While the American Nurses Association (ANA) has generally been known as the organization that represents the profession across all education, practice, and demographic spectrums, a number of organizations focused on specialties and subspecialties in nursing practice have formed over the years. For example, the American Association of Nurse Anesthetists was organized in 1931 followed by the Association of Collegiate Schools of Nursing in 1932 and the Association of Operating Room Nurses in 1949. Other organizations focused on ethnicity, demographics, and scholarship have also emerged, such as the National Association of Hispanic Nurses; the National Council of State Boards of Nursing; and Sigma Theta Tau. Many of these organizations advocate for nurses and nursing in their particular area of interest. Most also advocate for patients. For example, through its chapters, the National Black Nurses Association (NBNA) has tackled the issue of obesity by providing screening and education to local communities (NBNA, 2008).

It is estimated that there are over 100 nursing associations organized in specialty practice areas or other spheres of interest. Many of these organizations establish standards of practice; offer certification programs; provide continuing education opportunities; publish professional journals; and lobby lawmakers and regulators on matters of public policy. A number of the organizations compete with each other for the time, talent, and dues money of nurses. There is often rivalry among organizations as to who will represent the profession in the halls of Congress, before state legislatures, or in the media. It is interesting to note that the ANA now states that it “represents the interests of the profession,” though historically it claimed it represented the profession of nursing (ANA, 2010). The inability of the nursing profession to speak with “one voice” is an age-old predicament for the profession.

There is evidence that nursing organizations realize that collaboration rather than competition among organizations and across specialties will advance the profession. For example, the ANA has increasingly taken on the role of convener or partner with other nursing organizations for several initiatives including a study of the Economic Value of Nursing (ANA, 2008a) and an Assessment of Safety, Quality and Effectiveness of Care Provided by Advanced Practice Nurses (ANA, 2008b). The American Organization of Nurse Executives (AONE) and the American Association of Critical Care Nurses (AACN) collaborated in the publication of The Nurse Manager Inventory Tool and the provision of nurse manager certification.

Sixty nursing organizations representing over 700,000 nurses have joined the Nursing Organizations Alliance (The Alliance, 2010) (Box 82-1). The Alliance was created to replace the National Federation of Specialty Nursing Organizations and the Nursing Organization Liaison Forum in an effort to bring all nursing organizations under one roof to “…promote a strong voice and cohesive action to address issues of concern to the nursing community” (The Alliance, 2001). This initiative to bring nursing organizations together under one banner appears to be in conflict with the ANA, as the ANA allows for organizations representing the interests of nurses to affiliate with it (ANA, 2008c). Conversely, the Alliance’s “Guiding Principles” state that “The Alliance does not have delegated authority to speak for nursing or any member organization” (The Alliance, 2001). Such policies and practices make it difficult for the Alliance to speak with a strong voice or to take cohesive action, the purpose for which it was founded.

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