Racial reckoning, nurse staffing, workplace violence, and climate change were just four critical issues facing attendees at the 2022 American Nurses Association (ANA) Membership Assembly, the governing and official voting body of ANA, on June 10-11 in Washington, DC.

The Assembly is composed of representatives from ANA’s constituent and state nurses associations (C/SNAs), the Individual Member Division (IMD), and specialty nursing organizational affiliates (OAs), as well as the ANA Board of Directors. Eligible voting representatives elected national leaders to serve on the board of directors and nominations and elections committee (See ANA elects).

In the final Membership Assembly address of his term, ANA President Ernest J. Grant, PhD, RN, FAAN, acknowledged the momentous challenges that nurses have faced since the last in-person event in 2019.

“The past 3 years have been rough on all of us, but particularly for our frontline colleagues who have had to stare down the worst of COVID-19,” he said. “As an organization, we are going to have to continue to address this challenge, to lead on the response, to fight for millions of nurses across the country, and—as always—put the patients first.”

Grant underscored nursing’s commitment to public health during the crisis. “Our advocacy has made a huge difference,” he said. “ANA’s advocacy on vaccines, on COVID-19 mitigation and treatment strategies, and on healthcare disparities has saved lives.”

Grant noted how the COVID-19 pandemic put a spotlight on priorities he set when he took office in 2019 to address diversity in nursing, increase nurses’ engagement with consumers, and grow ANA membership.

“As part of its COVID-19 Survey Series, the American Nurses Foundation discovered that Black and Latino nurses were more likely than their White colleagues to be in roles providing direct care to infected patients—and they themselves were more than twice as likely to have been infected with the virus,” he said. “That was disappointing…and horrifying. But it also indicated that we are right to make ending racism in nursing a key priority of ANA.”

Providing clinical information and resources for maintaining well-being and ensuring that nurses know they have a professional home at ANA helped increase membership during the pandemic, Grant said, with the organization’s advocacy laying the groundwork for future growth.

Grant expressed his gratitude to Membership Assembly representatives and the ANA staff for their support during his term. “From the bottom of my heart, thank you for enabling me to serve ANA and the nursing profession. It has been the opportunity of a lifetime.”

Advocacy and optimism

In her report, Debbie Hatmaker, PhD, RN, FAAN, chief nursing officer of the ANA Enterprise, expressed gratitude for the first in-person meeting in 3 years, and encouraged attendees to continue the advocacy work that has been vital to ANA’s efforts to advance nursing priorities, including hundreds of Hill Day visits, both in person and virtually, that had taken place the day before.

“Your input and engagement help us become more influential,” she said. “That’s good for nurses and the profession, and for improving patient care and building a better health system.”

Hatmaker reported on progress made from last year’s practice and policy discussions and looked to the future.

“We plan to leave this Membership Assembly with renewed optimism and direction, remaining focused on this body’s priorities and our board’s strategic direction. We remain grateful for your input and guidance. I especially want to say thank you for the outreach and support you provided this past year. We could not have done this critical work without the commitment of our members.”

This year, Assembly attendees discussed three topics during dialogue forums, convened by the Professional Policy Committee, a process that ensures members’ voices are heard and reflected in ANA positions and priorities.

Staffing and safe patient care

Recognizing that the COVID-19 pandemic has exacerbated long-standing nurse staffing issues, the Assembly considered changes to existing ANA policy and approach related to nurse-to-patient ratios. Participants stressed the need for enforceable staffing standards and shared their successes and challenges in implementing various models.

Commenters shared a range of viewpoints, with some saying that staffing ratios are not politically feasible in certain regions of the country and others pointing out the need for multiple approaches to meet the needs of different states. Most agreed that ANA must take concrete action to address staffing challenges.

Assembly representatives approved a recommendation that ANA support safe patient standards including ratios that are acuity-and setting-specific as per nursing assessment and enforceable, and that ANA will engage with the C/SNAs to develop further details regarding standards, implementation, and enforcement. Assembly representatives also called on ANA to collaborate with OAs and C/SNAs to begin to develop evidence-based staffing standards for all nursing disciplines for publication.

