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Janice Petrella Lynch, MSN, RN, is nurse consultant and director of the Help & Resource Center at The Marfan Foundation.
When Jeff Solheim, MSN, RN, CEN, TCRN, CFRN, FAEN, FAAN, assumed the presidency of the Emergency Nurses Association in January, he established some of his key goals for the upcoming year.
How about pending legislation?
ENA is actively supporting two such bills. The first is the Title VIII Nursing Workforce Reauthorization Act that amends Title VIII of the Public Health Service Act and reauthorize nursing workforce development programs, which support the recruitment, retention and advanced education of nursing professionals, including many emergency nurses. The act was passed by the House of Representatives by voice vote on July 23, 2018. It is now awaiting action in the U.S. Senate. The bill extends advanced education nursing grants to support clinical nurse specialists and clinical nurse leaders; defines nurse managed health clinics; adds clinical nurse specialists to the National Advisory Council on Nurse Education; and reauthorizes loan repayments, scholarships and grants for education, practice and retention. ENA has long supported nursing workforce development programs as these programs further nursing education and training. The second bill ENA is actively supporting is H.795. Massachusetts ENA is advocating for this bill, which would strengthen penalties against those who assault a healthcare provider, including emergency nurses. Current law allows those who are convicted of assault or assault and battery against a healthcare provider to receive a fine and serve no jail time.

H.795 would remove language regarding fines and allow for longer sentences for those convicted. It also clarifies that a healthcare provider need not be in the act of treating or transporting a person to be protected under the law.
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What legislative items are of particular interest to the ENA at this time? Why?
ENA is strongly supporting the H.R.5223, Health Care Workplace Violence Prevention Act. Most workplace violence bills are found at the state level because states have jurisdiction over local criminal law matters. However, H.R.5223 is a federal bill that attempts to address the problem of violence in the healthcare workplace by requiring healthcare facilities that accept payments from Medicare and Medicaid take specific steps to prevent workplace violence and ensure the safety of patients and workers. The legislation will require healthcare employers, primarily hospitals and outpatient clinics, to develop and implement comprehensive workplace violence prevention plans. The plans must include procedures to identify and respond to risks that make healthcare settings vulnerable to violent incidents. In addition, it should ensure that employees are appropriately trained in mitigating hazards.
One of them is to bring emergency nurses throughout the world together. He envisions a mutual sharing of ideas and commonalities through cultural exchange trips, resulting in lasting friendships and professional bonds. He believes ENA members can learn as much from overseas peers as they can from those in the U.S. With more than 42,000 members in the organization, Solheim also recognizes the power of the ENA and its members in directly engaging with senators, representatives and their staffs, educating them on specific legislation and urging their support for legislation that ENA is backing.

ENA also partners with other healthcare organizations, including many nursing groups, to lobby on behalf of legislation of importance to emergency nurses, and it supports key legislative priorities during the annual Day on the Hill in Washington. Solheim shares the latest in ENA legislative initiatives and how the ENA is actively involved in the legislative process. He also talks about how emergency nurses can become more involved and why it is critical to their practice.
How does the ENA demonstrate support and involvement in the legislative process, both from the ENA office and in Washington?

ENA directly engages with senators, representatives and their staffs to educate them on specific legislation and urge their support for legislation that ENA is backing. This includes meetings on Capitol Hill and sending letters to members of Congress indicating our support for bills or specific public policies. ENA also partners with other healthcare organizations, including many nursing groups, to lobby on behalf of legislation of importance to emergency nurses. As part of our government relations efforts, we track bills throughout the legislative process and we aggressively support our priority legislation from bill introduction to passage in the House of Representatives and Senate. We also maintain the EN411 Action Network, which allows our grassroots advocates to show support for ENA’s legislative priorities with federal lawmakers. ENA supports key legislative priorities during our annual Day on the Hill. In 2018, we had our largest turnout yet of 160 ENA members from 43 states who came to Washington, D.C., to advocate in support of four bills. ENA provides in-person training at the Day on the Hill to educate members on the details of our bills and how to effectively interact with lawmakers.

Following the training sessions, ENA members meet with Senate and House members to advocate in support of our public policy priorities. Each ENA State Council can designate one or more individuals as chairperson or chairpersons of government affairs. Their job is to act as a direct liaison between their state councils and the state government as well as to manage state level advocacy for priority policies as determined by the state council and informed by the ENA public policy agenda. Finally, the Government Relations team steps in to assist ENA state councils when they are pursuing legislation at the state level. The team provides strategic and technical advice and support, including drafting or editing materials and reaching out to legislative offices. The team in the District of Columbia monitors priority legislation for the states and provides updates on changes to the status of these bills. Government Relations also assists states in drafting letters of support as well as testimony for members who are invited to speak before a committee.
How can nurses in emergency nursing get more involved in the legislative process?

To get more involved, the first thing emergency nurses can do is to join the
EN411 Action Network
, if they have not already, and take part in each of our current and future action alerts. By joining, they will receive the latest calls to action as well as a monthly newsletter that discusses issues affecting emergency nursing and updated information regarding our legislative priorities.

Emergency nurses can also attend ENA’s Day on the Hill in Washington, D.C., where they get first-hand experience and training in ENA’s priorities and meet with their lawmakers to discuss these priorities. Finally, ENA members can contact their chairpersons of government affairs to learn more about other opportunities for involvement.
Why should emergency nurses get involved in legislative issues?

Emergency nurses need to become actively involved in public policy issues because these issues have an enormous impact on their professional lives. Laws and regulations can influence emergency care and emergency nurses in a positive or negative way. If the voice of ENA is not heard at the federal and state levels, there could be negative consequences for the role of nurses in our healthcare system. Moreover, ENA needs to be a strong advocate on behalf of patients who need access to high-quality emergency care. A recent example is ENA’s support for SOAR to Health and Wellness Act. This bill will provide healthcare professionals, including emergency nurses, the training needed to identify and appropriately treat human trafficking victims. If passed, it will help emergency nurses better identify and treat these patients
One of the most recent ENA supported bills to pass was
Alaska H.B. 312
, a broad criminal justice reform package. Alaska ENA President Sue Metcalf, MSN, RN, CEN, worked closely with State Rep. Matt Claman and his staff to provide a letter of support for the bill in February. On March 19, Alaska ENA member Dawn Elliott testified at a Senate Judiciary Committee to tell her personal story of being assaulted at work. H.B. 312 will allow prosecutors to seek enhanced penalties against individuals who are convicted of aggravated assault of healthcare workers. It would also allow law enforcement officers to arrest someone at a healthcare facility for assault in the fourth degree without a warrant.

Although this does not elevate assault of an emergency nurse to a felony-level crime in Alaska, it is a big step forward in providing police additional authority to arrest individuals who assault emergency nurses. This bill was signed into law on June 14 by Gov. Bill Walker.
Additional ENA supported bills that have recently passed in the U.S. House of Representatives, Senate or in both chambers include:
  • Protecting Patient Access to Emergency Medications Act

  • The Military Injury Surgical Systems Integrated Operationally Nationwide to achieve ZERO Preventable Deaths (MISSION ZERO) Act

  • SOAR (Stop, Observe, Ask and Respond) to Health and Wellness
  • The Preventing Overdoses While in Emergency Rooms Act (POWER Act)

  • The Alternatives to Opioids in the ED Act (ALTO ED Act)
Although this does not elevate assault of an emergency nurse to a felony-level crime in Alaska, it is a big step forward in providing police additional authority to arrest individuals who assault emergency nurses.” Jeff Solheim, RN
Discuss some recently passed legislation that pertains to emergency nurses and supports them in their practice.