Not your usual health policy center

By Todd Lothery | 07/09/2019

One place in Washington, D.C., where they teach you to reach across the aisle.

Tony Yang, Pamela Jeffries, and Jean Johnson

Many centers for health policy conduct research and advocate reform. GW School of Nursing’s Center for Health Policy and Media Engagement takes it a few steps further.

They are everywhere. Some are called “centers” (or centres), others “institutes.” They are typically affiliated with a university, but not always—some are stand-alone organizations. Their names vary, but they all do roughly the same thing: study health policy and advocate for healthcare reform.

The one at Harvard Law School is called Center for Health Law and Policy Innovation. The one at Trinity College in Dublin is named Centre for Health Policy and Management. Johns Hopkins University? Institute for Health and Social Policy. Ohio State University? Center for Health Outcomes, Policy, and Evaluation Studies. The Robert Wood Johnson Foundation has one, too, a collaborative project with the University of New Mexico simply called Center for Health Policy.

And then there’s the Center for Health Policy and Media Engagement at George Washington University (GW). It’s different. It does what the others do—research health policy, educate students and others about it, and attempt to help shape its future—but this center differs from the others in several salient ways, starting with its location.

George Washington University is in Washington, D.C., where you can’t throw a stethoscope without hitting a think tank. Lots of smart people spend lots of time pondering policy—health and otherwise—in that city. And, obviously, D.C. is the legislative home of the U.S. government. What better place to be if you’re in the business of influencing health policy?

Although the center is only a couple of years old, it has quickly taken advantage of its location. Its proximity to politicos and policymakers has allowed it to bring in some heavy hitters as speakers. The presentation by Victor J. Dzau, president of the National Academy of Medicine, attracted an audience of nearly 300. The talk on the opioid epidemic by U.S. Surgeon General Jerome Adams drew a capacity crowd of 350. And the center snagged Suzanne Miyamoto, PhD, RN, FAAN, to participate in a seminar just a few months after she was appointed CEO of the American Academy of Nursing.

Educating nurses and future nurses
Speaking of nursing—this is, after all, a nursing magazine!—the second distinctive aspect of the Center for Health Policy and Media Engagement is that it’s part of the GW School of Nursing. Most centers or institutes associated with a university are part of a school of public health. Some are affiliated with a school of medicine or public policy, and a few belong to law schools. Although not unique—the Center for Health Policy at Columbia University in New York is also part of the School of Nursing—the GW center is unusual in that it focuses specifically on educating nurses on health policy.

Jean JohnsonJean Johnson, PhD, RN, FAAN, founding dean of the GW School of Nursing, observes: “Within nursing, I think one of the things that we tend to do is define a problem as a nursing problem, like nonpayment for Medicare or not being able to write such and such a prescription. When in fact we really need to be thinking about the big buckets of policy—is this a cost problem, is this an access problem, is this a quality problem, and if so, what are the potential answers to this?”

An Illinois native with a long and distinguished career in nursing and academia, Johnson has a bachelor’s degree in economics. She didn’t come to nursing until she experienced a rather scary illness.

“I was traveling quite a bit after college, and I lived on the Greek island of Spetses for a year. I got pneumonia there, and the island had no healthcare. I was so sick that I couldn’t even get to the boat. My friends were really concerned and were actually able to get a doctor there. When I was getting better, I started reevaluating my life and my direction. I had worked as a nursing assistant when I was in college, and I thought, wow, that was something that I really loved doing. I loved going to work every day. So, I decided on this Greek island—as I was taking antibiotics to get better—that I would go back to the U.S. and do what I needed to do to get into nursing school.”

And she did: Johnson matriculated at the University of Illinois at Chicago, Texas Woman’s University, and University of Wisconsin in Madison while working along the way at the Veterans Administration and in the psychiatric unit of a hospital. Her education culminated at GW, where she earned her doctorate in health policy.

“That [degree] connected my nursing and economics background because the program was very heavy on economics and statistics, which is exactly what I wanted,” she says. GW became her longstanding home. She has taught there for more than 30 years.

Mary Jean SchumannAlthough Johnson has been involved with the Center for Health Policy and Media Engagement since its inception, she credits fellow Midwesterner Mary Jean Schumann, DNP, RN, CPNP, FAAN, for laying a solid foundation for the center. Schumann was the center’s first executive director, helping establish it in early 2017 with a grant from the National Council of State Boards of Nursing.

Like Johnson, Schumann has had a long and varied career. School and work have taken her from her native Wisconsin to Michigan, Minnesota, Maryland, and the District of Columbia. She has a background in debate and worked for the American Nurses Association for nearly a decade, part of that time as the organization’s director of nursing practice and policy. She maintains that a critical part of policy is talking to the “other side.”

