Hello to all of our Illinois Nurses; I am filled with immense pride and excitement for the milestones and opportunities for the Illinois Nurses Foundation. This season marks a momentous occasion: the 10th anniversary of our 40 Under 40 Emerging Nurse Leader event. Over the past decade, we have had the honor of recognizing and celebrating the incredible achievements of 400 outstanding nurses who are shaping the future of our profession with their leadership, innovation, and dedication.

As we reflect on this journey, we extend our heartfelt congratulations to all the past and present honorees. Your commitment to advancing nursing and improving patient care is truly inspiring. The 40 Under 40 event highlights your exceptional contributions and serves as a beacon of hope and excellence for aspiring nurse leaders across the state. We hope to have seen you all there!

With the start of a new school semester upon us, I want to highlight the importance of supporting our scholarship funds. Education is the cornerstone of progress in our field, and the Illinois Nurses Foundation is dedicated to helping nurture the next generation of nursing professionals. Your donations to our scholarship programs are crucial in providing the financial support needed for students to pursue their nursing degrees and further their careers. By investing in these future leaders, we are ensuring that our profession continues to thrive and evolve.

Additionally, I am excited to announce that nominations are now open for our Nurse of the Year and Lifetime Achievement Award. These prestigious honors are a wonderful opportunity to recognize and celebrate the extraordinary contributions of your colleagues. Whether it’s a nurse who has demonstrated exceptional clinical skills, made significant contributions to nursing research, or shown remarkable dedication to community service, we want to hear about them. Nominate your peers and help us spotlight the remarkable individuals who make a difference.

As we move forward into this vibrant season, let us embrace the spirit of celebration, reflection, and support. Together, we can continue elevating the nursing profession and making a lasting impact on our communities. Thank you for your unwavering dedication and generosity.

I wish you all a successful and fulfilling fall season.

Warm regards,

Amanda Oliver BSN, RN, CCRN, CPST
President, Illinois Nurses Foundation

Dear Illinois Nurse Colleagues,

“There Is No Healthcare Without NURSES”.

It is an honor to address you today as your ANA-Illinois President, as I stand with you – a fellow Registered Nurse of Illinois. We all should be very proud as our profession stands at a pivotal moment in history, and I am filled with optimism as we navigate the challenges and opportunities ahead.

The Role of Nurses in Healthcare:Nurses are the backbone of our healthcare system. We are the first point of contact for patients, providing compassionate care, advocating for their needs, and ensuring their well-being. Our role has evolved significantly, and today, we are not just caregivers but also leaders, educators, and innovators.
Challenges and Resilience:The past few years have tested our resilience like never before. The global pandemic highlighted the critical role of nurses and the immense pressures we face. Despite these challenges, we have shown incredible strength, adaptability, and dedication. We have been on the front lines, saving lives and providing comfort in the most trying times.
Innovation and Education:As we look to the future, innovation and education will be key to our success. We must embrace new technologies and practices that enhance patient care and improve outcomes. Continuous education and professional development are essential to keep pace with the rapidly changing healthcare landscape. We must also advocate for policies that support our growth and ensure that nurses have the resources they need to thrive.
Advocacy and Leadership:Nurses must continue to be strong advocates for our patients and our profession. We have a unique perspective on healthcare, and our voices are crucial in shaping policies and practices. Leadership in nursing is not just about holding titles; it is about inspiring and empowering others, driving change, and making a difference in our communities.

I want to express my deepest gratitude to all the nurses who work tirelessly every day. Your dedication, compassion, and expertise are the heart of healthcare. Together, we will continue to advance our profession, improve patient care, and build a healthier future for all in Illinois and beyond……

The ANA-Illinois Professional Issues Conference will be held Saturday, November 2, 2024, at the Sheraton in Lisle, Illinois.

In 2022, we started a tradition of adopting a theme for the year. The theme would align with our mission and vision and help set the tone of our work for the year. Our theme for 2024 is “There Is No Healthcare Without NURSES”. The Political Issues Conference (PIC) Registration is now open, and I look forward to seeing you all at the conference.

Thank you for your partnership,

Dr. W. Zeh Wellington, DNP, RN, NE-BC

President of the American Nurses Association (ANA)- Illinois

“Nothing has ever been achieved by the person who says, ‘It can’t be done.’”- Eleanor Roosevelt

2024 ANA-ILLINOIS CANDIDATES ANNOUNCED

The election for the ANA-Illinois Officers and Directors will be held online September 17th thru October 1ST. The election will be conducted electronically. Watch your email and the ANA-Illinois website www.ana-illinois.org for the additional details. Candidates are listed in alphabetical order according to position.

All terms are for two years.

CANDIDATES FOR VICE PRESIDENT

Sam Davis MHA, RN, NEA-BC, CNOR
Associate Vice President
Rush University Medical Center

Jeannine Haberman DNP, MBA, CNE
Chair, Undergraduate Nursing Programs
Lewis University

Berenice Simpson MSN, RN
Nurse Leader, multiple areas
Advocate Health

CANDIDATE FOR TREASURER

Pamela S Brown PhD, RN, ANEF
Coordinator, Online Nursing
Illinois College

CANDIDATES FOR DIRECTOR (2 to be elected)

Tommi Cline DNP, RN, CHC, NE-BC
Chief Nursing and Compliance Officer
Hillsboro Health

Amanda Eichstaedt MBA, BSN, RN, NE-BC, NPD-BC, CPN
Manager of Patient Care Operations
Ann & Robert H. Lurie Children's Hospital of Chicago

Sunny Hampsey MBA, MSN, RN
VP, Nursing
Springfield Clinic

Diana Ortega BSN, RN
Clinical Nurse -- Wound Care
Rush Oak Park Hospital

CANDIDATES FOR DIRECTOR-RECENT GRADUATE (1 to be elected)

Sarah Elizabeth Quick RN
Registered Nurse 1
Illinois Department of Veterans Affairs -- Illinois Veterans Home Manteno

CANDIDATES FOR ANA REPRESENTATIVE (2 reps/1 alternative to be elected)

