Smoking cessation efforts had been gaining ground for decades. Tobacco use and smoking rates were dropping, year after year, as prevention and awareness campaigns worked to codify the dangers of tobacco. People weren’t just quitting smoking; people were avoiding the habit altogether—until the advent of vaping. Reversing a decade-long decline in smoking rates, e-cigarettes and vaping products have engendered an entirely new generation of would-be smokers to pick up the habit. Targeting underage users, the vaping industry experienced a boom. The issue grew with such ferocity that the U.S. Surgeon General declared a youth vaping epidemic in 2019.

To better understand the demands and demographics of the larger RN community, the Health Resources Services Agency (HRSA) compiled data from the National Sample Survey of RNs (NSSRN). Released in January 2020, the report is a compendium of information and questions RNs have answered about different aspects of the life and work. The data collected since 1977 provides insight into the latest trends and future workforce projections, and HRSA uses it to help allocate workforce resources.

In 2020, approximately 13,800 new cases of invasive cervical cancer will be diagnosed in the United States. Prevention and screening are critical to reducing its incidence, and the U.S. Department of Health and Human Services (HHS) launched an awareness campaign in January in recognition of Cervical Health Awareness Month. The movement educates women about cervical cancer risks, how and when to get the human papillomavirus (HPV) vaccine, the vaccine’s impact on cancer rates, and how to promote awareness.

The push and pull of budget negotiations makes for great headlines, but more important is the outcome when lawmakers finally arrive at a consensus. Earlier in December, the National Institutes of Health announced a $2.6 billion overall increase in funding, including a $297 million increase to the National Cancer Institutes (NCI), for fiscal year 2020.

In celebration and recognition of Florence Nightingale’s 200^th birthday, the World Health Organization (WHO) designated 2020 as the “Year of the Nurse and Midwife.” As part of this initiative, WHO is holding seminars, publishing papers, and is developing the first-ever State of the World’s Nursing report which will release at the 73rd World Health Assembly.

Congress returned from the winter holiday season to an administrative announcement partially curtailing flavored e-cigarettes and vaping mechanisms. Additionally, the U.S. Food and Drug Administration (FDA) began the year with the announcement of a new policy prioritizing enforcement against certain unauthorized flavored e-cigarette products to help curb the youth smoking epidemic. However, to the chagrin of the smoking cessation community, FDA is still allowing menthol and traditional tobacco flavors to be sold as usual, and reports have indicated that teens and other underage users will still opt for traditional products if they’re available.

Amid the epidemic levels of youth use of e-cigarettes and the popularity of certain products among children, the U.S. Food and Drug Administration today issued a policy prioritizing enforcement against certain unauthorized flavored e-cigarette products that appeal to kids, including fruit and mint flavors. Under this policy, companies that do not cease manufacture, distribution and sale of unauthorized flavored cartridge-based e-cigarettes (other than tobacco or menthol) within 30 days risk FDA enforcement actions.

Constitutional provisions, whose primary purposes are to create obstacles, govern the process that a bill goes through before it becomes law. The founders believed that efficiency was the hallmark of oppressive government, and they wanted to be sure that laws that actually passed all the hurdles were the well-considered result of inspection by many eyes.

Participants in ONS’s Fourth Annual Capitol Hill Days quickly saw the fruits of their efforts when two ONS priority bills were passed in the U.S. House of Representatives in October 2019. The yearly advocacy, education, and training event, held September 22–24, brought 110 ONS activists to Washington, DC, for two days of sessions, briefings, updates, and meetings. The advocates engaged in 55 hours of intensive political and policy analysis, enabling them to take the Society’s health policy priority agenda to the U.S. Congress and help transform the future of health care in the United States.

The Elijah E. Cummings Lower Drug Costs Now Act of 2019, otherwise known as H.R. 3, is a top priority for House Speaker Nancy Pelosi (D-CA). But she’s facing challenges from progressive Democrats on her left more so than the conservative Senate on her right. Watering down provisions in H.R. 3 too much will lose her the votes she needs to pass the bill in the House, but passing a bill that’s too overarching or progressive will allow Senate Majority Leader Mitch McConnell (R-KY) to refuse to take up the legislation at all.

Addressing the rising costs of prescription medications is a key priority for the Trump administration. As patients struggle with the financial burden of high drug prices, the U.S. Food and Drug Administration is reviewing options to import medications from Canada at a lower cost to consumers. However, the plan has major hurdles that FDA must address before it can become a reality.

