HR 1119, The National Nurse Act of 2011

After many years of tireless advocacy on the part of some very dedicated individuals, the push to establish the position of a National Nurse for Public Health under the Office of the Surgeon General has gained considerable Congressional support (currently nine co-sponsors in the House of Representatives) and is now known as H.R. 1119: The National Nurse Act of 2011.

For those of you unfamiliar with the issue, here is some history of the Office of the Surgeon General and the drive for the establishment of the position of a National Nurse for Public Health (adapted from a previous post here on Digital Doorway):

Since 1871, the Surgeon General of the United States---the nation's "chief health educator"---has overseen and guided the health of Americans. Charged with overseeing the U.S. Public Health Service, the Surgeon General is appointed by the President and approved by Congress for a four-year term. According to the official website of the Surgeon General, this individual's duties include, but are not limited, to:

• Protect and advance the health of the Nation through educating the public, advocating for effective disease prevention and health promotion programs and activities, and, providing a highly recognized symbol of national commitment to protecting and improving the public's health
• Articulate scientifically based health policy analysis and advice to the President and the Secretary of Health and Human Services (HHS) on the full range of critical public health, medical, and health system issues facing the nation
• Provide leadership in promoting special Departmental health initiatives, e.g., tobacco and HIV prevention efforts, with other governmental and non-governmental entities, both domestically and internationally
• Administer the U.S. Public Health Service (PHS) Commissioned Corps, which is a uniquely expert, diverse, flexible, and committed career force of public health professionals who can respond to both current and long-term health needs of the Nation
• Provide leadership and management oversight for PHS Commissioned Corps involvement in Departmental emergency preparedness and response activities
• Elevate the quality of public health practice in the professional disciplines through the advancement of appropriate standards and research priorities, and
• Fulfill statutory and customary departmental representational functions on a wide variety of federal boards and governing bodies of non-Federal health organizations, including the Board of Regents of the Uniformed Services University of the Health Sciences, the National Library of Medicine, the Armed Forces Institute of Pathology, the Association of Military Surgeons of the United States, and the American Medical Association.

From a nurse's perspective, what is missing from the Surgeon General's overall equation is the more robust input of a nurse who would serve more as an equal to the Surgeon General in terms of his or her ability to effect and implement health care policy in the interest of the American people. At this time, the U.S. Public Health Chief Nurse Officer (CNO) serves as Assistant Surgeon General, representing the Surgeon General's interests and opinions, and otherwise working in a subjugated role that the medical community might deem fit for a nurse.

The goal of the organizations and individuals behind the drive for a National Nurse of Public Health is "to elevate and enhance the Office of the PHS Chief Nurse to bring more visibility to the critical role nursing occupies in promoting, protecting, and advancing the nation's health."

The proposed role of the National Nurse for Public Health would be to:

• Assist in the initiation of a nationwide cultural shift to prevention.
• Bolster efforts to focus the public on healthy living.
• Intensify roles for nurses, including students and retirees, in community health promotion.
• Provide greater support to the Surgeon General in calling for improvements in health literacy and reduction in health disparities.
• Encourage all nurses to spread prevention messages in their communities.
• Encourage participation of nurses in Medical Reserve Corps (MRC) units.
• Provide leadership to network with existing volunteer health promotion efforts.
• Strengthen linkages with providers, nursing programs, and public health leadership.
• Serve as a visible national spokesperson for professional nursing.
• Increase public awareness of nursing roles and contributions.
• Enhance nursing recruitment and education throughout all communities.
• Support and justify additional funding for nursing education, research and service.

The National Nurse for Public Health would work to slow the growth of preventable diseases; promote health awareness, increase health literacy, and reduce health disparities; promote health careers and increased resources; enhance visibility and public recognition of nursing.

It is the opinion of many involved in the call for the establishment of a National Nurse for Public Health that it is time for nursing to have a equal seat at the nation's health care table. While some might argue that the aforementioned Chief Nurse Officer of the U.S. Department of Public Health already adequately fulfills that role, most still see that role as one of subservience to the Surgeon General rather than one of professional equality. Just as nurses are rarely consulted by the media for their expert opinions vis-a-vis the various challenges faced by the nation and its beleaguered health care system, the government also fails to fully utilize nursing's unique and crucial input to the fullest extent possible, in the interest of the health and well-being of the American people.

The establishment of the position of the National Nurse for Public Health would set a new standard for a more accurate and realistic recognition of nursing's importance to health and health care in the United States. If the federal government enthusiastically and publicly embraced nursing, making its crucial contributions crystal clear, perhaps the public, the media and the private sector would all then have a greater understanding of, and appreciation for, the multitudinous ways in which nursing positively impacts the health of millions of Americans.

Most importantly, however, the establishment of this position would certainly bring an important voice even more strongly to the ongoing conversation about health and health care in America. A National Nurse for Public Health could, in effect, deliver a unified message of preventive health at a time when millions of Americans---including millions of children---live without health insurance or access to regular primary care. At a time of crisis and uncertainty vis-a-vis the health of the country, the National Nurse could very well be a welcome, stabilizing and empowering voice of reason and prevention.

I fully support the passage of HR 1119, and I urge readers of Digital Doorway to contact their representatives in order to urge them to support this important health care legislation. For more information, please visit the website of the National Nurse Campaign, join their Facebook page, or visit the take action page on the National Nurse website.