WEBVTT 00:00:04.992 --> 00:00:08.440 position:50% align:middle - [Jim] So, the next session on our agenda this afternoon is 00:00:08.440 --> 00:00:11.410 position:50% align:middle "To the Capitol and Beyond! Taking Policy Risks." 00:00:11.410 --> 00:00:19.147 position:50% align:middle As you can see, the presenter is Dr. Maryann Alexander, and that's not me. 00:00:19.147 --> 00:00:26.263 position:50% align:middle I'm going to step in and give Maryann's presentation today. 00:00:26.263 --> 00:00:28.120 position:50% align:middle So, welcome to St. Augustine. 00:00:28.120 --> 00:00:33.225 position:50% align:middle The city was founded in 1565 by Spanish explorers. 00:00:33.225 --> 00:00:38.880 position:50% align:middle As I understand it, it's the oldest continuously inhabited European-established settlement 00:00:38.880 --> 00:00:41.469 position:50% align:middle in the contiguous United States. 00:00:41.469 --> 00:00:46.774 position:50% align:middle As you look out to the seashore, or go into the historic parts of town, 00:00:46.774 --> 00:00:50.533 position:50% align:middle you can't help but recognize the beauty of this area. 00:00:50.533 --> 00:00:53.138 position:50% align:middle Personally, I'm looking for the fountain of youth. 00:00:53.138 --> 00:00:57.258 position:50% align:middle I understand it's somewhere around here, anything that I can maybe do to get rid of the circles 00:00:57.258 --> 00:00:58.524 position:50% align:middle and the bags around my eyes. 00:00:58.524 --> 00:01:01.561 position:50% align:middle I haven't found it yet, but if you happen to visit there before we leave, 00:01:01.561 --> 00:01:03.044 position:50% align:middle please let me know where it's at. 00:01:03.044 --> 00:01:10.231 position:50% align:middle As you look through the agenda, and you look towards the event on Friday, 00:01:10.231 --> 00:01:14.252 position:50% align:middle you might question, just a little bit, why the Kennedy Space Center? 00:01:14.252 --> 00:01:18.566 position:50% align:middle What is the connection between the Space Center and public policy? 00:01:18.566 --> 00:01:20.891 position:50% align:middle I asked myself this same question. 00:01:20.891 --> 00:01:25.369 position:50% align:middle I'm excited about getting to go, but just trying to understand what the connection between the two. 00:01:25.369 --> 00:01:29.833 position:50% align:middle So, our theme for this meeting is boldly exploring. 00:01:29.833 --> 00:01:36.738 position:50% align:middle You can't explore, you can't be an explorer without being willing to take on risk. 00:01:36.738 --> 00:01:42.004 position:50% align:middle You know, I think about when we were playing as children. 00:01:42.004 --> 00:01:48.060 position:50% align:middle We all wanted to dress up as cowboys, cowgirls, or maybe you wanted to be an astronaut. 00:01:48.060 --> 00:01:49.794 position:50% align:middle Those were the two big ones for us. 00:01:49.794 --> 00:01:53.684 position:50% align:middle You wanted to take on those risks and go exploring. 00:01:53.684 --> 00:01:57.894 position:50% align:middle Some really might argue that there is no greater risk than space exploration. 00:01:57.894 --> 00:02:00.923 position:50% align:middle That would be the penultimate type of risk. 00:02:00.923 --> 00:02:06.030 position:50% align:middle So Maryann was sharing with me that, in 1999, she was attending a meeting 00:02:06.030 --> 00:02:08.407 position:50% align:middle at the National Institutes of Health. 00:02:08.407 --> 00:02:12.009 position:50% align:middle As I understand it, there was a lot going on at that time. 00:02:12.009 --> 00:02:15.005 position:50% align:middle NIH had its own moonshot, if you will. 00:02:15.005 --> 00:02:15.733 position:50% align:middle They had a... 00:02:15.733 --> 00:02:18.461 position:50% align:middle They were working on cracking the genetic code. 00:02:18.461 --> 00:02:25.323 position:50% align:middle They had recently signed off on the guidelines for stem cell research, and that information was being forwarded 00:02:25.323 --> 00:02:27.556 position:50% align:middle to President Clinton for his approval. 