The vaping conversation has drawn the attention of everyone on Capitol Hill, and it’s been a contentious debate so far. Tensions were high at the White House during a meeting with smoking cessation advocates after the Trump administration decided to step back from promises to ban flavored vaping products.

In 2018, long-time National Institute of Nursing Research (NINR) Director Patricia Grady, PhD, RN, FAAN, retired. A national search yielded no new directors, and the National Institutes of Health appointed Principal Deputy Director Lawrence Tabak, DDS, PhD, to serve as acting NINR director. However, when the director of the National Institute of Dental and Craniofacial Research announced she would retire at the end of 2019, Tabak, who previously served as the dental agency’s director, was appointed as the obvious replacement.

Throughout the country, Americans have seen the effects of opioid abuse. Rising numbers of overdoses have sent shockwaves through communities from Miami to Seattle and everywhere in between. As such, addressing the national opioid epidemic is still a major priority for the Trump administration.

Tobacco products are under more scrutiny than ever before. With the rise in youth vaping, the advent of flavored e-cigarettes, and the production of other nicotine delivery systems, the U.S. Food and Drug Administration (FDA) has tightened its review process for new products. The agency is looking to the smoking cessation community, taking insight from the Trump administration, and weighing feedback from other elected officials in the Senate and House of Representatives for ways to protect public health. That said, companies are using technology to create new tobacco-based products, and FDA must find ways to assess harm while balancing free market interests.

Once considered a death sentence, a cancer diagnosis was distressing and difficult on many levels. However, for the past 50 years the United States has been committed to finding treatments and cures for cancer; we have turned a corner, reversing devastating trends and changing the prognosis to one of survivorship for many.

ONS is a critical voice in the advocacy arena, helping to steward bills that are important to the future of oncology nursing practice and successful patient-centered care. On October 28, 2019, two ONS priority bills—the Palliative Care and Hospice Education and Training Act (H.R. 647) and the Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728)—passed the U.S. House of Representatives with unanimous bipartisan support.

As the largest ONS chapter in the United States with more than 2,000 members, the Houston ONS Chapter is primed to make an impact with the state’s lawmakers. In August 2019, chapter members did just that, combining forces with other local chapters for a pilot event featuring ONS policy education and advocacy training deep in the heart of Texas. Almost 100 ONS members participated to get support and education to speak with decision makers about the needs of the profession as well as the patients oncology nurses serve.

The evidence is clear: Nicotine is an addictive substance. Even current smokers acknowledge its power, and addiction information is required in advertisements and product promotions. Despite tobacco’s known issues, people still smoke at alarming rates. With vaping, e-cigarettes, and flavored tobacco being introduced to younger and younger consumers, youth smoking is on the rise for the first time in decades.

The youth vaping epidemic has dominated headlines since the U.S. surgeon general elevated the issue to the nation’s spotlight. In a 2019 survey of junior high and high school students, the National Institute on Drug Addiction (NIDA)—an arm of National Institutes of Health—found that the rate of e-cigarette use had doubled since 2017.

With the 2020 presidential election cycle in full swing, some Democratic candidates are pushing an aggressive proposal to combat the rising costs of prescription drugs by potentially ending patents for high-cost medications. Breaking the patent of an existing drug to allow competitors to make a cheaper version is a bold step to combat the drug pricing issue, but the potential proposal doesn't seem to be getting much negative push back from either side of the aisle. Many see it as a way to keep the industry in check, and the provision makes for great political fodder on the campaign trail.

Reaching a broad audience, Department of Health and Human Services (HHS) Secretary Alex Azar spoke to the American Cancer Society’s Cancer Action Network in early September 2019 about the state of healthcare delivery in the United States and outlined the Trump administration’s priorities. Azar praised advocates for being leaders in promoting more investments for education, prevention, and research, and he noted the laudable achievements thus far.

Designated as a national epidemic, opioid addiction and abuse are front and center at the federal level as lawmakers work to support the discovery of new treatments and resources to curb the growing problem. The National Institutes of Health (NIH), with support from the White House, Congress, and the Department of Health and Human Services, awarded $945 million in funding for grants, contracts, and cooperative agreements across 41 states for the Helping to End Addiction Long-Term (HEAL) Initiative. Targeting novel chronic pain interventions, opioid abuse, and the addiction crisis, the HEAL Initiative will funnel funding and resources into efforts that can make an impact immediately and in the future for healthcare providers and their patients.

