The Role of the RN/APRN in Policy-Making

Week 8 Discussion

Vladimir Berrios- Student ID A01238310

MSN-PMHNP, Walden University

NURS-6050C-40: Policy & Advocacy for Pop Hlth-Fall 2024

Dr. Crystal Dodson

Being a Registered Nurse (RN) and/or an Advanced Practice Registered Nurse (APRN) is a privileged profession, in the sense that it offers many opportunities to participate in policy making, which can significantly influence healthcare delivery and patient outcomes. For an altruistic professional the ability to help society as a whole is a great perk, two opportunities are:

Serving on Policy Advisory Boards or Committees

Nurses can work on local, state, and/or national healthcare policy boards and committees (Abood, 2007). Since nurses are the “soldiers” on the frontlines of healthcare, they bring their unique and extensive clinical expertise and patient care perspectives to these organizations. Since these boards help shape healthcare regulations, guidelines, and reforms, the nurse has the ability to greatly influence and contribute to the healthcare landscape by affecting policies that shape healthcare delivery. For example, the Florida Board of Nursing or the National Advisory Council on Nurse Education and Practice, can be shaped by nurses serving on these boards, thereby possibly influencing scope of practice regulations and nursing licensure.

Unfortunately, nurses may face challenges including constraints due to clinical responsibilities, limited knowledge of policy-making processes and an apprehension of voicing opinions in a non-medical setting. Great ways to overcome these challenges include mentorship from experienced nurse leaders, attending workshops or training on policymaking and advocating for employer support to participate during working hours. Being stretched thin does not help anyone and in fact can contribute to the nurse not being able to achieve goals in multiple areas.

Advocating for Legislation through Professional Organizations

Additionally, nurses can join professional organizations such as the American Nurses Association (ANA) or state nursing organizations (American Nurses Association, 2020). They often advocate for healthcare policies and nurses can participate by writing letters to legislators, take part in advocacy days at state capitals, or by providing important expert testimony on healthcare bills. A challenging aspect of this opportunity is that nurses might feel uncertain about how to engage with legislators or lack confidence in navigating the political world. Fortunately, these organizations offer legislative training programs that can help address these challenges. The nurse can also attend policy briefings that teach them how to effectively communicate with lawmakers.

It is also important to help increase nurse participation to thereby increase the role of the influence of the nurse in the healthcare delivery system, two strategies include:

Engage in Professional Networking and Mentorship Programs

For example, a mentorship guided attendance at a legislative advocacy event can provide hands on learning about the policy making process. Therefore, mentorship is a great tool the nurse can use to increase participation and also help guide and help ease the learning curve that can be steep in the beginning of learning about the policy process. Developing networks with this organizations such as the ANA can also help collaboration and thereby increase participation

 Use Social Media and Digital Platforms for Advocacy

This example seems obvious when taking into consideration the modern world we live in today, yet one would be remised in not mentioning how effective and powerful social media can be. They help bring awareness to policy making by reaching the mass nursing population, using platforms such as LinkedIn and Instagram. Professional organizations could also use email campaigns to highlight ways to get involved, like signing petitions or joining committees.

Again, the nursing profession offers an amazing opportunity to really make a difference in our communities. By following these strategies nurses can optimize our overall positive influence on the future of healthcare policy.

References

American Nurses Association. (2020). Nurses’ role in advocating for healthcare policy. ANA. https://www.nursingworld.org/practice-policy/advocacy/ [nursingworld.org]

Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in Nursing, 12(1). https://doi.org/10.3912/OJIN.Vol12No01Man02 [doi.org]

Edwards, N., & Rowland, D. (2020). Leadership in health policy: A role for nurses. Nursing Administration Quarterly, 44(2), 163-170. https://doi.org/10.1097/NAQ.0000000000000409 [doi.org]

In today’s ever-evolving healthcare landscape, both registered nurses and advanced practice registered nurses alike are increasingly viewed as key players in shaping healthcare policy at both the federal and state levels. Nurses are the largest group of healthcare workers involved in healthcare service delivery, and more than 35 million people are estimated to work as nurses worldwide (Barzegar et al., 2020). It is essential for improving the accessibility and quality of healthcare for nurses to participate in policy making due to their unique clinical experience and patient-centered approach to care. Despite this however, many nurses are either unaware of the opportunities available for policy-making or face challenges when trying to participate in policy-making.

Two Participation Opportunities for Nurses in Policy-making

One way nurses can help with policy-making is by serving on health policy committees and/or advisory boards at the national, state, or local level. These committees and advisory boards often guide healthcare reforms, policies, and legislative decisions. In Florida, nurses can participate in the Florida Department of Health advisory board and policy boards at the hospital. For example, the hospital where I work has the Hospital Nursing Practice Council. The purpose of this council is to provide a forum to exchange ideas and information to achieve excellence in the practice of professional nursing as well as to enhance the quality of patient care by utilizing evidence-based policies and practices to improve patient outcomes.

Another way nurses can help with policy-making is by engaging in legislative advocacy through professional organizations such as the American Nurses Association and the American Association of Nurse Practitioners. Nurses can contribute to drafting and supporting legislative bills through these organizations, attend advocacy meetings at the different legislature levels, and meet with lawmakers to discuss healthcare policies.

Challenges to participation and ways to overcome the challenges

There is a myriad of challenges nurses face in participating in different organizations and policy-making. Challenges to participating in organizations such as the Hospital Nursing Practice Council include a lack of time due to stressful clinical schedules as meetings are often scheduled during the middle of shifts that nurses are working and unable to leave the unit or nurses are unable to come in on days off. Education, experience, or confidence in joining these organizations also plays a role in nursing participation, as newer nurses often feel as if they are lacking in these areas to make a meaningful impact on policy-making and change. To help overcome these challenges, nurses can discuss schedule flexibility with nursing managers when meetings occur or inquire with employers whether professional leave is available for nurses to participate. To help nurses overcome inexperience, unit nursing specialists can provide nurses with education on policy advocacy courses and/or mentorship with a more experienced nurse advocate, which can help boost confidence for the newer nurses.

Challenges also affect participation in policy-making in professional organizations such as the American Association of Nurse Practitioners, which can be geographical and/or financial constraints to attending conferences like the AANP Health Policy Conference. As well as difficulty staying up to date with current policy issues and changes. To overcome these challenges, professional organizations that make it easier for nurses across various locations to participate will offer virtual or online conferences for nurses to stay better informed; attending webinars and subscribing to newsletters can help nurses stay up to date on policy issues and changes.

Strategies to Advocate for Opportunities

One strategy for advocating for opportunities could include using social media platforms and professional networks to highlight policy-making chances. Nurses use these platforms to join or create professional nursing groups to share information about upcoming continuing education opportunities related to policy-making, upcoming legislative advocacy days, and committee appointments. For example, posting about the American Nurses Association Annual Hill Day. This is where nurses, nursing students, and advocates nationwide can encourage fellow nurses to participate and meet with legislators to impact healthcare reform.

Another strategy for advocating for opportunities could include collaboration with professional organizations, hospitals, and nursing schools to offer webinars or workshops aimed at educating nurses and nursing students on how to get involved in policy-making. These workshops or webinars could include speakers with legislative experience, explain how to apply for committee roles or engage with legislators, and offer resources on traversing the political process. For example, organizing a webinar on how to get involved in the legislative process for the applicable state in which the nurse resides and having a nurse speaker who has successfully navigated healthcare policy-making.

By recognizing relevant opportunities, overcoming challenges to participation, and actively communicating these opportunities, nurses can become more empowered and influential advocates in shaping healthcare policy. Practicing nurses as expert clinicians, members of an autonomous profession, and patient advocates have a duty to engage with public policy (Scott & Scott, 2021).

