Organizing NPs and NP Organizations

Synergy is the dynamic and energetic atmosphere created when individuals and groups work together to produce results none could obtain independently. It comes from 2 Greek words: syn, meaning “together,” and erg, meaning “to work”—in other words, to work together. My “NPs on the Edge” columns this year have outlined a vision for the future that NPs can achieve if we can only learn to work together synergistically.

In my first column this year, I evoked 2 historic nursing visionaries and social reformers. Florence Nightingale brought nurses into positions of respect and advanced the evolution of medicine by sanitizing operative procedures and hospitals. Lillian Wald founded the Henry Street Settlement and the Visiting Nurse Service in New York City in 1893, creating public health institutions still at work today. Both of these women established nurses as social reform leaders. Their actions and achievements prove that disrupting the status quo is essential to achieve social change. If NPs today are to live up to the legacy of these visionary leaders, we must match their bravery and tenacity. We must come together with the same determination to solve the major public health problem of our time: chronic lifestyle diseases.

In my second column, I wrote that in order to fulfill our social responsibility and right a broken health care system, full practice and prescriptive authority for NPs is essential. This is a nonnegotiable mandate that must be demanded by every individual NP and every NP organization. It should be the unifying political cause that directs our legislative agenda. We cannot equivocate, and we need not doubt ourselves. The essence of NP care suits the health needs of our time just as perfectly as Nightingale’s and Wald’s care suited the health needs of their time. We must defend and take ownership of our methods of practice. We must describe our unique expertise to everyone who does not understand us. At every opportunity, we must challenge demeaning labels such as “nonphysician,” “mid-level,” and “physician extender.” We must constantly explain the distinctions between “nurse” and “nurse practitioner,” until NPs are well understood.

In my third column, I laid out the core measurements for optimum health to prevent and treat chronic diseases. Reaching these goals requires healthy lifestyle behaviors and, sometimes, medication. NPs are the only health care professionals who are trained in both medicine and nursing. We know how to treat both the health problem itself and the patient’s response to the problem. Helping patients get to goal on all of these core measurements is the only way chronic diseases will be effectively controlled and prevented.

In my most recent column, I discussed the need for NPs to reach out to the media. Overcoming our social invisibility is the key to having a voice and influence. Neither legislators, government leaders, nor the general public will pay attention to us until we are seen and heard from in the media.

Challenges for NPs and Our Organizations
So far, NPs have not been effective organizers. NP organizations suffer from fragmentation, divisiveness, and low membership relative to the total number of NPs (see the table on page 19). It is hard to say these organizations truly represent nurse practitioners, given that most NPs do not support them by joining and paying dues. The small size of these organizations prevents them from garnering the resources and clout they need to accomplish meaningful political reform or effective media outreach on behalf of NPs.

Lack of coordination and failure to share resources among national, state, and local NP organizations dilute the money and energy that members do contribute. Individual and organizational NP initiatives repeatedly hit dead-ends because the efforts aren’t supported or carried forward by a unified community of organized NPs working synergistically with the nursing profession as a whole. NP organizations and educational institutions focus only on NP issues and ignore issues of public health, leaving us lacking in social relevance.

It’s time we take a giant, bold, collective leap over the edge and into the future. NPs need to get organized. The NP profession is made up of 147,000 disconnected individuals and a host of disorganized organizations, foundations, networks, and councils. All have some growing and changing to do, and it needs to be done fast.

NP Organizations Need to Organize
NP organizations need to coalesce, merge, and share resources. If they want to attract more members (and more dollars), they must prove themselves competent and relevant to a larger percentage of the 147,000 practicing NPs.

Reaching out and inviting all NPs— clinicians, educators, researchers, and administrators—to the table and incorporating all the divergent views will lead to innovative solutions to old problems.  Abandoning the status quo will allow NPs to evolve into something more socially relevant.

Specifically, all NP organizations should coordinate their efforts to pursue the following unified agendas:

Obtain funding and grass-roots support from a majority of NPs in order to lobby effectively for full practice and prescriptive authority for NPs across all 50 states.

Launch a robust and coordinated media outreach campaign that explains and promotes NPs’ vision, authority, and expertise and outlines a clear health care plan for the public.

Advocate boldly for a national health initiative led by NPs to get every American to goal on every single health risk.

Individual NPs Need to Become Activists
NPs have an unprecedented opportunity at this moment in history. It is up to each one of us to take full advantage of it. Whatever your passion, whatever cause you support, whatever you believe—act on it and invest money in it.

As I see it, every NP should be making 3 types of donations: time, money, and self. Every NP should:

Reach out to local, state, and national politicians and legislators at every opportunity. Explain NPs’ urgent need for full practice and prescriptive authority and how we will use that authority to provide exactly the type of health care that’s most needed and in shortest supply. It’s easy to reach out via email. All it takes is a donation of time.

Join and pay dues to local, state, and national NP organizations. Don’t skip organizations because you’ve given to a group on another geographic level. Make additional donations if you feel the organization is adequately representing your interests. Do it today! Make a donation of money.

Reach out to the media. Write a letter to the editor. Call in a story to your local newspaper. Get interviewed on a local radio show. Meet the press whenever and wherever the opportunity arises. It’s a donation of self.

Synergy = Energy²
United and cohesive NP organizations, when aligned with 147,000 NP activists,  all working toward the same solutions—that would be a powerful force for health reform!

Finding solutions to the difficult social and behavioral problems that lead to disease is both a humanitarian issue and a political one. Eliminating the causes of chronic disease will require changing the very nature of our social values and disrupting many of our social structures. NPs can help guide those changes if we work together energetically and synergistically.

This column is also posted on Carla’s blog at www.maverickhealth.com/blog, where you are invited to leave comments. Carla also welcomes feedback at info @maverickhealth.com.