THE PIONEER
Written: 5/15 - 5/17.

We are not the biggest nursing association in California...

...but we work the hardest to support you. Over the past seven weeks we've been vocal on a number of initiatives important to nurses and the future of the nursing profession. However, there is also a lot that happens behind closed doors, on phone calls, and in coalition meetings that don't make it into our regular communications.

In an effort to be more transparent, we're lifting the curtains on the work we've done since the shelter-in-place order, as well as shortcomings we've noticed.

While this will by no means be an exhaustive list, we believe it is our duty to highlight our value to you, our members.*

Sincerely,
-Your Executive Director, Dr. Marketa Houskova, and ANA\California Team

*The Pioneer is typically sent out on Thursdays evenings... but this issue is so important we wanted to be available to reply to your questions and comments.
ADVOCACY OVERVIEW

The past seven weeks of COVID19 have been... intensive... to say the least, with ANA\California hard at work. We were members of numerous coalitions, projects, initiatives, follow-up calls, zoom discussions, legislative calls, media requests, follow-up conference calls, work groups, healthcare groups, and national calls.

Our Executive Director alone attended nearly 540 calls and Zoom meetings in those seven weeks. "Our priorities were focused on strengthening and preparing the California nursing workforce for possible pandemic response," said Dr. Marketa Houskova. "Three priorities - 1) California Gov. Newsom's call for an extra 40,000 'surge' beds in hospitals and alternative care settings, 2) protecting our nurses on the frontlines, and 3) supporting nursing students' ability to complete their semester - brought ANA\California to the forefront of the COVID-19 pandemic response."

While the future remains uncertain, we can say, thankfully, that California's shelter-in-place and physical distancing efforts have flattened the curve... for now. However, it is important to recognize that had the crisis developed like it did in New York or Italy, California's nursing workforce and its pandemic preparations, ranging from activating retired nurses to utilizing nursing students, was an area of policy development where nursing organizations collaborated in various work groups.

In particular, to operationalize Gov. Newsom's Executive Order, the Governor's Office asked prominent professional nursing organizations to develop tools for healthcare organizations to utilize these workers to their full potential. A planning video conference was convened in late March with leaders from coalition partners including:

  • California Hospital Association
  • California Organization of Associate's Degree Nursing
  • California Simulation Alliance (HealthImpact)
  • Association of California Nurse Leaders
  • California Association of Colleges of Nursing
  • American Nurses Association\California
  • Family Health Centers of San Diego
  • California Nursing Student's Association
  • Health Workforce Initiative
  • Healthforce Center at UCSF

The coalition partners determined that the best approach to equip nursing schools, hospitals, and alternative care sites to utilize California HealthCorps workers was to focus on the areas of practice, academia, and recruitment. This call led to the creation of the COVID-19 California Practice Group.

ANA\California co-chaired the COVID-19 California Practice Group , led by Health Impact, which focused on processes and steps to bring nurses and nursing students to hospitals and community care settings so they may provide care during the pandemic. Co-chairs also included the California Hospital Association and the Association of California Nurse Leaders.

The COVID-19 California Practice Group created four documents to suggest resources and guidance for clinical agencies and to address the following:

  • How to prepare a clinical agency to work with nursing students who may be assigned to a hospital through HealthCorps,
  • How to educate staff in understanding the educational needs, skills, and abilities of nursing students deployed through HealthCorps in a crisis situation,
  • Where the alternative care sites are located in California, and
  • What documentation is needed for students to record and track their clinical experiences.

ANA\California participated in several calls with the CA BRN Interim Executive Officer, Loretta Melby, where we discussed BRN's response to Gov. Newsom's Executive Order on March 31, 2020. We discussed the Department of Consumer Affairs' (DCA) waivers that - in our opinion - did not give nursing programs enough flexibility to assure nursing students academic progression and their timely graduation.

While the DCA had issued a new waiver allowing 50% of simulation education on April 9th (set to expire on June 3, 2020) , we pointed out how insufficient that waiver has been for many programs. Moreover, the deadline is creating even more uncertainties for nursing schools and nursing students about their next semesters, graduation, and entry into the California workforce. Will the DCA extend the June 3rd deadline? How should nursing programs proceed while the future of the waiver is unsure?

Following those calls, ANA\California created a Phone2Action digital campaign activating nurse advocates who unleashed more than 2,700 messages sent to the Governor, Assembly Speaker, Senate Pro Tem, Chairs of Assembly and Senate Committees, and the Director of the DCA. We shared this campaign on all our communication platforms, with our coalition partners, to individual nursing leaders through direct messages, and most importantly with the California Nursing Students Association's Board of Directors.