Amanda Eichstaedt MBA, BSN, RN, NE-BC, NPD-BC, CPN
Manager of Patient Care Operations
Ann & Robert H. Lurie Children's Hospital of Chicago

Joseph Hernandez BSN, RN
ICU PACU RN
West Suburban Medical Center

Jameszetta James MJ, MSN, RN, ASC-BC, ACM-RN
Nursing Supervisor & NOURISH Recruitment Specialist
Shirley Ryan & Rush University Medical Center

Diana Ortega BSN, RN
Clinical Nurse -- Wound Care
Rush Oak Park Hospital

CANDIDATE FOR NOMINATING COMMITTEE (3 to be elected)

Jameszetta James MJ, MSN, RN, ASC-BC, ACM-RN
Nursing Supervisor & NOURISH Recruitment Specialist
Shirley Ryan & Rush University Medical Center

Lovey Reynolds PhD, RN, CPN, CNE
Nursing Faculty
Malcolm X College

American Nurses Association Elects New National Leaders at Its 2024 Membership Assembly

ANA President Re-elected for a Second Term

SILVER SPRING, MD -- On June 29th, the American Nurses Association (ANA) announced that the voting representatives of ANA's Membership Assembly re-elected Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, of the Oregon Nurses Association to a second term as ANA president to represent the interests of the nation's more than 5 million registered nurses. As ANA's 38th president, Dr. Mensik Kennedy will lead the ANA Board of Directors and ANA Board of Directors Executive Committee and continue to work on issues and initiatives that are critical to advancing nursing and health care.

ANA's Membership Assembly also elected 4 members to serve on the 9-member Board of Directors. The Membership Assembly re-elected board members Secretary Amanda Oliver, BSN, RN, CCRN, CPST, of ANA-Illinois and Director-at-Large Edward Briggs, DNP, MS, APRN, of the Florida Nurses Association. The Membership Assembly also elected Director-at-Large Ahnyel Burkes, DNP, RN-BC, NEA-BC, of the Louisiana State Nurses Association and Director-at-Large, Staff Nurse Josephine Agyei, BSN, RN, of ANA-New York. Terms of service for Dr. Mensik Kennedy and the other elected members of the Board of Directors will commence on January 1, 2025.

The following ANA board members will be continuing their terms on the ANA board in 2025: Vice President Anita Girard, DNP, RN, CPHQ, NEA-BC, of ANA\California; Treasurer Joan Catherine Widmer, MS, MSBA, RN, CEN, of the New Hampshire Nurses Association; Director-at-Large, Recent Graduate Nikule Abel, BSN, RN, of the Minnesota Organization of Registered Nurses; and Director-at-Large Khaliah Fisher-Grace, PhD, RN, CPHQ, PCCN-K, of the Individual Member Division.

Elected to serve on the Nominations and Elections Committee: Mavis Mesi, DNP, MSN, RN, of the Colorado Nurses Association; Vinciya Pandian, PhD, MBA, MSN, RN, ACNP-BC, FCCM, FAANP, FAAN, FFNMRCSI, of the Maryland Nurses Association; and Kimberly Velez, MSN, RN, of ANA-New York.

MEDIA CONTACT: newsroom@ana.org

I sit here, staring at the computer. How different my life is now, more than 20 years later, and I think that things are not so bad; I survived, almost 3,000 others did not. But the nightmare lives on within me, like it does for most of us since that fateful day, September 11, 2001. I still wake up crying sometimes, the memories of those families I worked with burning in my dreams. It is still too hard to watch the videos, look at movies and photographs, read about how it all happened with each passing year and on key milestone years.

Tuesdays were one of my favorite days, for they were the first day of my clinical instruction week. Working as an assistant professor of nursing was a dream come true for me. I had taught at all levels of nursing education, but found the BSN level the most exciting and stimulating. The give and take with the students, the excitement they demonstrated, and the challenges of preparing them for the "real world" were all on my mind that Tuesday.

I was sitting at the nurses' station, reading over a patient chart, when a patient walked up to me and said, "A plane just flew into the Pentagon". Many thoughts ran through my head: Was the patient experiencing DTs? What was the patient's diagnosis? How could he stand there and say something so patently impossible and keep a straight face? Without consciously forming my reply, "pull the other one" came out of my mouth. He kept telling me that it was true and that a plane had flown into one of the World Trade Centers, too. Wondering if he or I were going crazy, I noticed that there were no nurses anywhere to be seen and the halls were empty. I went into his room with him and the horror began to sink in.

Like so many health care workers, my first thoughts were how I wished there was something I could do to help. What would be the fatality rate? What would be the casualty rate? How could New York health care institutions and professionals handle the burden? It was several minutes before the truth struck me: I was one of those trained to deal with this. I was one of those who would be helping. This was what I had really been training for all those years at the Red Cross. It was overwhelming me, all of it. I wanted to help, but . . . was it safe to travel to New York? Were more terrorist acts going to occur? How would I get around New York? What could I really do? And what about my students? My lectures? My head was spinning with so many thoughts I did not know what to do.

Being an American Red Cross (ARC) RN was an exciting experience. It has allowed me to meet other healthcare professionals from all around the US and to learn about other areas of this country. When a disaster hits, the ARC RN plays a vital role in caring for the victims of the disaster. We help people in a myriad of ways: obtaining vital medications lost in the disaster, replacing lost prosthetics, finding shelter, getting immediate healthcare, and, sadly, helping to bury family members lost in disasters. The thought of what would be needed for the victims and families of those caught in the 9/11 disasters was staggering compared to what I had done before.

Like so many, I wanted to jump on a plane or into my car and drive recklessly to the sites. I knew, however, that this would not be helpful and could turn me into a victim as well, if I was not careful. So, I waited at the ARC Chapter House in Springfield, IL, wondering what I could do locally. It was not long before we all realized that family members here in our chapter had lost loved ones and friends and that we would have to deal with much grief and lack of information to help them. My role became helping to train new volunteers as quickly as possible, answering questions, and beginning to process travel arrangements for volunteers and family members who were going to the East Coast.

