By Carole Koelle
Inland Valley Daily Bulletin
October 3, 2010

Assemblyman Curt Hagman's attack on registered nurses and our professional voice, the California Nurses Association, in a recent point of view (Sept. 23), and the bill he has sponsored to dictate what nurses are able to learn to better advocate for our patients, symbolize what is at stake for California patients and nurses in the November election.

Spurred by Meg Whitman's similar offensive against nurses and CNA this year, it is clear that Hagman's bill and commentary are part of a concerted effort to silence the collective voice of RNs and blunt our ability to work together to protect our patients.

That assault comes at a critical juncture. Our health care system remains in crisis, with big health insurers pushing through new double-digit premium increases, rampant denials of needed care, and the introduction of changes in the delivery of care at the bedside that too often compromise the safety of patients.

Hospitals and other providers today receive the bulk of their revenue from financing arrangements which have reversed the priorities of our medical system from providing care to maximizing profits or surplus revenue that often involves limiting access to care, ignoring individual patient need, and disregarding minimum standards of safe, quality care.

Against this backdrop patients need a strong, independent voice, backed by our unified ability to stand up to hospital managers or insurance bureaucrats to assure our patients get the appropriate care they need when they need it.

RNs are uniquely qualified to fill that role, as a result of both our legal and ethical responsibility to advocate for our patients under California law, and the breadth of our education and clinical knowledge and experience.

But to properly fulfill that role, we need to be able to be fully up to date on the ever evolving dramatic changes in the health care industry and the means to meet our professional obligation to protect and independently advocate for the interests of our patients.

Essential to the performance of our responsibilities are our continuing education courses which inform and provide us the ability to evaluate and respond to dangerous industry practices, both in patient care settings where we work and in the regulatory and legislative forums which govern our practice.

Yet Hagman, as a stalking horse for Whitman, the insurance giants and other opponents of our professional union, now seek to severely restrict our ability to provide safe care in the exclusive interests of our patients, in this case by effectively destroying the essential continuing education foundation of our professional practice.

With this shortsighted and dangerous bill, they want to redefine our educational curriculum to what is deemed acceptable by Whitman, Hagman and a health care industry whose interests are contrary to the interests and safety of our patients and the professional responsibilities of RNs.

To see the future of where that could lead, look at the Texas educational system where political extremists have sought to rewrite American history into a politically correct script that would leave Texas students ill prepared to compete with students in other states or countries where political extremists are not limiting what they can learn.

Every year, CNA takes positions on hundreds of pieces of legislation and regulatory developments affecting our patients, our practice and our profession.

Our patient advocacy approach meets the core purpose of RN continuing education established by the Nursing Practice Act. Further, our program has become a model for winning real safe patient care reform all throughout the nation, as it was when CNA sponsored California's landmark law requiring safe staffing in hospitals through legally enforced minimum, specific RN-to-patient ratios.

The fruits of that law, achieved against the opposition of the Hagmans of the day, became apparent earlier this year in a landmark national study from the University of Pennsylvania which found that similar New Jersey and Pennsylvania hospitals had 14 percent and 11 percent, respectively, more patient deaths as a result of not meeting our gold standard in safer staffing.

That's the reality of what we study in our educational classes - not the falsehoods that Hagman and Whitman's handlers purport - and why it is so critical that we be able to continue those programs without the political branding that Hagman would impose.

Carole Koelle, RN, is a member of the California Nurses Association Board of Directors. She lives in Apple Valley.