Nursing News

ANA’s President Discusses Future of Nursing, Challenges and Reform


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By Claire Brocato, contributor 

August 12, 2010 - The American Nursing Association’s (ANA’s) newest president, Karen Daley, Ph.D, RN, MPH, FAAN, knows what it takes to champion a cause, to engage policymakers in meaningful reform, and to persevere until barriers are removed and nurses’ voices are heard. She is not a newcomer to advocating for nurses and working tirelessly to create safer, healthier workplaces for the nation’s 3.1 million RNs.

Karen Daley, Ph.D, RN, MPH, FAAN
New ANA president, Karen Daley, Ph.D, RN, MPH, FAAN, sees tremendous opportunities to elevate nursing practice, improve safety and reshape health care delivery models.

Daley launched her nursing career at Brigham and Women’s Hospital in Boston, Mass., where she worked as a direct care nurse for more than 25 years until a needlestick injury forced her to walk away from clinical nursing practice. Daley subsequently became actively engaged in the area of needlestick prevention and worked with the ANA toward passage of legislation to mandate the use of safe needle devices in health care settings. In November 2000, Daley was invited to the White House to witness President Clinton sign the “Needlestick Safety Prevention Act” into law.

Daley is a past president of the Massachusetts Association of Registered Nurses (MARN) and of the Massachusetts Nurses Association. She was inducted as a Fellow of the American Academy of Nursing in recognition of the national and international impact of her needlestick injury prevention advocacy, and, in 2006, she was honored as a Living Legend by MARN.

Recently, NurseZone had the opportunity to talk to Daley about her latest leadership role and her thoughts on the challenges and opportunities that lie ahead for the nursing profession.

Q: As president of ANA, what are your key goals for the next two years?

A: Today ANA is a vibrant, robust, global enterprise, and we actively work on behalf of the nursing profession in so many arenas—advocacy, policy, education and improving conditions within care environments, to name a few. One of my goals as ANA’s president is to communicate how this powerful work benefits every practicing nurse in this country.

Also, transforming our health care system is certainly one of the most important opportunities and challenges that our nation faces within the next few years. Barriers within practice settings need to be removed so nurses can function at levels that utilize all their knowledge and skills. As ANA president, another top priority will be keeping nurses informed about the implementation of health care reform as it rolls out and to help nurses envision the future and position themselves for success so they can take advantage of the new opportunities that health care reform will bring.

Q: What do you believe are the greatest challenges that nurses face today?

A: There is no question that nurses in the U.S. need relief within their practice environment from issues that pose barriers to the provision of safe, quality care. Nursing remains one of the most worthwhile and rewarding professions, but it’s also physically and emotionally demanding, and even dangerous at times.

Workplace violence, preventable musculoskeletal injuries, and inadequate nurse staffing levels are some of the biggest barriers to providing quality patient care. We know these issues contribute to poorer patient outcomes as they account for higher levels of nurse illness and injury, burnout, turnover and even premature retirement from nursing. Knowing these conditions are largely preventable also makes them unacceptable in today’s health care environments. 

It is also becoming increasingly critical that safety cultures become part of the norm within all health care practice settings. Employers, as well as nurses, must take steps to lead efforts to ensure that there are adequate systems and policies in place to protect health care providers and to support safe, quality care for patients. It makes basic, good sense that when you take care of nurses, you take better care of patients.

Q: Where, in your opinion, do you believe nursing has seen the most progress?

A: Nurses have really moved forward in becoming more visible, powerful voices in the advocacy and public policy arenas, particularly at the federal level...During the fight for health care reform, nurses were successful in making their voices heard through grass-roots advocacy and, as a result, played a vital role in keeping the pressure on lawmakers and building momentum for passage and enactment of health care reform.

In recent years, substantial progress in promoting safer and more effective practice environments has also been made through the Magnet Recognition Program, a program that was launched by ANA’s subsidiary, the American Nurses Credentialing Center (ANCC). Magnet hospitals create environments that value RNs and their well-being, involve nurses in shaping evidence-based nursing practice, and encourage professional advancement. As a result of that work and commitment, Magnet hospitals demonstrate a higher level of nurse satisfaction and retention. I believe this represents significant progress for our profession and the patients we serve. Currently, there are approximately 368 Magnet facilities in the United States.

Q: Where do you think the most work is still needed in nursing?

A: Staffing continues to be a critical issue in our health care system. Nurses are overburdened and we know inadequate nurse staffing impacts the quality of patient outcomes and safety. Nurses need to be empowered to make decisions and to determine unit-level staffing needs based on the factors we know make a difference, including nurse experience and competence, patient acuity and flow, among others…[ANA] won’t stop advocating on this issue until federal legislation is enacted to assure patient needs are met.

Our country is also facing an ongoing shortage of RNs despite recent increases in the number of graduates from nursing programs. We are going to see the demand for health care intensify as the baby boomer population ages and as access to health insurance coverage expands. As many as 30 million additional Americans could be added to the health care system given recently enacted reforms. ANA is collaborating with policy makers and developing strategies to address this serious crisis. There must be significant workforce investments in initial, advanced and continuing education for nurses so we can add appropriate numbers of RNs to meet these increasing demands.

Q: What areas of nursing practice do you believe will change the fastest in regards to health care reform?

A: The Affordable Care Act will create unprecedented new opportunities to reshape health care delivery in this country. With newly enacted reforms, there will be a fundamental shift from a disease-oriented system towards one where more emphasis is placed on wellness and illness prevention. The goal will be to transform from the current “sick care” system to a true health care system. By improving patient access to primary care as part of these reforms, there will be more opportunities for APRNs [advanced practice registered nurses] to practice to the fullest extent of their capabilities.

Provisions within reform legislation reflect lawmakers’ recognition that qualified nurse practitioners represent a previously untapped resource relative to the future of primary care. Recognizing the integral role that APRNs can play in the delivery of patient-centered primary care helps bring the focus of our health care system back where it is likely to have the greatest impact—on healthier patients and communities.

Q: What are your thoughts on the future of nursing?

A: I believe this is a time of tremendous possibilities for nursing. Against the backdrop of health care reform, we have an opportunity to elevate nursing practice as never before and to design models of health care delivery that promote greater health and prevent illness all along the life continuum. An increased emphasis on quality and outcomes will create more demand than ever before for the integration of multi-disciplinary care systems that are evidence-based and outcomes-focused.

Most importantly, we must use this time to remove barriers to safe, quality nursing care so that registered nurses and APRNS can practice at levels that match their knowledge and skills. Overall, these long-term investments in our nation’s health care system will create new foundations and beginnings for health care throughout this country. Nursing needs to be engaged in the forefront of these changes. I can personally attest to the fact that ANA will be there.


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