During the next weeks, I began planning for my turn to go to one of the disaster sites. Finally, on September 28th, my Director of Volunteers told me that I was the last disaster RN in the state to be asked and could I be ready to go on October 2nd. I had to make my decision. I later found out that 97% of the disaster trained ARC RNs in the US had been to one of the disaster sites and 90% had been there more than once, since others were not available or were responding to other disasters across the US.

Preparing to go to a disaster is interesting. Usually, we are sent to areas without any major amenities. We may go to areas that are muddy, wet, lacking electricity, with washed out roads and no "normal" means of transportation. We usually take with us work clothes, sturdy shoes, and a 3-week supply of any medications we are on. I packed all these things, not knowing how different this disaster would be.

When I returned to the Springfield ARC Chapter House on October 1st to get my airline tickets and cash advance (money we use for daily needs, such as food, washing clothes, and other necessities), I was told I would be going to Stamford, CT. I sat there blinking and repeating the location, asking if my director was positive this was the right place. What did Stamford have to do with the disasters? While I had studied geography in school, like everyone else, I had never been to the New England area or the East Coast before and was thinking of how Illinois sits in relation to other states around it. It made no sense to me, but I was going to go where they sent me and do what was needed. I figured that I would find out when I got there what was going on.

The trip to Connecticut was not the most pleasant experience I ever had. Everyone wondered if our plane would be hijacked, would we die like those poor people who woke up one day, went to work, and were victims of terrorism? None of the delays just getting on board the airplane mattered to anyone. We were all more than willing to let security personnel go through our luggage and ask us endless questions. A trip that normally took three hours now took seven. That was fine with me.

I arrived in Hartford at midnight on the 3rd of October, exhausted, unsure of where I was to go and what I was to do. The ARC is wonderful in making help available to volunteers on assignments, with phone numbers to call for up-to-date information on conditions in the disaster area, weather reports, and names of who to contact, so I had plenty of contacts to call for answers to my questions. When I called the local ARC Human Resource Officer, I was told to go to a certain hotel, get some sleep, and meet up with two other volunteers in the morning for the drive to Stamford. I did all of this and arrived at national ARC Headquarters (HQ) in Stamford at about 1030 that day.

When one goes on an assignment, one usually is told that, until arriving at the disaster site and having a task to do, it is often "hurry up and wait", sometimes meaning hours or days of sitting around doing nothing. We are advised to take along crossword puzzles, reading materials, and other things to occupy the time when we arrive the first day. So, after checking into my hotel and reporting to HQ, I sat down, expecting to do nothing for at least four or five hours.

Three hours later, I found myself in the living room of a woman whose husband had been killed at the World Trade Center (WTC), trying to find out what her health needs were. My head was reeling from all the information I had received in this brief time and being on an assignment so quickly. I now knew why I was in Connecticut; 1200 of the almost 3000 people who died at the WTC were from Connecticut, a fact that stunned me, until someone later took me to a spot where I could view the ocean. That was when I found out that distances were very different on the East Coast from central Illinois. I knew that, intellectually, but not at a gut level. My colleague pointed across the water to a not-so-distant land mass with lots of tall buildings on it and told me that was New York, only a 40-minute commute on the rapid transit system from Stamford. Now I understood.

The 9/11 attacks were horrid for all Americans; worse for some than others, of course. For those of us who volunteered to go to these sites, it became so much more. That first family I sat with was a foreshadowing of what was to come. The husband had been out of work for over a year and had just started work that Monday at the WTC. He and his family were so proud of the new position he had and were excited about starting a new phase of their lives. Their two sons, 17 and 23, had driven their father to the WTC on Monday to celebrate the new job only to learn about the tragedy as they drove back to Connecticut. I met his dogs, precious pets of his from before he was married. I was shown his picture. I sat for two hours with his wife and just listened to their story . . . how important that simple act became with all the families with whom I worked.

I learned how important it was to ask the right questions. Assessing my clients’ needs was difficult. Grief and shock were prevalent in so many and the usual questions were answered vaguely. Asking "How are you?" or “What do you need?” received a blank look or a "Fine" or “Nothing” in reply. Very specific questions, such as how our clients were sleeping, when they had last eaten or taken medications, and to name a list of resources, family members, and friends that they might need to call, were necessary. We volunteers were in shock, too, and many of the ARC Disaster Health staff were forgetting to eat, sleep, and take their medications, also, looking as in shock as those they were there to help.

For me, 9/11 is a series of stories, of men and women, fathers and mothers, and children, with names and faces still in my heart and mind after all these years. It is personal. It is knowing the parents and brothers of one of the airline stewardesses and knowing, when I see the video of the second plane flying into the WTC, that she was on it and her family was watching that and watched it over and over everyday, trying to stop her flying to her death, praying that it was all a nightmare and this time the plane would not crash.

And 9/11 is captured for me in the paperwork we filed on each death. Because I arrived three weeks into the disaster, I could see the story unfolding in the paperwork. Reams of paper came in, with a name of a possible victim, sent in by family members who had gone to government agencies trying to find out if that family member survived. Each page was a short history of a human life: name, age, sex, address, phone numbers, place of employment, last time seen by the report initiator, significant other's name, Tower employed in, last contact and so on. At the end of each page was typed in one of three words: presumed missing, missing, dead. As each week passed, one could see the word changing, as verifications of death were sent to us.

This is one role that many people do not know that the ARC does: They file the morbidity and mortality reports for the CDC in all disasters. All that information goes through Disaster Health Services RNs. I had never been on a disaster that had any deaths before this. Now I spent hours making sure all the death notices and forms were filled in properly, sent to the proper agencies, and filed in our files correctly, when I wasn't sitting with a family listening to another story, crying with another mother, father, spouse, brother, sister . . .

One thing that struck me over and over was that for so many there was no finality. ARC Disaster RNs go to funerals and we went to one funeral after another at this disaster to support the families. It was something I wasn't really prepared for since we did not often have to do that in my Chapter. At all but one of those funerals, there was no body in the casket, just an empty coffin in an empty grave. So many family members told me that they were positive, when all the confusion died down, that their family member would turn up and they would all laugh at the thought that their son/daughter/mother/father/aunt/uncle/friend had died and had a funeral. Especially the mothers told me this, weeping over pictures, denying that their child was dead, insisting it was all a mistake.