References

Barzegar Safari, M., Bahadori, M., & Alimohammadzadeh, K. (2020). The Related Factors of Nurses’ Participation and Perceived Benefits and Barriers in Health Policy Making. The Journal of Nursing Research : JNR, 28(4), e103. https://doi.org/10.1097/jnr.0000000000000385

Scott, S. M., & Scott, P. A. (2021). Nursing, advocacy, and public policy. Nursing Ethics, 28(5), 723–733. https://doi.org/10.1177/0969733020961823

De Bortoli Cassiani, S. H., Moreno Dias, B., Rivera, J., Deubel, A. N. R., Pérez, T. R., Malpica, D. R., & Caffe, S. (2024). The role of nurses in implementation of public policy on adolescent health in Colombia, Ecuador, and Peru. Health Research Policy and Systems, 22(1), 77. https://doi.org/10.1186/s12961-024-01134-6

Wilson, D. M., Underwood, L., Kim, S., Olukotun, M., & Errasti-Ibarrondo, B. (2022). How and why nurses became involved in politics or political action, and the outcomes or impacts of this involvement. Nursing Outlook, 70(1), 55–63. https://doi.org/10.1016/j.outlook.2021.07.008

It is imperative for Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) to be included in policy-making processes due to many aspects, one being their first-hand knowledge of patient care. This is because their views can help design healthcare legislation that will improve patient outcomes and the scope of practice for the nursing profession. One opportunity for nurses to be involved in this process is joining professional nursing organizations such as the American Nurses Association (ANA). Joining an organization of this nature provides nurses with the initiative to enhance patient safety measures, voice opinions, and innovative solutions in healthcare processes that have an impact on policy decisions that affect their practice and patients outcomes (ANA, 2017.). Another opportunity would be getting involved in State and Federal legislative policy reform, such as supporting bill proposals like The SAVE Act, which allows APRNs to practice independently in their state, to their full scope of practice without a supervising or collaborating physician (NCleg.gov, 2023). By enabling APRNs to practice independently, this kind of engagement enables nurses to lobby for the removal of restrictive restrictions and enhances healthcare accessibility and efficiency throughout the state (NCleg.gov, 2023).

Some challenges these opportunities may present, particularly APRNs, may encounter opposition from physician associations or other interested parties to legislation that broadens the scope of nursing practice. Building partnerships and evidence-based research are two ways that nurses can highlight the benefits of these actions (Walden University, 2018). A lack of policy literacy is another potential challenge, as many nurses may not fully understand healthcare laws or recognize the significant role they can play in influencing policy decisions. To overcome this, nurses can participate in direct forums, attend workshops, and engage with evidence-based research to educate themselves on policy matters. By doing so, they can better appreciate the value of nursing input and advocate effectively for meaningful changes within the healthcare system.

Strategies to communicate the existence of policy-making opportunities for RNs and APRNs include connecting and collaborating with other members of the healthcare interdisciplinary team. The combined forces strengthen advocacy efforts by presenting unity to influence policy change. Through forming alliances and promoting interprofessional dialogue, nurses can remain knowledgeable and inspired to participate in the legislative process.

(Walden University, 2018). An additional strategy could be hosting workshops and seminars that provide nurses with access to ongoing education on healthcare policy and the legislative process, which can provide the tools needed to fully engage in policy-making (ANA, 2017). 

References

Health policy – American Nurses Association (ANA). ANA. (2017, October 14). https://www.nursingworld.org/practice-policy/health-policy/

The save act. (public) sponsors. NCleg.gov. (2023). https://www.ncleg.gov/Sessions/2023/Bills/House/PDF/H218v1.pdf

Walden University, LLC. (Producer). (2018). Getting your Program Designed and Implemented [Video file]. Baltimore, MD. Retrieved from https://waldenu.instructure.com/courses/131071/pages/module-4-learning-resources?module_item_id=4984775

Nurses need to get into policymaking so they can work on making the lives of other nurses easier and safer. We will forever be surrounded by social issues such as safe staffing, pandemics, and violence in healthcare, to name a few. Public policy can be complicated, however, so we need to be up-to-date on the latest developments and be able to develop plans and join organizations to make things better.

Nurses have many opportunities to help with policy and decision-making. One of the easiest ways for nurses to participate is through the ANA. The ANA allows nurses to be seen and heard. By joining the ANA, a nurse or advanced practice nurse can join a vast community of people as well as resources to pursue decision-making both locally and federally. At our hospital, nurses had the opportunity to work on magnet status. When we made magnet status a group of nurses were allowed to join a conference through the ANA where they learned about leadership skills, how to help with policies, with many other things. Not to mention nurses who are part of the ANA form companionship with other nurses. The ANA can help the nurse implement changes in staffing, safety, and education to name a few. I like that the ANA not only works on getting nurses to understand social changes and allows them to form policies, but it also helps with continuing education by offering free or cheap credit hours and conventions readily available to its members.

Another option nurses and APRNS have is ICN, which is another organization. They have wanted to help implement policies for nurses. They have been powerful throughout the COVID pandemic trying to help nurses run more smoothly when rules were ever-changing. They want to find better ways to do things in practice with evidence-based research. Nurses are starting to become more involved in policy and decisions within their organizations and some more organization-led committees and groups are developing. I think more will come in the upcoming years, which will be beneficial for nursing practice overall.

Things I would do to advocate for different nursing organizations would be word of mouth, for one. Talking about the benefits of joining organizations that help us. The more you advocate for yourself to others, the more it becomes a movement and people start to notice. As others are more comfortable discussing these topics maybe recommend a workshop or a class to get to know one another and discuss ways they have found to get into policy making. As you form yourself an organization you can pass the word on to others over time, which will cause a ripple effect and others will be more comfortable listening and joining.

References:

American Nurses Association (ANA). (n.d.). Advocacy. Retrieved October 16, 2024, from https://www.nursingworld.org/practice-policy/advocacy/

Hajizadeh A, Zamanzadeh V, Kakemam E, Bahreini R, Khodayari-Zarnaq R. Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nurs. 2021 Jul 12;20(1):128. doi: 10.1186/s12912-021-00648-6. PMID: 34253210; PMCID: PMC8273557.

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed., pp. 77-93). : Jones & Bartlett Learning.

Main Post

Main Discussion Post

The American Nurses Association (ANA) establishes in the Nursing Scope and Standards of Practice that nurses must advocate for their patients, which includes advocating for healthcare policy that provides a voice to the people in our communities and improves the quality of care that is provided for all (2021). Improving health equity and decreasing health disparities requires ongoing and thoughtful analysis and evaluations with appropriate legislative changes. As nurses, we offer unique perspectives to assist legislators in developing meaningful healthcare legislation.

Opportunities for Nurses to Participate in Policymaking

Morris (2023) discusses ten different ways nurses can be involved in healthcare policy legislation. One of these is to join and participate in nursing organizations as these associations advocate not only for nurses, but for policy and legislation that impacts of healthcare (Morris, 2023). Nursing associations can be local/regional, state, national, or specialty based, but they all advocate for the delivery of quality evidence-based healthcare. Attending legislative sessions provides nurses with the opportunity to learn more about the process allowing nurses to identify areas of impact within their communities or related to specific topics of interest or concern (Morris, 2023). Building a professional relationship with legislators, lobbyists, or others that influence policy provides the opportunity for nurses to collaborate and have conversations regarding healthcare policy and provide valuable insight from the nursing perspective (Morris, 2023 & Walden, 2018a). Nurses can also be involved in healthcare policy advocacy by providing their expertise in analysis of proposed healthcare legislation including evidence-based practice and research that supports proposed legislation (Morris, 2023).

Challenges for Nursing Involvement in Policymaking

Sharpnack discusses several reasons nurses are not involved in healthcare policy and legislation including a lack of familiarity of the process or where to begin and the absence of policy mentorship in nursing (2022). In my own experience in nursing school in the 1990s, advocacy of healthcare legislation was discussed, but not at length. It was a psychology class that brought me to local legislative hearings. We were encouraged to join professional organizations because of their advocacy for nursing and education. Other factors impacting nurses actively engaging in healthcare policy advocacy are time limitations because of work and home schedules and insufficient knowledge or education on how to analyze healthcare policy or the legislative process, which can be intimidating and frustrating (Hajizadeh et al., 2021).

Ways to Overcome Challenges

Sharpnack indicates that we can improve nursing advocacy for healthcare legislation through “education, mentoring, and sustained engagement and to develop a shared agenda for healthcare policy that focuses on achieving health equity” (2022). Through additional education and mentoring, we can ensure understanding of the legislative process as well as the specialized role nurses have in healthcare legislation that provides for quality healthcare. Ongoing education and mentoring, whether formal or informal, within our organizations will lead to more nurses being involved in legislative advocacy.