“I believe that policy is a lot more than just legislation or bills,” says Schumann. “You change policy through a variety of means: regulations, guidelines, scope and standards. But if you’re going to do it legislatively, you need much bipartisan support, and that’s difficult. Most nurses are not necessarily educated in getting out and talking to people who don’t agree with their point of view. So one of the things that we try to teach in this certificate program is how to reach across the aisle and have a conversation with someone who is not likely to agree with you. How do you find some common ground so that you can begin to build an approach that might have broader acceptance?”

Engaging with media
In addition to coaching nursing students on talking to people with opposing positions, faculty at the center prepare them to present their policy arguments to another, perhaps more crucial, audience: the media. That’s where the second part of the center’s name, “media engagement,” comes in, and it’s another facet of the center that sets it apart.

“The media engagement piece is focused around several things, most of which nurses haven’t been exposed to,” Schumann says. “To help people become comfortable in front of a camera. To craft a message and understand what the goal is for that discussion. To stay on message when they are interviewing or being interviewed. To communicate that message using social media like Twitter, Facebook, and Instagram. To use blogs as a way to engage in that process. To interact with TV and radio. To be able to write op-eds.”

The overarching purpose of these strategies is to build confidence in nurses so that they’re better equipped to deftly disseminate policy ideas when interacting with the media. And why is interacting with the media so important? Because research has shown that nurses’ voices are not being heard outside of the settings in which they serve.

Take the Woodhull Study. The original report, “The Woodhull Study on Nursing and the Media: Health Care’s Invisible Partner,” was commissioned in 1997 by Sigma Theta Tau International Honor Society of Nursing (Sigma) and conducted by the University of Rochester School of Nursing. The results found that “nurses were identified as sources in only 4 percent of quotes or other sourcing in health news stories in leading print national and regional newspapers and 1 percent in weeklies and industry publications . . . Nurses were never cited in health news stories on policy and were rarely identified in photos accompanying the articles” (Center for Health Policy and Media Engagement, para. 1).

Twenty years later, things have only gotten worse. Last September, the center published the results of “The Woodhull Study Revisited: Nurses’ Representation in Health News Media.” The study was led by Diana Mason, PhD, RN, FAAN, who joined GW after leaving Hunter College in New York, and Barbara Glickstein, MPH, MS, RN, who, with Mason, cofounded the Center for Health, Media and Policy at Hunter. That 4% nurse sourcing number in health news stories from the original study? It was down to 2%.

For 17 years running, nurses have been the most trusted professionals, consistently rated at the top for honesty and ethics, according to an annual Gallup poll. Nonetheless, journalists tend to consider physicians as the more knowledgeable resource, which isn’t always correct. In many situations, nurses are the better resource. But both Johnson and Schumann assert that nurses must bear some responsibility for their lack of exposure.

“The way I look at it, any health policy issue that any of us want to ever be successful needs to have a media strategy,” says Johnson. “We as nurses have to step up. Physicians are usually put forward by institutions as the experts, but even when nurses are, they don’t immediately get back to the person, they don’t make the effort right away, and then the story is over and the opportunity is lost.”

Schumann adds that nursing schools aren’t helping the cause, at least on social media.

“Our study found that 80% of what schools tweet about is inward-facing,” she says. “They’re tweeting to their students, their faculty, and their alumni, and they’re talking about things related to the school of nursing rather than external-facing issues that can engage the larger healthcare community or consumer population.”

Reaching nurses through the arts
Even as the Center for Health Policy and Media Engagement trains students to “step up” and connect with the media, it reaches nurses in another unconventional way: through the arts. This marks one more difference between the center and other institutions with the same purpose.

“To be honest,” Johnson recalls, “when I took over the center on an interim basis, I said, ‘We have poets? We have a comic?’”

Yes and yes. The center has two poets—Joy Jacobson, MFA, and Seema Reza, MFA—and a comics artist, MK Czerwiec, MA, RN, who goes by ComicNurse on Twitter. All three are part of the center’s senior fellowship program, which aims to bring fresh perspectives to nursing and health policy. Jacobson, for instance, conducts poetry writing workshops with nurses, helping them process their feelings and experiences. And the center recently received a grant from the Poetry Foundation to determine if introducing poetry writing to nurses can reduce burnout at MedStar Washington Hospital Center, the largest private hospital in D.C.

“One of the challenges of the helping professions is that we tend to take a lot in, and we try to pretend that we can just absorb all that, but at some point we have to be able to sort it out,” says Schumann. “So I think using poetry or comics or any other sort of art form to make sense of our world and the undesirable things that happen in it can help us step out and get a little bit of distance and perspective.”

Johnson believes that, beyond helping nurses manage their emotions, the arts can be tapped to illuminate policy.

“I ultimately see our poets creating a compendium of poetry that reflects policy issues,” she says. “That may sound a little corny, but I think it’s fascinating and very doable because every policy issue affects people in one way or another, and we don’t think about being able to express policy artistically.”

Here at RNL, we find the center’s use of the arts fascinating as well. More on that subject in a future article.

Todd Lothery is publications specialist at Sigma.

Check out “Extending the use of evidence-based practice to health policymaking,” a sample chapter from Evidence-Informed Health Policy.

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