00:02:27.556 --> 00:02:33.552 position:50% align:middle In addition to all of this, protection of human subjects 00:02:33.552 --> 00:02:36.341 position:50% align:middle had become a significant issue. 00:02:36.341 --> 00:02:40.569 position:50% align:middle There were a number of research studies at hospitals, at universities, 00:02:40.569 --> 00:02:46.287 position:50% align:middle even with the Department of Veterans Affairs, that had been shut down because of concerns 00:02:46.287 --> 00:02:49.811 position:50% align:middle about the impact on the human subjects. 00:02:49.811 --> 00:02:53.160 position:50% align:middle Violations had occurred, and the government was stepping in 00:02:53.160 --> 00:02:54.839 position:50% align:middle and was about to crack down. 00:02:54.839 --> 00:02:59.008 position:50% align:middle An alphabet soup of government agencies were convened for this meeting. 00:02:59.008 --> 00:03:04.129 position:50% align:middle There were representatives from universities the country, from hospital systems. 00:03:04.129 --> 00:03:08.341 position:50% align:middle They were all here to examine the issues and come up with solutions. 00:03:08.341 --> 00:03:13.599 position:50% align:middle Maryann explained that all the usual players that you would expect at a meeting of this caliber were there. 00:03:13.599 --> 00:03:20.439 position:50% align:middle People from HRSA, from Health and Human Services, from Food and Drug Administration, they were all there, 00:03:20.439 --> 00:03:24.363 position:50% align:middle making introductions and asking questions as they were going around the room. 00:03:25.239 --> 00:03:30.562 position:50% align:middle She said, next, someone from NASA spoke up, and everyone's heads kind of whirled around, 00:03:30.562 --> 00:03:35.816 position:50% align:middle trying to figure out what in the world is someone from NASA doing at this meeting? 00:03:35.816 --> 00:03:38.240 position:50% align:middle Why would they even be present? 00:03:38.240 --> 00:03:46.992 position:50% align:middle And what is their connection to the impact of research on human subjects, or public policy, for that matter, 00:03:46.992 --> 00:03:48.430 position:50% align:middle anything that was being discussed. 00:03:48.430 --> 00:03:53.062 position:50% align:middle And, as I understand it, one of the participants kind of said as much, you know, 00:03:53.062 --> 00:03:53.905 position:50% align:middle "What are you doing here? 00:03:53.905 --> 00:03:55.545 position:50% align:middle What's the purpose of this? 00:03:55.545 --> 00:03:58.223 position:50% align:middle And they indicated that... 00:03:58.223 --> 00:04:04.620 position:50% align:middle The representative from NASA stood up and said that their astronauts were human subjects 00:04:04.620 --> 00:04:09.330 position:50% align:middle who took bigger risks than participants in any type of clinical trial. 00:04:09.330 --> 00:04:13.375 position:50% align:middle These were the...or any type of research project. 00:04:13.375 --> 00:04:15.865 position:50% align:middle The astronauts were taking that ultimate risk. 00:04:15.865 --> 00:04:22.438 position:50% align:middle Those astronauts that have come through the space program over the years have changed the world 00:04:22.438 --> 00:04:25.725 position:50% align:middle more than you and I could ever begin to imagine. 00:04:25.725 --> 00:04:30.474 position:50% align:middle Through those great risks have come incredible benefits to our world. 00:04:30.474 --> 00:04:36.873 position:50% align:middle Even the roots of telemedicine are entwined with NASA's earliest days 00:04:36.873 --> 00:04:38.783 position:50% align:middle and the modern history of human spaceflight. 