To those who are not familiar with ...

To those who are not familiar with the political order of the United States, our sway can be a bewildering maze of legal terminology, confusing processe and intimidating personalities. What makes this equal more complicated is that the political connected view is slightly different in each state. Fortunately, however, our political arrangement is relatively stable after decades of tinkering. The scheme stays much the same, calm as the personalities change.

What is the political connected view in which we live and work? This article at hands a general overview of the US political a whole including federal and state of the same heights of government. More importantly for our members, this body will be viewed in the connection of AORN's legislative priorities.

AORN'S PRIORITIES

What are AORN's legislative priorities and where do they fit with the US political system? In October 2000 the AORN Board of Directors approved four priorities praiseed by AORN's Legislative Committee.

* render certain the supervisory presence of the professional RN in the perioperative arena through promoting AORN's position that "Every surgical patient be entitled tos a perioperative nurse," and ensuring that all state laws and regulations require an RN single to circulate.

* Medicare reimbursement for certified RN first assistants (CRNFAs) and third-party reimbursement for RN first assistants (RNFAs) in the states.

* Supervision and regulation of assistive personnel AORN supports the establishment of basic educational standards for surgical technologists (STs) In addition, AORN suspends opposition to the registration or certification of ST as lengthy as it is under the state nursing board or equivalent.

* Patient and personnel health and safety in the perioperative arena.

THE FEDERAL SYSTEM

American federalism, as defined in the US Constitution, divides command between the national and state on a levels (1) Both levels of management interact with the people and have certain powers above the people. The Constitution also provides for the separation of power between the executive, legislative, and judicial branches of rule This diffuse and complex order does not lend itself to easy summation; (2) however, it does help interrupt tyranny in the hands of any single in kind individual, branch of government, or institution.

The United States also is a democracy, a control by the people through either direct or indirect elections. As a citizen and a voter you and the other voter in your political district are constituents of picked officials at several levels of dominion For national office, you consecrated by a vow for a president indirectly from one side the Electoral College system and directly consecrated by a vow for US representatives and senators. Likewise, each eligible citizen can ballot for a governor, senator, and representative at the state plain Citizens also elect representatives at the local horizontal and within special districts.

As an AORN member and a potential political activist, it is important that you know the basics of our political a whole Understanding this system provides a means of influencing decisions that affect the nursing profession. With this knowledge, you can begin to evolve an effective political advocacy strategy. Political activist and author Joel Blackwell assigns to this as the "ARM" strategy (ie, attitude, relationship, message). (3)

Blackwell and other political consultants emphasize that individuals posses the personal political power to affect political change. An on the same level more powerful influence is fix however, by working with others onward a common issue. As Blackwell points without "Most often, political goals are achieved within an association of people, either formal or informal [as in a coalition]." (4)

THE NATIONAL LEVEL

Within the executive branch of the US command and under the leadership of the president, there is a vast federal bureaucracy. (5) This bureaucracy is made up of 14 cabinet-level departments that have charge of hundreds of bureaus, services, administrations, divisions, and regulatory agencies.

The Center for Medicare and Medicaid Services (CMS) (formerly the Health Care Financing Administration) is located subject to the umbrella of the US Department of Health and Human Services. The CM operates the one and the other the federal Medicare program and permanent funds the federal portion of the Medicaid program, which is administered by way of individual states. Medicare provides health insurance to individuals age 65 and older Medicaid provides health care coverage to reasonable income families and individuals. (6)

RN in the OR. single in kind of AORN's legislative priorities is to make secure the supervisory presence of the professional RN in the OR. In December 1997 CM propos a command change to remove prescriptive language requiring RN in the OR. (7) This behavior change would apply to hospitals and ambulatory surgery center that receive Medicare and Medicaid reimbursement. AORN members and Headquarters staff members be agreeable toed directly to CMS regarding this propos direction change and requested that the agency preserve the prescriptive language. Although CM stated that a decision would be issued in 2000 no final lordship has been released to date. (8)