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Political Activism by the Nurses of FNA A Sample of Outcomes from History. PRESENTED BY: Willa Fuller Compiled by Janice Hess, ARNP, DNP. Historical Political Activism Perspective: On the Shoulders of Giants.

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Political activism by the nurses of fna a sample of outcomes from history

Political Activism by the Nurses of FNAA Sample of Outcomes from History


Willa Fuller

Compiled by Janice Hess, ARNP, DNP

Historical political activism perspective on the shoulders of giants
Historical Political Activism Perspective: On the Shoulders of Giants

  • Fundamental Ideologies: Nursing is a moral endeavor based in caring and advocacy (Ballou, 2000)

  • Visionary leaders: On the Shoulders of Social and Political Activists Nursing Giants:





Common threads or lessons learned from these political activist nursing giants
Common threads or lessons learned from these political activist nursing giants:

  • A passion and desire to make a difference

  • A belief that nursing has a moral and professional obligation to get involved

  • Dedication and perseverance

  • Involvement of others in their political

    activism efforts-forming grassroots efforts

So what is so different today factors that may act as barriers to political involvement
So what is so different today? activist nursing giants:Factors that may act as barriers to political involvement:

  • Oppression or stereotyping of nursing profession based on medical and administrative hierarchies in health care.

  • Nursing’s heterogeneity as a group

  • Lack of membership in professional organization

Factors continued
Factors: (continued) activist nursing giants:

  • Political-ethical dilemma

  • Lack of political science education

  • Too much to do, too little time

How do we move from apathy to political involvement
How do we move from apathy to political involvement: activist nursing giants:

  • Register and get out the vote

  • Get involved through professional organization membership and networking

  • Contribute to your Political Action Committee

  • Find Political Mentors

Political activism by the nurses of fna a sample of outcomes from history

Strategies for Revitalizing Nursing Political Activism activist nursing giants:

  • Education: nursing curriculum, professional organizations

  • At work : Talk with

  • peers

Political activism by the nurses of fna a sample of outcomes from history
Model for change: How do we reach the desired outcome? Moving Florida Nurses from Apathy to Political Activism

Outcomes Moving Florida Nurses from Apathy to Political Activism

1913 First legislative committee formed by FNA

First bill passed by FNA and signed into law on June 7, 1913 was a bill for State Registration of


1919 FNA went on record to support the Jones-Raker Bill giving female RNs rank in the military. ANA

lobbied for this bill.

1922 FNA lobbied for a bill classifying nurses as

professional. This was passed by the House and

the Senate.

Outcomes continued
Outcomes (continued) FNA

1939 First nurse practice act was passed.

1950-1951 Practice act revised. LPN included and RN and

LPN practice was differentiated. LPN educational standards increased.

1954 FNA developed recommendations for employment


Outcomes continued1
Outcomes (Continued) FNA

1955 National Bolton Bill passed providing military

service commissions for male nurses.

Note of Interest: Minimum wage was raised from

75 cents to $1.00

1956 FNA sued and the Florida Supreme Court

unanimously agreed that RN’s were not subject to

occupational license tax.

1959 FNA opposed a bill that would lower standards

for LPN Education. Bill was killed in committee

after the FNA Legislative Chair testified before

the committee.

Outcomes FNA

1960 FNA recommends employment practices and standards for the workplace including no

discrimination, hours of work, salaries, on call

service, vacation, termination, etc.

The Florida Board of Nursing, along with the

Florida League for Nursing and the Florida

Association of the Development of Jr. Colleges

formed a group to educate hospitals about this new

RN educational option.

Outcomes FNA

1963 FNA creates minimum employment practices for

Public Health nurses on the basis of higher quality of

patient care.

Supports Kerr-Mills bill which was legislation

regarding care for the elderly, but only if it includes,

home care and nursing home care services. Bill was

passed with FNA’s requests included but there were

no appropriations.

Outcomes FNA

1964 FNA, FHA and FMA met for two days to discuss

common issues.

1965 ANA begins a public campaign to work on the

economic plight of professional nurses.

Note of interest: In 1955, FNA conducted a survey

that revealed Florida nurses made $500 less than

nurses nationwide.

