NRS 440 Shirley Nathan Pulliam & Lauren Underwood Discussion

DQ1 Parneet Kaur 2 posts Re: Topic 4 DQ 1 State legislature- Erin Murphy Erin Murphy, MA, RN- She graduated from University of Wisconsin as Registered Nurse with Bachelor’s Degree during 1984. She had worked as medical-surgical nurse, surgery nurse, University of Minnesota Hospital. She served Minnesota Nurses Association for 14 years starting in 1989. She chosen in Minnesota House of Representatives in 2006. During her term, she was able to bring changes in healthcare system on different issues. Erin has shown contributions to affordable childcare, women’s health, school employees given access to healthcare, and projects on infrastructure. She is trying to pass bill in Minnesota State regarding option for public health insurance. Erin strength knowing thoughts of people by conducting meetings in community, and organization of house parties. She has taken initiative to talk to people throughout the Minnesota state that will help rebuild broken bridges by asking questions. Erin States those problem-solving and listening skills well played in politics, so she has been recruiting nurses since last seven years (Szulecki, 2017). Health Care Homes- The changes made in healthcare in 2008 by authorizing legislation namely Health Care Homes by Erin Murphy. It help Chronic or complex healthcare patient by having better results related to their health and improvement quality of life. This is due to services provided to community regarding prevention, wellness, and management of self. Healthcare save lot of money in terms of billions of dollars. (Szulecki, 2017). Reference Szulecki, D. (2017, April). Nurse in the legislature. American Journal of Nursing,17 (4), 6869. https://journals.lww.com/ajnonline/Fulltext/2017/04000/Nurse_in_the_Legislature.37.aspx DQ2 Norma Meredith 1 posts Re: Topic 4 DQ 1 Health care professionals hold an array of political offices in the United States. Born on the island of Jamaica Shirley Nathan-Pulliam RN, BSN, MAS currently hold the position as a Maryland legislator since 2014. She previously spent time working in the state’s House of Delegates. In 1998 she attained 2.8 million for breast cancer diagnosis and treatment for low income women and $500,000 for oral cancer diagnosis and treatment for men living on the street and undeserved. In 2003 she helped create a bill to address racial and ethnic disparities in the state of Maryland. In 2004 Hose Bill 86 Office of Minority Health Disparities with in the Maryland department of Health. NRS 440 Shirley Nathan Pulliam & Lauren Underwood Discussion

Her goal is for every department to have a policy that addresses health care needs. While working as a nurse she saw the need for health insurance amongst the less fortunate and that is the driving force behind what she does as a Legislator. Lack of Health care insurance has created many clinical problems that could have been prevented or eradicated. Limited resources and financial barriers are the driving force behind inadequate health maintenance. Even with free clinical in certain area it’s still not enough to address all the needs because the clinics are being run with inadequate amount of staffing or equipment. Lifespan depends on health and wellness. Reference SENATE. (n.d.). Retrieved September 07, 2020, from https://msa.maryland.gov/msa/mdmanual/05sen/html/msa12283.html DQ3 Anabel Moronta 1 posts Re: Topic 4 DQ 1 Topic 4 DQ1 Healthcare delivery is a field that requires the collaboration of various professionals so that the patients can enjoy the best services. Nurse legislators are a current trend role of nurses where nurses or former nurses directly or indirectly engage in political decision-making towards healthcare policies. Therefore, nurse legislators can assume the leadership posts or contact the elected leaders about the laws and rules that influence service delivery in the nursing industry. The formulation of most programs and healthcare reforms occurs in the U.S Senate or Congress; however, for a very long time, nurses do not get their views and grievances addressed because the leaders have insufficient or no knowledge regarding this sector. Lauren Underwood is an African-American nurse legislator who was a former registered nurse and is currently a member of the U.S House of Representatives from Illinois 14th district (Washington Today, 2019). The congresswoman introduced the U.S Border Patrol Medical Screening and standards Act to ensure proper medical services to individuals under apprehension by the U.S Customs and Border Protection. Moreover, this Act would improve the provision of health services to apprehended individuals since it advocates standardization of processes and training of the service providers in the Department of Homeland Security (Nurses Serving in Congress, 2019). In addition, the Act tips the department of homeland security to research and address the gaps in the provision of medical screening services to apprehended individuals at the border. Before her election, NRS 440 Shirley Nathan Pulliam & Lauren Underwood Discussion