I worked with the family of the one casket that held a body in Connecticut. For hours, we sat with his mother, learning about her son. He had been an Eagle Scout, a volunteer for Big Brother/Little Brother, and was to be married the next year. Since his death, his dog of seven years refused to go into his master’s old childhood room, whining whenever he passed by the room. It was representative of something we heard over and over: Pets who seemed to know their owner was dead and mourned in their own way.

As all mothers and fathers we spoke with during that time, his parents had trouble dealing with their son's death. The presence of a body helped them accept the reality that so many others could not face. The ARC Disaster Team listened as his mother told us how relieved she was to have his body, that she knew he had not burned to death, and that his body was not going to be part of a landfill. She felt guilt over his death, because she had been on the phone with him just before the towers collapsed. She had begged him to leave his office and try to escape, but he refused. He said they had been told over loud speakers in the Towers that the buildings were safe and for everyone to remain where they were. He was confident that they knew what was going on and told her he would do as they directed. She heard him tell her how much he loved her as she watched the Towers fall and the phone line go dead . . . .

There were so many stories and I remember them so clearly: that husband just starting his new job in the WTC on Monday; the young father expecting his second child in two months, leaving behind his pregnant wife and three year old son; the 26 year old who had turned in his resignation on Monday in order to start his own business, in two weeks. I carry these people in my heart now, they still haunt my dreams some nights, and watching or hearing anything about 9/11 still makes me cry. Because of all this and others I met and had a chance to offer a small bit of help and healing to, I am a bit different today. It's hard to say what has changed within me. All I know is that I, and millions more were changed that day.

Abstract
The NCLEX examination serves as the defining entry point to practice for every registered nurse. The history and evolution of this exam has been influenced by historic events as well as reflecting changes in the healthcare system and role and function of registered nurses. In the first part of the series, the need for a licensing exam, the history of the NCLEX, and a review of its evolution was provided. In this second of the four-part series, the challenges of preparing graduate nurses for practice through appropriate evaluation of clinical judgment is explored.

Pulling Back the Curtain on the NCLEX:
Theory to Practice Gap: The Clinical Judgment Model
Healthcare and medical science are rapidly expanding fields of knowledge, and nursing is necessarily evolving at the same exponential pace. In previous decades, nursing education and preparation for practice was mainly based on the acquisition and assessment of knowledge. However, in practice today, knowledge alone is insufficient; the application of this knowledge is paramount for safe, effective nursing practice. As nursing practice has grown and changed, the evaluative means used to determine adequate preparation to practice has also changed. Clearly, there is a continuing, pressing need for new graduate nurses to enter practice prepared to care for increasingly complex clients in a stressful and demanding environment (McGarity, et al. 2023).
Alarmingly however, surveys have shown that new graduate registered nurses are less prepared to function in a healthcare environment than in previous years with only approximately 23% of new graduate nurses able to reason at the level necessary to provide care in a safe manner (Kavanagh & Sharpnack, 2021). This is startling, and both nurse educators and the licensing bodies for nursing have focused their efforts to both teach new nurses the needful skills of clinical judgment and critical reasoning and test their application of knowledge in order to better prepare these graduates for practice.
Even before the COVID-19 pandemic clearly illustrated, the healthcare environment and patient care requires critical thinking skills and clinical judgment to safely navigate and practice amongst the myriad technologies, diagnostics, and treatments of today’s continuously evolving and more complex healthcare environment. Remembering enough nursing-related facts alone is not sufficient to prepare a newly graduated registered nurse for the responsibility of safely caring for clients; it is expected that registered nurses use the knowledge they acquired to carry out their responsibilities and tasks to oversee and provide quality patient care. With this understanding, the licensure exam which ascertains readiness for practice cannot test solely on knowledge either, but has had to evolve as well in order to establish the acceptable standard for entering nursing practice as a registered nurse (Ignativicius, 2021).

Measuring Clinical Judgment
A crucial component of readiness for practice is clinical judgment or critical thinking, both of which refer to the process by which a person gathers and recognizes objective and subjective data in order to understand the presenting problem, develop appropriate solutions to the problem, and evaluate the outcomes for quality. Tanner’s groundbreaking work describes the components of clinical judgment and the qualities that influence this thinking process which include noticing, interpreting, responding, and reflecting (Tanner, 2006).
With this and other research involving over 200,000 graduate nurses and over 100 nurse experts providing further understanding, the National Council of State Boards of Nursing (NCSBN) undertook to modify the existing licensing exam to increase its testing of clinical judgment (NCSBN, 2024). Drawing heavily on Tanner’s clinical judgment model, the NCSBN developed their own Clinical Judgment Measurement Model (NCJMM) as a framework for evaluating new graduate nurses’ readiness for practice. The NCJMM is not a definitive model of clinical judgment, rather it provides a process for quantifying and inferring the ability of a nurse to use clinical judgment in their decision-making (NCSBN, 2024).

Clinical Judgment Measurement Model
The NCJMM guides nurses through specific steps that are designed to navigate clinical reasoning and application to practice. Built in layers, the NCJMM developed contextual levels that move from the broadest understanding to the direct application of nursing knowledge in a specific scenario in a psychometrically rigorous and measurable progression. In order to meet the set requirements of the NCLEX, the graduate nurse must demonstrate their mastery of all six steps that describe the clinical judgment process.
The first step is recognizing the cues. This means that the graduate nurse is able to sort irrelevant information from relevant information and prioritize the most concerning data. Next, the cues must be analyzed and a potential list of conditions that could be responsible for the signs and symptoms created. A solid understanding of pathophysiology and various conditions is necessary, as the next step is prioritizing the hypotheses. This incorporates considering the possible causes of the client’s signs and symptoms and including or excluding a diagnosis based on the data on hand. Urgency of condition, time from onset, risk factors, and seriousness of potential outcomes must all be considered. This guides the next step of generating solutions. Solutions are generated through an understanding of the best potential outcome of the given scenario and the interventions that should or should not be implemented in order to achieve that. This provides a framework for taking action, the next step in the NCJMM model. In order to take action safely and appropriately, the first four steps need to be completed correctly, and a solid understanding of different interventions, diagnostic tests, and pharmaceuticals along with their potential complications applied to the situation. After taking action, the outcomes need to be evaluated, and that includes recognizing if an intervention was effective or ineffective, if the client’s status is improved, or if another intervention could be implemented. The following "below" graphic is a flow chart illustrating the NCJMM (NCSBN, 2019).

