American Nurse Advocacy
Institute (ANAI)
In October 2016, the authors at-
tended the American Nurse Advo-
cacy Institute (ANAI) in Wash-
ington, DC. ANAI, a year-long
mentorship program hosted by
the American Nurses Association
(ANA), develops political leader-
ship skills and prepares program
graduates to serve as advocacy
mentors to colleagues and state
organizations.
Over several days, Ashlee and
Caroline met with ANA staff
members and RN representatives
from 18 states. They participated
in educational sessions, including
political environmental scans and
digital advocacy. RNs also met
with senators, representatives,
and staffers to discuss ANA’s leg-
islative priorities and bills.
After returning to Pennsylvania,
Ashlee and Caroline implemented
a project to promote RN advo-
cacy for individuals affected by
the state’s opioid epidemic. As pe-
diatric RNs, Ashlee and Caroline
focused their project on helping
children affected by parental opi-
oid abuse, specifically maternal
opioid abuse.
Early Education
Prior to ANAI, Ashlee, with the
support of PSNA, testified in
front of the Pennsylvania House
of Representatives House Com-
mittee on Children and Youth
on the topic of caring for babies
with neonatal abstinence syn-
drome (NAS). Careful research
and thought was put into craft-
ing a factual and heartfelt testi-
mony. Testimony was provided to
Issue 73, 1 2018 Pennsylvania Nurse 16
representatives on the commit-
tee and field experts, including
pediatricians, neonatologists, and
children social services. The testi-
mony aimed to provide firsthand
accounts of the impacts of NAS
on children and Pennsylvania’s
communities. In addition, the
testimony advocated for improved
access to preventative substance
abuse treatment for women of
childbearing years.
PSNA’s mentorship and commu-
nication with the Department of
Government Affairs led Ashlee
to feel confident in presenting
frontline staff experiences related
to the cries of NAS babies. While
it was an intimidating experience
for a RN who was new to advoca-
cy work, it was a valuable learn-
ing opportunity. Policy should
be shaped and guided by content
experts and professional experi-
ences. Testimony by professional
nurses provides a voice to unique
populations served by RNs. It is
this testimony that shapes health
policy and protects the most vul-
nerable people in our society.
After the field experts presented
the dire situation of the Common-
wealth and its infants, the House
committee formed a taskforce to
continue efforts to decrease the
incidence of NAS and improve
the early detection of NAS. The
county social services programs
have become overwhelmed with
referrals of NAS babies while fac-
ing limited resources. The legisla-
tors needed to hear from content
experts to understand the situa-
tion. Once the taskforce was au-
thorized, working groups formed
to begin tackling the problem of
NAS in Pennsylvania.
Additional Research
The authors also focused on
Pennsylvania legislation related
to the opioid epidemic, including
mandated reporter requirements.
It can be difficult to categorize
information when reporting NAS.
While seeking clarity on the
subject, Ashlee was connected
with the National Center on Sub-
stance Abuse and Child Welfare
(NCSACW). The organization’s
mission is to “improve family
recovery, safety and stability by
advancing practices and collabo-
ration among agencies, organiza-
tions and courts working with
families affected by substance use
and co-occurring mental health
disorders and child abuse or ne-
glect” (NCSACW, 2018, para. 2).
Next, Ashlee was linked to a
Pennsylvania Department of
Health workgroup for substance
exposed infants where she was
formally asked to join the Multi-
Disciplinary Workgroup on
Infants with Substance Exposure
as a professional nursing and
PSNA representative. The group
consists of professionals from the
PA Department of Health, De-
partment of Corrections, Ameri-
can Academy of Pediatrics, PA
American Congress of Obstetri-
cians and Gynecologists, Hospital
and Health System Association
of Pennsylvania, National Center
on Substance Abuse and Child
Welfare, and other professional
organizations. The goal is to use a
public health approach to mini-
mize prenatal exposure to sub-
stances and improve infant, child,
and family outcomes. The group
is committed to actionable work
to serve these families. Action
items have consisted of creating