00:04:38.783 --> 00:04:43.202 position:50% align:middle I mean, they had to be able to monitor the impacts of space travel on the human body. 00:04:43.202 --> 00:04:47.874 position:50% align:middle What was the absence of gravity going to do to the circulatory system? 00:04:47.874 --> 00:04:49.277 position:50% align:middle What was it going to... 00:04:49.277 --> 00:04:50.938 position:50% align:middle How was it going to impact the body? 00:04:50.938 --> 00:04:56.022 position:50% align:middle How were we going to be able to monitor the health of the astronauts that are at the Space Station? 00:04:56.022 --> 00:05:02.741 position:50% align:middle There are so many things in our world today that have been impacted because of the space program. 00:05:02.741 --> 00:05:10.110 position:50% align:middle Dr. Jordan was talking about President Kennedy's address at Rice University in 1962. 00:05:10.110 --> 00:05:16.718 position:50% align:middle And when the President was discussing the necessity for the United States to become an international leader 00:05:16.718 --> 00:05:22.063 position:50% align:middle in space exploration, he didn't say, "We want to go to the moon," 00:05:22.063 --> 00:05:25.377 position:50% align:middle or "We would like to go to the moon," or "It might be a good idea." 00:05:25.377 --> 00:05:30.518 position:50% align:middle He said, "We choose to go to the moon," and do the other things, not because they are easy, 00:05:30.518 --> 00:05:31.998 position:50% align:middle but because they are hard. 00:05:31.998 --> 00:05:39.518 position:50% align:middle That was an incredible display of human will, of political will, being able to step out there 00:05:39.518 --> 00:05:40.872 position:50% align:middle and say, "We're going to do this. 00:05:40.872 --> 00:05:41.984 position:50% align:middle I'm going to lead us. 00:05:41.984 --> 00:05:45.001 position:50% align:middle We're going to do this because it's what we need to do as a country." 00:05:45.001 --> 00:05:51.876 position:50% align:middle The greater the risk, oftentimes, the greater the benefit. 00:05:51.876 --> 00:05:57.762 position:50% align:middle You know, there was a great risk for the space program, but out of that came an incredible benefit. 00:06:00.912 --> 00:06:07.611 position:50% align:middle I think anytime you take on that kind of risk, and then you see the success from it, 00:06:07.611 --> 00:06:12.441 position:50% align:middle there is an exhilaration that comes from the accomplishment, from that achievement. 00:06:12.441 --> 00:06:14.921 position:50% align:middle And it motivates us to go on and try to do more things. 00:06:14.921 --> 00:06:20.640 position:50% align:middle It motivates us to go on and tackle new ideas, and keep pressing forward. 00:06:20.640 --> 00:06:31.646 position:50% align:middle Let's rewind about 45, 46, 47, 48 years to another time that risk came into play. 00:06:31.646 --> 00:06:34.516 position:50% align:middle These are some of the founders of NCSBN. 00:06:34.516 --> 00:06:40.646 position:50% align:middle If you look across the screen, you see Joyce Schowalter, Mildred Schmidt, 00:06:40.646 --> 00:06:44.137 position:50% align:middle Trudy Malone, Elaine Elibee, and Pat Keefe. 00:06:44.137 --> 00:06:48.643 position:50% align:middle I can remember them because of the conference rooms at NCSBN. 00:06:48.643 --> 00:06:51.827 position:50% align:middle That's forever memorialized there. 00:06:51.827 --> 00:07:00.683 position:50% align:middle Their idea of an organization solely for the regulator, that really must have seemed like a moonshot 00:07:00.683 --> 00:07:04.043 position:50% align:middle at that time, and for those individuals. 00:07:04.043 --> 00:07:09.879 position:50% align:middle There was a huge risk in even talking about separating from the American Nurses Association. 00:07:09.879 --> 00:07:13.931 position:50% align:middle You know, from a political standpoint, it wasn't a favorable idea. 00:07:13.931 --> 00:07:18.057 position:50% align:middle ANA would be losing some of its most influential members. 