Vaping has been associated with significant public health effects during the past several months, according to the Centers for Disease Control and Prevention. Congress is making e-cigarette regulation a top priority—especially in the wake of the youth smoking epidemic. Now, several members of Congress have developed their own legislative efforts to address the national issue.

Vaping has become a national health issue on Capitol Hill. With more teens than ever using the devices, along with reports connecting lung injury and respiratory illness with vaping, policymakers are eager to understand the problem and act swiftly. Part of the problem includes the high levels of tetrahydrocannabinol and nicotine in vaping products. Congress is working to address the problem through several legislative bills, but few are moving as fast as the public health impact seen in news reports.

As ONS advocates participate in the 2019 ONS Capitol Hill Days training and advocacy event in Washington, DC, from September 22–24, 2019, a recent Journal of Nursing Administration post about nursing influence in health policy is timely. It serves as a reminder that a nurse’s work in patient-centered care goes beyond the bedside or chairside. Nurses are educators, influencers, innovators, and sage guides for patients, policymakers, and the greater healthcare industry.

Chicago ONS Chapter member Janice Phillips, RN, CENP, PhD, FAAN, said it all in her op-ed published on Morning Consult. The entire Democratic field of presidential candidates has declared some form of healthcare overhaul, albeit to varying degrees of change. With expanded access and reduced costs for patients and families as a priority, the centerpiece to most presidential hopefuls’ domestic policy program is redesigning a struggling system.

Health care is a top domestic issue for U.S. voters, and the president is speaking more and more about his administration’s plans to find accessible, affordable healthcare options for millions of Americans. Speaking this summer at the Better Medicare Alliance in Washington, DC, Department of Health and Human Services Secretary Alex Azar outlined three key points where the Trump administration plans to improve health care.

The cancer prevention conversation is tricky for providers to navigate. Not surprisingly, people want to do everything it their power to prevent cancer. But sometimes conversations involve uncomfortable elements of health care—like sex or sexually transmitted diseases—that can quickly derail the discussion. Despite this, the human papillomavirus (HPV) vaccine is one case where prevention efforts have a led to huge increases in participation, especially among children. Following that thread, the Centers for Disease Control and Prevention (CDC) have committed to spearheading the cancer prevention conversation by encouraging people to discuss cancer prevention early in their children’s lives.

From New Hampshire to Arizona, millions of American families are confronted by the impact of opioid addiction. It’s one of the few remaining bipartisan issues on which the U.S. Congress continues to agree. Its reach is pervasive, it’s an international and domestic issue, and it has led politicians to cross the aisle and work together. Finding initiatives and funding programs to enact real solutions has become a national priority, and the Department of Health and Human Services (HHS) is earmarking nearly $400 million to fight the ongoing opioid epidemic.

As the youth smoking epidemic persists and illnesses related to vaping make the headlines, the U.S. Food and Drug Administration (FDA) is searching for solutions to combat the growing impact of new tobacco and nicotine products. After weeks of public outcry, FDA has doubled down on its regulatory stance, issuing several statements—including new warning letters to large tobacco companies—to reinforce its commitment to aggressive oversight and regulation of new tobacco products.

A patient is rushed to the emergency room, diagnosed, and taken to surgery immediately. The patient recovers, but weeks later a bill arrives beyond any expectation, and too often ability, to be paid. This practice has become so routine that it has its own name: balance billing or, more commonly, surprise medical billing. It strikes many Americans with the burden of their ailment once again. 

After years of confusion, discussion, debate, and dedicated advocacy work, lawmakers are finally understanding what palliative care is—symptom management, not hospice—and how it’s employed in care. The benefits of early palliative interventions for many diseases, including cancer, can improve quality of life for patients as they navigate their diagnoses. To increase awareness and availability of palliative care in practice, Senators Jacky Rosen (D-NV), John Barrasso, MD (R-WY), Deb Fischer (R-NE), and Tammy Baldwin (D-WI) launched the bipartisan Senate Comprehensive Care Caucus on July 31, 2019.

With the 2020 election cycle kicking into high gear, upcoming presidential debates will continue to highlight health care as a major domestic issue. Downstream contests for House and Senate seats are also in play, and health care will serve a huge role in those campaigns, too. Candidates are offering a slew of different options like a new single-payer system, Medicare expansion, Medicare for All, Medicare for All with an additional buy-in program, and many other iterations.

