Why I’m Leaving the American Nurses Association

Please read my first ever policy-oriented piece in the Healing Newsletter

Deciding not to renew my American Nurses Association’s (ANA) membership was a tough decision. Many bedside nurses might think it shouldn’t have been since they have never felt the ANA really represents the rank-and-file. I understand their complaints, but the problem for me is I like to believe people will rise to the occasion during critical situations. Therefore, during the pandemic I kept believing that the American Nurses Association would embrace their primary mission and start to really advocate for frontline nurses by say, promoting safe staffing legislation along with increased pay for nurses. Because that never happened—or at least not in a way that satisfied me—soon I will no longer be a member of the ANA.

ANA’s refusal to stand up for nurses during Covid became apparent during the last presidential election, when the ANA did not endorse Joe Biden for President. They chose not to endorse either candidate, even though former President Trump mocked masking, resisted authorizing the Defense Production Act for manufacture of personal protective equipment, and repeatedly muddied the public health waters by promoting ineffective and sometimes dangerous treatments for Covid. Those behaviors put nurses at increased risk of infection and death during the pandemic, and nurses died of Covid during Trump’s presidency, though it’s hard to say exactly how many. As of March 17, 2021, Covid had felled an estimated 1140 nurses in the U.S. The ANA made a political decision at odds with valuing nurses’ lives, and that bothered me…a lot.

As the pandemic continued to wear down nurses and other health care workers, including physicians, ANA kept a great dashboard of increasing levels of nurse burnout and short staffing, but instead of advocating for real solutions to these real problems with the health care work environment, they went the “self-care” route instead. “Self-care” seems unobjectionable on the surface, but it becomes suspect when promoted as a cure for work stresses that go way beyond what a yoga class or meditation app can help with. Overworked nurses sometimes confronted with more death in a day than they used to see in a week need administrative and mental health support, not, for example, a special kind of shower head. And yet, a shower head was one of ANA’s offerings, until this ad got deleted from Twitter:

Copied from a retweet posted October 2021.

Continuing in the “self-care” track, the May 2022 issue of American Nurse magazine—the “Official Journal of the ANA”—promoted “On-The-Job-Self-Care” on the cover. The accompanying article, called “Self-care during a single shift,” and one suggestion in particular, was what led me to finally give up on the ANA. Here it is:

“The Pause” was developed by nurse Jonathan Bartels at UVA to give Emergency Department staff a moment to stop and collect themselves with a shared moment of silence following a patient’s death. It’s a great idea and has been recommended as standard practice for all EDs. The “Pause at the Pump,” though, puts a mental health burden on overworked nurses at a key moment of clinical care. Nurses sanitize our hands every time we leave a patient’s room, and usually when pumping out sanitizer we are reviewing that last patient encounter and thinking about what action we need to take on their behalf: get pain medicine, check a test result, call the physician with a question. To suggest filling that instant with a self-care mantra or prayer implies that it is empty static time, which it isn’t. In fact, overworked nurses have no static time at all and the idea that meditating while cleaning their hands might in any way address nurses’ considerable on-the-job stress was the last straw for me.

So much of what plagues nursing right now is staffing—there aren’t enough nurses working in hospitals, and as a result nurses burn out and quit while patients also suffer. The “Nurse Staffing Think Tank: Priority Topics and Recommendations that I found on the ANA website reveals ANA’s indolent approach to the problem of staffing. The very first sentence says, “The nurse staffing crisis has no simple fix.” This is categorically wrong. During the pandemic, travel nurses willingly worked hard in stressful situations because they were earning much more money than usual. The economics are basic and undeniable: nurses, like most other employees, will stay on the job if they are adequately compensated. It is simple.

In addition to higher hourly wages, requiring safe staffing at hospitals and skilled nursing facilities is also needed to retain nurses. Pay nurses more to get them to return to the bedside, and then make rules that keep nurses from working short, to keep them from giving up.

This is where my real heartbreak with the ANA comes from. Under “Nurse Staffing Crisis” on the ANA website, the problems with nurse understaffing are detailed, but their “Action” recommendations include writing to your member of Congress, or leaving your story on the ANA website. That is not advocacy.

It may seem that I am calling out the ANA to purposefully criticize them, that I’m willing to burn this bridge to give my gripes the legitimacy of outrage. But I honestly do not want to burn a bridge and I’m not letting my membership expire because I’m outraged. I’m calling out the ANA because I want the pain nurses went through during Covid, and the difficulties they continue to face, to be taken up by the ANA in a substantive way. There are four million nurses in the U.S. I want the ANA to represent all of us, to harness the power of those four million voices by working hard for nurses. I want the ANA to be worthy of the name American Nurses Association.

REMINDER: You can sign up for my virtual event on June 23 at 6pm ET by clicking HERE.