The 2016 Presidential Election: Reality vs. Myths.

Politics in a democracy requires governance through debate. Nurses are an important part of the voting public and we need to assess our own anger, expectations, and values for this election. Recognizing four myths during this election season can improve the political conversation. This conversation must acknowledge different groups, interests, and opinions and then seek ways to balance or reconcile those interests. Using this as a mental model to define our politics rather than succumbing to divisive rhetoric, we can take a major step toward building a better political system.

Election 2016: Where Are We with the Affordable Care Act?

As this election campaign, like many, has been more about personality than policy, it is important to remember that positions on policy are the real substance of election outcomes. Although health care is ranking lower than other national issues in the minds of voters, it remains a vital topic. Nurses need to stay informed on this important issue, especially regarding the policy proposals from both parties and candidates

Transforming Mental Health Care: Starting with Change Around the Edges.

It is essential for those of us who work in health professions to recognize the good work individuals and organizations are doing to improve the delivery of mental health services in communities across the country. Despite their allure, new practices and radical innovations are hard to come by and resisted by many organizations. Programs like Mental Health First Aid and Make It Ok are examples of how a program can alter a person's understanding of mental illness. Without knowing about successes and new models of care, nurses cannot be as strategic in their efforts to influence meaningful social and systemic change. Changes at the edges of the health care system are happening in the care of mental illness. Changes must continue to be made that will eventually make their way into the center.

Reframing Political Differences: One Conversation at a Time.

The profession of nursing, by it's very nature, is wrought with significantly complex moral and political disagreements. These issues cannot simply be avoided by being relegated to private discussions because their resolution is crucial to the common good. It is important for nurses to develop skills in public discourse if we are to bridge the political divide and influence local, state, and national policy. Failure to do so will leave us with ineffective and dismissed voices.

Dismantle or Improve ObamaCare? Nurses Must Take Action.

Following the 2014 mid-term elections, what will the next 2 years of Republican leadership do to change the structures still being put into place to meet the goals of the Affordable Care Act (ACA)? Nurses need to be visible by creating partnerships with their new state and federal representatives and by demonstrating collaboration through identified shared values. Nurses must hold all congressional leaders accountable for continuing to improve access to quality and affordable health care, while containing costs and strengthening incentives to provide a client-centered approach to care delivery. As health care reform legislation is a highly charged political battleground, nurses must support legislative changes in the ACA that will strengthen our health care system, not weaken it.

Health insurance exchanges: A call for nursing action.

State health insurance exchanges will provide the opportunity for consumers to have options regarding health insurance coverage. Nurses have a vital role to play in the implementation of exchanges. Knowing the basic facts about how these exchanges will work, what the benefits will be, and access to reliable information sources will enable nurses to provide trusted guidance. The development of this new insurance marketplace is also an opportunity to address the long-standing barriers to advance practice registered nurses (APRN) practice.

Madness in America: holding a rational conversation.

The random, unexpected killing of 20 innocent children in Newtown, CT, touched us all. Targeting people with mental illness who use firearms as the problem in such tragedies is a poor simplification. Delivery of quality care for complex chronic health problems like severe mental illness and substance abuse requires a systematic coordinated effort with resources and expert capacity. We need a health care system that can assess and provide care for the severely mentally ill who may be at risk for becoming violent. Let's challenge the status quo and not simply blame mental illness for these tragedies. As the largest health profession in this country, nurses can make a difference by using the evidence regarding mental illness and violence to hold crucial and rational conversations.

The 2012 election: your vote is your voice.

In this presidential election, as the largest group of health care providers, nurses are witness to the impact of effective and failed health care policies across all health care settings on individuals, communities, agencies, and states. Nurses have a responsibility to not only be informed and participating voters, but we also need to inform those around us on how the current health policies are improving or preventing the delivery of access to quality, cost-effective care. Nurses have the opportunity and responsibility to be key informants regarding the impact of health care reform on the health care delivery system, on the profession, and on health care outcomes. The collective voice of 3.1 million nurses could change the results of this close election.

Quality in life and death: can we have the conversations?

As nurses, we participate in providing social justice through the delivery of health care. While much of what we do supports healthier lifestyles and healing, we must also acknowledge that for an increasing number of our patients, life may have become irreversibly painful and unwanted. Nurses have acute sensitivity to the dilemmas faced by dying patients and their families. Our empathy and know-how in such cases dictates that we make an effort to relieve such suffering. Easing suffering will require assessments of the changing terrain of end-of-life care and the populations receiving that care. Dialogues can bridge the interest of patients, providers, and policymakers and ultimately legislation that reinforces ethical end-of-life care and ensures a voice for those who will be most affected.

The future of the Affordable Care Act: will we abandon health care reform?

With obstacles to the Affordable Care Act (ACA) growing, nurses need to continue to educate themselves about the ACA and the issues it is designed to address. While it has many shortcomings, the ACA invests in creating a new infrastructure that holds the potential to improve care quality and contain costs. Health economist Victor Fuchs suggests three areas must change if we are to have a health care system that is quality focused: information, infrastructure, and incentives. The current health care legislation is noble and lays a basis for future structural cost containment. The health care system continues to unravel as our politicians remain polarized over reform efforts. We must engage or we will never find solutions, never see reform.

From Wall Street to Main Street: how will the economic meltdown impact health care reform?

What will happen to health care in the wake of the financial market crisis? Many health policy and economic experts are asking whether it is possible for any of the promises for health care reform to be realized. We could find ourselves in a catastrophic collision between national security priorities and domestic policy goals. Nurses must be vocal regarding the need to reform health care or it may be sidestepped if budgeting continues to prioritize the war abroad and not the crisis at home.

Immigration and health care reform: shared struggles.

The connection between health care and immigration share overlaping key areas in policy reform. General concern, anger, and fear about immigration has been spreading nationwide. While illegal immigrants' use of expensive emergency department services does add to the cost for uncompensated care, this expenditure is not a primary cost driver but more a symptom of little or no access to preventative or primary health care. As a result of federal inaction, more state politicians are redefining how America copes with illegal residents including how or whether they have access to health care. The overlap of immigration and health care reform offers an opportunity for us to enter the next round of debate from a more informed vantage point.

Ten lessons in collaboration.

Collaboration is a substantive idea repeatedly discussed in health care circles. The benefits are well validated. Yet collaboration is seldom practiced. So what is the problem? The lack of a shared definition is one barrier. Additionally, the complexity of collaboration and the skills required to facilitate the process are formidable. Much of the literature on collaboration describes what it should look like as an outcome, but little is written describing how to approach the developmental process of collaboration. In an attempt to remedy the all too familiar riddle of matching ends with means, this article offers key lessons to bridge the discourse on collaboration with the practice of collaboration. These lessons can benefit clinical nurse managers and all nurses who operate in an organizational setting that requires complex problem solving.