Far from replacing the steps of the nursing process, the steps of the process outlined above are solidly rooted in the nursing process that has been a foundational paradigm for the critical thinking necessary to nursing practice. Assessment, analysis/ diagnosis, planning, implementation, and evaluation are evident and completely aligned with the NCJMM steps of recognizing cues, analyzing cues, prioritizing hypotheses, generating solutions, taking action, and evaluating outcomes. The additional descriptive elements of the NCJMM provide further contextual refinement for measuring and validating the application of clinical judgment.
New question formats demonstrate the inclusion of the NCJMM in the NCLEX testing platform. These include evolving case study questions that progress through all six parts of the NCJMM framework, testing the graduate nurses’ comprehension of the client problem and ability to reason through the steps of anticipating treatments and recognizing when outcomes are met or when new or different interventions need to be applied.

Conclusion
As nursing practice continues to broaden and develop, the entry-level requirements for safe, effective nursing performance have also deepened. Remembering sufficient information from textbooks is no longer adequate preparation for the role of nurse, and by expanding the original steps of the nursing process into the NCJMM, the NCSBN is able to use this clinical judgment framework to better evaluate the clinical reasoning and critical thinking that are crucial components of nursing practice with the overall goal of better preparing graduates for real-world practice. The third article in this series will review the initial NCLEX results after the NCJMM-based changes were put into practice and trace trends in NCLEX pass rates and prelicensure nursing education.

In the landscape of healthcare, nurses occupy a pivotal position, not only as caregivers but also as crucial advocates for health policy reform. Their patient care experience, regardless of setting, grants them a unique perspective on the healthcare needs and challenges faced by the public, making their voice essential in the development and implementation of health policies at both state and national levels. This article delves into the role of nurses in advocating for public policy, the strategies they employ, the challenges they face, and the impact of their advocacy on healthcare.

Understanding the Role of Nurses in Policy Advocacy

Nurses, by virtue of their profession, are inherently advocates for their patients. Their advocacy transcends individual patient care, extending into the broader realm of health policy, where they work towards shaping policies that promote the health and well-being of the general public. At the state and national levels, nurses contribute their expertise to inform policy decisions that affect health care delivery, access, and quality. They serve on advisory boards, participate in legislative committees, and work with professional associations to advocate for policy changes that align with the best interests of patients and the healthcare system.

Strategies for Effective Advocacy

Nurses employ various strategies to influence health policy effectively. These include education and awareness, collaboration, public engagement, and political involvement.

Education and Awareness

Nurses utilize their firsthand experience to educate policymakers on the impacts of health policies on patient care and outcomes. For example, a nurse working in a pediatric unit could share insights with local legislators about the challenges families face due to lack of access to affordable healthcare. By presenting data on increased hospital readmissions or delayed treatments, nurses can illustrate the tangible effects of policy decisions on community health. Additionally, nurses might contribute to policy briefs or white papers that detail the benefits of proposed health legislation, such as expanding Medicaid coverage, based on evidence and their clinical observations.

Collaboration

Through their involvement with professional organizations like the ANA and state nurses’ associations like ANA Illinois or specialty organizations such as Emergency Nurses’ Association (ENA) or Case Management Society of America (CMSA), nurses can participate in larger advocacy campaigns. An example of this collaboration might be the development of a national campaign to address the nursing shortage. By pooling resources and expertise, these organizations can conduct research, publish findings, and present unified policy recommendations to lawmakers. Nurses can contribute by participating in surveys, sharing their experiences, and helping to draft policy statements that reflect the needs and challenges of the profession.

Public Engagement

Nurses engage in various activities to raise public awareness about health issues. For example, a nurse specializing in diabetes care might organize community workshops to educate the public about diabetes prevention and management, advocating for policies that support nutritional education and physical activity programs in schools. Similarly, nurses can use social media platforms to discuss the importance of vaccinations, debunking myths, and encouraging public support for vaccination policies. Public speaking engagements, such as at school boards or community centers, allow nurses to directly address concerns, share knowledge, and advocate for health policy changes that benefit the community.

Political Involvement

Nurses' involvement in the political process is crucial for advancing health policy. For instance, a nurse with experience in mental health services might support a candidate who prioritizes mental health reform, or they might volunteer to help with a campaign focused on improving mental health resources. Some nurses take their advocacy a step further by running for local, state, or national office, aiming to directly influence policy from within the political system. By holding office, nurses can more effectively champion health policy initiatives, introduce legislation, and work with colleagues to ensure that health policies are informed by clinical expertise and evidence-based practices.

Challenges in Policy Advocacy

Despite our critical role, we face several challenges in advocating for policy changes.

Limited Time and Resources: Given their primary commitment to patient care, nurses often find it challenging to allocate time and resources to policy advocacy efforts.

For example; Sarah, a registered nurse working in a busy urban hospital, is passionate about advocating for policies that improve patient safety and healthcare quality. However, her demanding work schedule, which often includes overtime and night shifts, leaves her with little energy and time to engage in advocacy efforts outside of her clinical responsibilities. This time constraint limits her ability to stay informed about policy developments, participate in advocacy groups, or attend legislative hearings that typically occur during her working hours.

Potential Solution: Hospitals and healthcare organizations could support nursing staff interested in advocacy by offering flexible scheduling options or dedicated time off for policy engagement activities. Additionally, establishing partnerships with advocacy groups could provide nurses like Sarah with resources and opportunities to participate in advocacy efforts more efficiently, perhaps through virtual platforms that fit their schedules.