Underwood worked with the Medicaid plan in Chicago to ensure high quality and costefficient care. References Nurses Serving in Congress. (2019). retrieved from: https://underwood.house.gov/media/pressreleases/underwood-introduces-legislation-improve-medical-screenings-us-mexico-border Washington Today. (2019). Retrieved from https://underwood.house.gov/ DQ4 Samantha Malouff 1 posts Re: Topic 4 DQ 1 Although I am quite a way from Minnesota, I found this nurse’s journey and story quite interesting in regards to advocating for patients and improving health care delivery. Erin Murphy is one of the leading women and nurses in the state of Minnesota. She took an early liking to politics and nursing and realized the two had more in common than she expected. She has worked a variety of settings from medical-surgical nursing, operating room nurse, and as a transplant team nurse. Erin Murphy’s first success was the passage of MinnesotaCare, which is an insurance program from low-income workers who are not able to purchase private insurance (Szulecki, 2017). One of Murphy’s next successes was being elected into the Minnesota House of Representatives and got a seat on the Health and Human Services Finance Committee.

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This helped to shape healthcare reforms so that quality and affordable healthcare was more accessible. This statewide reform helped to promote health wellness and prevention, self-management of symptoms, and is linked to a better quality of life. From the sounds of it, Erin Murphy shows no signs for slowing down when it comes to being active in legislation and being an advocate for patients, nurses, the community, and the state. This nurse’s story is very inspiring and goes to show that nurses have an important role at a local, state, and federal level. Nurses now more than ever are encouraged to participate in being a legislator to help improve our health care delivery system. References Szulecki, D. (2017). Nurse in the Legislature. American Journal of Nursing, 117(4), 68– 69. https://doi.org/10.1097/01.NAJ.0000515241.67042.09 DQ5 Parneet Kaur 2 posts Re: Topic 4 DQ 2 A new legislation passed in state of Virginia regarding Nurse Practitioner given full authority to work independently without supervision of physician. The supervision required only until Nurse Practitioner completes 9,000 hours with either physician or total of 5 years of working together with physician. This battle to erase restrictions on nurse practitioners fought by nurses against physician groups and legislators (Stringer, 2019). Steps taken to get legislation approved- A bill was proposed by Virginia Council of Nurse Practitioners in year 2018 regarding allowing Nurse practitioners to work independently after 1040 hours under supervision of physician. Nurses expecting supervision under physician-working hour’s increase by 3,000 but decisions rolled up to 9,000 or 5 years. According to RN Fagan, they did not reject legislation because it will give opportunity to 50 percent nurses in state to work independently, as they had been working more than 5 years. Virginia Council of Nurse Practitioners were teaching how to do advocacy efforts by conducting webinars and other training to nurses. This lead to governor received 200,000 nurses letter regarding restrictions on qualification of physician collaborator. Governor based on letters per registered Nurse Fagan rejected the restrictions (Stringer, 2019). NRS 440 Shirley Nathan Pulliam & Lauren Underwood Discussion

There are 22 states in America where Nurse practitioner work with autonomy. The information can obtained from other states of America, which does not have NP (Nurse practitioner) autonomy, and then find people who can support this issue. The lawmakers and doctors need given education regarding this issue in other states of America (Stringer, 2019). Reference Stringer, H. (2019, July). Nurse practitioners gain ground on full practice authority. Retrieved from- https://www.nurse.com/blog/2019/07/24/nurse-practitioners-gain-ground-full-practice-authority/ DQ6 Anabel Moronta 1 posts Re: Topic 4 DQ 2 Topic 4 DQ2 In the U.S, Medicare is the primary insurance body that provides health benefits to the beneficiaries. However, the Center for Medicare and Medicaid Services (CMS) has rules and legislations that govern the reimbursement of ‘never events.’ Never events are the serious adverse events that may occur to a patient during their stay in the hospital because of the nurses’ laxity and irresponsibility; thus, the CMS considers these events are reasonably preventable and cannot pay for them (Cherry & Jacob, 2017). The CMS initiated these rules in 2002; nonetheless, the rules have undergone milestone changes to include an array of events in 2016 that the CMS will not reimburse the healthcare providers since they deem them reasonably preventable. In 2016, the National Quality Forum produced a list of reportable events that make legislation about the events the CMS considers ‘never events;’ thus, do not attract any reimbursement (Patient Safety Primer, 2019). The events include surgery on the wrong body part, surgery performed on the wrong patient, wrong surgical procedures, foreign object retained in the body after surgery, air embolism, blood incompatibility, and falls and trauma. Therefore, if a patient suffers due to any of the above never events, the CMS’s third-party reimbursement service will not settle the bill (Patient Safety Primer, 2019). Consequently, the CMS consider this as nurse negligence and should be responsible for the costs. The legislation on never events has ensured that the nurses and the healthcare officers are responsible and accountable for their actions NRS 440 Shirley Nathan Pulliam & Lauren Underwood Discussion