Professional Nursing Associations

Meeting Needs of Nurses and the Profession

Pamela J. Haylock

“Great organizations demand a high level of commitment by the people involved.”

—Bill Gates

The landmark Woodhull Study on Nursing and the Media (Sigma Theta Tau International, 1998), published over a decade ago, identified inaccurate portrayals of nurses and nursing in the media as especially problematic if the profession is to be actively represented in policymaking at all levels, ranging from institutional to federal policymaking circles. Recommendations of the report centered on the invisibility of nursing and, subsequently, the absence of a recognized nursing voice. Nearly a decade later, Buresh and Gordon (2006), authors of From Silence to Voice, asserted that the public does not understand nurses and the significance of nursing work; further, nurses’ reluctance to talk about their work is potentially catastrophic for nursing. The continued misunderstanding of nursing by the public and those with influence renders nursing vulnerable to limited support and resources for education and practice (Buresh & Gordon, 2006).

A 2009 Gallup survey reveals findings similar to those of the Woodhull Study—that opinion leaders do not perceive nurses as important decision-makers or revenue generators, even as nurses are trusted sources of information, second only to physicians (Robert Wood Johnson Foundation [RWJF], 2010). The 2009 findings reveal that nurses are expected to have the least amount of influence on future health care reform compared to other stakeholders, including patients and physicians. A major barrier to nurses’ abilities to influence policy development and management of health systems and services is the perception that nursing does not have a single voice in speaking on national issues (RWJF, 2010). Getting to that single voice requires high levels of commitment by nurses to the profession and to their professional organizations.

Professional nursing associations offer members opportunities to engage in discussions and advance solutions for issues of quality, access, and costs of care (Ridenour & Trautman, 2009) and at the same time, advance the profession. Active and engaged members influence the direction of their associations, as well as the ways in which nursing and nursing care are considered, defined, taught, and delivered. Members can be involved in establishing organizational priorities, including research; the organization’s advocacy priorities; and efforts to establish and advance nursing care through development of guidelines, standards, and education that reinforce consistent evidence-based practice. It is at these levels of involvement that members can influence the future of the nursing profession (Lambert & Lambert, 2005).

Evolution of Nursing Organizations

Nursing organizations emerged in the late nineteenth and early twentieth centuries as nursing became a social force. The first nurses’ organization, the Royal British Nurses’ Association, was founded in 1887. In North America, nursing groups initially appeared as alumnae associations focused on nursing schools and alumnae groups. Need for a broader focus became apparent along with the recognition of the importance of nursing influence (Dolan, Fitzpatrick, & Herrmann, 1983). A meeting of superintendents of nurse training schools was held at the 1893 Chicago World’s Fair, resulting in the formation of the American Society of Superintendents of Training Schools (ASSTS). ASSTS became the National League of Nursing Education, and later, the National League for Nursing. In 1896, 10 alumnae associations merged to become the Nurses’ Associated Alumnae of the United States and Canada. The group’s name changed in 1899 to the Nurses’ Associated Alumnae (NAA) of the United States. The American Nurses Association (ANA) was formed in 1911 as the successor to the NAA. State nurses associations were organized in 1901 to enhance nurses’ influence in state legislative initiatives for the registration of nurses and to control nursing practice, including improving employment conditions, limiting duty hours, and advocating hospital employment of greater numbers of graduate nurses (Reverby, 1987).

The International Council of Nurses (ICN), founded in 1899, is the oldest international association of professional women (Dolan, Fitzpatrick, & Herrmann, 1983). Membership in the ICN was initially offered to self-governing national nurses associations, a requirement designed to encourage formation of associations in every country, thereby elevating nursing standards globally. Today, the ICN membership is a federation of national nurses associations representing the nursing profession in over 128 nations, with a mission “to represent nursing worldwide, advancing the profession and influencing health policy” (ICN, 2010).

Between 1950 and 1980, changes in nursing practice resulted in a transition from pupil nurse-provided care in hospitals to hospital-employed nurses, and related changes in nursing education (Lynaugh, 2008). The Nurse Training Act of 1964 (NTA), a component of President Lyndon Johnson’s Great Society initiative, reflected the centrality of nurses and nursing to America’s health agenda. Nurse traineeships supported the development of masters degree programs, and nurses were encouraged to enroll through availability of tuition and stipends. The NTA was a catalyst for the development of many specialty nursing organizations in the 1970s.

Nursing Organizations and Today’s Nurses

Working together, association staff, volunteer leaders, and members can find and optimize the match between the motivation of current and potential members to join and volunteer, the creation of meaningful volunteer opportunities, and member benefits (Sadler, 2003) and organizations’ needs to benefit the profession and society.