Lack of Policy Education

Navigating Political Dynamics: The political nature of policy advocacy can be daunting, requiring nurses to navigate complex legislative processes and partisan dynamics.

Example: Alex, a nurse practitioner, is keenly interested in influencing healthcare policy to better address the needs of the underserved populations he works with. However, he finds himself at a disadvantage because his nursing education provided limited exposure to health policy, making it difficult for him to understand how to effectively advocate for change or where to access reliable policy information and analysis.

Potential Solution: Nursing education programs can integrate health policy into their curricula, offering courses that cover the basics of health policy, the legislative process, and advocacy strategies. Professional organizations could also offer workshops, webinars, and continuing education courses focused on policy education and advocacy skills, making it easier for nurses like Alex to acquire the knowledge needed to be effective advocates.

Navigating Political Dynamics

Linda, a nurse with decades of experience in public health, decides to advocate for more comprehensive community health services in her state. She quickly encounters the challenge of navigating the complex and often polarized political environment, where health policy decisions are influenced by various stakeholders with competing interests. Linda struggles to find common ground among legislators who have preconceived notions about healthcare funding and priorities.

Potential Solution: Nurses can benefit from mentorship and training on political negotiation and building bipartisan support for health policy initiatives. Joining forces with experienced lobbyists or advocacy organizations that understand the intricacies of political dynamics can provide nurses with the strategies and support needed to navigate these challenges more effectively. Engaging in coalition building with other healthcare professionals and patient advocacy groups can also amplify their voice and impact in political discussions.

Impact of Nurse Advocacy

The impact of nurse advocacy on health policy is profound. Nurses have been instrumental in advancing significant health policy initiatives, such as the Affordable Care Act, patient safety legislation, and scope-of-practice laws. Their advocacy has led to increased access to healthcare, improved healthcare quality, and enhanced patient safety. Moreover, nurses' involvement in policy advocacy has elevated the nursing profession, highlighting the critical role nurses play in healthcare beyond direct patient care.

Case Study: Illinois Nurses and the Nurse Licensure Compact Advocacy

The Nurse Licensure Compact (NLC) represents a significant policy initiative aimed at allowing nurses to have one multistate license, enabling them to practice in their home state and other NLC member states without obtaining additional licenses. This case study focuses on the efforts by Illinois nurses to advocate for the state's participation in the NLC, highlighting the strategies used, challenges encountered, and the outcomes of these advocacy efforts.

The NLC offers a solution to the nursing shortage by facilitating the mobility of nurses across state lines, thus improving access to healthcare, especially in underserved areas.

The advocacy campaign for Illinois to join the NLC involved coordinated efforts from various stakeholders, including nursing professionals, nursing associations like the American Nurses Association-Illinois (ANA-IL), Case Management Society of America, Chicago Chapter (CMSA Chicago) and other healthcare advocacy groups. Key strategies included:

- Education and Awareness Campaigns: Advocates sought to educate both the public and legislators about the benefits of the NLC, including enhanced nurse mobility, increased access to care, and improved disaster response capabilities.

- Lobbying Efforts: Nurses and their representatives engaged in direct lobbying efforts, meeting with state legislators to discuss the importance of the NLC and how it could address Illinois' nursing shortage.

- Coalition Building: Recognizing the power of numbers, Illinois nurses collaborated with other healthcare professionals, educational institutions, and patient advocacy groups to build a broad coalition in support of the NLC.

- Testimonies and Hearings: Nurses provided testimonies during legislative hearings, sharing personal stories and professional insights to illustrate the NLC's potential impact on healthcare delivery in Illinois.

Challenges

Advocacy efforts faced several challenges, including opposition from those concerned about state sovereignty over nursing licensure and fears that the NLC might lead to a reduction in nursing standards. Additionally, there was resistance due to concerns about potential revenue loss from out-of-state nurse licensure fees and the administrative adjustments required to comply with the NLC's provisions.

Some labor unions were wary of the NLC, fearing that it could lead to an influx of nurses from other states, potentially undermining local nurses' bargaining power and working conditions. A significant barrier to NLC adoption was the spread of misinformation about the Compact, including unfounded claims that it would lower nursing standards and compromise patient safety. The complexity of the legislative process itself presented challenges, including finding sponsors for the NLC legislation and navigating it through committees in the face of competing legislative priorities.

The path to NLC adoption in Illinois is fraught with challenges, from opposition based on concerns about state autonomy and economic impacts to fears about labor conditions and the spread of misinformation. Through targeted education, dialogue, and the presentation of evidence-based arguments, advocates continue to work to address these concerns, highlighting the NLC's potential to enhance nursing mobility, improve healthcare access, and maintain high standards of nursing practice. These efforts underscore the importance of clear communication, stakeholder engagement, and perseverance in advancing policy changes in the face of opposition.

Outcome and Impact

The advocacy efforts surrounding the NLC in Illinois demonstrate the complexities involved in policy change, especially when it requires balancing local control with the benefits of national standards and reciprocity.

Regardless of the immediate legislative outcome, the campaign for the NLC in Illinois has highlighted the importance of nurse advocacy in influencing health policy. It has shown that nurses, through organized and strategic advocacy, can play a pivotal role in shaping policies that affect the nursing profession and healthcare delivery across state lines.

The advocacy campaign for the Nurse Licensure Compact in Illinois exemplifies the critical role nurses play in health policy advocacy. Through education, lobbying, coalition-building, and personal testimonies, Illinois nurses have brought significant attention to the NLC and its potential benefits for healthcare access and quality. This example underscores the power of nurse advocacy in driving policy discussions and reforms, demonstrating the ongoing commitment of nurses to enhancing the healthcare system for the betterment of patients and the profession alike.

The process of advocating for the NLC in Illinois serves as a valuable lesson in the importance of persistence, collaboration, and effective communication in the pursuit of policy change. It reflects the broader challenges and opportunities faced by nurses as they seek to influence health policy in a way that supports the profession and improves patient care across the nation.