With our heads held high, Michelle Santizo, RN, PHN, MSN, and I walked right into Capitol Hill, ready to tackle meetings with important members of the U.S. Congress. On that day in July 2019, we spoke with staff members working for the offices of both Kamala Harris (D-CA) and Diane Feinstein (D-CA).

The high cost of prescription medications—often lifesaving drugs—has become an unsustainable burden for many American patients. It’s a central topic in the healthcare conversation and a complex issue with countless moving parts. National opinion polling finds that a majority of people want to see changes in drug pricing.

The decision to allow Medicare to cover the cost of CAR T-cell therapy—a new and expensive form of immunotherapy—is an important one for patients seeking the treatment, especially after rounds of failed tradition therapies. Educating federal agencies and government representatives about the importance of new treatments like CAR T cells have helped drive coverage decisions, and the patient advocacy community—like ONS’s very own advocates—are to thank.

Health care is the top domestic policy issue for Americans, but with so many different ideas to make the healthcare system more accessible and affordable, the issue is becoming increasingly complex. Because of its far-reaching impact, health care is often a politically charged topic and little change has yet been seen on a legislative level.

For nearly two decades, smoking rates among all ages were on the decline. Restrictions on marketing, sales, and distribution made it difficult for underage smokers to get their hands on traditional cigarettes, and adults were seeing the benefits of smoking cessation campaigns and education.

In divisive times, fewer congressional bills find their way to the president’s desk without considerable bipartisan support. The dance of legislation is complex. Maneuvering through the legislative terrain and avoiding political landmines requires partnerships, expert data, and—at times—a little bit of luck. In the case of the Cancer Care Planning and Communications Act (H.R. 3835), that’s the story so far.

It’s an extraordinary time for biomedical research. Advancements in science, investments in research studies, and an increased access to patients through clinical trials have continued to transform the medical community’s understanding of cancer care and the best ways to treat and cure tumors. Achieving successful outcomes requires specific and dedicated therapies, tailored to each individual.

Few know the power that prescription medications have on the quality of life for patients more than nurses. In more than just physical ways, access to affordable drugs is essential to patient-centered care and emotional, psychological, familial, and even financial stability. For too long, the cost and availability of medicines have been barriers to health care, rather than opportunities for survivorship. 
 

As health care advances, so too does our understanding about the numerous conditions affecting patients, including their mental health and well-being. Messaging from federal agencies like the Centers for Disease Control and Prevention (CDC) about mental health is taking an inclusive, wholistic approach to the many aspects of mental health. CDC presented new educational applications for providers to consider when talking to their patients about mental well-being and their continued success in treatment.

The Presidential Early Career Award for Scientists and Engineers (PECASE) is the highest honor early-career professional researchers can receive from the federal government. On July 15, 2019, two nurse researchers were included among this year’s recipients. National Institute of Nursing Research-supported scientists, Sarah Rossetti, RN, PhD, and Tracey L. Yap, PhD, RN, WCC, CNE, FGSA, FAAN, were acknowledged for their promise and leadership in nursing science and patient-centered research.

The Palliative Care and Hospice Education Training Act (PCHETA) is a key ONS policy priority. After unsuccessfully navigating both chambers of the 115th Congress prior to the 2018 midterm elections, the bill had to begin its legislative journey once again in the new 116th congressional session.

After the U.S. surgeon general’s announcement that youth smoking epidemic was in part a result of vaping and tobacco companies’ marketing and advertising of flavored products, federal agencies began looking for ways to address the growing problem. The ease at which elementary and high school students can access vaping mechanisms was a battle cry for former U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, who was an outspoken advocate for regulating and penalizing companies that targeted marketing efforts at young Americans.

From soaring prescription medication costs to surprise medical bills, the issue of high healthcare costs has dominated headlines for months. Both sides of the aisle have been outspoken about the issue in a rare showing of bipartisanship. But despite the attention paid to the issue, little has been done legislatively to corral rising healthcare costs for patients and consumers. The recent announcement that the Senate wouldn’t vote on its healthcare cost bill prior to the August recess has left many wondering if the issue would be addressed at all.

In June 2019, in honor of Men’s Health Month, a group of Georgetown nurses, oncology specialists, and professionals from other concentrations volunteered for ONS at the annual Men’s Health Network Congressional Health Screening on Capitol Hill. It was an experience that I will never forget. To be in the offices of the U.S. Congress and to meet elected officials and their staff was incredible, but being able to do what nurses do best—act as the most trusted healthcare professional for patients—was wonderful.