Meet 3 nurse advocates
From the Hill to the boardroom, these nurses take their practice to a different level
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By Marcia Frellick
EDITOR'S NOTE: Marcia Frellick is a freelance writer.
Pushing for change has become such a cornerstone of nursing the American Nurses Association declared a Year of Advocacy to showcase individual and collective efforts at all levels.
“For nurses, every year is a year of advocacy, both at the bedside and beyond,” said Janet Haebler, MSN, RN, ANA’s senior associate director of state government affairs. “As the largest group of health professionals in the U.S. and because they are consistently ranked highest in ethical behavior and honesty, nurses are in a unique position to influence the direction of healthcare.” During the Year of Advocacy in 2018, the ANA educated and inspired nurses about ever-growing opportunities to promote change, she said. That change can come at any level, from an individual practice or community to Capitol Hill.
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Rep. Eddie Bernice Johnson
Congresswoman
Rep. Eddie Bernice Johnson (D-Texas), poised to begin a 14th term in the state’s 30th congressional district was the first registered nurse elected to Congress in 1992. She had been serving in public office since 1972, when she entered the Texas House of Representatives, following a passion that grew from activism in the Civil Rights Movement, she said. Johnson said nursing and politics require many of the same attributes — patience, listening, mediation and the ability to synthesize large amounts of information. Her training came in handy in trying to gain passage of the Affordable Care Act, she said. A former hospital nurse, Johnson was one of the few people in Congress at the time who was an expert in patient care. “[Congress] had only one other nurse at that time and she was a school nurse,” she said. “I was the only person who had any hospital healthcare delivery experience.” Her service in Congress has stretched beyond healthcare. Johnson has served on committees that consider critical issues in transportation, the environment, technology, science, space and infrastructure.
Among her current advocacy efforts is helping to develop legislation that would build programs to retrain transportation workers who would be displaced as more driverless vehicles come into use.

Also, as Ranking Member on the Committee on Science, Space, and Technology, Johnson also has introduced legislation to increase participation of women and underrepresented minorities in Science, Technology, Engineering and Mathematics careers. Johnson specialized in psychiatric nursing and said she calls on those skills often in dealing with people and studying behavior in pushing for issues important to her. Nurses have unique abilities in writing legislation, she said. “Most nurses have to have some knowledge of finance, planning, loyalty, dependability, trustworthiness, initiative and leadership,” Johnson said. “It takes all of that to make a good legislator.” Seniority brings opportunity, she said, but there are still plenty of opportunities for nurses new to advocacy. “It’s not difficult to get involved in advocacy,” she said. “You can write. You can be involved in elections. You can run (for office) yourself. Or you can pick the person you want to represent you and help them and keep your subject matter before them.”
Lynne Meadows, RN
School nurse
Although Lynne Meadows, MSN, RN, has been coordinator for Student Health Services in Fulton County Schools in Atlanta for 18 years, her advocacy spans local, state and national levels. Meadows serves on the National Association of School Nurses’ board of directors. Every winter, school nurse representatives from 50 states gather on Capitol Hill to present to legislators what they believe are the most important issues. For the past few years, the major target of her advocacy has been securing the future of the Children’s Health Insurance Program, she said. This year she discussed the issue with the congressional delegation from Georgia. “We were able to bring them real data about what we’re seeing in the schools,” she said. “We’re seeing some of the highest numbers of kids with chronic illnesses as we’ve ever seen before.” That includes everything from allergies to cancer, she said, adding that in her district, 33,000 of 98,000 children have a diagnosed medical condition.
“This year we were thrilled to find out CHIP would be extended 10 years,” she said, adding the news was particularly exciting in Georgia where “We have 1.3 million kids on Medicaid and 200,000 or more take advantage of CHIP.” But that win doesn’t mean a break from advocacy. Already, her next target for action looms and this one is centered in her state. The proposed budget for Georgia includes a line item for a more-than $580,000 cuts for school nurses. Because school nurses often work alone in a school, that means entire schools would not have a dedicated school nurse, Meadows said. Meadows, who already has testified before the state appropriations committee, said she questions the use of a formula tied to enrollment to decide the cuts. If a school loses students, the remaining students don’t have any less need for a school nurse, she said. She wants school nurses to know part of the responsibility in advocating is to let people know the value of the role. Consider a school whose nurse notices a student has an unsteady gait. That nurse, who observes the gait as the child walks down the school hallway, may be the only one who notices and the only person who leads that child to a physician’s office. “No one will know the role you played unless you tell them,” Meadows said. “That’s not to pat ourselves on the back, but to share what’s important about the role.” For many children school nurses will be the first line of healthcare providers they see. The days of putting on Band-Aids and sterilizing scrapes are over, she said. In addition to preventive and acute care for children, school nurses also consult with parents to ensure children are getting the proper vaccinations. “All of the nurses on my team have 20-plus years of nursing experience,” she said. “And it takes all of that to manage the kids we see. It’s not like a hospital where you can consult with colleagues. We don’t have that in the education settings.”
Karen Mercereau, RN
Patient advocate
When Karen Mercereau, RN, of Tucson, Ariz., accompanies a patient to a physician’s appointment, she often comes armed with two lists of questions. On one list are questions patients can ask the doctor comfortably, eliciting answers they can understand. The other may contain a list of questions that may take medical knowledge to ask of the physician and then explain to the patient. Mercereau started Tucson-based RN Patient Advocates in 2002 to help fill the gaps in help patients need in times of short appointment times, low literacy levels and increasing medical errors. “What we do is connect the dots so everyone knows what everyone is doing,” she said. That can mean making sure medical providers are talking with each other or family members are on the same wavelength or that patients understand their care and their choices. In the case of her company, which hires only those with at least an RN credential, advocates are hired by patients or patients’ family members and provide a clinical focus. They may be hired by adult children who live far away or by a patient or family members who want to make sure they understand the terms of a consent form, for instance. Patient advocates in other segments may be hired by hospitals or insurance companies with different purposes. According to Cigna, most hospitals have at least one patient advocate on staff and can help families with any problems a loved one has during a hospital stay. They also can work with a patient’s employer if the person faces possible job discrimination because of medical issues. Advocates also gather information in a patient’s medical records, sometimes going back as far as 20 years to search for information that can help enhance a care plan. Mercereau’s company can plot out trends on a graph from those records, such as complete blood counts and lipid and metabolic profiles. “Doctors don’t have all the right information,” she said. “Medical records are scattered everywhere.” Their ultimate goal, Mercereau said, is to educate and support patients and give them the tools they need to help them engage in their own healthcare so that they are confident and knowledgeable in asking the right questions and making the right choices for themselves. “We are the educators, the communicators and the connectors,” she said.
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