President's Point

NONPF Newsletter, Volume 12, Number 3, 2001

Serving as the President of NONPF is a most rewarding leadership journey. The president has the opportunity to partake in some wonderful challenges along this journey, and one example is the Primary Care Policy Fellowship (PCPF) sponsored by the US Public Health Service. NONPF nominates its presidents to compete for one of the 30 Fellowships available each year, and I was chosen for the 2001 session.

The PCPF lasted for 4 weeks—1 week each in February and March, and 2 weeks in June. The Fellows came from all primary care related disciplines—nursing, medicine, dentistry, dental hygiene, pharmacy, social work, systems management. We came from all parts of the country and were diverse in terms of ethnicity, education, political persuasion, gender, and professional and personal experiences.

The major assigned task was for the Fellows to produce a primary care policy paper with recommendations for the Secretary of Health and Human Services, Tommy Thompson. The Fellows were to form interdisciplinary teams, and each team would advance a different policy change. Sounds simple? It was not simple but highly challenging and truly gratifying.

How did the program prepare us for this task? We started with a weeklong series of presentations from leaders in health related organizations, including (forgive the acronyms) DHHS, HRSA including the Bureau of Health Professions with the Division of Nursing, AHRQ, HCFA (now CMS), VA, Indian Health Service, and others. The presentations offered too much content to assimilate but were great to hear and discuss and to ponder the vastness of US health bureaucracy. The second week targeted leadership development—a series of activities and events to increase self awareness (strengths and weaknesses) and creativity, improve team work, and generally get to know the group well enough to form stable teams to produce the policy papers. We were mixed and matched time and again, so we got to know one another pretty well.

The second half of the Fellowship consisted of 2 weeks in DC filled with activities: Conferences; more lectures; presentations on budgeting; a great policy analysis of the effects of the new tax cut on health spending; site visits to the HCFA and VA offices; lobbying on the Hill during the week the Senate Committees were turning over to the Democrats; and media training (outstanding!). We had team meetings and more meetings and burned midnight oil to produce the final, polished policy paper. We had ample opportunity to apply the leadership principles we learned during the second week.

Our experiences culminated in presentations by each team to the Deputy Secretary for the Department of Health and Human Services, Dr. Claude Allen. We did not know for sure when we would present or to whom until shortly before the actual presentation. As one of the 4 presenters (2 were NPs—Carolyn Montoya of ACNP was the other), I had practiced my 5 minute talk in front of the team several times and many more times with a superb coach, fellow nurse Barb Douglass, CNM from California. The critiques were tough—“you were great, except for…” — from 30 reviewers. All 4 teams performed beautifully. Although Deputy Allen had been in the position only 10 days, he was open and aware, asked in depth questions, and was extremely supportive of the process. We were very pleased to have such a high level and meaningful discussion so early in his tenure.

What did I learn? Even after years of working shoulder to shoulder with clinicians from other disciplines, this experience expanded and refined my understanding of interdisciplinary collaboration more than any other. The group's diversity and motivation led us to a concept and a paper that each member of the team could support—the intent, the language, the domains, the players, the costs. In the true vein of trans-disciplinary functioning, we transcended allegiance to our own disciplines to reach a more inclusive and more realistic paper. Rest assured, nursing values were well represented, but I learned to use systems language so other disciplines could grasp and perhaps accept the intention more fully. Pulling that paper together was a bigger task than I expected (all that work for just 2 pages and 5 minutes of presentation??), but reaching agreement on all points took time. Plus, we wanted to make an impact by selecting a universal and pressing health care need, conveying the urgency, and proposing solutions. I think we accomplished our goal, but you can look on the web site and judge for yourself.

After completing both the Robert Wood Johnson Executive Nurse Fellowship and the USPHS Primary Care Policy Fellowship this year, I appreciate the worth of such training. To those of you who aspire to leadership roles or simply find yourself in one, I recommend that you pursue the highest possible level of leadership training. NONPF is currently seeking funding for our Leadership Institute to prepare NONPF members for more advanced leadership positions. In the meantime, NONPF has exemplary leadership opportunities through its committees, Board positions, special interests groups, and task forces. Participating on the national level provides a broader policy perspective, occasions to collaborate with other organizational leaders, and many opportunities to be proactive. You, too, can be NONPF president and be selected for the Primary Care Policy Fellowship!

Ever onward,

Lucy Marion, PhD, APRN, BC, FAAN