SDNA Needs Assessment and Core Issue Progress Report

By Lani White, Board of Directors Task Force Chair

One only needs to superficially peruse the American Nurses Association website (nursingworld.org) to know that nurses are actively focused on the business of improving health care. Like the American Nurses Association (ANA), South Dakota Nurses Association (SDNA) has developed Core Issue Initiatives addressing areas of need that relate specifically to nursing practice in South Dakota. It is again time to update each of you on the initiatives, activity in progress and activity that has been completed.

Evolution of a Process

In 2003 the House of Delegates directed a special task force to evaluate the Council structure of SDNA and present recommendations to the 2004 Annual meeting. Because the Council structure was no longer meeting the need, the primary recommendation of the task force was the development of a needs assessment system to determine core issues for nursing in South Dakota. The recommendation further delineated the recommendation that the needs assessment methodology allow each member the opportunity to give input in determining the strategic direction of the organization. As a result, SDNA members directed the Board of Directors to initiate a Needs Assessment process as the mechanism to determine organizational direction on an ongoing basis. In 2004 the task force implemented the first member needs assessment to establish core issues and identify preferred operational changes.

 Overview of Needs Assessment Results

Member needs assessment input outlined the desire for the organization to focus efforts on legislative oversight and initiation, continuing education, advocacy for nursing and clients and practice issues in that order of priority. From that assessment, the Core Issues for the next three years were developed. The core issues include: Workplace Advocacy, Nursing Shortage, Professionalism in Nursing, and Health Policy Oversight and Development. In addition members provided input related to the desire for more communication on state and national issues.

Core Issue Process Implementation

In 2005 the core issue development process was modified as directed in the annual meeting to accommodate the Needs assessment system and to establish Priority Task Forces to address issues defined as being critical in South Dakota. Workplace Advocacy and Professionalism Task Forces were developed. Each implemented action plans, which have been the focus of their activities. Health Care policy development and oversight was directed to the Government Relations Committee (GRC) as the desired actions were already within the scope of the activity of that established committee. SDNA joined forces to address nursing shortage issues with the Board of Nursing directed, South Dakota Nursing Workforce Center.

The Board of Directors and the Executive Director reviewed operational procedures and made significant changes with primary focus on methods of communicating information to members.

Core Issue Task Force Activities 

Professionalism Priority Task Force

The Professionalism task force identified goals of:

• Advocating for nursing to be a partner in decision-making processes
• Developing cohesiveness among nurses
• Enhancing professional behaviors of nurses
• Improving the image of nursing
• Discussing ethical issues affecting patient care

A series of continuing education workshops began in the fall of 2005 with subsequent presentations to continue through 2007. The workshops, co-sponsored with the Board of Nursing and Regional Networking, have been presented in Sioux Falls and Deadwood and are available to be duplicated in any district location within the state. The workshop series includes:

• Protect Your Nursing License: What Every Nurse Needs to Know
• Nurse-to-Nurse: Survival Skills You Need for Professional Success
• Professional Pride: Be the Change You Want to See

In addition the task force applied for a $10,000 grant from the Center for American Nurses (CAN) to support the development of continuing education workshops throughout the state. The first attempt to obtain this grant was not successful and another attempt is in process.

SDNA collaborated with the South Dakota Association of Healthcare Organizations (SDAHO) and the Board of Nursing to develop and provide education for the first Long Term Care Leadership Academy. Planning for the 2007 Academy is currently in process.

Areas still in development and evaluation stages are a quick guide to professional practice and a Career Guide which could be available for purchase. In addition a legal column is being developed for the South Dakota Nurse which will answer professional practice questions from the membership.

Workplace Advocacy Task Force

Two workshops have been presented related to workplace advocacy issues. Hear Me Roar: Using Your Nursing Voice in the Health Care Jungle focused on empowering nurses, delegation strategies, navigating the generations and working with Native American Clients. A second workshop focusing on End of Life, Palliative Care and the Role of the Nurse was presented in fall of 2006. A Workplace Advocacy continuing education series is being considered to be delivered throughout the state using teleconferencing for delivery. The series would include:

• Creating a Healthy Workplace Environment
• Cultural Diversity in the Workplace: Creating a Culturally Sensitive Work Relationship
• Nurse to Patient Ratios: What the Numbers Mean for Patient Safety and Nurse Satisfaction
• The Aging Nursing Workforce: Projected Nursing Shortage and Nursing Needs for the Future

Consideration is being given to development of a quick guide for nurses on workplace issues such as stress reduction, work and sleep patterns and recognizing and approaching conflict/hostile relationships.

In addition the task force is working on mechanisms to recognize contributions of nurses to the organization, the field of nursing and years of participation in the organization.

Government Relations Committee

Government RelationsCommittee focus is on health policy and legislation that furthers the practice of nursing and advocates for health care consistent with SDNA's Health Policy Agenda. The committee reviews current legislation and determines positions based on the Agenda. SDNA hires a lobbyist, who is present in Pierre during the entire legislative session. The lobbyist along with nurses from across the state testify related to SDNA positions on identified legislative issues. In February of each year Nurses Day at the Legislature is held giving nurses and nursing students the opportunity to communicate our positions to legislators and to see the legislative process in action.

