Advocacy Assessment

NURS 492 Community Health Nursing

Purpose of Assignment
The purpose of this assignment is to allow the student the opportunity to complete an indepth analysis of a health issue in order to serve as an expert witness advocating for
community health nursing and consumers. An issue involves controversy and therefore
may include positive and negative aspects. Students are expected to present a sound
logical argument regarding the issue assigned
Approach to Assignment
The assignment was approached by performing a research on the decision-making
process for new regulations in the state of Hawaii. A current situation related to nursing
practice was selected and its benefits and consequences were analyzed. Another research
was performed with the goal of obtaining evidence from formal organizations that could
support my aspect on a situation. Negative feedback of possible approval was also
provided to avoid viewers from becoming bias.
Reason for Inclusion
It was essential for this assignment to be included to show a way on how to advocate the
community and for the advancement of Nursing. This also provides an example of how to
appropriately communicate and express an opinion towards formal leaders. This letter
can be used as a guideline when writing a formal letter.
Communication
Expresses oneself and communicates effectively with diverse groups and
disciplines using a variety of media in a variety of contexts
I wrote a formal letter as an effective form of formal communication. I also
expressed my opinion to Senator Brian Schatz in the appropriate manner I feel
our nation leaders are not showing validation to the education, exposure,
compassion and love we have for the U.S. population. This imbalance across the
States emphasizes that Advance Practice Registered Nurse are not competent
enough to care for people.

Accesses and utilizes data and information from a wide range of sources to
enhance patient and professional communication
I read the assigned module regarding advocacy for 492 class. I also performed a
research to review how to write a letter to a senator www.altaread.org/lettersenator.asp

Research
Evaluates research that focuses on the efficacy and effectiveness of nursing
interventions
I stated a thought that was emphasized by a nursing journal based practice on
evidence I would like to remark Nursing Profession is known for health
promotion and disease prevention efforts via education and advocacy.
Leadership
Demonstrates self-direction, professional accountability, and advocacy adhering
to legal and ethical nursing
I demonstrate self-direction and professional accountability by performing the
research without any mentoring and by writing the letter regarding on the
importance of advancing nursing practice. I adhere to an ethical and legal form by
formally expressing my own feelings using the appropriate form of
communication.

Initiates community partnerships to establish health promotion goals and

implements strategies to meet those goals
I initiated a partnership and health promotion by providing strategies by placing
APRN in these areas increase health awareness, identification of community
resources to increase healthcare compliance especially in our lower income
population, and providing alternative measures allowing our patients to feel in
control of their own health.

Articulates the values of the profession and the role of the nurse as member of the
interdisciplinary health care team
I articulated the value of the profession by writing about the Nursing Consensus
developed in 2008 by the National Council State Board of Nursing and stating its
goal to improve patient safety, to expand access to care and to decrease health
care cost.

Professionalism
Demonstrates advocacy, accountability, and adherence to standards of practice
and legal and ethical principles.
I demonstrate advocacy by performing an intense research in how to write a
formal letter to a senator, accountability by providing the consequence if a bill is
approved advance nurses lack in training requirements which could lead to
misdiagnosis, inability to manage complex illness, and possible misusage of
prescriptions and diagnostic test. I adhere to standard of practice, legal and

ethical principle by expanding my education (obtaining my BSN), practice at the

bedside based on evidence and follow my hospitals policy and procedures.

Understands the effect of legal and regulatory processes on nursing practice and
healthcare delivery, as well as limits to onesown scope of practice
I now understand the importance of becoming the active member of nursing
organizations as this advocate not only for our patients but for our future nursing
career. I learned how certain companies are driven by finances related to
healthcare delivery and also kept me aware of my own scope of practice.

Demonstrates accountability for ones own professional practice.

By advancing my career in obtaining my Bachelor's degree in Nursing and by
writing this advocacy letter related to expanding the scope of practice of advanced
nurses as this not only benefits the community but my future goal.

Advocates for professional standards of practice using organizational and

political processes.
I advocate for professional standards of practice for Advance Practical Registered
Nurses by participating with the local government in this current decision-making
process for the approval of bill SB 2672 in the state of Hawaii.