Strategies to Advocate for these Opportunities

Trautman discusses three factors that are required to influence healthcare policy as evidence, communication, and relationships, better preparing us to advocate for the advancement of meaningful healthcare policy (Walden, 2018b). Since nurses are providing care, we offer a unique perspective that is essential for the development of not only hospital policies, but state and federal legislative policies. Evidence can be achieved through performing research for legislators or by providing an analysis of research to improve understanding of complex medical data. Communication would be collaborative conversations about the care we provide, the challenges we face, and how proposed legislation will impact quality healthcare delivery. Relationships can be built over time with a common goal of improved healthcare legislation. Nurses are in a unique position to increase understanding, provide differing perspectives, and positively impact healthcare legislation (Short, 2022). Sharpnack cites Smiley et al. and the 2020 National Nursing Workforce Survey stating that “with 4.2 million registered nurses in the United States, the largest group of health care professionals in the nation, working collectively, nurses could wield enough political power to reform the nation’s healthcare system” (2022).

References

American Nurses Association. (2021). Nursing scope and standards of Practice (4^th ed). American Nurses Association

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021, July 12). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8273557/

Morris, G. (2023, November 10). 10 Ways nurses can get involved in policy. Nurse Journal. Retrieved from https://nursejournal.org/articles/ways-nurses-can-get-involved-in-policy/

Sharpnack, P. (2022, May 31). Overview and Summary: Nurses’ impact on advocacy and policy. OJIN: Online Journal of Issues in Nursing, 27(2). Retrieved from https://ojin.nursingworld.org/table-of-contents/volume-27-2022/number-2-may-2022/nurses-impact-on-advocacy-and-policy/

Short, N.M. (2022). Milstead’s health policy and politics: A nurse’s guide (7^th ed.). Jones & Bartlett Learning.

Walden University, LLC. (Producer). (2018a). Getting your program designed and implemented [Video file]. Baltimore, MD: Author.

Walden University, LLC. (Producer). (2018b). Health policy and politics [Video file]. Baltimore, MD: Author.

Registered Nurses and Advanced Practice Registered Nurses have numerous opportunities to engage in healthcare policy making, which is crucial for influencing changes in the healthcare system. For one RN’s and APRN’s can engage in professional organizations, such as the American Nurses Association or state-level nursing associations. These associations actively influence health policy. Nurses and Advanced Practice Registered Nurses can participate by joining committees, attending advocacy days, or engaging in lobbying efforts. Through these channels, nurses can collaborate with other healthcare professionals to push for legislative changes that impact patient care, nursing education, and healthcare access. One challenge is that policy-making processes can be complex and time-consuming. RNs and APRNs often face time constraints due to demanding work schedules, making it difficult to commit to policy activities. Additionally, the intricacies of policy language and legislative procedures may be intimidating for those without formal policy training. To overcome these barriers, nurses can start by participating in smaller advocacy roles that fit within their schedules, such as writing letters to legislators or signing petitions. They can also seek out policy education and training programs, which many nursing organizations offer. Mentorship from experienced nurse leaders can provide guidance on navigating the policy landscape.

Secondly RN’s and APRN’s can seek appointments to governmental health advisory boards, task forces, or councils. These bodies are often established to provide expert advice on health-related issues and help shape policies at the state or federal level. By joining these groups, nurses can offer their expertise on healthcare delivery, patient care, and public health issues. One of the significant challenges is securing a position on these committees, as competition may be high, and appointments are often politically driven. Additionally, nurses may feel underqualified or lack confidence in their ability to contribute to high-level policy discussions. Networking and gaining visibility within professional organizations can increase the chances of being appointed to these committees. Building relationships with policy makers, attending public meetings, and staying informed about open advisory roles can also help. Nurses can boost their qualifications by pursuing advanced degrees or certifications in health policy.

Some strategies for advocacy and communication strategies include social media and professional platforms and hosting policy workshops and webinars. To advocate for these opportunities, nurses can use social media platforms such as LinkedIn, Twitter, and professional networks to highlight ways to engage in policy making. Sharing success stories, legislative updates, or simple steps to get involved can inspire peers to participate. For example, the American Nurses Association uses twitter to disseminate information on upcoming policy meetings or health-related bills, encouraging RNs and APRN’s to take action. Another strategy is to organize policy workshops or webinars aimed at educating nurses on how to engage in policy activities. These workshops can cover essential skills, such as how to communicate effectively with legislators or write policy briefs. Partnering with local nursing schools or hospitals to offer continuing education credits could further incentivize attendance. For instance, offering a workshop on how to advocate for nursing -friendly policies could attract a wide range of participants interested in healthcare reform. By actively promoting these strategies, more RN’s and APRN’s can be empowered to engage in the policy-making process and contribute to the improvement of the healthcare system.

References

Aforbes. (2023, November 10). 10 Ways Nurses Can Get Involved In Policy – NurseJournal.org. NurseJournal.org. https://nursejournal.org/articles/ways-nurses-can-get-involved-in-policy/

Aforbes. (2024, February 22). Why Policy Engagement Is The Next Big Nursing Trend – NurseJournal.org. NurseJournal.org. https://nursejournal.org/articles/the-role-of-nurses-in-policy-engagement/

Inayat, S., Younas, A., Andleeb, S., Rasheed, S. P., & Ali, P. (2023). Enhancing nurses’ involvement in policy making: A qualitative study of nurse leaders. International Nursing Review, 70(3), 297–306. https://doi.org/10.1111/inr.12828

Practice and Advocacy Resources for Nurses | ANA. (2017, October 14). ANA. https://www.nursingworld.org/practice-policy/

Zalon, Margarete L. PhD, RN, ACNS-BC, FAAN; Ludwick, Ruth PhD, RN-BC, APRN-CNS, FAAN; Patton, Rebecca M. DNP, RN, CNOR, FAAN. Strengthening Nurses’ Influence in Health Policy. AJN, American Journal of Nursing 124(9):p 28-36, September 2024. | DOI: 10.1097/01.NAJ.0001028316.80475.bf.

BreAnn Norris

Main Discussion Post

Week 8

Opportunities

Nurses and Advanced Practice Registered Nurses (APRN) play a valuable role in influencing legislation. According to Etowa et al. (2023), the nursing field makes up a substantial part of the healthcare field as a whole. Etowa et al. (2023), suggests that nurses have the opportunity to have a powerful presence in the healthcare legislative process however, there is an underrepresentation of nurses in policymaking. An opportunity for nurses and APRNs to participate in policymaking is by becoming a member and actively participate in professional organization such as the American Nurses Association (ANA). These types of organizations are very active in legislation and influence policymaking.  Professional nursing organizations also have a strong presence in legislative influence. The ANA has a page that is called “RNAction” and displays opportunities to view, participate, and comment on the ANA’s legislative activity. Another opportunity for nurses to participate in policymaking is to prepare evidence-based practice research on the policy change that is desired and present it to local legislators. Oestberg (2013) discusses how evidence-based practice is at the pinnacle of nursing and how it can also be used to express to promote policymaking.

Challenges

            There are many challenges to the proposed opportunities as previously listed. “Nurses’ involvement in health policy making is clear; however, still few are involved in policy-making processes, even in the clinical context” (Hajizadeh, A. et al., 2021). A challenge is that even though nurses hold a powerful position in politics, not enough nurses have the desire to participate in the policy-making process in general. Another challenge is that there may not be enough quality evidence for the proposed policy. The process of gathering sufficient evidence may also take a large amount of time and nurses are generally exhausted from such a heavy workload.

Solutions

Some solutions to the above challenges include more nurses participating in healthcare legislation and embarking in original research or utilizing other resources to gather evidence. An example of this is seeking out information from other healthcare organizations that may support the proposed policy. Morris (2023) advises to ensure the evidence gathered is written in simple language that a non-medical background legislator can understand. This will make it easier for legislators to understand and implement the proposed information.

Recommendations

Recommendations for an increase in nursing participation in politics as recommended by Hajizadeh et al. (2021), include incorporating more education and information about healthcare policymaking advocacy in nursing school. Another way to improve participation is to have healthcare organizations such as hospitals create a leadership that makes up a policymaking advocacy committee that is involved with local legislators.

