Judith B. Collins and Rebecca (Rice) Bowers-Lanier “The activist is not the man who says the river is dirty. The activist is the man who cleans up the river.” —Ross Perot In the mid-1990s, Virginia nurse leaders began a journey toward speaking with one voice for nurses and nursing in the public policy arena. This chapter chronicles the journey focusing on the development and growth of the “Nurses’ Kitchen Cabinet,” a loosely organized group of nurse leaders committed to a common nursing policy agenda during the 2005 gubernatorial campaign. We also discuss the ensuring influence of nursing in gubernatorial health policy reflected over a 4-year administration. Finally, we discuss the important factors contributing toward the success of the Kitchen Cabinet and lessons learned for the future. Our journey began with nurse leaders’ commitment to working together in the policy arena. We had already strengthened the Virginia Nurses Association’s commitment to working with all nurses and nursing organizations; formed the Legislative Coalition of Virginia Nurses (LCVN); broadened the membership in the Nurses’ PAC (N-PAC, the political action committee for nurses in the state); and established a tax-exempt public-private partnership, the Virginia Partnership for Nursing (VPN), to develop and implement nursing workforce development activities. By 2005, the LCVN, the VPN, and the N-PAC still had not attained a “tipping point” in advancing public policies supporting the profession despite their successes in bringing nurses together around legislative activity, launching statewide campaigns for nurse education and recruitment, and contributing to campaigns. Our goal was to make certain that the gubernatorial candidates knew nursing’s platform and included nurses in health policy decisions in the executive branch. To accomplish this, Virginia nurses created the Kitchen Cabinet. The mission of the Kitchen Cabinet was to educate the candidates about the nursing shortage, propose solutions, influence political campaigns, and change public policy. The members were volunteer nurse opinion leaders who were passionate about the mission and able to be dynamic and agile as the process unfolded. All nursing stakeholders were at the table—practice, education, associations, regulators, and policy influencers. The methods required the Kitchen Cabinet to separate policy development from electoral politics for action. Thus, though members differed on political persuasion, the Cabinet developed a common policy platform. The Kitchen Cabinet agreed on a plan to work together to develop a consensus, nonpartisan policy platform (Box 89-1). The process of policy development entailed hearing from and acting on the requests from the VPN, which includes all stakeholders in nursing practice, and the state’s educational programs. The first request, from the VPN, focused on creating a center for nursing workforce development. The Commonwealth had no ongoing systematic process for collecting and analyzing data about the supply and demand for nurses. Without adequate data, workforce planning had been based on national and anecdotal workforce data. In 2000, we had successfully lobbied for a one-time appropriation to study the nursing workforce; the report was completed in 2001. It served as a catalyst for subsequent work on nursing education, particularly at the associate degree level. But the data collection and analysis were not sustained subsequently. The second request centered on obtaining funds to support an increase in educational capacity. We used three data sources to support this request: national supply and demand projections estimated at the state level; National League for Nursing and American Association of Colleges of Nursing data on the aging faculty with impending plans for about 50% of faculty to retire within the next decade; and increasing demands for nursing education slots throughout the Commonwealth. Using the data available about the nursing workforce in Virginia, we were able to devise the following simple sound-bite message used by all:
Taking Action
The Virginia Nursing Kitchen Cabinet
The Context
The Policy Development
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