Question

1. What strategies would enhance the effective influence of nurses as a collective special interest group in policy advocacy and electoral politics? Share at least three, with one of the three being a specific example of using media.

Answer 1

Influence of nurses as a collective special interest group in policy advocacy and electrol politics:-

Whether they acknowledge it or not, all nurses are touched by the policy and politics of health care system and the impact the policies, legislation, and regulations developed in those arenas have on the way they practice their profession. Many special interest groups involved in health care actively participate in the development of health care policy by providing critical information legislators need to make decisions. Nurses cannot afford to remain in the background or added as an after thought to the policy and legislative arenas. As the largest single group of health care providers, nurses have the potential to successfully advocate from a diverse power base; and they and have a unique perspective on health care policies and expertise to share with power brokers. Nurses need to be a strong voice actively advocating for positive change. Nurses strengthen their power base when they network with nursing colleagues and other supporters to build consensus on important issues.

As the health care system continues to change, more and more nurses are choosing to take on the advocacy role, working to get health care policies which reflect nursing’s perspective implemented. However, without a sound understanding of the legislative process, policy advocates run the risk of having their message wasted by working with the wrong people or at the wrong time. There are multiple ways to advocate for nursing, ranging from simply making a phone call or writing a letter to expressing your opinion on an issue of importance, all the way to running for office yourself. Even the busiest professionals can find convenient ways to advocate for a better health care system.

Connection between policy advocacy and politics :-

from a proposal to an actual program that can be enacted, implemented, and evaluated, the policy process is impacted by the preferences and influences of elected officials, other individuals, organizations, and special interest groups . These different factions do not necessarily view the issue through the same lens and often have diverse and competing interests.

Political interactions take place when people get involved in the process of making decisions, making compromises, and taking actions that determine who gets what in the health care system. Special interest groups and individuals with a stake in the fate of a health care policy use all kinds of influencing, communication, negotiation, conflict management, critical thinking, and problem solving skills in the political arena to obtain their desired outcome.

Strategies for Effective influence of nurses as a collective special interest group in the Legislative Arena:-As nurses get ready to take their issues into the legislative arena and to use their legislative power and political clout, it is essential to determine which strategies will be timely and most effective. There are the five following strategies: entering the legislative arena, understanding steps in the process, understanding the power players, understanding committees, and communicating with legislators.

(1.)Entering the Legislative Arena:-

The legislative arena is where most advocates concentrate their efforts to make their point of view on a particular issue known. It is where citizens go to meet their legislators and meet with people who are staff for the legislators and the various committees, and where they testify at hearings and briefings.Entering the legislative arena is the first step in bringing about policy change.

Examples:- (a) When Maggie Flanagan found herself with a musculoskeletal injury after years of bedside nursing, she spoke up in the legislative arena in her state to educate policy makers about the need for Safe Patient Handling legislation.

(b.) When Karen Daley suffered a needle stick injury at work, she courageously carried her own experience into the legislative arena to advocate for Safe Needle Protection policy.

(C) When Patti Moss and Iva Hall, nurse researchers from Texas, identified the need for legislation to develop a comprehensive disaster preparedness plan that included home bound medically fragile patient populations, they went to the legislative arena to get needed legislation enacte.

(b.)Understanding the Steps of the Legislative Process:-

knowing legislative process is fundamental to the movement from a problem to a viable program. It is the process that enacts laws, creates and funds health programs, and balances health policy with other policy domains. Once an issue takes its place on the public agenda, a bill must be introduced, delegated to a committee, hearings held, and committee action taken on the bill before the legislation is taken to the floor for a final vote. (For a review of how a bill becomes a law and other nuts and bolts of political action go to The Legislative Process). Each state has a similar legislative process to authoritatively make policy decisions.

Example:- Patti Moss and Iva Hall learned first hand lessons of how to use the legislative process effectively for patients and the profession. When the results of their research revealed the need for a change in the Texas law, they went to work. Working with a consultant, they developed a bill that would make the changes needed to remove barriers to a comprehensive disaster plan. Once the bill was drafted, they had to identify a legislator willing to introduce and sponsor the bill. They used posters, slide presentations, and verbal explanations to present the highlights of their research and the bill they were proposing to local legislators and their staff. Newly elected state Representative Joe Deshotel agreed to introduce the bill and shepherd it through the process. A companion bill was introduced in the state Senate by Senator David Bernsen. Making many trips to Austin for visits to the offices of key legislators, these nurse advocates learned to present their issue in a concise two-minute speech. They also made a point of actively listening to the legislators in an effort to help support the legislators’ causes as the legislators supported theirs. By the end of the legislative session, the efforts of these two nurses were rewarded with the enactment of their legislation paving the way to the establishment of an improved state disaster plan for individuals with special disaster needs .

(3.) Knowing the Key Players:-

In the legislative arena there are always key players who have the ability to impact the outcome of proposed legislation. Final voting decisions are influenced by many factors other than the merits of the issue. These factors include party politics, personal preferences, district voters’ preferences, and the pressure of organized interest groups. Shaping the final outcome and content of the proposed policy change depends on identifying the supporters as well as the non-supporters among legislators, contacting the chairperson and the members of relevant committees, and most importantly contacting one’s own legislator.

As constituents, nurses have considerable power to influence legislation especially when nursing has a firm, cohesive preference on an issue. When potential voters are divided or don’t care, a legislator is less likely to take their preferences into consideration when voting.

(4.) Understanding Committees:-

Committees are the centers of policy making and public education at both the federal and state levels. Proposed legislation is given the most intensive consideration at the committee stage. This is when conflicting points of view are discussed and where legislation is hammered out. The committee chairperson controls the work of the committee; and by negotiating with committee members, establishes the agenda for the consideration of a given bill. Committee procedures perform a gate keeping function by selecting from the hundreds of measures introduced in each session those that merit floor debate and ignoring the rest. Committees conduct hearings to educate committee members and the public about a particular bill under consideration. Hearings provide an opportunity for various views to be discussed. Nurses can influence the process at this point by requesting an opportunity to testify.

5)Communicating with Legislators:-

Each year, legislators at both the state and federal levels must wade through hundreds of bills that cover a broad range of issues. It is impossible for them to be knowledgeable about all issues and to completely understand each bill. This is where advocates can wield a lot of power by helping their own legislators to evaluate an issue and determine how they will ultimately vote on that issue.

The effective advocate will work to develop communication skills in order to convince others to listen and gain the perceptions of others. Repeated contacts with legislators and their staffs made in a straightforward manner greatly increase the likelihood that the information one provides will be heard and understood, and perhaps influence their decisions.

When dealing directly with policy makers, advocates must be informed, be concise, and be clear about what they want. Writing a well crafted letter, sending emails, leaving a written summary of your issue with staff, sending thank-you notes, and inviting the legislator to visit your workplace are all ways to get one’s legislators to consider one as an expert on health care and nursing issues and to make contact when they need information related to nursing and health care.

(6.) media influence on legislative processes:-

In the area of policy-making, media can contribute to setting the agenda for the press, the public, and policymakers through highlighting what issues are newsworthy at a particular time . Media can also influence how the public and policymakers view or think about certain issues through selecting some aspects of a perceived reality and making them more salient in a communicating text . Another way media can influence policymakers is through shaping public opinion, which in turn, exerts pressure on policymakers to respond .For instance, media advocacy is known as a popular strategy in public health that can assist in increasing public awareness and mobilizing decision-makers for policy change.