October 31, 2018 | NLN CEO Update on Opioid Legislation and ACE Series Expansion

I must begin with thoughts about the sadness and devastation that saturate our country. The NLN continues to extend our warm thoughts and prayers to the families and communities who have suffered loss. From the unacceptable reality of 11 lives taken at the synagogue in Pittsburgh, a place of worship, to the 14 pipe bombs unsuccessfully aimed at Democratic leadership, we are experiencing an era of painful, inexcusable malevolence. I must add also that two lives were lost at a grocery store last week when the entrance to a church was unavailable. This happened in my home state of Kentucky.

Let me reassure you. Nurses, first providers, other health care clinicians, and staff continue to provide care to all, including the alleged perpetrators of these heinous acts. It is with caring, integrity, and a commitment to diversity and inclusion that we can be relied on to provide excellent care with civility. That, according to the Gallup poll, earns us the trust of the nation.

Now, amazing as it may seem, I have some good news for you.

In case you missed it, last week President Trump signed into law bipartisan legislation designed to tackle the opioid epidemic. Among its provisions, the law targets the flow of fentanyl and other illicit drugs to the United States from other countries; authorizes the National Institutes of Health to research potential non-addictive painkillers; and authorizes a number of grant programs for nonprofits and other entities fighting the epidemic. The most exciting provision for nursing is one that permanently allows nurse practitioners and physician assistants to prescribe medication-assisted treatment (MAT) for opioid use disorders while also providing a five-year authorization for clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives. This provision will enable advanced practice nurses (APNs), often the sole providers of care in rural and medically underserved areas, to become critical agents of change in treating patients with substance use disorders.

Until the Senate and House met to reconcile their versions of the bill, it was uncertain that the section allowing for flexibility with respect to medically assisted treatment would stand. With your support and the support of our fellow nursing organizations, we were able to make a difference, enabling nurses to practice to the full extent of their education and training, therefore directly improving the health of our nation. I want to congratulate Christine Murphy, director of public policy and advocacy for the NLN, for the work she did in moving this legislation forward. As a reminder, the NLN Advocacy Action Center is designed to help you and your students take an active role in molding the policy issues facing the nursing profession today.

One reason I believe we were able to achieve bipartisan support for this legislation has to do with the power of stories. You may recall that during the 2016 political campaign, the opioid epidemic was front and center, with individuals describing the devastating effects addiction had on their families and entire communities. At that time, according to the 2016 National Survey on Drug Use and Health, 116 people were dying each day from opioid-related drug overdoses. Legislators could not turn away from these stories, even in their own states.

Today, within our high-tech health care environment, nurse educators turn to stories as they teach students to provide holistic, patient-centered care. Although we use manikins of extraordinary complexity we understand that to create meaningful experiences for students, it is essential to focus on individual patients and their families over a period of time. That approach is at the heart of ACE, our NLN Advancing Care Excellence Series, which recently expanded to ACE.P — Advancing Care Excellence Pediatrics.

With the generous funding of the Hearst Foundations, the NLN has developed ACE.P unfolding cases to focus on the increasing impact of environment, housing, and access to care for children in vulnerable populations. Damon McAdams was taken to the emergency room with vomiting and diarrhea, but careful investigation by his nurse led to concerns about a potential diagnosis of autism. Careful assessment by a clinic nurse revealed that Mia Jones had severe dental caries. Through ACE.P, nursing students follow these children over time and in different settings. The teaching strategies offered on the site incorporate ACE.P Knowledge Domains and ACE.P Essential Nursing Actions into student learning experiences. And it's all free.

I hope you will take advantage of ACE.P, just as you use ACE.S (Advancing Care Excellence Seniors), ACE.Z (Advancing Care Excellence Alzheimer's Disease), ACE.V (Advancing Care Excellence (Veterans), and ACE.D (Advancing Care Excellence Disability). I wish that the ACE series had been available to my faculty when I was a nursing student and then a dean. What a wonderful way to teach and learn.

I am also happy to report that in collaboration with AARP, the NLN is developing a new series, Advancing Care Excellence for Caregivers (ACE.C). With generous funding from the John A. Hartford Foundation, AARP asked the NLN to create unfolding case studies and teaching strategies to assist faculty in teaching students about the individualized needs of caregivers during transitions of care. One unfolding case is ready now. Mary Cato, MSN, RN, of Oregon Health & Science University, has expanded on the story of Julia Morales and Lucy Grey, whom you may know from ACE.S. Julia has lung cancer and wishes to stop treatment. Their story, as it unfolds, and the wide variety of teaching resources available to educators will provide meaningful lessons to nursing students for years to come.

I would be remiss if I did not tell you that the ACE program is housed in the NLN Center for Excellence in the Care of Vulnerable Populations, directed by chief program officer Dr. Janice Brewington. Since ACE.S was initiated in 2009, NLN members have played a key role in developing the resources we offer. Scroll to the end of each unfolding case to find the name of the author. Also note that Teaching with ACES: A Faculty Guide by Dr. Elaine Tagliareni, who brought so much of the ACE program to life, is available for purchase. Built on the evidence-based, theoretical ACE.S framework, it was awarded third place in the 2017 AJN Book of the Year Awards in Gerontologic Nursing.

In addition, I would like to extend my sincere congratulations to Dr. Roseminda Santee on having won the Outstanding Filipinos – American award (TOFA). She was recently honored during the ceremony held at Carnegie Hall in New York City. Dr. Santee received her award during Filipino American History Month. We are so proud of our colleague Dr. Santee. She serves on the National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA) and is associate dean at Trinitas School of Nursing in Elizabeth, New Jersey.

Election day is right around the corner, Tuesday, November 6 to be exact — you know the importance your vote holds. Hold on to your caring, integrity, diversity/inclusion, and excellence. Hold on to your values. Together we will make it through to the other side of this sadness. For 125 years the NLN has been available to promote excellence in nursing education to build a strong and diverse nursing workforce to advance the health of the nation and the global community. We will do the same for the next 125 year and so on.

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Next Issue of the NLN Member Update: Wednesday, November 14, 2018. View previous issues of NLN Member Update »