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The stated purpose of the Nurse in Washington Internship (NIWI) program is "to provide nurses the opportunity to learn how to influence health care through the legislative and regulatory processes. Participants learn from health policy experts and government officials, network with other nurses, and visit members of Congress."


The objectives of NIWI are the following:


1. Describe how nurses can be involved and influence policy at the local and national level


2. Discuss how to work effectively with legislative staff to advance policy agenda


3. Network with other nurses with similar clinical/political interests


4. Describe key steps to effect change in the legislative process


5. Identify techniques to advance legislative issues at the grassroots level


6. Identify legislative, political, and economic forces driving healthcare policy and delivery changes today



Basically, I found through my participation in NIWI that it is advocacy training for nurses so that they can effectively meet with their congressional representatives both in Washington, DC, and in their district offices. For those without a basic understanding of government and the legislative process, it provided a good overview.


The NIWI program is open to any nurse who wishes to attend the training, but most of those in attendance were from various nursing alliance organizations. Some of these organizations have specific legislative agenda, such as the Emergency Nurses Association, and others do not. NIWI developed an overarching agendum where they asked participants to discuss with their individual legislators, which included supporting $200 million for the Nursing Workforce and Development programs at Health Resources and Services Administration in fiscal year information 2008 funding (see "Take Action to Support the Nation's Nurses" handout and other faxed documents). NIWI's agendum is for the broad community of nursing and would be easily supported by all nursing organizations.


Nurse in Washington Internship training is 312 days and includes one partial day visiting members of Congress. Participants are asked to visit both their senators and local congressperson. One nurse from North Carolina and I visited these three offices and met with healthcare policy staff. We were not able to meet with the senators or representatives because of their schedules.


As far as outcomes are concerned, it is hoped that NIWI participants remain in contact with their congressional representatives and continue to advocate for nursing issues. Since the National Nursing Staff Development Organization (NNSDO) does not have a legislative platform, I can certainly see how the broad NIWI positions could easily be adopted by NNSDO and communicated to the membership. This could be a good start on developing NNSDO's own specific platform related to nursing education issues. It would also plant the seed for our members that we not only have to be aware of legislation, but that we also must be active in influencing it.


Along with this, the other aspect that might be helpful for NNSDO members is a basic primer on the how-tos of advocacy. Such topics as finding legislation information online, gathering background information on relevant topics, and identifying individual congresspersons and senators and their positions on healthcare issues would be good starting points. An interesting point that I learned at NIWI is that the House of Representatives has a Nurse Caucus and that my representative is an active and supportive member of it. I wonder how many NNSDO members (or nurses in general for that matter) know if their individual representative is a member of the Nurse Caucus.


In summary, I think that there is great potential for NNSDO to move forward on educating our members about advocacy and influencing the legislative process. As far as a legislative platform is concerned, we can certainly use the NIWI issues as a start and then proceed from there.


Summarized by


Mary E. Holtschneider


Legislative Liaison



In 2005, NNSDO was invited to join an independent panel of nurse leaders from clinical, research, and academic settings on genetics and genomics. To add a new subspecialty to the education of all nurses is an overwhelming undertaking, and this consensus panel met to plan why and how this change could occur. After this meeting, the knowledgeable leaders composed the booklet "Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics." NNSDO endorsed these competencies. In 2006, the original group met again to establish how these recommendations could be met. A time line was established, and four goals were prioritized. The following delineates the progress made toward those goals.


Each of the four goals of the Strategic Implementation Plan has seen activity. Much work remains to be done, but progress has been made towards achieving each goal.



Provide the structure, direction, and focus for all efforts identified under the three critical goal areas of Practicing Nurses, Academics, and Regulation/Quality Control as well as provide centralized coordination of strategic plan activities.


1. Developed a framework for the U.S. Center of Genetic Nursing Education


* Have submitted two separate proposals for funding


* Unfortunately, neither has been funded


* Continue to explore financial support


2. Established and maintained a Competency Initiative Listserve


3. Established a Competency Activity Matrix to track all activities


4. Established a core slide set for dissemination of the competency information


5. Developed a newsletter article template distributed to all endorsing organizations updating them on this initiative.




All nurses in practice will have a foundation of knowledge in basic human genetics and genomics and current applications to nursing practice.


1. Developed and received IRB approval for a pilot test of a nursing survey to assess baseline nursing competency in genetics and genomics


* Will be followed by a national survey in collaboration with the American Nurses Association


* Data will be compared to data from a family practice physician survey


2. Presentations at or scheduled for the following meetings:


* Sigma Theta Tau




* American Academy of Nursing


* American Association of Colleges of Nursing (AACN)


* International Society for Nurses in Genetics


* National League for Nursing


3. Worked with the Nephrology Nursing Society to develop a genetic/genomic chapter for the Core Curriculum for Nephrology Nursing


4. Partnered with organizations to move genetics and genomics forward for their constituency


* Sigma Theta Tau


* American Nurses Association


5. Lobbied for inclusion of the Competencies in the Newly Developed Breast Care certification to be offered by the Oncology Nursing Certification Corporation


6. Completed a series of genetics/genomics in nursing in the Journal of Nursing Scholarship, now being published as a book.



All nurses will have a foundation of knowledge in basic human genetics and genomics and current applications to nursing practice.


1. Developed and received funding for a collaborative meeting with AACN to establish


* Learning outcomes and practice indicators


* A multimedia faculty genetic/genomic tool kit


2. Participated and presented on the Competencies at the AACN meeting to revise the Baccalaureate Nursing Essentials


3. Distributed the Competencies to all 1,626 Schools of Nursing in the United States and Territories


4. Developed and received approval for a session on Implementing the Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics at the AACN Baccalaureate Education Conference, November 2007


5. Partnered with the Human Resources and Services Administration Bureau of Nursing to


* Identify opportunities for funding


* Recruit experts who would be willing to pursue funding for projects related to nursing faculty development




Genetics and genomics are included practice contents on assessments of quality healthcare outcomes.


1. Developed a proposal for a State of the Science meeting to establish research priorities that will serve as the underpinning for the development of research that produces the essential outcome data needed to incorporate genetics and genomics into NCLEX and accreditation.


2. Distributed the Competencies to all 59 United States and Territories State Boards of Nursing



This review is by no means complete but provides you with an update of some progress in implementation to date. If you would like more information about any of the above, please contact Dr. Mary Krugman, the NNSDO representative to the genetics and genomics initiative. Dr. Krugman's e-mail address is