The Georgia Nurses Association took a new and improved approach to its GNA Legislative Day on Jan. 31.

"We made it a two-tier event and eliminated the reception with legislators that we usually held at night," said Michael McCann, CNM, MS, the GNA's director of legislation and public policy. "In the past, we had found ourselves competing with other receptions and not really drawing the legislators that we needed to meet."

(ENLARGE)

Cindy Balkstra

Politics is about building relationships, and that doesn't really happen at large receptions, said Cindy Balkstra, MS, RN, CNS-BC, the new GNA president. "One-on-one experiences are much more effective for everyone. My representatives and senators in Savannah knew me, but when I moved to North Georgia in the fall of 2006, I got in touch with my new legislators.

"The earlier you can start getting to know your congressmen, the better. That way, when you have an issue that demands attention, they know you — and not just from a once-a-year event."

Balkstra hopes to strengthen the voices of nurses in the Georgia Legislature and to work toward solutions to the state's health care crisis during her two-year term.

The GNA encouraged its members and nursing students to invite their state senators and representatives to meet with them during the GNA event.

Building on last year's turnout of nursing students, the GNA made the morning a student-focused event. There was no fee for the morning session at Georgia State University, where students met for an orientation to the legislative process before walking to the Capitol to watch a session in progress.

For practicing nurses and GNA members, the afternoon session included meeting the organization's legislative team and its new advocates, Jay Morgan and Wendi Clifton of the J.L. Morgan Co. Inc., and hearing about the organization's goals for 2008.

Some issues to watch during the session:

• Nursing-faculty shortage and salaries: Last summer, GNA officials and representatives from nursing specialty organizations testified before the Senate Study Committee on the Shortage of Doctors and Nurses in Georgia, chaired by state Sen. Cecil Staton (R-Macon).

"We continue to raise awareness of how the nursing-faculty shortage impacts the nursing shortage and how nursing-faculty salaries are way below what a nurse can make in the field. This is a budget issue, so we're working with the Board of Regents and governor's office to ask them to address salaries," Balkstra said.

• Funding for public health nursing: "Public health nursing salaries need to come up to an adequate working wage and their budgets need to be increased as well, especially in light of their responsibility for disaster planning and the resurgence of TB [tuberculosis] and possibility of avian flu," Balkstra said. "We didn't get a good response on this issue last year, but we will continue pushing it because it's really a public safety issue. In times of crisis or disaster, whom are we going to rely on? Public health nurses."

• Funding for a health care data-analysis center: "Many other states use a nursing work force center model to collect and analyze data about the work force," Balkstra said. "We'd like to start with nurses and branch out to other health care professions. In light of the shortages, how can we predict, judge trends or analyze the state's needs and plan for them if we don't have data?"

• Criminal background checks for newly licensed nurses: Other states make these checks part of the licensure application process; the GNA and the Georgia Hospital Association would like that to happen in Georgia. The check would be done when a nurse applies for a license to practice in Georgia, and the cost would be the applicant's responsibility.

Legislation on this would likely come from the secretary of state's office and would necessitate amending the Nurse Practice Act.

• Refinements in defining advanced practice registered nurses: "If the Nurse Practice Act is opened, then we will likely want to look at who can practice as advanced practice nurses," McCann said. "When the Nurse Practice Act was last amended in the late 1980s, clinical nurse specialists and other designations, such as psychiatric nurse practitioner, were not listed under the advanced practice act. Given more recent trends in practice, we would want to bring the statute up to date.

"Allowing psychiatric nurse practitioners to practice as advanced practice nurses would greatly benefit the mental health system in Georgia, so we'll be raising awareness about that."

• Prescriptive privileges for APRNs: United Advanced Practice Registered Nurses of Georgia is not satisfied with the state Board of Medicine's rules and regulations for APRN prescriptive privileges.

"We believe that [the board] exceeded the legislative intent of the bill (from 2005)," McCann said.

The requirement of 10 hours a month of physician supervision puts added financial and time burdens on practices that employ APRNs and could limit access to health care, McCann said.

Right now, APRNs operate on a two-tier system: those who have applied to write prescriptions under the new system; and those who continue to call in prescriptions, because they consider the new rules too cumbersome or costly.

"We've heard that [the Medical Association of Georgia] may try to make everyone practice under the same rules and regulations, so we'll be watching this issue very closely," he said.