Outcomes FNA

1966 FNA Legislative Committee Issues

  • Eliminate Practical Exams with written exams for LPNs

  • Increase licensing fees

  • Change requirements for RN to include BSN

  • Limit consecutive terms of the Board of Nursing to 2

  • Increase travel perdiem (BON?)

  • Employ an Executive Director

  • Allow BON to license a non-citizen as long as they

    become a citizen within 6 years.

Outcomes FNA

1969 FNA filed a bill requiring an RN to be on duty each

shift at nursing homes. Bill did not make it out of


1971 Reporting of child abuse by nurses, teachers etc

Immunizations required before children enter school

Mandatory PKU testing

Comprehensive alcoholism prevention

Outcomes FNA

1975 Nurse Training Act

  • Note of interest: Previously there had been minimal emphasis on enlisting nurses and educating them about legislative advocacy. This activity began to increase in the 70’s.

  • FNA submitted changes to the Nurse Practice Act to redefine the expanding role of nurses. Legislation passed 112-1 in the Senate and 38-0 in the House. Signed by Governor Reuben Askew in July of 1975. ( Bill included mandatory CE’s for licensure to go into effect by 1980 and to be regulated by the Board of Nursing.

1976 senator bob graham
1976-Senator Bob Graham FNA

  • Advice to nurses on limited NP reimbursement by state Medicaid program:

    • Be specific when presenting your position. Give details and FACTS. Avoid cliches.

    • Establish one on one relationship: nurse to legislator

    • Establish continuity of contact-call or visit your legislator regularly.

      Note of interest 1: During this time there was a bill to rescind the right of public employees to represented by collective bargaining.

      Note of interest 2: FNA Lobbyist worked to get the funds appropriated to fund the administration of continuing education by the Board of Nursing.

Outcomes FNA

1979 Baker Act Bill allowing NP and CNS’s in mental

health to initiate proceedings considered

1980 Nurse Day in Tallahassee- Beginnings of Political

Action Days and later FNA Lobby Days

1981 Lobbyist in Tallahassee year round

Members will be alerted to pertinent bills

Struggle to get nurses engaged continues.

Nurse Action Day in Tallahasee

ARNP Advanced Practice Committee working on

issues. FNA ARNP’s and FANA joined forces.

FNA supports ratification of the ERA

Outcomes FNA

1982 Negotiation with FMA to protect NP Scope of

Practice Successful

FN-PAC formed. Legislative Committee disbanded.

ANA- Medicaid reimbursement for CNM’s was passed.

1983 LDC Network formed with the goal of having a nurse

assigned to every legislator.

ARNP’s can apply for and receive Medicaid numbers

for reimbursement purposes.

Nurse Anesthetists included in health insurance


Outcomes FNA

1984 FNA successfully lobbied for funding of the Impaired

Professionals Program ( later IPN)

Living Will Legislation passed with FNA lobbying.

Toxic Substances bill passed, protecting nurses.

Lay Midwives grandfathered in but no new training

would be allowed. This was later repealed by

Governor Chiles but more stringent standards were

applied as negotiated by FNA.

Outcomes FNA

1985 First newsletter report by Barbara Lumpkin.

Irma Rochlin, RN elected to the House.

Nurse Practice Act to undergo Sunset Review. FNA

uses this to encourage nurses to get involved.

240 nurses attend Political Action Days

Continued lobbying for banning smoking in public


After two years of lobbying by ANA and the states,

President Reagan signs Nurse Training Act with

decreased funding.

Outcomes FNA

1985 Bill that would transfer approval of nursing educations

programs to DOE rather than BON. FNA thwarted this


Continue to work on 24 hour RN coverage for nursing


1986 Sunset review of Nurse Practice Act closely monitored

by FNA. Complete.

Mandatory seat belts signed into law.

FNA major funder of Florida Pay Equity Coalition.

Study showed that females and minorities are

“subtantially undervalued”

Outcomes FNA

1986 Governor Bob Graham speaks at FNA Convention.

90% of FNA endorsed candidates won elections.

Commission on the Future of Nursing formed.

Swift intervention by FNA attaches an amendment to

another bill requiring Occupational Health Nurses to

be notified of toxic substances in the workplace.