Follow our directions in the signature below to learn how to be activated for future Phone2Action campaigns.
A BRIEF WORD FROM OUR PARTNERS

"Nursing advocacy in health and public policy using research and data was foundational to Florence Nightingale’s vision for modern nursing practice. ANA\California has been a valued partner in representing professional nursing to statewide nurse leader coalitions. It has been a pleasure to work with and learn from thoughtful ANA\California leaders in advancing the profession. Happy International Year of the Nurse and Midwife!" - Garrett Chan, PhD, APRN, FAEN, FPCN, FNAP, FCNS, FAAN, President & CEO, HealthImpact

"On behalf of the California Hospital Association, it gives me great pleasure to celebrate the International Year of the Nurse and Midwife, and thank all RN’s for their unwavering care during these unprecedented times.  Who better than California's RN leaders to chart a course through these highly uncertain, ambiguous, volatile times. Nursing is a complex business and the fruits of your labor are ever present. I offer special recognition to the HealthImpact Practice Work Group, who developed rigorous tools and resources rapidly to meet the surge capacity demands of the state. These tools were developed by a robust nursing community focused on the needs of our communities in the true sense of collaboration and commitment. Putting tasks to action for a safer, healthier California, thanks, again!" - BJ Bartleson, RN, MS, NEA-BC, VP for Nursing & Clinical Services, California Hospital Association

"ACNL is honored to recognize nurses for their compassionate and competent care this Nurses Week, especially in the Year of the Nurse and Midwife. Our participation in the workgroup convened by HealthImpact was a rewarding experience in support of California’s nurses, and is a reminder that leadership in a time of crisis is a collaborative process." - Donna Kistler MSN, RN, Interim CEO, ACNL
ADVOCACY CONTINUED...

We also recognized the continued affects of bill Worker Status: Employees and Independent Contractors - more commonly known as AB 5 or the "gig worker bill" - since it went into affect January 1st, 2020. The bill has left many independently contracted nurses unable to supply their services during this critical time while others, such as physicians, are exempt from these same standards.

In response, ANA\California launched another Phone2Action digital campaign to ask Gov. Newsom to immediately issue an executive order, temporarily suspending AB-5 restrictions for nurses and advanced practice providers working as independent contractors. Furthermore, our Executive Director connected with media, providing comments and quotes for several articles, and as well as directing them towards specific stories from members of California Association of Nurse Practitioners (CANP), California Association of Nurse Anesthetists (CANA), and California Nurse Midwives Association (CNMA).

A few weeks later, Senate Bills 900 & 990 surfaced, both seeking to amend and repeal AB-5 to exempt various members of health professionals. ANA\California's contracted lobbyist, Roxanne Gould, worked to include "nurses" into the language of the bills.

NOTE: As of 3:23pm, May 14th, Roxanne Gould, who was ready to testify in support of the bill, notified ANA\California that Senator Hill had recently called the Senate Labor Committee to order and announced that SB 900 has been pulled from the agenda.*

* Wondering why? Watch this recent YouTube video update by Roxanne Gould and Marketa Houskova, discussing legislation and why many anticipated bills may be cut due to criteria set forth by the Senate.

Be sure to follow us on LinkedIn, Youtube, Facebook, Instagram, or Twitter, as we share more updates about legislation in the coming days and weeks.
During our Listening Tour in February 2020, ANA\California's Board of Directors traveled to Fresno, CA to learn about important issues impacting the Central Valley's local communities. As we began to see COVID-19 cases spike, we felt it was our duty to continue to support our nurses and care facilities on the frontlines in these communities.

That's why we're happy to announce that ANA\California has purchased and delivered 1,100 masks to nurses on the frontlines in Skilled Nursing Facilities (SNFs) and hospice care. Both Golden Living of Reedley, CA and Fresno Post Acute Care of Fresno, CA were thankful for our contributions. See the heart-warming photo below from Golden Living at the bottom of this email.

On a larger scale, ANA\California also joined in ANA national's campaign call for Personal Protective Equipment (PPE), in which 125,000 nurse advocates from across the U.S. sent over 325,000 messages to the President and U.S. Congress. We don't need to tell you just how instrumental this was in advancing the production and procurement of PPE for healthcare workers in all states.

When nurses weren't able to access enough PPE to sustain themselves, we connected with infectious disease experts, Nurse Specialist for the United States Department of Health and Human Services and ANA\California member, Thao Tran, MSN, APRN-CNP, FNP-BC, RN-BC, PHN, CHIPS and Dr. Elizabeth Beam, an Assistant Professor at the University of Nebraska Medical Center College of Nursing, and partnered with Trusted Health to help answer pressing questions on how to better protect yourself, your families, and your communities. Read their answers to common nurses' questions regarding COVID-19, PPE, and more.