Conclusion

Nurses are indispensable advocates in the realm of state and national public policy. Through their unique perspective, evidence-based approach, and unwavering commitment to patient welfare, nurses influence health policy in ways that improve the healthcare system and public health outcomes. Despite the challenges, their advocacy efforts are crucial in shaping policies that reflect the needs and interests of patients and the healthcare community. As healthcare continues to evolve, the role of nurses in policy advocacy will undoubtedly expand, underscoring the importance of their voice in the ongoing dialogue about health policy and reform.

Nurses’ advocacy in public policy is not just beneficial but essential. It bridges the gap between clinical insights and policy decisions, ensuring that health policies are informed by on-the-ground experiences and aimed at optimizing healthcare outcomes. As nurses continue to navigate the complexities of health policy advocacy, their efforts will remain vital to the advancement of healthcare reform at both the state and national levels.

CE Test Questions

1. What role do nurses play in health policy advocacy at the state and national levels?

A) They solely focus on individual patient care.

B) They serve on advisory boards and participate in legislative committees.

C) They limit their advocacy to within hospital settings.

D) They provide financial support to healthcare institutions.

2. Nurses' involvement in policy advocacy is limited to educating policymakers.

True/False

3. Which strategy do nurses NOT use for effective advocacy?

A) Engaging in political campaigns

B) Limiting collaboration to within the nursing profession

C) Educating the public and policymakers

D) Running for political office

4. How has nurse advocacy impacted health policy?

A) By decreasing access to healthcare

B) Through the promotion of patient safety legislation

C) By reducing the quality of healthcare

D) None of the above

5. All nurses have formal education or training in health policy, which enhances their advocacy efforts.

True/False

6. What effect does nurse advocacy have on the nursing profession?

A) Diminishes the public's trust in nurses

B) Elevates the profession by highlighting nurses' roles beyond patient care

C) Has no significant impact on the profession

D) Reduces the scope of practice for nurses

7. Nurses' advocacy efforts are crucial for shaping policies that reflect the interests of healthcare providers only.

True/False

8. Which of the following is NOT a result of nurses' involvement in policy advocacy?

A) Increased access to healthcare

B) Enhanced patient safety

C) Reduced importance of evidence-based practice

D) Improved healthcare quality

9. What is a common challenge that nurses face when advocating for health policy?

A) Excessive free time for advocacy work

B) Overabundance of resources for advocacy

C) Navigating complex legislative processes and limited time

D) Lack of interest in policy outcomes

Correct Answer: C) Navigating complex legislative processes and limited time

10. Which of the following best describes the benefits of the Nurse Licensure Compact (NLC) as advocated by nurses?

A) Decreased nurse mobility between states

B) Enhanced nurse mobility and improved healthcare access

C) Increased healthcare costs due to multistate licensing

D) Reduced emphasis on patient safety

Illinois Nurses Foundation Announces Revamped Nurse of The Year & Lifetime Achievement Awards

The Illinois Nurses Foundation is thrilled to introduce the newly revamped and reimagined Nurse of the Year and Lifetime Achievement Awards! These prestigious honors have been updated to better reflect the incredible contributions and dedication of nurses in our community.

Nurse of the Year Award

Our Nurse of the Year Award celebrates the exceptional achievements and dedication of nurses who go above and beyond in their professional practice. This award is designed to recognize those who have demonstrated outstanding clinical skills, leadership, and a commitment to patient care. The selection criteria have been expanded to include:

Innovative Practices: Highlighting nurses who have introduced groundbreaking practices in healthcare.

Leadership Excellence: Recognizing those who have shown exceptional leadership within their teams and organizations.

Community Impact: Celebrating nurses who have made significant contributions to their communities through volunteer work or public health initiatives.

Nomination Process:

Any individual or organization may nominate a candidate for the Nurse of the Year Award by submitting a nomination form online. The nomination must include:

A nomination narrative (250-750 words).
One letter of recommendation that speaks to the nominee's qualifications.
A donation of $50 or above.

Lifetime Achievement Award

The Lifetime Achievement Award honors a distinguished nurse whose career has been marked by significant contributions to the nursing profession and healthcare. This award is a testament to a lifetime of dedication, excellence, and impact. Key aspects of the award include:

Career Contributions: Acknowledging a long-standing commitment to the nursing profession with a notable impact on healthcare.

Mentorship and Education: Celebrating those who have mentored and educated future generations of nurses.

Advocacy and Policy: Recognizing efforts in advocating for healthcare policies that improve patient care and nursing practice.

Nomination Process:

Any individual or organization may nominate a candidate for the Lifetime Achievement Award by submitting a nomination form online. The nomination must include:

A nomination narrative (500-1500 words).
Two letters of recommendation demonstrating the nominee's qualifications.
Resume or CV.
A donation of $250 or above.

We invite you to nominate outstanding nurses who exemplify excellence in their field. Join us in celebrating the remarkable achievements of these dedicated professionals!

For more information and to submit your nominations, please visit Nurse of the Year Award and Lifetime Achievement Award .

Let's honor the extraordinary contributions of nurses and their unwavering commitment to excellence in healthcare!

Nurses – the deadline to renew your IL RN, APRN, FPA license was June 30, 2024. If you

need to reinstate your IL nursing license, please complete and submit the request form

https://idfpr.illinois.gov/dpr/reactivate-your-license.html A reinstatement packet will be

provided for licenses which expired or went inactive less than five years ago. If you

have questions, please call 1-800-560-6420.

This webpage https://idfpr.illinois.gov/dpr/reactivate-your-license.html is available for

professionals looking to reinstate or restore Illinois professional licenses that expired

or were placed in inactive status by licensees. Any other inquiries submitted via this

page will NOT receive a response. The request is submitted online. A reinstatement

packet will be provided for licenses which expired or went inactive less than five years

ago.

