June 3, 2005
The Honorable Michael O. Leavitt
Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, DC 20201
Dear Secretary Leavitt:
The American Nephrology Nurses Association (ANNA) supports the role of nurses in all areas of health care practice. As the voice of more than 12,000 nephrology nurses who care for patients with kidney disease, ANNA knows the high value that qualified nurses bring to the care of our nations patients.
We are writing to affirm our position that nurses must be recognized and valued by policymakers and legislators when actions are taken (and decisions are made) that impact the care of patients. We are aware that a Technical Advisory Group was recently formed as a result of the Emergency Medical Treatment and Active Labor Act (EMTALA).
ANNA is concerned that a qualified, registered nurse from an emergency department was not appointed to the EMTALA Technical Advisory Group. A complete account of our nations emergency care system and the effect that EMTALA is having upon it is not possible without active participation from the emergency nursing community.
In the vast majority of our nations emergency departments, nurses are the first individuals to provide care to patients. The nurses interaction with patients takes place before the patient sees a receptionist for registration, a physician for a medical screening exam (the nurse may even be the person to do the initial medical screening exam), a lab or x-ray technician for testing, or other health care professionals for the specialty care that they provide.
Nurses are required to be knowledgeable about EMTALA regulations to ensure that patients are not inadvertently screened away from the emergency department and are cited as defendants in law suits against hospitals when violations are alleged.
Clearly, nurses are centrally involved in emergency care from the initial contact a patient makes with the hospital emergency department and, as such, have a perspective and knowledge that are not represented in the current structure of the EMTALA TAG.
ANNA requests that this oversight be addressed immediately by adding a practicing registered nurse from the field of emergency nursing to the Technical Advisory Group of EMTALA.
Thank you for your consideration of our request.
Suzann VanBuskirk, BSN, RN, CNN
President, American Nephrology Nurses Association
cc: Dr. Mark B. McClellan, CMS Administrator
Patricia Kunz Howard, PhD, RN, CEN, President Emergency Nurses Association
ANNA Board of Directors