Senator Brian Schatz

Senate Bldg Room # 7-212
Honolulu, HI, 96850
Dear Senator Brian Schatz,
My name is Diana Pulido. I am a Registered Nurse (RN) in the State of Hawaii. I am
writing to request your support on bill SB 2672 relating to Advanced Practice Registered
Nurses (APRN). This act is important because it supports the major elements of the
Consensus Model for APRN regulation developed in 2008 by the National Council State
Board of Nursing and endorsed by 48 organizations (the list can be accessed by visiting
www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf). The purpose
of this model is to ensure APRN licensure, accreditation, certification, and education
regulations are aligned across the nation in order to improve patient safety, to expand
access to care and to decrease health care cost (Campaign, n.d.). As a nurse, as a
patient, as a citizen and as a devoted advocate for the advancement in Nursing profession,
I feel our nation leaders are not showing validation to the education, exposure,
compassion and love we have for the U.S. population. This imbalance across the States
emphasizes that Advance Practice Registered Nurse are not competent enough to care for
people.
Some Physicians are against the granting of full practice authority to Nurse Practitioners
as reported on a survey conducted a survey by Karen Donelan, MD from Harvard
Medical School (Ready, 2013). Some of the concerns identified were the possible
increase in health cost and the poor quality these Practitioners can provide. Physicians
feel advance nurses lack in training requirements which could lead to misdiagnosis,
inability to manage complex illness, and possible misusage of prescriptions and
diagnostic test (Mills, n.d.). These surveyed Physicians felt "The education, training, and
the experience of nurse practitioners varies dramatically from state to state, whereas the
training of family physicians and physicians, in general, is consistent, regardless of
medical school or state," (Ready, 2013).
There is a current shortage of physician in the area of Primary Care Services due to the
increase in compensation of other specialty areas (Tolman, 2014). The lack of primary
clinics visits increases unnecessary usage of Emergency Services which can increase
healthcare cost nationwide. A great benefit of granting full authority to ARPN is they can
provide primary care services at a lower cost and lower compensation. I would like to
remark Nursing Profession is known for health promotion and disease prevention efforts
via education and advocacy (Tolman, 2014), by placing APRN in these areas increase
health awareness, identification of community resources to increase healthcare

compliance especially in our lower income population, and providing alternative

measures allowing our patients to feel in control of their own health. Other essential
benefits stated by the National Council State Board of Nursing include:

Ensure public safety by requiring advanced practice registered nurses to be

licensed as APRNs. Currently, our jurisdiction does not require this. This would
be in addition to the registered nurse (RN) license and is a recommendation in the
Consensus Model for APRN Regulation. Both licenses would be regulated by the
jurisdictions board of nursing.
Establish graduate level nursing education as the minimum level of academic
requirement for APRN licensure. Graduate level education requires advanced
courses in many areas, including pharmacology, as well as extensive clinical
practice hours, in order to earn the graduate degree.
Ensure that all APRNs have met the requirements for advanced education from an
accredited graduate program. The bill requires all APRN education programs to
undergo a board of nursing approval process and be accredited by the American
Association of Colleges of Nursing Accreditation.
Require professional certification for APRN licensure. Graduates of nursing
programs are required to take and pass a certification examination in their area of
APRN specialty. This exam helps establish entry-level competency. APRNs are
held to professional standards established by the certifying body, in addition to the
jurisdictions nurse practice act.
Improve the publics understanding of who is providing their care. The goal is for
the title advanced practice registered nurse (APRN) to be adopted by every
jurisdiction to provide an easily recognized professional designation in all
jurisdictions. APRNs will be required to legally represent themselves as APRNs,
followed by their specialty role (CNP, CNM, CRNA or CNS). For example, the
legal title/signature for a nurse practitioner would read Barbara Smith, APRN,
CNP.

APRNs are a highly valued and integral part of the health care system. They have the
necessary knowledge and skills to care for patients in the absence of providers and can
tremendously improve access to health care in rural areas of the jurisdiction. In addition,
a large interdisciplinary team will be greatly beneficial to our nation during unexpected
catastrophes.
As the representative for the Nursing Profession, I want to appreciate your consideration
of this letter in regards to SB 2672 to improve the provision of health care to the citizens
of State of Hawaii. Please contact me with any additional questions you may have.
Respectfully Yours,

Diana Pulido
Registered Nurse
Delli001@odu.edu
(123)456-7889

Reference
In National Council State Board of Nursing. Retrieved from
https://www.ncsbn.org/APRN_formletter_Legislator_web.pdf
Campaign for Consensus. (n.d.). In National Council State Board of Nursing. Retrieved
from https://www.ncsbn.org/738.htm
Mills, C. (n.d.). Why NPs Need Full Practice and Prescriptive Authority. In Maverik
Health. Retrieved from http://www.maverickhealth.com/blog/entry/why-npsneed-full-practice-and-prescriptive-authority/
Ready, T. (2013, May 15). Physicians, NPs Disagree on Expanded Practitioner Role.
In Medscape Multispecialty. Retrieved from
http://www.medscape.com/viewarticle/804256
Tolman, D. (2014, July 9). Breaking away: The ethical case for nurse practitioner
independence. In ResearchGate. Retrieved from
https://www.researchgate.net/publication/216179159_Breaking_away_The_ethica
l_case_for_nurse_practitioner_independence

"I pledge to support the Honor System of Old Dominion University. I will refrain from
any form of academic dishonesty or deception, such as cheating or plagiarism. I am
aware that as a member of the academic community it is the responsibility to turn in all
suspected violators of the Honor Code. I will report to a hearing if summoned."

Name: Diana Pulido

Signature: DianaCPulido
Date: June 24, 2016