Nurses in Policy-making
Government involvement in healthcare was solidified by creating federally funded programs such as Medicare and Medicaid (Milstead & Short, 2019). These programs have influenced the delivery and accessibility of health care to the public and are a driving force for creating health care policies. Nurses and APRNs can and should actively participate in the policy-making process.
Two Ways that Nurses can Participate in Policy-making
RNs and APRNs can participate in policy-making through participation in professional nurse associations like the American Nurse Association (ANA). The ANA advocates for the nursing community and public health by participating in politics and legislature that relate to healthcare (American Nurses Association, n.d.-a). Professional nursing organizations are special interest groups that influence the healthcare political arena. The ANA even helps elect nurse representation to congress.
Another way that RNs, specifically APRNs, can be involved in policy-making is by using their autonomy to implement a policy at their own discretion (Tummers & Bekkers, 2014). If implementing a policy will have a meaningful impact on clients/patients, then an APRN can enact the policy as they work autonomously.
Challenges to the proposed methods of participation in Policy-making
A challenge to working with a professional nurse association may be the cost and commitment. The ANA costs between $100 and $200 annually, comparable to most professional nurse associations (American Nurses Association, n.d.-b). The benefits, however, make the expense worthwhile. The organizations give you access to webinars, continuing education opportunities, job opportunities, networking, and organizational voting rights.
Tummers & Bekkars (2014) found that a challenge to implementing policies using discretion was the willingness to implement. The willingness to implement a new policy directly correlates to the discretion (autonomy) of the individual (Tummers & Bekkers, 2014). As long as the practitioner is comfortable in their autonomy, they will be more willing to implement policies that will have meaningful, positive impacts on their patients.
Opportunities to Advocate for Participation in Policy-Making
ways to advocate for nurse’s involvement in policymaking involve awareness of their ability and right to be involved. While it has been enlightening learning about politics in this graduate-level program, The importance of political involvement should be taught at the beginning of a nurse’s career. Nursing school already has enough classes and a limited time frame to educate. Instead of an individual course, policy-making can be incorporated as it applies to each class/lesson.
Hospitals and care facilities should also encourage their nurses to participate in policymaking and legislature to self-advocate and represent the community. Workplace newsletters and emails are potential ways to disseminate current political information and encourage participation. Hospitals are directly affected by healthcare policies and are stakeholders in most policy-making endeavors (Mcgonigle & Mastrian, 2019).
Conclusion
Nurses should be involved in the Policymaking process for healthcare issues. Nursing schools and professions should educate and empower RNs to participate in the political process and represent the nursing community. APRNs have the autonomy to implement their policies in practice; however, they should still make an effort to facilitate change for the healthcare community (Tummers & Bekkers, 2014). Nurses as individuals or with the backing of a professional nurse association can advocate for the profession by influencing policy and legislature (American Nurses Association, n.d.-a).
References
American Nurses Association (ANA). (n.d.-a). Advocacy.
https://www.nursingworld.org/practice-policy/advocacy/
American Nurses Association (ANA). (n.d.-b). Membership.
https://www.nursingworld.org/membership/
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge
(4th ed.). Burlington, MA: Jones & Bartlett Learning.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.).
Burlington, MA: Jones & Bartlett Learning.
Tummers, L., & Bekkers, V. (2014). Policy Implementation, Street-level Bureaucracy, and the
Importance of Discretion. Public Management Review, 16(4), 527–547. https://doi-org.ezp.waldenulibrary.org/10.1080/14719037.2013.841978
How are you doing?
I have been a nurse for quite some time but had never really known what the professional nurse’s associations were all about until I started this master’s program. The American Nurses Association (ANA) advocates on behalf of RNs and APRNs at the top levels of government, where policies are conceived, debated, and implemented (Federal Issues, n.d.). I have since joined the American Nurse Association and am learning more and more about the offered benefits. Until this class, I was unaware of how much support the association lends to nurses in policy-making. Are you part of a professional nurse association? If you are, would you use them as a resource to help change a policy within your professional field or department? Now that I know the resource is available, I would reach out to them for assistance and empowerment.
You mentioned autonomy in nursing and how it can influence policy-making. Being autonomous takes courage and discipline, as well as knowledge and wisdom. I have been the only nurse a couple of times in my nursing career, and it has taught me to be more autonomous and hold myself accountable. I had to sometimes learn by the “sink or swim” method. I sunk a lot but then started learning how to swim. Have you had periods in your career where you were the only nurse and had to make most decisions based on your wisdom and discernment? I agreed with you when you mentioned that as long as the APRN is comfortable with their autonomy and judgment, they would be more willing to implement policies meaningful to their patients. In the journal article, Strategies for Enhancing Autonomy and Control Over Nursing Practice (2010), Marla Weston states how nurses with high levels of control over their nursing practice have the responsibility and opportunity to provide input and make decisions related to their training which includes policy change that affects the context of the care they deliver.