References

American Nurses Association (ANA). (n.d.). RNAction. https://rnaction.org/sitepages/homepage.aspx

Etowa, J., Vukic, A., Aston, M., Iduye, D., McKibbon, S., Georgia, A., Nkwocha, C., Thapa, B., Abrha, G., & Dol, J. (2023). Experiences of nurses and midwives in policy development in low- and middle-income countries: Qualitative systematic review, 5. https://doi.org/10.1016/j.ijnsa.2022.100116d

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing 20(128). https://doi.org/10.1186/s12912-021-00648-6

Morris, G. (2023). 10 ways nurses can get involved in policy. Nurse Journal. https://nursejournal.org/articles/ways-nurses-can-get-involved-in-policy/

Oestberg, F. (2013). Getting involved in policy and politics. Nursing Critical Care, 8(3). https://doi.org/10.1097/01.CCN.0000429392.92546.6f

Policy Making Opportunities for RNs/APRNs

As a component of professional nursing, active participation in the policy process is essential in the formulation of policies designed to provide quality health care at sustainable costs to all individuals (Short, 2022). Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) have unique opportunities to influence healthcare policy due to their frontline experience and expertise in patient care. Here are two opportunities for them to actively participate in policy-making:

Engagement in Professional Nursing Organizations:

Nursing organizations in particular, continue to serve as critical platforms for policy advocacy—the practice of engaging in political processes to initiate, enact, and enforce structural and policy changes to benefit populations (Chiu et al., 2021). RNs and APRNs can join professional organizations such as the American Nurses Association (ANA) or specialty groups like the American Association of Nurse Practitioners (AANP). These organizations often have advocacy arms that work directly with policymakers to influence healthcare legislation. One challenge is the time commitment required to actively participate in these organizations, especially for nurses with demanding work schedules. Additionally, there may be a lack of awareness about how to get involved. Nurses can overcome these challenges by prioritizing time management and seeking support from their employers to participate in advocacy activities. Organizations can also provide clear pathways and resources for involvement.

Direct Advocacy and Lobbying:

RNs and APRNs can engage in direct advocacy by meeting with legislators, providing testimony on healthcare issues, or participating in lobbying efforts. They can share their firsthand experiences to inform policy decisions. Nurses may face challenges such as a lack of experience in political advocacy or feeling intimidated by the legislative process. Overcoming challenges consist of obtaining education and training in advocacy skills which can empower nurses. Mentorship programs within nursing organizations can also provide guidance and support.

Strategies to Advocate and Communicate Opportunities:

Organize workshops and seminars focused on policy-making and advocacy skills. These can be hosted by nursing schools or professional organizations to educate nurses about the legislative process and how they can get involved. Utilizing Social Media and Online Platforms is a second option. Leverage social media and online platforms to disseminate information about advocacy opportunities. Creating dedicated groups or pages where nurses can share experiences, resources, and upcoming events can increase awareness and participation.

By actively engaging in these opportunities and overcoming associated challenges, RNs and APRNs can play a significant role in shaping healthcare policy to improve patient outcomes and the nursing profession.

References

American Nurses Association (ANA). (2020). Nurses’ role in policy-making. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/

Chiu, P., Cummings, G. G., Schick-Makaroff, K., Thorne, S. (2021). “Policy Advocacy and Nursing Organizations: A Scoping Review.” Policy, politics & nursing practice vol. 22,4: pp 271-291. doi:10.1177/15271544211050611

Congress.gov (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning.

As healthcare workers who see the deficiencies in healthcare system policies and healthcare overall, we have an essential role that heavily influences change for the greater good of society (Salvage & White, 2019). We push hospital administrations and legislators to revise their methodology of care and magnify how these policies affect patients and those caring for them. We are taught the importance of patient advocacy. However, advocacy as a healthcare professional does not just include the care we provide for our patients but the policies that are a driving force behind the care we provide (Salvage & White, 2019). We must know the policies affecting healthcare systems, patients, and healthcare professionals. Knowing how to actively participate in making policies is equally important, along with being knowledgeable about the policies being proposed and passed as they relate to healthcare reform (Chiu et al., 2021).

Opportunities for Advocacy for RNs and APRNs

Professional nursing organizations allow RNs and APRNs to become informed about current and potential policies being discussed on local, Congressional, and Presidential agendas. In addition to keeping nurses informed, they allow the opportunity for action (Chiu et al., 2021). Professional nursing organizations can be joined within individual healthcare organizations, nursing schools, and nationwide. Organizations such as the American Nursing Association, ANA compile nursing concerns and data collected to share with policymakers and advocate for reform (Wilson et al., 2020).  Another national professional nursing organization is Sigma Theta Tau, which nurtures a thirst for action while in nursing school but allows membership to continue after graduation to attend conferences and stay informed through newsletters about legislation changes in nursing (Wilson et al., 2020). It is important to remember that not all policies are enforced on a federal level. State professional nursing organizations also allow nurses to advocate in state legislation.

Challenges and Overcoming Barriers

Being an advocate is not an easy path, as numerous challenges and obstacles may impede or delay action. We are currently faced with a nursing shortage to care for increased patient needs with increased acuity (Wilson et al., 2020). Increased patient care needs require nurses to attend to the immediate physical needs of patients and may not be available to attend conferences or lobby legislators (Salvage & White, 2019). While numbers can make an impact, a well-formed, evidence-based position can make just as much of an impact that will be hard to ignore (Turale & Kunaviktikul, 2019). Another challenge can be a lack of professional development in the policy-making process and policy development. Understanding the processes is crucial, as it grants RNs and APRNs an understanding of the proper steps to take and the information needed, ensuring no time is wasted with easily avoidable mistakes (Chiu et al., 2021). One major challenge is the lack of legislators’ understanding of healthcare’s needs to be sustainable and meaningful. People do not understand what they do not know, which can result in ignorant policy decisions (Salvage & White, 2019). Presenting data and allowing legislators to experience our world is a way to overcome this challenge.

Strategies to Improve Advocacy and Communication

Encouraging RNs and APRNs to advocate is only one side of the coin. Healthcare professionals often feel that their voices or concerns are not heard, and they fall on deaf ears (Wilson et al., 2020). One strategy to improve advocacy and communication is to show RNs and APRNs that their involvement makes a tangible difference (Chiu et al., 2021). By highlighting advocacy’s impact on old and recent policies, we can validate their efforts and encourage them to continue their involvement (Wilson et al., 2020). Another strategy is making sure that safe spaces are created for RNs and APRNs to express their concerns. Revealing weaknesses in a healthcare system or policy can be discouraging, especially if you feel powerless or that consequences will be the result (Salvage & White, 2019). Healthcare systems often have annual education that employees must complete to be compliant. Incorporating modules on professional nursing organizations and policymaking may be beneficial and inspire healthcare professionals to speak up more and get actively involved (Turale & Kunaviktikul, 2019).

Conclusion

Advocacy is a foundational principle that we, as nurses, possess for our patients and ourselves. We must utilize our tools to reach a larger audience and get our voices and concerns heard (Wilson et al., 2020). Obstacles may seem impossible to overcome, but with persistence and time, success is obtainable. Drive and ambition should be paired with knowledge to ensure that when we present concerns or suggestions to legislators, they make a lasting and concise impact.

References

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics, & Nursing Practice, 22(4), 276–296. https://doi.org/10.1177/15271544211050611

Salvage, J., & White, J. (2019). Nursing leadership and health policy: Everybody’s business. International Nursing Review, 66(2), 147–150. https://doi.org/10.1111/inr.12523

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International Nursing Review, 66(3), 302–304. https://doi.org/10.1111/inr.12550

Wilson, D. M., Anafi, F., Kusi-Appiah, E., Darko, E. M., Deck, K., & Errasti-Ibarrondo, B. (2020). Determining if nurses are involved in political action or politics: A scoping literature review. Applied Nursing Research, 54, 151279. https://doi.org/10.1016/j.apnr.2020.151279

Opportunities for Nurses to Participate in Policymaking

RNs and APRNs can participate in policymaking by attending legislative hearings and making their voice heard (Morris, 2023). A few important things that these hearings cover are nurse staffing ratios, Medicaid expansion, and scope of practice (Morris, 2023; The Florida Senate, 2020). Getting involved requires tracking relevant bills through the Florida Senate or House websites and following the legislative calendars (The Florida Senate, 2024; Florida House of Representatives, n.d.). Once a hearing of interest is identified, one can register to publicly share testimony to support or deny a bill by submitting a committee appearance form through the Florida Senate or House websites (The Florida Senate, 2024; Florida House of Representatives, n.d.). One challenge is the demanding schedules of nurses, which can make it difficult to attend hearings in person (Hajizadeh et al., 2021). To overcome this, nurses can submit written testimony or partner with professional organizations to coordinate advocacy efforts (Spader, 2023; ANA, n.d.).