Please utilize License Lookup if you do not remember your license number. On this

form, the top section: type of license: Nursing Board, then include your first name,

last name, state (Illinois) and “captcha” to find your Illinois license number

https://online-dfpr.micropact.com/lookup/licenselookup.aspx

For U.S. residents with an Illinois nurses license, to change your email address, U.S. mailing

address or phone number, please click on this link to update the information:

https://idfpr.illinois.gov/fpr-applications/licensereprint.html. This form is not for

international residents who must download a paper form found on that same page.

Military families: Members and Spouses who are an active duty member or whose active

duty service concluded within the preceding two years before application. In addition to

expedited review of your application (30 days), the Department’s dedicated Military Liaison

will work with you and your military installation’s military and family support center to help

you through the licensing process. Learn more here: https://idfpr.illinois.gov/military.html.

You may also email the Military Liaison using this email address:

fpr.militarylicense@illinois.gov.

• To print your license or download an electronic copy to your phone, just head to the IDFPR

website https://idfpr.illinois.gov/fpr-applications/getmylicense/loginprof.html.

The IDFPR “Requirements of an Internationally Educated Nurse” document is available

online here: https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/renewals/apply/forms/cgfns-02.pdf. Resources on this document include the names of Board of Nursing approved

vendors for items required to apply for an Illinois nurse license.

Information includes that endorsing an active license from another state requires: an application by Endorsement.
If the state of original licensure required a Credential Evaluation Service (CES) report at the time of original licensure, a (CES) report is not required for the Illinois licensure endorsement process.
An English equivalency test is not required as long as the nurse applying for Illinois endorsement took and passed the NCLEX® national licensure examination.

On the IDFPR Nurses webpage, there is a list of all 137 Illinois Board of Nursing approved

RN/Registered Nurse and LPN/Licensed Practical Nurse pre-licensure nursing education

programs: https://idfpr.illinois.gov/content/dam/soi/en/web/idfpr/forms/dpr/nurseschools.pdf.

A complete copy of the Illinois Nurse Practice Act and the Rules may be found on the Division

of Professional Regulation (DPR) Nurses webpage (https://idfpr.illinois.gov/profs/nursing.html).

or on the Illinois Nursing Workforce Center’s website (https://nursing.illinois.gov/nursing-

licensure/nursing-act-rules.html).

Applications for Full Practice Authority APRN (277) and Full Practice Authority APRN

Controlled Substance (377) licenses may now be completed online. Create an account

on IDFPR’s online portal (https://online-dfpr.micropact.com), select the applications, and

complete and submit them to IDFPR. Find helpful checklists for completing your application

here: https://idfpr.illinois.gov/dpr/professional-licensing-illinois.html.

Complaints against any individual or entity regulated by the Division of Professional

Regulation may be filed by following the instructions here:

https://idfpr.illinois.gov/admin/dpr/dprcomplaint.html. For a complete list of professions

licensed by DPR, please click here: https://idfpr.illinois.gov/Forms/Brochures/DPR.pdf.

The May 2024 enforcement report: https://idfpr.illinois.gov/news/2024/may-2024-

enforcement-report.html

Please note: Pursuant to Illinois law (20 ILCS 2105/2105-117), all information collected by

the Department during an examination or investigation of a licensee, registrant, or applicant

is confidential and cannot be publicly disclosed. This includes complaints and any

information collected during an investigation. Exceptions to this law exist only for law

enforcement, other regulatory agencies with appropriate regulatory interest, or a party

presenting a lawful subpoena. The Division of Professional Regulation online complaint form

may be found here: https://idfpr.illinois.gov/admin/dpr/complaint.html.

Reports: https://nursing.illinhois.gov/resources/data-reports.html

The Illinois Nursing Workforce Center conducted a voluntary survey participation with Illinois

licensed Licensed Practical Nurses (LPNs) through two email blasts on February 16 and

March 3, 2023. The data portal remained open from February 16 through March 21, 2023. A

total of 8,367 LPNs completed the survey for a survey response rate of 31%. Diversity: the

LPN workforce is the most racial and ethnically diverse of Illinois licensed nurses. There is

more racial and ethnic diversity in the LPNs that are less than 45 years of age.

Past IDFPR licensed nurse reports dataing back to 1984 are also on this webpage.

The purpose of the Illinois Nursing Workforce Center (INWC) is to address issues of supply and

demand in the nursing profession, including issues of recruitment, retention, and utilization of

nurse manpower resources. The INWC has sections with links to all levels Illinois nursing

education from pre-licensure to APRN specialization, links to continuing education

requirements for license renewal, links to annual IBHE and ISAC scholarships and

applications during application windows, and there are reports created with data

collected with past license renewal. Find those resources and more at

https://nursing.illinois.gov

Diversity, Equity & Inclusion Next Generation Scholarship	Shirley	Rivera	Chamberlain University
Diversity, Equity & Inclusion Next Generation Scholarship	Tiffany	Moore	Chamberlain University
Diversity, Equity & Inclusion Next Generation Scholarship	Sohaib	Mir	Rush University
Diversity, Equity & Inclusion Next Generation Scholarship	Daniela	Rendon	DePaul University
Diversity, Equity & Inclusion Next Generation Scholarship	Eric	Peprah Osei	University of Illinois Chicago
Diversity, Equity & Inclusion Next Generation Scholarship	Araceli	Orozco	Illinois State University
Arthur L. Davis Scholarship	Laurel	DeMay	MENP Program at DePaul University
D2 Scholarship	Alexus	Maldonado	University of St. Francis
D2 Scholarship	Brianna	Kelderhouse	University of St. Francis
D21 Scholarship	Claudia	Choe	University of Illinois Chicago
South Suburban Nursing Scholarship	Kayla	Savage	Saint Xavier University
Wendy Burgess Memorial Scholarship	Rebekah	Moeller	Loyola University Chicago
Wendy Burgess Memorial Scholarship	Lillie	Gorby	Loyola University Chicago
Sonne Scholarship	Cedar	Toavs	DePaul University
Alma J. Labunski Memorial Scholarship	Claire	Ginsberg	Loyola University
Alma J. Labunski Memorial Scholarship	Ji Na	Choi	North Park University
Alma J. Labunski Memorial Scholarship	Iram	Ahmad	North Park University