Journal of Nursing Law, Volume 13, Number 1, 2009
The Office of the National Nurse
Teri Mills, MS, RN, ANP, CNE
Alisa Schneider, MSN, RN
The health of our nation is deteriorating; our health care system is in crisis. Nursing is strategi-
cally positioned to be the driving force for change within the health care system. Nurses across the
country and internationally are uniting behind the initiative to establish the Office of the National
Nurse (ONN), a federal office of prevention led by a nurse within the current U.S. Public Health
Service structure. Collectively, nurses have had great influence on formation of this initiative into
policy for implementation, yet a few select national nursing organization decision makers oppose
the policy initiative, attempting to silence the collective voice of nurses calling for change. Nurses
are ready to address not only their concerns about workplace and workforce issues but are equally
eager to develop a collaborative system of nursing leadership for the health of the country. Policy
for this new era will require a willingness from within the profession to embrace change to improve
the health of Americans.
Keywords: Office of the National Nurse; public health; prevention; health policy; nursing
leadership
A
s the largest health care workforce in the 50 million uninsured; additionally, many more Ameri-
country, nurses have led major change in the cans are underinsured, and as the economy worsens,
health care system. Nurses are becoming more these numbers are sure to rise. In 2008, the American
politically astute and using their collective power to be public was informed that total health care spending
instrumental in making changes in workplace and work- is projected to reach $2.5 trillion, or 17.2% of the U.S.
force issues and patient safety, as well as to increase the Gross Domestic Product (ABC News, 2007) and it will
numbers of students entering nursing education. Nurses increase if nothing is changed. The American Diabetes
are now calling for a transformation from the current Association (2008) reports that the total estimated
sick care system to one of health care. In collabora- cost of diabetes care in 2007 was $174 billion and that
tion with others concerned about the wellness of the 54 million additional Americans have pre-diabetes,
nation, they are uniting behind the policy initiative to placing them at high risk for developing Type II diabe-
establish an Office of the National Nurse (ONN) within tes. Although our country has economically benefited
the U.S. Public Health Service (USPHS). Despite the call from the development of medications and treatments
for reform, implementation of policy for a new era of for the management of chronic diseases like diabetes,
prevention will require innovative, visionary, and politi- we face a $58 billion reduction in national productivity
cally sophisticated leadership from within nursing. related to diabetes alone (American Diabetes Associa-
tion, 2008), and as this is the impact of just one chronic
A SYSTEM IN CRISIS disease, we simply cannot continue to accept this as
justification for continuing as we are.
The health of our nation is deteriorating; our health
care system is in crisis. There are increasing epidem-
Epidemics
ics of preventable diseases, health disparities continue,
and health literacy remains a problem for far too many America prides itself on being the wealthiest power in
people. There has been little focus on prevention in the world, but when it comes to health care we have little
the current system and the country is in a constant to boast about. Eighteen other countries are doing better
state of reaction to these factors. We now have nearly at reducing preventable deaths than the United States
Copyright 2009 Springer Publishing Company • 13
DOI: 10.1891/1073-7472.13.1.13
14 • Journal of Nursing Law • Vol. 13, No. 1
(Dunham, 2008) and the United States ranks 29th among And although improvements in numbers of those attain-
all industrialized countries in infant mortality (Harris, ing basic education have been seen across the country,
2008). Every year, $1.3 trillion is spent on managing the minorities continue to have lower education rates; in
impact of the seven most common chronic diseases, and order to use current computerized health care and edu-
if we continue with the current efforts to address these cation services, a high level of literacy is necessary.
conditions there will be a 42% increase in cases of these
same diseases (DeVol et al., 2007). The country is faced Poor Health Literacy
with deciding how many more trillions of dollars we are
The current health care system has a high expectation
willing to spend to maintain the status quo.
of the consumer, who must be able to