & Levi, J. (Eds.). (2012, May). Health in mind: Improving education through wellness. Washington, DC: Healthy Schools Campaign and Trust for America’s Health. Retrieved from http://healthyamericans.org/ assets/files/Health_in_Mind_Report.pdf Gass, R. (2010). What is transformational change? transform. vision & practice for transformative social change. Retrieved from http://transform.transformativechange .org/2010/06/robertgass/ Independent Sector. (2012). Beyond the cause: The art and science of advocacy. Retrieved from http://www.independentsector.org/ uploads/advocacystudy/IS-BeyondtheCauseFull.pdf Kovner, C., & Spetz, J. (2011). The future of nursing: An interview with Susan B. Hassmiller. Nursing Economics, 29(1), 32-34. Retrieved from http://www .nursingeconomics.net/necfiles/news/JF_11_ Kovner.pdf Patterson, K., Grenny, J., Maxfield, D., McMillan, R., & Switzler, A. (2008). Influencer: The power to change anything. New York: McGraw-Hill.