ANA\California also took action after the announcement of AB 664 (Asm. Cooper & Asm. Gonzales). " This bill would define “injury,” for certain state and local firefighting personnel, peace officers, certain hospital employees, and certain fire and rescue services coordinators who work for the Office of Emergency Services to include being exposed to or contracting, on or after January 1, 2020, a communicable disease, including coronavirus disease 2019 (COVID-19).

Roxanne Gould and Dr. Marketa Houskova noticed a small but particular change needed in SECTION 1. Section 3212.18 (a), which read: "(3) Health care employees who provide direct patient care in an acute care hospital..." Roxanne and Marketa discussed this bill with Asm. Cooper's Staff where they offered an amendment aimed at the fundamental work of nurses caring for patients in subacute care facilities as also being on the frontlines of COVID-19 pandemics. 
NOTABLE MENTIONS

We were so happy to be able to include Chris Cinkowski RN, BSN, CCRN policy expert and Master of Public Health student at John Hopkins University, in our efforts throughout the past weeks. Chris was instrumental in drafting portions of The Pioneer Newsletter, drafting advocacy campaigns, and joining coalition calls and meetings.

ANA\California is looking forward to Senate Resolution from Senator Anna Caballero (D-12) recognizing nurses during National Nurses Week… but due to COVID-19 receiving it on the Senate floor won't be possible at this time.

Three members of our Board of Directors were invited to be editors and contributors on a book offering dozens of actions you can take to keep you and your family safe during Coronavirus. Dr. Chris Tarver DNP, RN, CNS, NEA-BC, (ANA\California Nursing Practice Director), Dr. Ruth Rosenblum DNP, RN, PNP-BC, CNS, (ANA\California Secretary), and Zack Huddleston BSN, RN, PHN, (ANA\California Membership Director) we're so proud of the work you did to help in the production of Beat the Coronavirus: Strategies for Staying Safe and Coping With the New Normal During the COVID-19 Pandemic. Check out the book!

Furthermore, our board members joined each other on a virtual call to send a message to nurse members expressing their gratitude and appreciation for Nurses Week/Nurses Month and for all that you do. Watch the video to see what each of them had to say!

We also created the ANA\California COVID-19 Resources page on our website where we share many relevant articles, resources, and information.

You may also note ANA's running list of COVID-19 Legislative, Regulatory, and Advocacy Updates .
SHORTCOMINGS

While nurses were, and are, crucial to caring for patients inside and outside of facilities, the COVID-19 pandemic has showed certain spheres where professional nurses' voices were yet again missing. Despite ongoing efforts of multiple nursing organizations, our voices and expertise were not included during various state emergency and disaster planning and implementation, in communication with the California Office of Emergency Services, Governor's Office, Dept. of Public Health, Dept. of Health and Human Services, HealthCorps, or the DCA. The need to strengthen nursing presence in the policy arena has never been more pressing or prominent. ANA\C will continue in our efforts to elevate your voices in these important policy conversations.

While ANA\California was a part of the Health Impact team that worked on strengthening CA nursing workforce as directed by the CA Dept of Health & Human Services, Dr. Ghaly and the CA Office of Emergency Servies, existing plans on pandemic nursing workforce response highlighted that nurses' expertise was not at the table during high-end statewide disaster planning meeting or implementation decision-making. Moreover, let's not forget about the complete lack of professional nursing presence at the Governor's press briefings during a statewide emergency that required nurses' dedication, determination, expertise, skills, and abilities to suppress it.
FINAL NOTES

The COVID-19 crisis opened a door for nurses to take charge of our profession, change the existing system that did not serve our patients or our communities, strengthen nursing presence in policy, politics and media to educate, assure, and guide the public as the most honest and ethical profession for the past 18 consecutive years.

We are continuing in our work to advance the health and well-being of all Californians and the profession of nursing. We are so grateful for your hard work and dedication, and we look forward to continuing serving you, our members.

Happy Nurses Month!
Golden Living of Reedley, CA
Hello. We're ANA\California.

We enhance the health and well-being of Californians and advance the profession of nursing by advocating for legislation, regulation, and policies. We focus on improving quality care, quality experiences, quality nurses, and the quality of our profession. We're the ANA\California Team and we're here for you. How can we help?

Thousands of nurses have participated in our advocacy campaigns recently and we thank you for your support!  For those of you who've missed out on these critical campaigns, we've made digital advocacy as easy as 1-2-3.

1. Text "ANACNURSES" to 52886
2. Click the link in text message
3. Opt-in to receive curated action messages

ANA\California uses Phone 2 Action to do the heavy lifting for you. Send pre-written messages directly to your state representatives - all in one click!

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ANA\California is available for speaking arrangements. Email us.
Questions or feedback? Just reply to this email.

-- Your ANA\California Team