Another way that RNs and APRNs can actively participate in policymaking is by educating other nurses on how to get involved (Cleveland et al., 2019). There is power in numbers, so developing educational workshops or webinars within our workplaces to inform other nurses about the importance of policy involvement can help drive change (ANA, n.d.; Cleveland et al., 2019). For example, a hospital-based education campaign could introduce staff to bills relevant to nursing practice, such as those expanding nurse practitioner autonomy, and encourage them to write letters of support to legislators (Spader, 2023). A challenge in implementing these educational efforts would be the need for more resources, like adequate staffing, for many nurses to engage in additional activities (Hajizadeh et al., 2021). This can be addressed by incorporating advocacy training into new hire onboarding or offering continuing education credits to incentivize participation (Hajizadeh et al., 2021).

Two strategies to better advocate for or communicate these policymaking opportunities are using social media platforms and partnering with professional organizations (Altmiller & Hopkins-Pepe, 2022; ANA, n.d.). Social media offers an efficient way to engage nurses by sharing legislative updates, advocacy events, and actionable steps, such as reminders to submit written testimony before hearings (Morris, 2023; Altmiller & Hopkins-Pepe, 2022). For example, creating Facebook or LinkedIn groups dedicated to advocacy can keep nurses connected and informed in real time (Altmiller & Hopkins-Pepe, 2022). Partnering with organizations like the American Nurses Association offers opportunities to educate large audiences about healthcare legislation while providing community engagement through organized events (ANA, n.d.). These strategies spread awareness and empower more nurses to confidently shape healthcare policy (Cleveland et al., 2019).

References

Altmiller, G., & Hopkins-Pepe, L. (2022). Influence of technology in supporting quality and safety in nursing education. National Library of Medicine. Retrieved October 16, 2024, from https://doi.org/10.1016/j.cnur.2022.06.005

ANA. (n.d.). RN Action. Retrieved October 16, 2024, from https://rnaction.org/SitePages/Homepage.aspx

Cleveland, K., Motter, T., & Smith, Y. (2019). Affordable care: Harnessing the power of nurses. OJIN. Retrieved October 16, 2024, from https://doi.org/10.3912/OJIN.Vol24No02Man02

Florida House of Representatives. (n.d.). Committee/ subcommittee appearance record. Retrieved October 16, 2024, from https://www.myfloridahouse.gov/Sections/Committees/AppearanceRequestForm.aspx

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses’ participation in the health policy-making process: a systematic review. National Library of Medicine. Retrieved October 16, 2024, from https://doi.org/10.1186/s12912-021-00648-6

Morris, G. (2023, November 10). 10 ways nurses can get involved in policy. Nurse Journal. Retrieved October 16, 2024, from https://nursejournal.org/articles/ways-nurses-can-get-involved-in-policy/

Spader, C. (2023, January 19). Making real change: How nurse leaders can collaborate with legislators. OR Manager. Retrieved October 16, 2024, from https://www.ormanager.com/making-real-change-how-nurse-leaders-can-collaborate-with-legislators/

The Florida Senate. (2020). Direct care workers; Bill summaries. MyFloridaHouse.gov. Retrieved October 16, 2024, from https://www.flsenate.gov/Committees/billsummaries/2020/html/2294

The Florida Senate. (2024). Senate daily calendars, interim calendars and weekly schedules. MyFloridaHouse.gov. Retrieved October 16, 2024, https://www.flsenate.gov/Session/Calendars/2024

Week 8 Discussion Post:

Nurses, RNs, and APRNs can play pivotal roles in policy-making and influencing healthcare-related legislation. Before exploring ways that nurses can influence policy, it is essential to recognize the importance of participation. Simply choosing to participate in practices to influence policy has been found to be one of the most significant barriers to nurses’ role in policy change. This means that shifting leadership focus to empowering and enhancing nurses’ participation can create a more influential impact on policy-making.

Advocacy is a powerful tool for RNs and APRNs to influence legislation and policy-making. Many organizations, such as the American Nurses Association (ANA), actively lobby for and directly influence policy and legislation. Through advocacy, nurses can be empowered to create change at local and national levels with the support of these groups. During critical times, such as the COVID-19 pandemic, legislators often rely on advocacy groups like these to swiftly develop action plans. APRNs can also hold influential positions in state nursing associations, directly shaping policy.

Strategies to improve advocacy and spread awareness of policy influence avenues within the nursing world may prove effective means of increasing participation. One simple strategy to advocate for policy is to stay aware of potential or proposed changes in legislature. This can keep individuals more knowledgeable about the current climate within the policy creation space and allow for informed advocacy to take place more easily. Another means to influence and advocate for policy change is to participate in or even create the research that the policy is based upon. Many policy creation decisions are evidence-based when related to healthcare. Advocating on behalf of research can create both positive change within policy and also call on researchers to develop more solid evidence to guide practices. Nurses provide consistent patient-centered views on healthcare that can bring about a positive change in the policy creation process (Arabi et al., 2014).

References:

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. PubMed, 19(3), 315–322. https://pubmed.ncbi.nlm.nih.gov/24949073

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00648-6

How do nurses influence health policy? (n.d.). Default. https://www.healthstream.com/resource/blog/how-do-nurses-influence-health-policy

Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) hold pivotal roles in healthcare that extend beyond patient care into the realms of policy-making. Two significant opportunities for these professionals to engage in policy include participating in professional nursing organizations and serving on governmental advisory boards. Professional organizations, such as the American Nurses Association (ANA), offer nurses a platform to influence health policy by drafting position statements and lobbying for legislation that impacts nursing and patient care (Robbins, 2020). Additionally, serving on advisory boards allows nurses to contribute directly to policy decisions that affect healthcare standards and practices at both state and federal levels.

However, these opportunities also present challenges, primarily related to the lack of time, resources, and sometimes the necessary skills to effectively influence policy. Many nurses struggle with balancing clinical responsibilities with advocacy roles, which can be resource-intensive (Laurenzi et al., 2021). Furthermore, nurses may also face the challenge of a lack of formal training in policy-making processes. To overcome these barriers, continuous professional development programs in health policy could be integrated into nursing education and training. Such programs can equip nurses with the skills and knowledge needed to navigate the complexities of policy environments effectively. Moreover, healthcare organizations can support nursing advocacy by providing time and resources for nurses to engage in these activities.

To enhance the participation of RNs and APRNs in policy-making, it is essential to adopt strategies that raise awareness and facilitate engagement. First, professional nursing organizations should actively promote the success stories of nurse-led policy initiatives through conferences, webinars, and social media to inspire and educate nurses about the impact of their involvement in policy-making (McNett et al., 2022). Secondly, nursing education programs should include policy education as a core component of the curriculum, emphasizing the role of nurses as policymakers. This integration can cultivate a strong foundation of policy knowledge from the onset of a nurse’s career, thereby fostering a more proactive approach to policy participation.

References

Laurenzi, C. A., Skeen, S., Rabie, S., Coetzee, B. J., Notholi, V., Bishop, J., Chademana, E., & Tomlinson, M. (2021). Balancing roles and blurring boundaries: Community health workers’ experiences of navigating the crossroads between personal and professional life in rural South Africa. Health & Social Care in the Community, 29(5), 1249-1259. https://doi.org/10.1111/hsc.13153

McNett, M., Tucker, S., Thomas, B., Gorsuch, P., & Gallagher-Ford, L. (2022). Use of implementation science to advance nurse-led evidence-based practices in clinical settings. Nurse Leader, 20(3), 297-305. https://doi.org/10.1016/j.mnl.2021.11.002

Robbins, K. C. (2020). The year of the nurse: Nurse-led initiatives. Nephrology Nursing Journal, 47(2), 167-171.

The role of the RN/APRN in policy making

Nurses can play a pivotal role when participating in policy making and health policy. Nurses can join organizations, associations, councils, etc. According to Short, “Professional experts such as registered nurses are often asked to serve as panel members or consultants or to serve on committees that provide input to policy makers.” (2022). This can be on a state or federal level. There are many options available.