Being autonomous as an APRN and practicing authority is a privilege that the ANA strongly supports. The ANA states, “Full practice authority is generally defined as an APRN’s ability to utilize their knowledge, skills, and judgment to practice to the full extent of their education and training (ANA’s Principles for Advanced Practice Registered Nurse (APRN) Full Practice Authority Purpose, n.d.).
Becoming influential in policy work requires a commitment to acquiring knowledge and developing the skills that will lead to change (Laureate Education, 2018). Thank you for your post, Jessica. Best of luck as you venture into the advanced field of caring for people.
ANA’s Principles for Advanced Practice Registered Nurse (APRN) Full Practice Authority Purpose. (n.d.). https://www.nursingworld.org/~4af5d1/globalassets/docs/ana/ethics/principles-aprnfullpracticeauthority.pdf
Federal Issues. (n.d.). ANA. https://www.nursingworld.org/practice-policy/advocacy/federal/#:~:text=The%20American%20Nurses%20Association%20%28ANA%29%20works%20to%20advance
Laureate Education (Producer). (2018). Design and Implementation [Video file]. Baltimore, MD: Author.
Weston, M. (2010, January). Strategies for Enhancing Autonomy and Control Over Nursing Practice. Ojin.nursingworld.org. https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol152010/No1Jan2010/Enhancing-Autonomy-and-Control-and-Practice.aspx
When talking about the healthcare professionals, the roles of nurses, either the registered nurses (RNs) or the advanced nurse practitioners APRNs) can not be underrated. Nurses offer a unique, expert perspective on every aspect of the health care system and have an important voice in efforts to improve health (American Nurses Association [ANA], n.d.). Based on this, their involvement in the policy-making process is very paramount. The participation of the nurses in policy-making will facilitate patient care delivery. RNs’ and APRNs’ influence in health policies protects patient safety, increases the quality of care, facilitates their access to the required resources, and promotes quality health care (Arabi et al., 2014).
Nursing organizations promote active participation by nurses in policymaking. For instance, the American Association of Colleges of Nursing emphasizes the role of nursing in the policy. For example, many educational programs incorporate policymaking into their curriculum. The National League for Nursing and the American Nurses Association also expect nurses to address policy as part of their professional role (Burke, 2016a).
How Nurses Can Partake in Policy-Making Process
A few of the numerous ways a nurse can partake in policymaking process are reading through pieces of literature and learning how policy is developed. Also, one should seek out policy areas one wants to influence, search the internet, research, and contact nursing organizations that participate in policy development. Nursing organizations and organizations such as AARP have multiple user-friendly internet sites that provide information about participating in policymaking activities (Burke, 2016b). Another way to become actively involved in policymaking is to meet with both local and state legislatures. Also, nurses can become actively involved in policymaking by becoming a nursing organization member such as American Nurses Association (ANA) or any other nursing professional organization (ANA, n.d.).
Challenges in Policy-Making Process
As there are many opportunities to get involved in the policymaking process, so are some challenges. One of those challenges includes difficulty in getting the ideas/agenda to the floor of the house. To overcome this challenge, one must be sure that he/she is knowledgeable with evidence-based facts regarding the issue before presenting to the policymakers. Involving the media is another way to get one’s agenda to the floor of the house and finally passed into law. Disseminating the information through social media brings the issue to the public’s awareness, which in turn pressurizes the law makers. Social media can support nursing campaigns and help the profession build relationships with key stakeholders to influence policy and political processes (O’Connor & Holloway, 2019).
References
American Nurses Association. (n.d.). Health Policy. Retrieved January 17, 2021 from https://www.nursingworld.org/practice-policy/health-policy/
Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian journal of nursing and midwifery research, 19(3), 315–322.
Burke S. (2016). Influence through policy: Nurses have a unique role. Retrieved January 17, 2021 from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role
The Role of the RN/APRN in Policy-Making
Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.
What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?
Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
- Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
- Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.
By Day 3 of Week 8
Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.
By Day 6 of Week 8
Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Good am Dr. Robin, I read an article about how to facilitate and improve the involvement of nurses in healthcare policymaking. Nurse scholars, nursing organizations, associations, and other health care groups are working on how to enhance their political visibility and activities which is needed to show their advocacy in dealing the disparities in healthcare system and to protect the profession from certain policies that could have a negative impact on the profession. The Political Action Committee of the American Nurses Association (ANA) fights to give voice and visibility to nursing within the halls of Congress (ANA, 2018) and provide opportunities to have direct interactions with the legislators which is an invaluable experience for nurses to learn the process of policy making. There are previous studies that have identified to enhance the participation of nurses in policy making through exposure to political relevant stimuli, membership in organizations, and active psychological engagement. Empowering nurses is also significant in a way that it supports to participate in actions and decision-making related to health policymaking development. Participating in policymaking requires verbal and behavioral empowerment. (Ryles, 1999) suggested that true empowerment can only be achieved when there is balance of power between oppressors and oppressed. Nursing is often perceived as oppressed group. The empowerment model was created to enhance health policy development that consists of four concepts which are knowledge, experience, environment, and participation. The knowledge focuses on three main areas that includes health policy, political skills, and leadership. Experience is about incorporating knowledge and skills into practice which will facilitate professional credibility, involvement, and mentorship. Involvement creates an environment to enable the access of participation in health policies development through having a positive image of nursing, supportive structures, processes, and resources. Lastly, Participations is being part and permanent influence, involvement, and making contribution in the process and development of health policy. In this stage it focuses on 3 components that are related to participation which includes expertise development, evidenced inform practice, and visibility. Experience and involvement in health policy development through nursing professional associations will further enhance and strengthen the knowledge and skills. Nurses will need to be proactive in creating an enabling environment which will enhance their participation in health policy development. Participation will help develop expertise and nursing visibility in the health policy development process.