00:07:18.893 --> 00:07:24.233 position:50% align:middle They'd be losing the ones who really had all the power and authority, quite honestly, they'd be stepping out. 00:07:24.233 --> 00:07:27.253 position:50% align:middle The idea was met with great dissension. 00:07:27.253 --> 00:07:30.820 position:50% align:middle And then, to top it all off, they had no money. 00:07:30.820 --> 00:07:31.580 position:50% align:middle There was no budget. 00:07:31.580 --> 00:07:33.750 position:50% align:middle There was no way for them to accomplish this. 00:07:33.750 --> 00:07:36.030 position:50% align:middle But they kept asking the question, "Why was it necessary?" 00:07:36.030 --> 00:07:37.700 position:50% align:middle It was the right thing to do. 00:07:37.700 --> 00:07:42.880 position:50% align:middle Having the regulator be part of the professional association, how could you do both? 00:07:42.880 --> 00:07:45.680 position:50% align:middle And that was one of the things that those ladies kept questioning. 00:07:45.680 --> 00:07:47.978 position:50% align:middle It's just the right thing to do. 00:07:47.978 --> 00:07:52.711 position:50% align:middle All the risks were present, but there still seemed to be a substantial benefit 00:07:52.711 --> 00:07:55.670 position:50% align:middle for stepping out and taking that move. 00:07:55.670 --> 00:08:01.497 position:50% align:middle How can you be part of a professional association and still be responsible for protecting the public? 00:08:01.497 --> 00:08:03.876 position:50% align:middle It just didn't seem to make sense. 00:08:03.876 --> 00:08:09.532 position:50% align:middle Dr. Jordan mentioned that, in leadership, you never know exactly what the ending is going to be, 00:08:09.532 --> 00:08:14.660 position:50% align:middle but you have to be willing to step out and take that move to see what's going to happen. 00:08:14.660 --> 00:08:18.056 position:50% align:middle It was a lesson in risk and public policy. 00:08:18.056 --> 00:08:25.078 position:50% align:middle At the 1975 House of Delegates for the ANA, a vote was planned to talk about the creation 00:08:25.078 --> 00:08:27.687 position:50% align:middle of a new agency, a new organization. 00:08:27.687 --> 00:08:34.061 position:50% align:middle And being politically savvy and astute, Mildred Schmidt knew that the vote... 00:08:34.061 --> 00:08:35.706 position:50% align:middle they didn't have the votes. 00:08:35.706 --> 00:08:40.956 position:50% align:middle It wasn't going to go their way, and it was probably going to fail, and if it did, 00:08:40.956 --> 00:08:45.096 position:50% align:middle she knew that it was going to be a long time before there was the political will, 00:08:45.096 --> 00:08:51.577 position:50% align:middle before there was the ability for them to bring it up again if it failed that time, 00:08:51.577 --> 00:08:55.566 position:50% align:middle just difficult to stir that appetite, to get people to move on again. 00:08:55.566 --> 00:08:59.401 position:50% align:middle So, in a brilliant policy move, Miss Schmidt came up with the idea of taking 00:08:59.401 --> 00:09:00.662 position:50% align:middle an incremental step. 00:09:00.662 --> 00:09:02.672 position:50% align:middle She said, "Let's create a study group. 00:09:02.672 --> 00:09:09.442 position:50% align:middle Let's create a task force that can review the idea, can take a year, bring the information back 00:09:09.442 --> 00:09:11.752 position:50% align:middle at the next House of Delegates. 00:09:11.752 --> 00:09:14.451 position:50% align:middle It gave everybody an opportunity to kind of think about it. 00:09:14.451 --> 00:09:19.857 position:50% align:middle It gave the task force the ability to create some goodwill, to get their ducks in a row, 00:09:19.857 --> 00:09:20.945 position:50% align:middle to build support. 00:09:20.945 --> 00:09:27.951 position:50% align:middle And the House of Delegates that year supported that move and gave them the task force. 