In the FY 2000 Budget, Representative Christine Canavan, RN, successfully passed an amendment, which she proposed to establish a "special Commission to investigate and report on matters affecting the practice of nursing and the delivery of healthcare services by nurses". This has been fondly dubbed the Nursing Commission. The Governor vetoed this section, but with MNA's assistance, Rep. Canavan succeeded in getting a unanimous override vote from the House of Representatives. The Senate followed her lead with another unanimous override vote. I had an opportunity to interview her and ask about her vision of the Commission's purpose, expectations and projected timetable.

Craven. Can you tell me why you filed an amendment to the budget to establish this Nursing Commission?

Rep. Canavan. "It's about time that nurses should take advantage of three nurses in the state legislature. I'm hoping that this process will allow nurses to talk to nurses. The problems facing nurses today are better understood by other nurses. I frequently get calls from nurses about the fears and difficulties they are facing at work. Instead of taking these calls individually, the Commission can allow for a public discussion of these issues as they effect not only nurses, but every citizen in the Commonwealth."

Craven. Please explain how the amendment forms the Commission membership.

Rep. Canavan. "The fact that the amendment survived the budget process at all, is amazing. The Senate obviously has a keen interest in addressing this same issue. The original amendment language did not have any senators to be appointed, but we very much welcome the senators' input. They serve large and diverse populations. We hope to bring this Commission to the places where nurses are, all over this state."

The Commission language, which is now law, establishes an appointed body of five Representatives and five Senators. They are to be appointed by the Speaker of the House and the Senate President, respectively. The Commission is charged with "gathering information from health care providers and licensed or unlicensed employees, on the impact of their job performance of any/all current regulations, promulgated by any and all state agencies. This information will be compiled for a comprehensive review of the efficacy of any and all regulations on indirect and/or direct patient care." In addition, the commission may report to the General Court the results of its investigation and study and its recommendations, if any, together with drafts of legislation necessary to implement them, by filing with the Clerks of the House and the Senate by December, 2000.

Craven. How do you envision that this Commission will undertake its work?

Rep. Canavan. "The first step is getting the appointments made so the Commission becomes a reality. I expect then, that we will hold a number of hearings across the state. I would like to try to cover every district. I would also like to include many participants to testify, including, but not limited to: individual nurses, nursing organizations, schools of nursing and the Board of Registration in Nursing. I expect to have from six to eight hearings in 2000. I would also like to schedule them at scattered hours to accommodate the many different working schedules of nurses. I really want nurses to fill us in on their difficulties and experiences. These may be shared in person or in writing. Most importantly, I want nurses to voice any and all solutions they would offer to solve these problems. I want to help nurses have a safer environment in which to work and deliver care."

Craven. What do you hope is the outcome of this process?

Rep. Canavan. "I want to hear what the media doesn't necessarily print and what legislators don't gets the chance to know. I want to hear about nursing practice at the day to day staff nurse level. What is it like under regulations that have changed practice because of Medicare reimbursement, hospital consolidation, replacement by unlicensed personnel and the nurse's attempt to deliver safe and competent care?

Nursing schools teach us to be advocates for the patients, but current practices make this impossible for nurses. How can nurses meet this mandate in the current health care environment?

I also want to know what are the positive programs and ideas that do work. I would like to hear from employers who do support nurses.

I am concerned about nurses'concerns regarding maintaining their license in good standing. I have reviewed the proposed new regulations by the Board of Registration in Nursing. I also know of many of the concerns of nursing organizations.

I believe the Nursing Commission is an actual opportunity for nurses to have some public say, which will have members of their profession who are legislators, listen. When they speak to us about life on their shift, their language, terminology, and actions will be understood. We will know what they are talking about."

"In the current environment, too many non-licensed personnel are making the decisions about how we practice our profession. It is our hope that this Commission remedies that. I hope that we hear from people who have not had the opportunity to testify, who may be shy, who may have beeen uninvolved in safeguarding their profession before. I hope to talk to nurses who have been working on these issues, too."

"The whole point of the Commission is for positive results. The Speaker of the House, Representative Thomas Finneran has already shown considerable support for this work. I expect that will be enjoyed through the life of the Commission's work. One blessing of a two-year session is that the second half of the session is not as hectic. I expect to complete this work by the Spring of 2000 and file a report to the Clerk in a timely manner so any decision by leadership to file any legislation before the deadline date can be made. I am thankful that the MNA has also been critical to the formation of this Commission to date. This is historic for nursing in Massachusetts."

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