Alhassan, A., Siakwa, M., Kumi-Kyereme, A., & Wombeogo, M. (2020). Barriers to and Facilitators of Nurses’ Political Participation in Ghana. Policy, Politics, & Nursing Practice, 21(1), 152715441989960. https://doi.org/10.1177/1527154419899602
Links to an external site.
Shariff, N. J. (2015). Empowerment model for nurse leaders’ participation in health policy development: an east African perspective. BMC Nursing, 14(1). https://doi.org/10.1186/s12912-015-0078-6
Nursing involvement in policymaking is fundamental to achieving cost-effective and quality patient care. Policymakers should develop policy by considering public opinion and evidence-based data. Nurses can assist with evidence-based data. They can provide input uniquely derived from their nursing perspectives and experiences. (Milstead & Short, 2019).
Challenges
A challenge for nursing participation in policymaking is having their voice heard and recognizing that they bring a meaningful perspective to the table even if a physician is already present. Disch (2020) writes that often it is difficult to get a nurse involved in a group or committee if a physician is already a part of it. Rasheed et al. (2020) describe this as “intra- and interprofessional power dynamics” to explain the hierarchical structure of the nurse and physician relationship as a barrier to nursing engagement in policymaking. Nurses should “participate in policy debates and discussions over social media” (Rasheed et al., 2020, p.451) and take on participation opportunities at the institutional level. By doing these things, they can work toward “improving the image of nursing and confronting the dominance of physicians” (Rasheed et al., 2020, p. 451). Another challenge nurses face when participating in policymaking is inexperience and difficulty explaining their position on a particular policy. Rasheed et al. (2020) and Abood (2007) report that experienced nurse advocates should work with new nursing advocates to provide mentoring experiences. A more experienced nurse can help with a visit to a policymaker and provide information on how to discuss legislation.
Participation
A way to participate in policymaking is by joining a politically active national nursing organization. Nurses have a more powerful voice together and a better chance of advancing policy formation that will benefit patients and families. The American Nurses Association allows nurses to sign up and participate in their advocacy campaigns. These advocacy campaigns are active at federal and state levels; they include a political action committee, information on how to message legislators and provide information on the nursing role to federal agencies that implement laws. The American Nurses Association lobbies, educates and builds relationships with members of Congress while new policies are being developed to help incorporate the nursing perspective (American Nurses Association, n.d.).
Nurses in their field possess expert power about the knowledge and skill needed and can offer unique insight. They possess personal experience and knowledge and can educate policymakers to inform their decision process. Nurses can attend public meetings and draw upon their expert knowledge to inform about the policy implications and express their perspective on the solution offered. This can help sway decision-makers about policy solutions (Abood, 2007).
Opportunity Awareness
Many nurses need to be made aware of the variety of ways to participate in policy development. One of the best ways to identify opportunities for participation would be to reach out to other nurses and gather a group together to go and attend a legislative session or public meeting on a policy. Learning about how policies are made can help identify areas where nurses can participate. Another way to promote awareness is to make nursing participation in public policy part of nursing education. This helps to provide a foundation for where nurses can begin participation in the process (Rasheed et al., 2020).
References
Abood, S. (2007, January 31). Influencing health care in the legislative arena. Online Journal of issues in nursing, 12(1). https://doi.org/10.3912/OJIN.Vol12No01Man02
Links to an external site.
American Nurses Association. (n.d.). Advocacy. Retrieved April 13, 2023 from https://www.nursingworld.org/practice-policy/advocacy/
Links to an external site.
Disch, J. (2020) Nursing leadership in policy formation. Nursing Forum, 55(1), 4-10. https://doi.org/10.1111/nuf.12375
Links to an external site.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones and Bartlett Learning.
Rasheed, S. P., Younas, A., & Mehdi, F. (2020). Challenges, extent of involvement, and the impact of nurses involvement in politics and policy making in the last two decades: An integrative review. Journal of Nursing Scholarship, 52(4), 446-455. https://doi.org/10.1111/jnu.12567