Joining a professional association

Associations such as the American Nurses Association (ANA) are constantly working towards change in health care and nursing policy. According to the ANA, “One of the primary ways we achieve this is by advocating on behalf of registered nurses at top levels of government as policies are conceived, debated, and implemented.” (n.d.). The ANA has an online federal advocacy program called RNAction. On this site, you can see what the ANA is doing to help with the advancement of healthcare legislation, especially nursing legislation. It also shows you ways that you can become involved as an advocate yourself. One drawback is the constraints of your employment. It may be difficult to get involved in policy making when you do not have the time between your work life balance. Policy making also may feel a bit overwhelming if you are not familiar with the topic. A lack of experience could cause a nurse to shy away from the task.

Joining a national advisory council

A council such as the National Advisory Council on Nurse Education and Practice (NACNEP) is a board that advises the secretary of the U.S. Department of Health and Human Services (DHHS) and U.S. Congress on policy issues under the Public Health Service Act Title VII Nursing Workforce Development. (HRSA, 2024). You can nominate yourself or be nominated by someone else to a seat on the council. You can also virtually join meetings as they arise through the HRSA website. The most effective way would be to serve on the board but that can be difficult. The seats on the board can be competitive or require endorsement through someone already seated on the board or political ties.

Ways to advocate opportunities for RNs/APRNs

                One way to advocate for nurse involvement in health policy is to raise awareness of this topic on all educational levels. According to Hajizdah et. al., “Preparing nursing students to participate in health policy is critical to ensuring the nursing workforce can effect the plans, structure, and financing of healthcare.” (2021). Social media is another tool to raise awareness. Our world is a technological one now and most people have access to the internet in some capacity. Social media can bring awareness to health policies through ads, groups, posts, reels, etc. According to O’Connor, “Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice…” (2017). These are the two greatest outlets to allow nurses to be more engaged in health policy.

Resources

Federal advocacy. ANA. (2017, October 14). https://www.nursingworld.org/practice-policy/advocacy/federal/#:~:text=The%20American%20Nurses%20Association%20(ANA,conceived%2C%20debated%2C%20and%20implemented.

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00648-6

National Advisory Council on Nurse Education and practice. HRSA. (2024, January). https://www.hrsa.gov/advisory-committees/nursing

O’Connor, S. (2017). Using social media to engage nurses in health policy development. Journal of Nursing Management, 25(8), 632–639. https://doi.org/10.1111/jonm.12501

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide. Jones & Bartlett Learning.

Week 8 discussion

When creating a nursing word cloud, what kinds of words would you use? I feel Advocacy, organization, hard work, and empathy would all be relevant. To your list, would you add policy-maker? Would that, in your opinion, be a particularly noticeable part of the word cloud?

Joining Professional Nursing Organizations

By interacting with state-specific associations or professional organizations like the American Nurses Association (ANA), registered nurses and advanced practice registered nurses can take an active role in policymaking. These groups frequently support laws that have an impact on patient care, nursing practice, and healthcare delivery. Nurses can influence healthcare policy, take part in advocacy campaigns, and contribute to regulatory reforms by joining. Challenges may be issue such is time constraints brought on by clinical practice responsibilities, which can make it hard for nurses to participate in advocacy or organizational meetings. Lack of expertise or experience in policymaking is another obstacle that could make people reluctant to fully participate.  How to overcome this challenges on will have to focus on time management and setting priorities: Nurses can schedule time to attend advocacy events, webinars, or virtual meetings. Some groups provide quick, targeted possibilities that nonetheless have an influence, including signing petitions or writing letters to lawmakers. Educate and mentor to gain confidence and expertise in policymaking, nurses might attend workshops and conferences or enroll in professional development courses provided by these organizations.

Participating in Policy Committees or Advisory Boards

Nurse Representatives are a common feature of policy committees or advisory boards in numerous healthcare facilities, municipal governments, and professional associations. APRNs and RNs can influence policy on topics like healthcare access, nursing workforce legislation, and patient care standards by participating on these boards. Challenges would be navigating the intricacies of institutional and political processes can be quite difficult for nurses who are new to policy work. It might be frightening or daunting. There could also be obstacles to entry, like not knowing how to participate in these committees or not having the necessary professional connections. To overcome this challenges nurses can find mentors who are already involved in policy work or collaborate with colleagues who have experience in advocacy to help them navigate the process. Attend conferences, networking events, or even engaging with nurse leaders on social media can open doors to policy committees. Nurses should also actively seek opportunities within their workplaces by inquiring about available policy committees or positions on advisory boards.

Strategies to Advocate for and Communicate Policy-Making Opportunities

Leverage Social Media and Professional Networks: Sharing information about how nurses can participate in policy-making on social media sites like Facebook, LinkedIn, and Twitter is a good way to spread awareness of policy-making opportunities. Updates on current legislative concerns, advocacy efforts, and committee or board membership possibilities are frequently shared by advocacy groups and professional associations. Another tactic is to host informative webinars or seminars about healthcare lobbying and policy. These gatherings can teach APRNs and RNs how to participate and increase their understanding of policy-making opportunities. Participation and impact might be raised by working with nearby nursing schools or healthcare institutions.

References

American Nurses Association (ANA). (2020). Nurses’ role in policy-making. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/

Ellenbecker, C. H., Fawcett, J., Jones, E. J., Mahoney, D., Rowlands, B., & Waddell, A. (2017). A participatory action research study to promote the use of evidence in health policy decision-making. Nursing Outlook, 65(1), 23-31.

Phillips, J. P., Evans, J. L., Tooley, S., & Shirey, M. R. (2018). Nurse leader perceptions of policy advocacy: A qualitative study. Journal of Nursing Administration, 48(4), 212-218.

Shariff, N. (2019). Empowering nurses to be at the frontline of health care industry innovations through graduate education. Journal of Professional Nursing, 35(2), 85-92.

The Role of RNs and ARNPs in Policy-Making    

Nurses play major role and an excellent participation/collaboration in the healthcare field. Nurses are not only taking care of patients; they spend more time with the patients then their providers. they play a special part in the life of the patients and the influence to demonstrate understanding toward their situations, get their trust, make the feel comfortable. They are many aspects when it comes to implementation on policy-making. Many professional nursing organizations have explicit commitment to advance and have a positive effect on the legitimacy of the policy as well as reducing resistance during implementation. Professional organization justify that any policy that is effectively implementing and have nurse’s best interest have the opportunity to participate in policy-making. According to the definition by World Health Organization (WHO), health policies refers to decisions, plans, and actions undertaken to achieve specific health care goals within a society [5]. However, there are some crucial and hesitant steps to get involved in nursing organizations, local, and state legislature; the American Nurses Association, the American Academy of Nursing, and your state nurses association. Nurses are the largest group in the healthcare professional workforce and rapidly growing. They are positioned to understand how policies impact patients and communities and must involve in policy-making decisions, which involve scope of practice, advanced practice regulation, nursing shortages, and reimbursement.

When nursing organizations are attempting to implement change, research for evidence-based practice needs to be structured and validated. If not, the organizations will be in a vulnerable position when decisions are taking place. Most of the time the decisions made by politicians do not have any input of any healthcare professionals and do not have any ideas or understand the importance the professional contribution can help influence decision-making in a positive way. ARNPs have the opportunities to expend scope of practice laws, take leadership roles in health organizations policy, testify before legislators, and may be appointed to government health of nurses to educate students on the importance of policy involvement, encouraging in political advocacy, and training nurse to become healthcare agents. By taking these opportunities, RNs and ARNPs can have the greatest impact on shaping healthcare policy and advocating for reforms to improve care and effective outcome in nursing practice.

Advocate for These Opportunities

Advocacy is defined as the act or process of pleading for, supporting, or recommending a cause or course of action. Often in the healthcare field, nurses are the first and most frequent line of contact with patients of all backgrounds, and experiences seeking care. Nurses play the role of achieving the goal of health equity, but need a robust education, supportive work environments, and autonomy. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, social media, and maintaining patient and family-focused care into 2030.

Nurses act as advocates for their clients by protecting their patient rights and voicing their needs. Nurses have a long history of acting as client advocates, value and knowledge and fought for implementation of best practices, addressing challenges, safety measures, quality improvements, and outcomes. Leveraging these attributions, nursing will help to create and contribute to equitable public health and health care systems that are designed to work for everyone.

References

AbuAlRub R, Foudeh F. Jordanian Nurses’ involvement in health policy: perceived benefits and barriers. Int Nurs Rev. 2017;64(1):13–21. doi: 10.1111/inr.12249. [PubMed] [CrossRef] [Google Scholar] [Ref list]

doi: 10.1177/15271544211020999.

