A Conversation with Associate Dean Dr. Scott Ziehm, newly elected President of the Board at the California Association of Colleges of Nursing (CACN)

Posted Thu, 09/20/2018 - 10:33

Congratulations Dr. Ziehm!

The California Association of Colleges of Nursing (CACN) represents colleges and universities offering baccalaureate and higher degree programs for California's nursing students. CACN began as a place for nursing deans and directors to network and discuss higher education issues and trends in the nursing profession. While this continues to be relevant, members are increasingly interested in extending their influence as nursing leaders through public advocacy and collaborating with state legislators to find effective ways of articulating the importance of the nursing profession in the future of healthcare.

In a publication from January 2018, Statewide political activism for California academic nursing leaders, CACN leaders detailed the process they led to assist other state organizations to move toward political activism in support of the nursing profession from the academic nursing leadership perspective. On September 15, 2018, we spoke with Scott R. Ziehm, DNP, RN, who was the lead author on this publication, to get his insights about some of the challenges and opportunities for CACN in the rapidly changing landscape of the nursing profession.

Dr. Ziehm, what has it taken to move CACN to this legislative advocacy role?

We began with very deliberate actions that started back in 2011 during a strategic planning process. CACN members wanted to be more politically active to advance the our discipline and nursing education. CACN members valued meeting twice a year in a conference format but realized our impact would be greater if we collaborated with others within the state. We had been too isolated to have the level of impact we wanted to have as an influential statewide nursing organization. California prides itself as being progressive and as the state that leads the nation - CACN members wanted CACN to be that voice for baccalaureate and graduate nursing education.

We hired a legislative lobbyist back in 2011, who primarily told us that we needed to come together with a unified, one voice perspective on issues that were important to us.

Subsequently, CACN members decided to write position statements on topics that were of concern to the members, which include: Support for innovation and nursing academy; Support full academic privileges for doctorally prepared nurse-academics; Support for BSN for entry practice for professional nursing, among others. The development of these position statements reflect the mission and vision of CACN as an organization, and also gave members an opportunity to develop a unified voice on current issues of interest to nursing education.

What are some successes and challenges CACN faces going forward?

The State of California is quite diverse with large metropolitan and rural areas, each with its unique healthcare needs. The conflicting priorities of these these geographic can at times divide us, it is not easy to intuitively understand the difference in nursing workforce needs in rural and urban areas. Additionally, the State of California has a large number of registered nurses and a large variation of academic institutions with nursing schools. There are differences in academic institutions, for instance, whether its a private or public school, or whether its a part of the UC, Cal State or Community College system that are defined by their respective charters. Furthermore, each school has it’s unique mission, vision, and ways of contributing to the Nursing profession. Given these differences, it can be challenging for nursing deans and directors to unify behind one-voice related to the complexities of higher education and healthcare policy.

CACN has been a place where we come together as a statewide organization. We learn from each other and work to move the organization forward as a unified front. However, we realize in some discussions there are issues that CACN does not want to address. Staying focused on what is relevant to the whole has been how we have had of our greater successes.

With that in mind, and as a response to the strategic plan created back in 2011, in 2017 CACN members made our first visit to the legislative offices in Sacramento. That visit was very successful. CACN members unanimously voted to continue to dedicate the spring conference to visiting Sacramento legislators. We’ve become more active on policy issues, raise a unified voice in support of policy matters about nursing education and health care.

Started in 2017, repeated in 2018, and we are in the planning stages for our third visit to Sacramento in March of 2019.

What are your hopes for the future direction of CACN?

Regional Nursing Summit 2018 at Irvine, CACACN has been working in collaboration with the California Board of Registered Nursing (BRN) and other statewide organizations to plan the BRN Regional Summits. Over the next several weeks, the CA BRN, healthcare employers, union representatives and nursing academic leaders within each region will address issues related to clinical placements in pre-licensure nursing education. The goal is to identify better ways to sustain adequate clinical capacity and clinical placements for all types of pre-licensure nursing programs.

CACN is also focusing our efforts on the importance of masters and doctoral nursing education and meeting the full range of California’s nursing workforce needs. We recognized that CACN has been heavily focused on pre-licensure nursing education and clinical placement issues. However, CACN also represents the voice for nursing masters and doctoral education. Graduates from our nursing programs address the full-range of California’s nursing workforce needs. Nursing deans and directors with our faculty are part of the solution addressing the nursing shortage, the need for nurse practitioners to meet the scarcity of primary care providers as well as the nursing faculty insufficiency. We also have expertise related to caring for individuals and their families so CACN will also engage on legislative issues that address population health, including the opioid epidemic.

We need to get behind focused legislation so that we can be a greater force in a way that we are targeting our energies.

How will these changes affect the work of Advanced Nurse Practitioners?

In California, advanced practice registered nurses (APRN) need to be independent healthcare providers. While APRNs in some states like California have had to practice under the supervision of physicians, the tide is changing. There is recognition that nurse midwives and nurse practitioners deliver high-quality services - APRNs are cost-effective, and are increasingly valued as healthcare providers by the public. During this last year two California bills supporting greater independences for NPs and midwives did not move to a vote but both will be resurrected in 2019. CACN wants and is dedicated to helping pass legislation so the APRNs and midwives can practice in remote and rural areas of California where their services are in tremendous demand independently from physician oversight.

This map shows that California is the only West Coast state that does not actually allow for independent practice of NPs.  This map image titled, "Scope of practice for nurse practitioners" shows that California is the only West Coast state that does not allow for independent practice of NPs.

Nursing deans and directors have a wide sphere of influence that can help mobilize legislative change and address issues facing healthcare, with the support and input of the wider nursing community we can be successful. It comes down to unifying a voice, public advocacy, education and bringing stakeholders from all levels to the political process. CACN is already engaging in this kind of work.

Congratulations Dr. Ziehm! We at University of San Francisco School of Nursing and Health Professions look forward to following you and CACN as it makes progress within the legislative advocacy journey.