Examples of legislation supported in 2005 are provisions related to prescription of Schedule II drugs by nurse practitioners and certified nurse midwives, criminal background checks for nurse licensure, revised quorum requirement for the Board of Nursing, balanced instruction on human sexuality in public schools and appropriate emergency health care for rape survivors. The current session activities have focused on support of legislation related to children booster seat use, immunity from civil liability for use of automated external defibrillators, support of advanced directive clarification bills (the Senate bills), and the HPV vaccination initiative. Each year SDNA has supported tobacco legislation which advocates for improved tobacco control and related health care.

In addition to legislation supported, legislation opposed can be as important to health policy. SDNA has consistently lobbied against lay midwifery bills which do not address public safety and tobacco bills which do not advocate tobacco control and improved health care. Dozens of bills are monitored each year to assure safe practice for nurses and safe care for consumers. In addition NSTAT liaison nurses communicate with our national legislators related to our positions on national legislation.

SD Center for Nursing Workforce

SDNA joined forces with the Board of Nursing in the SD Center for Nursing Workforce. The mission of the Center is to design a nursing workforce prepared to partner with South Dakota citizens to meet their changing health needs. SDNA worked with the Board of Nursing to assure that lead nursing organizations were represented on the Governance Council. The Center involves collaboration with SDNA, SDONE, NEDDS and SDLPNA. The Council is currently reviewing nursing workforce data and is in strategic planning stages to determine South Dakota priorities for action. New workforce data becomes available early this year and will allow for more current review of status and evaluation for the nursing future in SD.

ReKindle Workshop

The members request for continuing education efforts are evident in the activities of each task force working on SDNA Core Issues. A valuable continuing education resource that was retained from the previous structure is the ReKindle Workshop held annually in Mitchell, SD. This workshop focuses on practice issues in nursing and continues to draw many members and non-members each year.

Operational Changes

Increased communication of state and national issues and activity was a consistent theme brought forth in the needs assessment. The Executive Director developed a professional, informative SDNA website which continues to evolve. The website provides extensive information related to the activities of the association as well as resources both state and national. You can learn about SDNA's Health Policy Agenda, the Foundation, the task forces, the calendar of events and district activities. A tour of the website gives a broad overview of many issues in nursing.

The SD Nurse has been redesigned to include more extensive information related to national, state and district activities and issues. The new structure includes sections which update on Foundation activities, communicate highlights of nurses in the news, and provide resources that are available on current nursing issues. Progress on ANA initiatives is highlighted along with activities of the Center for American Nurses (CAN). The Nurse is distributed to all nurses in South Dakota and provides a valuable nursing communication tool in the state.

The District structure has allowed more community communication and the capability to attend meetings in a closer geographic area. Districts which are unorganized due to low population in the area have been invited to join with another district giving members more convenient options for participation.

Within the last year the Board of Directors has made available an SDNA only and an ANA only membership option. These limited memberships along with special discounts for new graduates, full time students, unemployed nurses and retired nurses provide extensive financial options for all nurses.

E-mail communication has been added to supplement traditional communication methods. This allows more current, more frequent and in many instances more extensive distribution of information.

Toby Lyon, the previous Executive Director spearheaded the goal to move to a virtual office, consequently realizing efficiencies and consistent availability to office staff. Her enthusiasm and skill in developing marketing and communication opportunities is evident throughout the organization. In January 2007, the Board of Directors hired Brittany Novotny as her replacement when Tobi chose a new opportunity in her career. Brittany's background in law and business are already exhibited in her continuing development of our marketing, practice and legislative agendas.

Needs Assessment Update

In February, 2007, the Board of Directors began the next update of the needs assessment process with a strategic planning session. The planning session addressed organizational effectiveness, core issue initiatives, organizational fiscal management, health care trends and futuristic planning for nursing. The strategies identified along with the next member needs assessment will provide direction to guide the organizational activity for the next three years.

You will have the opportunity to again participate in the needs assessment process. The current process will be completed this spring and summer with updated recommendations presented to the Constituent Assembly at Convention October 7-9, 2007 in Aberdeen, SD. In addition to the personal interviews, this update will include the opportunity to participate in the process electronically or through pencil and paper survey. The desired goal is to obtain feedback from each member of SDNA within the state.

Conclusions

The last three years have seen many changes in the face of nursing in South Dakota. Your voice was heard in the conversion to a needs assessment process, development of core issues and implementation of initiatives to meet the identified needs. Focus on workplace advocacy, professionalism in nursing, the nursing shortage and health policy were the driving force for all organizational activity.

Nurses are used to setting goals but these are often directed at patient outcomes. Your input in the SDNA needs assessment process provided the opportunity to be a participant in setting goals and shaping your nursing future and your nursing practice in South Dakota. Your organization is working for you.

We are each challenged to participate in reshaping the face of the profession. In the Premier Issue of American Nurse today, Cindy Saver (2006) sums up a philosophical strategy to survive in the new world—"Our work isn't changing, change is our work".