00:09:27.951 --> 00:09:33.834 position:50% align:middle Now, the study group was comprised of members of various boards of nursing, along with Barbara Nichols. 00:09:33.834 --> 00:09:39.223 position:50% align:middle Barbara was included to represent ANA's point of view, and she agreed to be part of the workgroup. 00:09:39.223 --> 00:09:41.119 position:50% align:middle Now, this was a huge risk for Barbara. 00:09:41.119 --> 00:09:47.637 position:50% align:middle As I understand it, she was preparing to run for president of the ANA the next year, 00:09:47.637 --> 00:09:53.366 position:50% align:middle and being associated with this group, it just wasn't going to be politically savvy for her 00:09:53.366 --> 00:09:55.525 position:50% align:middle to take part of it. 00:09:55.525 --> 00:09:58.584 position:50% align:middle At the end of the year, a feasibility study was proposed. 00:09:58.584 --> 00:10:01.721 position:50% align:middle And look what we have today. 00:10:01.721 --> 00:10:07.011 position:50% align:middle Out of that moonshot, out of that idea, we have the National Council of State Boards of Nursing. 00:10:07.011 --> 00:10:11.033 position:50% align:middle The resources that are provided to many of your organizations as Boards of Nursing, 00:10:11.033 --> 00:10:15.966 position:50% align:middle everything that we do here has public protection at the forefront. 00:10:15.966 --> 00:10:19.581 position:50% align:middle The member networking and engagement that are provided to each of us. 00:10:19.581 --> 00:10:25.371 position:50% align:middle And then, stop and think about the information that has been gleaned over the past 45 years. 00:10:25.371 --> 00:10:29.691 position:50% align:middle Being on the cutting edge of testing, research, licensure, discipline, 00:10:29.691 --> 00:10:34.273 position:50% align:middle and all of this that's been provided for us, because of those founding individuals, 00:10:34.273 --> 00:10:40.178 position:50% align:middle their willingness to take that risk, to take a step out, to have that moonshot idea, 00:10:40.178 --> 00:10:44.231 position:50% align:middle and be willing to take the risk to see what was going to happen. 00:10:44.231 --> 00:10:48.400 position:50% align:middle This organization was born out of the founders' moonshot. 00:10:48.400 --> 00:10:50.652 position:50% align:middle You might ask, 'What happened to Barbara Nichols?" 00:10:50.652 --> 00:10:53.128 position:50% align:middle Well, she did become president of the ANA. 00:10:53.128 --> 00:10:56.998 position:50% align:middle She had a solid foundation of relationships that she had built. 00:10:56.998 --> 00:11:00.193 position:50% align:middle You know what, that's one thing that you don't wait to do when you need it. 00:11:00.193 --> 00:11:02.797 position:50% align:middle You don't wait until you need those relationships. 00:11:02.797 --> 00:11:06.113 position:50% align:middle You start building them on the front side so that you've got that political capital, 00:11:06.113 --> 00:11:11.036 position:50% align:middle you've got that information saved up in the bank for when you need it. 00:11:11.036 --> 00:11:16.682 position:50% align:middle Barbara Nichols and those founding individuals knew that it was okay to take the risk, to asses the risk, 00:11:16.682 --> 00:11:20.750 position:50% align:middle to count the cost, to minimize the risk where possible, and to strategize. 00:11:20.750 --> 00:11:25.236 position:50% align:middle So, we brought you here today to help prepare you. 00:11:25.236 --> 00:11:27.222 position:50% align:middle It's okay to take a risk. 00:11:27.222 --> 00:11:30.601 position:50% align:middle There are going to be things in your journey, as a leader, as a regulator, 00:11:30.601 --> 00:11:32.050 position:50% align:middle where you're going to have to take a risk. 00:11:32.050 --> 00:11:37.570 position:50% align:middle You're going to have to identify and evaluate the risks, and then, also consider the potential benefits 00:11:37.570 --> 00:11:39.125 position:50% align:middle that the outcomes may bring. 