National Academies of Sciences, Engineering, and Medicine. (2021). The Future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press.  10.17226/25982 ↵ 10.17226/25982. [PubMed] [CrossRef] [CrossRef] [Reference list]

National Academies of Sciences, Engineering, and Medicine. (2021). The Future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press.  10.17226/25982 ↵ 10.17226/25982. [PubMed] [CrossRef] [CrossRef]

American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). American Nurses Association. ↵. [Reference list]

Nurses spend more time with patients than any other group of healthcare providers; we are the prime guardians. We need to make our voices heard by those in charge so they can hear what we believe is essential for our patients and ourselves (Oestberg, 2013). Nursing is one of the largest professions, with over 4 million nurses in the US alone. Our participation in policy that has implications for our work and patients is both a professional obligation and an ethical one. We count on the political process because healthcare delivery issues are wider than policy experts and professional busybodies like me. However, it is unfortunate that we are not involved more frequently in healthcare policy events.

The approach with the most significant potential to impact health policy-making may be that of Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRN). Here are two instances where they could be active in policy planning and implementation, some possible obstacles, and how to mitigate them. There are many opportunities for RNs and APRNs to have their say in policy-making (e.g., through professional nursing organizations like the American Nurse Association—ANA or state-level nursing associations). They also often fight for healthcare reform and push policies that improve both the patient care experience and nursing. Nurses could participate in committees, attend benevolence activities, or influence policy position statements.

Nurses experience rare and wide-ranging challenges. Because they have such busy schedules, they have few and far between opportunities to get involved with policy activities. In discussing policy, some nurses may appear ill-prepared because they feel unequipped about the legislative process or healthcare. Interactions with patients can be complex. On the other hand, we nurses have backs and ways to tackle these challenges. These are Time Management—Nurses can pursue flexible opportunities like virtual advocacy events or periodic committee meetings that fit into their schedules. Training—Various education and training programs on policy advocacy are available to nurses through professional organizations or academic institutions. For instance, the ANA delivers webinars and advocacy and policy resources.

Numerous healthcare institutions and governmental entities request RNs, especially the APRN variety, to participate in advisory or legislative committees regarding health matters. Nurses can influence healthcare policies in areas like nursing workforce planning, patient safety, and delivering care. The attitude of other healthcare professionals, policymakers, or organizations, who may not value these issues’ contribution to good clinical practice as much as they do other kinds of information from healthcare workers (like doctors and administrators). Without existing political ties, these opportunities can very well be challenging for nurses to have access to. Nurses can collaborate with other healthcare professionals, community leaders, or patient advocacy groups to build stronger collective voices and influence. Connection/mentoring — Nurses should build relationships with policy-making mentors or attend networking meetings where policymakers attend. You can be asked to formally contribute further by making connections like this.

Ways to advocate for policy participation opportunities leverage social media and digital platforms: To have greater input on policy-making opportunities, nurses and nursing organizations must also use social media platforms such as Twitter, LinkedIn, etc. Nurses Stay Informed, Act on Legislative Hearings. You might create a social media campaign that features key healthcare influencers or policymakers and tag them with #NursesinPolicy. Create policy-focused certificate and continuing education programs: Nurses must complete continuing education to renew licensure. Including policy-making content in these programs could expose nurses to advocacy opportunities more expeditiously. Hospitals and Universities can even develop particular courses in health policy advocacy, legislative processes, etc, or some hospital advisory board roles. For instance, “How to Advocate for Nursing Issues in State and Federal Policy” would be a great start for providing nurses with the necessary tools and confidence.

Informing RNs and APRNs about these opportunities and the barriers to be negotiated can help them drive healthcare policy that influences their profession in ways they believe influence patient outcomes.

References:

Oestberg, F. (2013). Getting involved in policy and politics. Nursing Critical Care, 8(3), 48. https://doi.org/10.1097/01.ccn.0000429392.92546.6f

American Nurse: The Official Journal of the American Nurses Association (ANA). (n.d.). American Nurse. https://www.myamericannurse.com/nursing-professions-potential-impact policy politics.

Ironside, P. M. (2015). Narrative Pedagogy: Transforming Nursing Education Through 15 Years of Research in Nursing Education. Nursing Education Perspectives, 36(2), 83–88. https://doi.org/10.5480/13-1102

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

The role of the RN/APRN in policy making

Nursing is the largest profession in the world. It places nurses in unique positions, as they have the potential to influence policies governing healthcare and other related fields where they exert their influence, as Short (2022) demonstrates. Therefore, nurses can assume roles influencing policy making in their advocacy for better healthcare. They should recognize the moral and professional obligations for engaging in legislation.  In the US, registered nurses and APRNs have unique opportunities to contribute to healthcare policy-making. However, most opportunities are presented at professional organizations. Therefore, they can identify problems, analyze policy implications, formulate policies, and use their professional bodies to lobby for policies that improve nursing practices at state and federal levels through their collective voices as the organizations help them amplify their quest to the relevant authorities (The CDC Policy Process | POLARIS | Policy, Performance, and Evaluation | CDC, 2021).

Besides, they can testify at legislative hearings, especially in Congress. It would ensure they directly participate in policymaking by providing expert opinions on matters affecting their practice. In return, it ensures legislators incorporate expertise from diverse stakeholders in drafting laws. For instance, nurses can present evidence to Congress to demonstrate how proposed legislations are poised to affect the healthcare landscape, thus giving policymakers real-world insights into how their legislative responsibilities would impact the general population (Chiu et al., 2021). However, despite having valuable opportunities, they face multiple challenges. For instance, time constraints make it challenging to engage in advocacy and lobbying due to demanding schedules. Bureaucracy also poses challenges due to the autonomy vested among policymakers. It makes it hard for them to meet with legislators, further crippling the implementation process (Tummers & Bekkers, 2014). However, it can be mitigated by deploying technology through virtual advocacy, thus enabling them to join online forums where they can converse with congressmen and lobby for relevant policies. Other nurses lack adequate knowledge about legislative processes (Han & Kim, 2024). Therefore, they do not participate in the processes. Nonetheless, this challenge can be addressed by motivating nurses to continue education and mentorship to gain the skills and knowledge needed to design policies.

References

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy Advocacy and Nursing Organizations: A Scoping Review. Policy, Politics & Nursing Practice, 22(4), 271–291. https://doi.org/10.1177/15271544211050611

Han, N. K., & Kim, G. S. (2024). The Barriers and Facilitators Influencing Nurses’ Political Participation or Healthcare Policy Intervention: A Systematic Review and Qualitative Meta-Synthesis. Journal of Nursing Management, 2024(1), 2606855. https://doi.org/10.1155/2024/2606855

Sacristán, J. A., & Dilla, T. (2015). No big data without small data: Learning health care systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017. https://doi.org/10.1111/jep.12350

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning.

The CDC Policy Process | POLARIS | Policy, Performance, and Evaluation | CDC. (2021, March 4). https://www.cdc.gov/policy/polaris/training/policy-process/index.html

Tummers, L., & Bekkers, V. (2014). Policy Implementation, Street-level Bureaucracy, and the Importance of Discretion. Public Management Review, 16(4), 527–547.

Opportunities to Participate in Policy-Making

The nursing profession has become one of the largest regulated professions globally. Their knowledge, skills, and advocacy are crucial in delivering the highest healthcare delivery and, lately, to policy-making. In this week’s discussion, there are two opportunities for RNs and APRNs to participate actively in policy-making: being a member of a professional association and appearing in Congress to advocate for a policy.

Being a professional association member has many benefits for both RNs and APRNs. A professional association is an organization that advocates for the nursing profession, which can influence changes in healthcare policy, represent and protect the interests of nurses, provide continuing education opportunities for nurses, and advocate for the highest quality care possible for the public (Halstead, n.d.). They provide the opportunity for its members to influence nursing practice, nursing education, healthcare standards, and policies (Halstead, n.d.). Moreover, they provide and facilitate different professional growth training, skill development collaborations, networking, and career advancement opportunities (Halstead, n.d.). An example is being an American Nurses Association (ANA) member. ANA is a very active organization that participates in health policy changes at both the federal and state levels. They continue to work and advocate for the nursing profession and to improve health and health care for all (American Nurses Association, n.d.).

