Issue link: https://nnumagazine.uberflip.com/i/927372
replaceable either by promoting multi-state nurse licensure com- pacts that permit nurses to work in any participating state (mak- ing strike breaking much easier), developing technology to make nurses obsolete, or by using less- er-skilled or unlicensed staff to usurp nursing duties and func- tions. "In nursing, there are always new developments; it's always changing," said Lisa Oliver, a pediatric and adult ICU RN at Eastern Maine Medical Center who recently joined the JNPC. "They're always trying to take the nurses away from the bedside and replace us with technology. They don't want to spend the money. But I want to be the one to take care of my patients. That's why I became a nurse. I want to be the one to give my patient a bath, because while you're giving a bath, you are also assessing and teaching your patient about their disease process." One of the most basic ways nurses can protect their practice is by ensuring that their workplaces, whether it's a clinic or a dialysis center or a floor of a hospital, are appropriately and safely staffed, so the strug- gle to win and enforce safe RN-to-patient staffing ratios is a centerpiece of the JNPC's work. "If staffing is not at an adequate level, you are not able to practice nursing the way you know you should be," said Audricia Brooks, a 24-year nurse practitioner at the Cincinnati VA Medical Cen- ter and a JNPC member. "Staffing levels influence how you do your job." Besides advocating for ratios laws at the national level and in states that do not have them, the commission reviews and updates the assignment despite objection (ADO) forms which are an essen- tial tool in protesting and documenting unsafe assignments that could jeopardize patients' health and nurses' licenses. Oliver said that filling out ADOs works when used collectively; she recalls one instance where her hospital's professional practice committee (PPC) observed 10 ADOs coming from one surgical floor. They used the documentation to call a meeting with management to get the staffing issues resolved. "You need to be an advocate for your prac- tice," said Oliver. "If they're asking you to do more with less, there are avenues you can take. One is to fill out ADOs and bring issues to the PPC. You must protect your patients, protect yourself, and pro- tect your coworkers. When you fill out an ADO, everyone signs it." Not surprisingly, the vast majority of nurses on the commission are 20-year, 30-year (and upwards) veterans of nursing, and another reason they all have for serving is to preserve and improve nursing practice for future generations of nurses. In recent years, they have noticed how student nurses who enter their hospitals for their clini- cal rotations seem less prepared than in previous years, have had less experience with patients in real-life situations versus simulation labs, and are less supported by their instructors. This state of affairs has them extremely concerned. "I want to fight for these young nurses to have the opportunity to care for patients themselves," said Oliver. Oliver, who normally works nights, remembers she once worked a day shift where student nurses were supposed to be gaining hands-on learning experience, but there was no apparent preceptor or instructor to be found. She took it upon herself to teach. "I said, 'Come on in, kids. Let's learn,'" she said. "When you have an intubated baby, what's the first thing you look for when you walk into the room? Where's my med cart?" Brooks gave similar examples. "In the last five years, I've found the NP students are not nearly as well prepared," she said of the nurses she pre- cepts. "I find I am doing more remedial work; they haven't learned the material well enough. For example, cranial nerves. It's one thing to learn about them, but they don't know enough about them: how to test for it, when to test for it." The JNPC hopes to develop a more robust outreach program to nursing schools and student groups in the coming years. "What excites me about the JNPC is that I can more clearly see the benefits of nurses defining nursing practice, not legislators or corporations," said Brooks, "If we're not careful, we will allow others to make us practice in a way that is not safe for patients and will increase our own liability." For more information about the JNPC, please visit http://nnumagazine.uberflip.com/i/924503-nursing- practice-informational-booklet-2017 O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 1 7 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 21 Your National Nurses United Joint Nursing Practice Commission members Got nursing practice questions or concerns? Your commissioners welcome your input. Please contact the nursing practice department by emailing nursingpractice@nationalnursesunited.org or calling (510) 273-2200 to learn your region's commissioner and get in touch. Region 1 Britta Houser Region 2 Marilu Ramirez Region 3 Elizabeth Aultman Region 4 Melissa Johnson-Camacho Region 5 William Flinn Region 6 Laura Owen Region 7 Joan Silva Region 8 Valerie Verity-Mock Region 9 Virginia Licerio Region 10 Kristan Delmarty Region 11 Margie Keenan Region 12 Dahlia Tayag Region 13 Patricia Crooks Region 14 Lisa Oliver Region 15 Irma Westmoreland NNU/Minnesota Doreen McIntyre NNU/Minnesota Bernadine Engeldorf NP at-large Audricia Brooks Public health Patricia Sanchez Board liaison Cokie Giles "What excites me about the JNPC is that I can more clearly see the benefits of nurses defining nursing practice, not legislators or corporations. If we're not careful, we will allow others to make us practice in a way that is not safe for patients and will increase our own liability."