00:11:39.125 --> 00:11:44.290 position:50% align:middle You'll minimize the risk through effective policy, prepare and educate the stakeholders 00:11:44.290 --> 00:11:46.060 position:50% align:middle about any residual risks. 00:11:46.060 --> 00:11:53.083 position:50% align:middle And we want to equip you to prepare and strategize, and ultimately be ready for the unexpected. 00:11:53.083 --> 00:11:57.170 position:50% align:middle So, we brought you to St. Augustine to boldly explore the ideas, to network, 00:11:57.170 --> 00:12:01.110 position:50% align:middle to spend some time together to see how we can energize you and motivate you. 00:12:01.110 --> 00:12:04.344 position:50% align:middle Start thinking about what your bold exploration will be. 00:12:04.344 --> 00:12:08.633 position:50% align:middle When you head home on Friday, you will have been provided the tools and resources 00:12:08.633 --> 00:12:11.858 position:50% align:middle to help you craft effective public policy. 00:12:11.858 --> 00:12:16.047 position:50% align:middle We're going to learn about the past so that you can help prepare for the future. 00:12:16.047 --> 00:12:20.867 position:50% align:middle And, hopefully, you will have been inspired and be ready to go back and enact change. 00:12:20.867 --> 00:12:23.119 position:50% align:middle What's your moonshot going to be? 00:12:23.119 --> 00:12:25.358 position:50% align:middle Is it going to be something at the State Capitol? 00:12:25.358 --> 00:12:30.892 position:50% align:middle Is it going to be building...creating local momentum on a particular issue? 00:12:30.892 --> 00:12:33.669 position:50% align:middle Is it going to be just changing the culture in your organization? 00:12:33.669 --> 00:12:34.419 position:50% align:middle What's it going to be? 00:12:34.419 --> 00:12:36.157 position:50% align:middle Maybe it's going to be something national. 00:12:36.157 --> 00:12:42.502 position:50% align:middle Perhaps you'll be influencing policy decisions, policy perspectives at the federal level. 00:12:42.502 --> 00:12:44.969 position:50% align:middle Maybe, maybe it's going to be international. 00:12:44.969 --> 00:12:51.059 position:50% align:middle Maybe you're going to be working on legislation that allows nurses to practice across international borders. 00:12:51.059 --> 00:12:58.899 position:50% align:middle Just perhaps it's going to be beyond the borders of this world, and into orbit, into space. 00:12:58.899 --> 00:13:00.911 position:50% align:middle You know, that's really not that far away. 00:13:00.911 --> 00:13:07.426 position:50% align:middle As I understand it, Johns Hopkins already has a program for nurses where nurses can participate 00:13:07.426 --> 00:13:12.089 position:50% align:middle in the space program, whether it be monitoring the astronauts as they're in space, 00:13:12.089 --> 00:13:17.523 position:50% align:middle or eventually practicing in space, sending nurses as astronauts. 00:13:17.523 --> 00:13:22.666 position:50% align:middle Don't forget, the possibilities that you have as a regulator, and as a leader, 00:13:22.666 --> 00:13:24.960 position:50% align:middle are endless and out of this world. 00:13:24.960 --> 00:13:30.114 position:50% align:middle Your small step may be a giant leap for nursing regulation. 00:13:30.114 --> 00:13:32.471 position:50% align:middle I hope each of you have a wonderful time this week. 00:13:32.471 --> 00:13:33.992 position:50% align:middle Enjoy the conference. 00:13:33.992 --> 00:13:36.635 position:50% align:middle If there's anything that we can do, please let us know. 00:13:36.635 --> 00:13:39.536 position:50% align:middle At this point, we'll have a break out in the lobby. 00:13:39.536 --> 00:13:43.784 position:50% align:middle And then we'll come back in at 2:30 for our next session. 00:13:43.784 --> 00:13:45.961 position:50% align:middle Thank you very much, and have a good afternoon.