Addressing verbal abuse and workplace violence

Approaches to workplace violence (WPV) in healthcare frequently focus on physical assaults in hospitals and overlook verbal abuse, which can be a risk factor for physical violence. In addition, practice and policy recommendations developed for inpatient settings may not be appropriate for or helpful in community settings, such as schools, community health centers, public health facilities, and similar places where WPV can occur.

Several commenters emphasized that prevention implementation must recognize behavior that is symptomatic of mental illness or cognitive impairment and apply an equity lens when assessing patient threats. Many pointed out that educators, nurse leaders, and regulators should ensure that nurses are trained in de-escalation techniques and that verbal abuse should be a part of discussions about workplace violence.

Assembly representatives called on ANA to engage key stakeholders to identify, develop, and advance strategies resulting in a comprehensive culture of safety and a zero-tolerance approach to verbal abuse and violence in all care settings, advance WPV prevention priorities in nursing practice and public policy, and advocate for better data collection to inform policy development.

Impact of climate change on health

Representatives proposed that ANA, as the leading nursing organization, should take a strong leadership position in addressing the impacts of climate change on human and population health. Accordingly, ANA should help prepare nurses to engage patients in conversations about climate change and its health impacts, which disproportionately affect the most vulnerable populations.

To help address the public health crisis caused by climate change, Assembly representatives approved the recommendation that ANA, C/SNAs, and the IMD include climate crisis and its consequential impact on human and population health as an essential component of their policy platform. Voting representatives also endorsed that ANA revise and establish as an official position the 2008 House of Delegates Statement on Global Climate Change and Human Health. Finally, the representatives called on ANA and its membership to promote nursing knowledge on the relationship between climate change and human and population health.

ANA’s racial reckoning statement

In 2021, ANA began an intense effort to understand its own history in relation to racism in nursing. The outcome of this examination is a reckoning statement that serves as an apology to nurses of color who have been harmed by decisions and omissions made by ANA that contributed to racism in the profession.

Members expressed overwhelming gratitude and praise for the reckoning statement, while emphasizing the importance of taking purposeful action.

Assembly representatives approved by unanimous consent for the association to embark on a racial reckoning journey and adopted ANA’s Racial Reckoning Statement. ANA is launching a multi-phase journey of accountability, healing, and reconciliation with the official racial reckoning statement as a starting point for an overdue journey toward the future.

Global impact

The second day of the Assembly opened with greetings from International Council of Nurses (ICN) President Pamela Cipriano, PhD, RN, FAAN, past president of ANA and a Virginia Nurses Association member. In her report, she gave an update on ICN’s Nurses for Peace campaign, which is supporting nurses in Ukraine with monetary donations and other assistance. Cipriano encouraged attendees to visit the ICN website to learn more about its efforts to uplift nurses in Europe and other areas who are struggling. “We’ll continue to work and fight for them just as they fight for their countries,” she said.

The power of nursing

In her report to the Assembly, ANA Enterprise CEO Loressa Cole, DNP, MBA, RN, NEA-BC, FAAN, conveyed the strength of the organization and its progress toward achieving Enterprise strategic goals.

“Our current strategic plan, which we initiated in 2020 and prepared before the pandemic, is anything but modest. And despite the many challenges of COVID-19, I can stand here and tell you that we are still executing to that plan,” she said. Cole highlighted key ANA Enterprise projects, including Reimagining Nursing, an American Nurses Foundation initiative that has awarded $14 million to 10 pilot projects that “will contribute to fundamentally changing the future of nursing,” said Cole. Learn more here.

“I believe in the collective strength, intellect, and passion represented in this room to build the future of our profession,” she continued. “With confidence I can say that despite the challenges of the past couple of years, the ANA Enterprise continues to answer the call. We are delivering. And we will spare no effort to build a better future for our organization and for nurses everywhere.”

The Assembly offered participants more opportunities for discourse with facilitated conversations on nurses’ mental health and well-being, lessons being learned from the COVID-19 crisis, and a presentation from the APRN task force.

Assembly attendees also participated in concurrent lunchtime discussions covering topics such as fulfilling members’ needs, amplifying the voice of the nurse, addressing the opioid crisis, and state-based innovation incubators. Attendees had opportunities to support causes specific to nursing, raising more than $23,200 for the American Nurses Foundation and more than $6,100 for the ANA-PAC.

—Elizabeth Moore is a content creator at ANA