Outcomes FNA

1988- Joint Committee of Board of Nursing and the Medical Examiner. FNA Recommendations

  • Permit ARNP’s to prescribe under protocol signed by both NP and physician.

  • File protocal annual with DPR (now BON)

  • Amendments to protocol be submitted within 30 days

    Other issues: Limit insurance companies ability to deny insurance based on HIV testing. Insurance companies must protect confidentiality.

  • Mandatory CE for HIV- this was supported by the membership.

  • AMA proposal of the Registered Care Technician (RCT). After a lot of nurse involvment and collaboration with FMA, this was defeated.

Outcomes FNA

1988 NPs allowed to prescribe all medications other than controlled substances.

  • “Snitch” bill requiring professionals to tattle on one another was defeated ( supported by FMA).

  • Support for Teen Moms and a bill regarding the patient’s right to refuse sustenance( supported by FNA) were defeated.

    1990 FNA-FMA joint task force collaborates on common


    1991 Opposed healthcare workers report their HIV status.

Outcomes FNA

1991 Pharmacists refusing to fill prescriptions by ARNP’s.

FNA worked with FNA attorney to address these


1992 ANA- Safe Needles Initiatives

1991-92 FNA encourages local legislative forums to engage

legislators on their home turf.

1993 QUIN Council organized

FNA invited by Gov. Chiles to speak at a press

conference regarding his Florida Health Plan.

Outcomes FNA

1992 350 nurses at Political Action Days

Clinical Laboratories Bill ( ARNP’s can now order)

1993 Coalition of FNA ARNP’s, FANA and the Florida

College of Nurse Midwives formed resulting in the

ARNP Legislative Task Force.

1994 ARNP Independent Practice/DEA numbers: Failed

Support for school nurses who are asked to do more

with less.

1994 President Ann-Lynn Denker and Barbara Lumpkin met

with President Clinton at the White House re:

  • healthcare issues.

Outcomes FNA

1976 Failed to pass: A bill supported by FNA banning

smoking in public places.

1978 FNA opposed institutional licensure for nurses.

Supported individual licensure.

1978 Florida Midwife Bill Passed: Governor Askew signed

into law a bill that required HRS to make available

services of nurse midwives who are certified as


Outcomes FNA

1994 MSN required for certification as an advanced practice

nurse. ( APN’s prior to 1997 grandfathered in).

1995 Foundation Nurses in Need approved by IRS

1996 Supreme Court rules that all RN’s are supervisors and

cannot be represented by collective bargaining. NLRB

agrees with ANA/FNA that this is not true.

1996 Defeated bill that would allow only nurses employed by

home health agencies to work in Home Health.

1997 ANA testified at NIOSH about the effect of downsizing on

the work environment of nurses.

Outcomes FNA

1997 JaneGale Boyd, FNA Member elected to the House.

FNA supports RN Identification on name badges

Political Action Days- Over 300 attended.

Marta Prado-FNA Member appointed to Clinton’s Health

Care Quality Commission

RN in Every School Campaign

1998 Jeb Bush visits FNA Headquarters prior to election

1999Term limits go into effect

Protect the title of Nurse to include RN’s and LPN’s only

Outcomes FNA

1999 Nursing home reform

Propaganda campaign by FMA against Nurse

Practitioner controlled substance prescribing


Regulation of Certified Nursing Assistants

2000 Campaign -1 in 44 voters is a registered nurse

FNA and nurse attorney Cynthia Mikos go to

Tallahassee to submit a legal challenge to the direct

supervision of CRNA’s by an MD or DO.

Conclusion: FNA

  • Nurses cannot afford to be spectators in the political arena. We must embrace political activism in order to become a part of the discussion and decision making related to needed healthcare change.

  • Moving from an invisible role to a prominent part of political advocacy will require that nurses look backwards for inspiration of past nursing political activist while looking forward as to how to “engage” the nursing profession in a new grassroots effort of political activism.

Outcomes FNA

2000 National Needlestick Prevention law signed by

President Clinton.