Another way for RNs and APRNs to actively participate in policy-making is by appearing before Congress to advocate for a bill to pass. One bill that was introduced in the Senate recently and has not gained any traction for the bill to pass is the S.113 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2023. This bill requires hospitals to implement a safe nurse-to-patient ratio and assign an RN to not more than the following number of patients in a unit at all times during each shift (Congress.gov, n.d.). This bill also protects the RN if he or she objects to or refuses to participate in an assignment that violates the specified ratios (Congress.gov, n.d.). Several studies have shown that a safe nurse-to-patient ratio improves patient outcomes and reduces healthcare costs, including the studies conducted in 2021 by Lasater et al. (2021) and McHugh et al. (2021), which show thousands of lives saved, improved patient outcomes, lower readmission rates, and decrease in healthcare costs. In addition, hospitals with higher NP-to-bed ratios of 3+-to-100 beds have lower odds of 30-day mortality, 7-day readmissions, shorter average length-of-stay, better care quality and safety, lower nurses’ burnouts, higher job satisfaction, and higher likelihood of staying in their jobs (Aiken et al., 2021). Advocating for bills that were introduced in Congress and sharing personal experiences can help inform politicians in their decision-making.

Challenges and Strategies

Unfortunately, great opportunities come with challenges. These challenges include the lack of resources, time, limited knowledge in policy-making, and pushback from policymakers.  However, there are strategies that RNs and APRNs can use to overcome these challenges. One great way to solve several of these challenges is to get educated. RNs and APRNs can take courses in policy-making. The policy-making process is a very complex process that requires a deep understanding of policy design. There are colleges in the US that provide courses in policy-making that do not require program admission. For example, Paula Lantz, a professor at the University of Michigan, launched a new open online course about public policy through Michigan Online to help learners understand the fundamentals of public policy. These fundamentals include steps of the public policy-making cycle, policy analysis, understanding the use of data to support policy design and evaluation, using real-world examples and insights from advocates and politicians, exploring societal challenges, and how policy can confront issues on a local, national, and global scale (University of Michigan, 2023). This is a very beneficial course for RNs and APRNs to acquire knowledge regarding policy-making and requires no policy background. Another way is to attend a certificate program through Walden University. Walden University offers public policy graduate certificate programs that can help learners improve their ability to create and evaluate policies that engage citizens and contribute to positive social change (Walden University, n.d.). This way, we will build our knowledge in policy-making and have a great knowledge of policy design, which can help reduce pushback from policymakers when we present a policy that is backed by research, data, and advocates. With the lack of resources, healthcare organizations reimburse employees who attend programs or continued education courses. RNs and APRNs can use this opportunity to use those resources and attend courses that benefit them to get educated in policy-making. Finally, with time constraints, time management is the key. RNs and APRNs can spend little time participating in policy-making, just as RNs and APRNs found the time when trying to advance their education through the MSN programs.

Strategies to Advocate for These Opportunities

Advocacy for these opportunities is beneficial for RNs and APRNs to participate in policy-making opportunities such as those mentioned above actively. There are two strategies that I can use to advocate better or communicate the existence of these opportunities to participate in policy-making. The first is the use of social marketing campaigns. According to Unterseher (2019), social marketing is a strategy used to reach a large targeted audience in the community to support behavioral change with little effort by using short videos or appealing graphics. Social marketing has been used for years in different industries, including healthcare, and I can use this to inform fellow RNs and APRNs of these opportunities to participate in policy-making. The second strategy is to use staff development meetings. A staff development meeting is a type of formal meeting that consists of topic-related agenda items that can educate staff in a limited time. Linking our homework from last week, staff development meetings can be used to inform and educate our colleagues regarding the opportunities to participate in policy-making. According to Persson et al. (2021), meetings are essential prerequisites for flourishing the relationship between colleagues to promote a healthy workplace relationship. Hence, staff development meetings can be used as a tool to educate, inform, and build healthy relationships with colleagues and build an extensive network of nurses.

References:

Aiken, L. H., Sloane, D. M., Brom, H. M., Todd, B. A., Barnes, H., Cimiotti, J. P., Cunningham, R. S., & McHugh, M. D. (2021). Value of Nurse Practitioner Inpatient Hospital Staffing. Medical Care, 59(10), 857–863. https://doi.org/10.1097/MLR.0000000000001628

Congress.gov. (n.d.). S.1113 – 118th Congress (2023-2024): Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act of 2023. Retrieved October 13, 2024, from https://www.congress.gov/bill/118th-congress/senate-bill/1113?s=1&r=2&q=%7B%22search%22%3A%22nurse+staffing%22%7D

Halstead, J. A. (n.d.). Professional Nursing Organizations (pp. 107–118). Jones & Bartlett Learning. www.nursing-alliance.org

McHugh, M. D., Aiken, L. H., Sloane, D. M., Windsor, C., Douglas, C., & Yates, P. (2021). Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals. The Lancet, 397(10288), 1905–1913. https://doi.org/10.1016/S0140-6736(21)00768-6

Persson, S. S., Blomqvist, K., & Lindström, P. N. (2021). Meetings are an important prerequisite for flourishing workplace relationships. International Journal of Environmental Research and Public Health, 18(15). https://doi.org/10.3390/ijerph18158092

Sacristán, J. A., & Dilla, T. (2015). No big data without small data: learning health care systems begin and end with the individual patient.

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). 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/10.1080/14719037.2013.841978

Unterseher, L. (2019). Social Marketing Campaigns as a Teaching Strategy for Health Promotion. Nursing Education Perspectives, 40(6), 381–383. https://doi.org/10.1097/01.NEP.0000000000000352

Walden University. (n.d.). Graduate Certificate in Public Policy. Retrieved October 13, 2024, from https://www.waldenu.edu/online-certificates-programs/graduate-certificate-in-public-policy

University of Michigan. (2023). Lantz launches online course about public policy fundamentals. https://fordschool.umich.edu/news/2023/lantz-launches-online-course-about-public-policy-fundamentals

Opportunities for RNs and APRNs in Health Policymaking

Registered Nurses and Advanced Practice Registered Nurses are great contributors to health policy development by a stronger voice for the nursing profession. The most critical opportunities available for RNs and APRNs to be involved in policy are through a professional nursing organization and workplace governance.

One influential opportunity exists in the professional organization for nursing, which is the American Nurses Association (ANA). Associations of this sort offer a forum wherein nurses can work toward the advancement of policies and changes that advocate healthcare delivery (American Nurses Association (ANA), n.d.). By membership, RNs, and APRNs could stand united, studying topics of interest, recommending actions, and participating in grassroots efforts to influence legislation. For example, nurses can speak about critical concerns related to staffing ratios or patient safety regulations.

Another venue is workplace governance. RNs and APRNs often serve on committees or boards that draft policy and then monitor its effectiveness within that particular healthcare institution. Due to their direct experiences in caring for patients, RNs and APRNs are able to give very valuable input into how policies are working and, based on evidence from their practice, how they should be revised (Short, 2022). For instance, a nurse serving on a hospital’s quality improvement committee can influence the development of policies that would promote quality patient care. However, many barriers to involvement still exist, such as a lack of understanding of the process of policymaking as an intimidating or daunting task in which to feel qualified. Klein & Sorra (1996) point out that RNs and APRNs are encouraged to seek out mentorship from seasoned colleagues and related training in health policy and advocacy.

Two actions have been considered most influential in better advocating for these opportunities. First, health policy training should be integrated into the nursing curriculum. This actionwill provide a foundation for knowledge that will enable new graduates to enter professional careers with an initial ability to engage in advocacy. Secondly, social media can be used as an effective drive to communicate policy opportunities and engage nurses in all advocacy activities. For example, some online campaigns can be designed to display the successful policy change brought about by the nurses themselves; this may inspire others to take part in it.

In conclusion, RNs and APRNs have major spheres of influence over health policy by professional organizations and workplace governance. Addressing these challenges in education and advocacy strategies will help improve their involvement with or formulation of healthy policies that benefit patients and facilitate the healthcare system.

References

American Nurses Association (ANA). (n.d.). Advocacy.https://www.nursingworld.org/practice-policy/advocacy/

Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055–1080. https://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=9704071863&site=edslive&scope=site&authtype=shib&custid=s6527200

Short, N. M. (2022). Milstead’s health policy and politics: A nurse’s guide (7th ed.). Jones & Bartlett Learning.