There are over 120 nursing specialty associations in the U.S. (Guide to Nursing Organizations, 2010). Additional associations have international and multidisciplinary membership, and still others represent ethnic groups, specialties, and specific interests of nurses. Participation in discipline-based and multidisciplinary associations is a philosophically-based responsibility nurses can choose to accept as a way of fulfilling a commitment to society, advancing nursing, and affording an interface between nursing, other professional disciplines, and society (Felton & Van Slyck, 2008). Some nursing leaders assert that membership in a “unified professional organization is a privilege and a requirement for the advancement of the profession” (Carson & Dinkel, 2008). The Code of Ethics for Nurses (ANA, 2001) section 9, articulates the following complementary roles of professional associations and association members:

The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. (p. 24)

Regardless of their focus, nursing associations facilitate and accomplish the work of the profession by a variety of means, typically described in mission statements, bylaws, and charters of committees and other working groups. The existence of so many diverse nursing organizations has advantages and disadvantages for the profession. On one hand, the diversity and large number of organizations would seem to indicate that there is an organization to fit most if not all of nurses’ needs and interests. Conversely, the diversity and large number of organizations creates competition for members, resources, media attention, and, in general, it complicates, dilutes, and weakens the efforts of the profession to speak with a single and forceful voice.

Mission statements define organizational purpose—its reason to exist (Nanus, 1992). Current mission statements and organizational visions and goals are usually offered on home or “about us” pages of organizations’ websites. The ANA mission is “Nurses advancing our profession to improve health for all” (ANA, 2010a). The mission of the American Nephrology Nurses Association is “to advance nephrology nursing practice and positively influence outcomes for individuals with kidney disease through advocacy, scholarship, and excellence” (ANNA, 2010). The Oncology Nursing Society (ONS) mission is “to promote excellence in oncology nursing and quality cancer care” (ONS, 2010). Each mission statement stipulates the “work” of the profession in slightly different ways but shares intentions to advance the profession and practice and, thus, to enhance individual, group, or community health-related outcomes.

The Relationship of Associations and Their Members

Nursing associations need members, and nurses need associations. Benefits flow both ways—from the association to its members, and from members back to the association. Despite changes in health care and nursing, and differences and similarities in generational cohorts of nurses, altruistic motives and the desire to make a difference in peoples’ lives continue to lead people to choose nursing as a career path (Sadler, 2003; Price, 2008). Volunteer activities offer avenues through which an individual member can contribute to his or her profession and to make a difference (Stengel, Gobel, & Itano, 2009; Sadovich, 2005; Sadler, 2003).

Member Benefits

Traditional benefits of organizational involvement are unique blends of products and services that define the value of membership, including the following (Smith et al., 2008):

• Information and knowledge collection and dissemination

• Networking and engagement

• Advocacy

• Volunteer opportunities

• Chapter or component benefits (local, regional, and special interest networking and project participation)

Findings from a study of members’ decisions to join and volunteer conducted by the American Society of Association Executives revealed personal benefits that are important to members holding governance and committee roles, general members, and nonmembers (Inzeo, 2009). Governance and committee members value networking and leadership opportunities highest, whereas general members rate access to the most up-to-date information in the field highest. Networking opportunities ranked second among general members.

Nurses appreciate traditional membership benefits and also value the benefits specific to nursing. Professional association membership offers nurses a broader perspective of nursing (the trends and concerns of the profession); connections to peers, mentors, and leaders; and support for collaborative action among nurses (Frank, 2005). A 2007 survey of ONS members found that members place a high value on educational resources (e.g., publications, conferences, and Web-based offerings), networking opportunities provided by involvement in chapters, special interest groups, project teams, and giving and receiving mentoring (ONS, 2007).

Educational Resources

New knowledge is essential to competent nursing practice, and specialty associations play vital roles in providing members with ongoing learning resources and opportunities. Typically, nurses join professional organizations for continuing education, to be updated on professional issues, and for networking opportunities. Educational offerings become increasingly important to nurse members as nurses’ employers institute cuts in nursing education budgets. Creative application of electronic communications and forums including social networking and Internet-based courses are increasingly available from nursing associations.

Career Advancement

Joining and volunteering for a professional nursing association provides opportunities to find or get promoted to a preferred role, and to develop the skills to become a recognized leader in one’s chosen field. Members who choose involvement beyond paying dues and receiving preset member benefits can observe, learn, and differentiate between leadership and management—observing colleagues who are effective (or not) in moving professional and personal agendas forward, and learning from colleagues’ successes and disappointments. Mentoring opportunities and relationships that occur as a result of association activities can affect one’s personal and professional development and career directions.