2001 FNA purchases subscription to Capital Wiz so

members can have access to legislators at their


Funding for staffing study in Governor Bush’s


Note of Interest: at this point we are only one of 6

states that did not allow NP’s to prescribe

controlled substances

Outcomes FNA

2002 Anesthesia Assistant Bill- defeated

ANA- Nursing Shortage Bill passed

NP’s can sign for for disabled Parking Permits for VA


Nursing Shortage Solutions Act

Yolly Roberson, RN and Attorney, elected to the House.

Funding for the Florida Center of Nursing

2004 CE Broker – very controversial issue

ARNP name can be on prescription bottle passed.

ARNPs/PAs can perform physicals on corrections


Outcomes FNA

2005 NP can perform physicals on firefighters and security


NP can sign disabled parking permits.

Blocked two bills that would limit practice.

10 million dollars in the budget for nursing education

Dermatology Bill proposing that patient must see a

dermatologist first. FNA Opposed.

Seek $5.00 from licensure fee to fund the FCN.

Bill limiting Domestic Violence and HIV education.

(enough is enough)

Outcomes FNA

2006 3 nurses re-elected to the legislature

FNA reaches out to Gov. Crist to included nurses in

the transition team.

Barbara Lumpkin retires, Anna Small is the new FNA


2007 Paula Massey retires

CNS’s defined in the practice act.

ARNP’s granted civil immunity when obtaining

informed consent.

Florida Center for Nursing named in honor of Barbara


Outcomes FNA

2007 Safe Lift bill failed

ARNP’s signing death certificate failed

Florida Coalition of Advanced Practice Nurses


Glitch bill to fix unintended consequences of the

CNS bill

Barbara Lumpkin Institute Conference

2008 Florida Center for Nursing threatened but

remained in the budget

Outcomes FNA

2008 Interim study ordered by the President of the Senate on

nurse practitioner prescribing of controlled substances

(for the 2nd time with a favorable conclusion)

2009 Safe Staffing Bill based on ANA Principles-opposed by

several groups-failed

Clinical labs bill mandates labs to take ARNP orders-


Bill to add donation to the FCN to the BON renewal

process passed.

Medicare fraud bill (1986) passed.

Outcomes FNA

2010 Glitch bill to 1986 –passed

Funding cut for FCN- ( removed from budget this

year) Attempted the $5 licensure fee. Legislators see

this as a “tax”

Tried new strategy on prescribing with Mike Bennett

ARNP’s removed before bill moves forward.

Authority for the Board of Nursing to approve

educational programs severely compromised. Over

100 nursing programs in the state at the present time.

BON recently put 12 schools on probation

Outcomes FNA

2011 Session in full swing

Reapportionment is key focus

Baker Act Bill on track to pass.

( Must be signed by Governor.)

Further fixes to the Medicare Fraud Bill. ( FNA had a

current student to testify. )

Head injury and high school athletes.

Supervision of surgical techs in the OR (FNA partnering

with AORN on this bill.)

References: FNA

  • Ballou, K. (2001). A historical-philosophical analysis of the professional nurse obligation to participate in sociopolitical activities. Policy, Politics & Nursing Practice, 1(3), 172-184.

  • Boswell, C., Cannon, S. and Miller, J.(2005). Nurses’ political involvement: Responsibility versus privilege. Journal of Professional Nursing, 21 (1), 5-8.

  • Conger, C. & Johnson, P. (2000). Integrating political involvement and nursing education. Nurse Educator, (25 (2), 99-103

  • Cramer, M. (2002). Factors influencing organized political participation in nursing. Policy, Politics & Nursing Practice, 3 (2), 97-107.

  • DesJardin, K. (2001). Political involvement in nursing AORN Journal, 74(5), 614-615

  • Dunphy, L. Florence Nightingale’s legacy of caring and its application. In M. Parker (Ed.), Nursing theories & Nursing Practice (2nd ed.). Philadelphia, PA: F.A. Davis Company.

References continued
References: Continued FNA

  • Rains, J.; Barton-Kriese, P. (2001). Developing political competence: A comparative study across disciplines. Public Health Nursing, 18(4), 219-224.

  • Roberts, J. and Group, T. (1995). Feminism and nursing. Westpoint, Connecticut: Praeger.