Question

It is vital for nurses to get involved and understand the political spheres that guide change within the industry. Getting involved takes time and effort. At times, nurses find it overwhelming or some find it cumbersome to get involved and to learn. When is a good time to get nurses involved? How can we encourage nurses to step up?

Answer 1

Nursing is the largest medical profession in the world with nearly 4 million nurses in the United States alone. As such, nurses have the potential to profoundly influence policy and politics on a global scale. In fact, it is the moral and professional obligation of nurses to be engaged in legislation that impacts their patients. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Unfortunately, nurses have historically had little involvement in policy that affects healthcare delivery.

Today nurses continue to make an important contribution to planning and decision-making, and to the development of appropriate and effective public, health and nursing policy on all levels. The work nurses do in influencing policy affects decisions that impact quality of life and universal access to care. There are several reasons for the limited nursing participation in policy and politics. Lack of awareness, inadequate skills, and little opportunity for involvement are just a few factors. Another barrier is the limited formal health care policy education in nursing. Time and resources are further obstacles to the nursing profession’s participation in politics. Additionally, studies show that nurses are not given sufficient support to generate the evidence needed to influence healthcare policy.

To be influential, nurses must see themselves as professionals with the capacity and responsibility to influence current and future healthcare delivery systems. The nursing profession is based on the science of human health and the science of caring. It operates from a framework that values all people in a holistic way and seeks to foster and advance people’s health throughout their lifespans and across all levels of society. To achieve these objectives, it’s essential that policies exist that define and integrate appropriate standards for delivery of care and address conditions necessary for that care to occur. Through policy work, nurses can and should influence practice standards and processes to assure quality of care. Nurses who influence policy help shape the care that will be provided today and tomorrow. Policies also impact resource allocation to support delivery of healthcare.

For nurses, the most important part of their job is delivering quality care. But there is more to high-quality care than knowing diseases; nurses also act as patient advocates. They can help patients make informed decisions regarding their health, including helping them navigate a complex medical system, translating medical terms and helping patients make ethical decisions. Because they have the most direct interaction with patients, nurses are ideally positioned to be advocates. When nurses successfully advocate for their patients, their work promotes the healing process.

The American Nurses Association (ANA) provides this definition of nursing practice: “The protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” The ANA also addresses the importance of advocacy in its Code of Ethics, specifically in Provision 3: “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.” Clearly, advocacy is a key tenet of nursing practice.

Preserving human dignity

In many medical situations, patients and their families are anxious and confused. A calm, experienced nurse can help patients navigate an unfamiliar system and communicate with their physicians. In some cases, nurses also educate the patient about tests and procedures. They should be aware of how culture and ethnicity can affect the patient’s experience while also adhering to privacy laws. In general, nurses are in a unique position that allows them to integrate all aspects of patient care, ensuring that concerns are addressed, standards are upheld and positive outcomes remain the goal.

Patient equality

The healthcare system is constantly changing, both in terms of organization and technological advancement. With these changes come shifting regulations related to the delivery of care and health services. However, nurses must remain above the fray, advocating for patients “with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems,” the ANA Code of Ethics states.

Freedom from suffering

Nurses enter the profession because they have a desire to help others. The core value of helping to prevent or manage suffering is a significant part of this. This can be achieved at the physical, emotional or psychological level, and is one of the most important aspects of patient care. Nursing professionals should be available for patients and their families as advocates for their well-being.

Nurses are advocates for their patients in several critical ways. They are communicators, liaisons, educators, interpreters and caregivers. A career in nursing entails filling multiple roles while providing quality care and striving for healthy outcomes for all patients.

Helping to make informed decisions

One of the most basic ways that nurses can be advocates for their patients is ensuring they have the right to make decisions about their own health. Especially if a patient is alert and competent, nurses should take the patient’s decisions seriously, even if the patient declines to take certain medication or refuses a treatment. When the physician doesn’t agree, the nurse has a responsibility to provide information so the patient can make informed decisions and to offer support.

Making patients a priority

The ethics involved in patient advocacy can make for complex situations. For example, if a patient is dealing with a terminal illness, family members may disagree about care. Although patients may only want comfort measures, oftentimes their loved ones seek strategies that can prolong life. Regardless of the family’s wishes, in this situation the nurse has a duty to facilitate the patient’s needs. Nurses must make the patient their priority. “Advocating is about standing up for the rights of your patients and firmly defending them even if you personally may not agree.

Being a resource

Another area that often calls for advocacy is the financial aspect of healthcare. Families are sometimes more comfortable discussing the difficulties they experience due to treatment costs with nurses, rather than physicians or other healthcare professionals. The conversations nurses have with patients can mitigate these situations, helping patients access the healthcare services they need.

Regardless of the multiple factors limiting the nursing profession’s potential impact on politics, the fact remains that nurses are vital to the development and implementation of healthcare policy. As the largest medical profession in the world, nurses should be leading the way in redesigning the healthcare system. But in order to do so, they will need to partner with members of other medical professions such as physicians. For this to happen, nurses must be skilled in patient care as well as in interdisciplinary teamwork, informatics and technology, implementing evidence-based practice, and quality improvement.

All too often, nurses become frustrated by policies affecting nursing practice, particularly when those policies are written by individuals with limited healthcare knowledge and experience. This frustration often leads to negativity, disillusionment, bitterness, and burn-out. Instead, nurses should channel their frustrations into making a positive difference in their profession.

The truth is, any nurse can influence policy and politics at the local, state, and federal levels. Locally, nurses can become politically active by assuming leadership positions in the healthcare system or contacting elected officials about legislation affecting the industry. Nurses can obtain formal training in politics, become involved in city councils and committees, or even run for local office. And something as simple as exercising the right to vote can impact healthcare policy.

Nurses have a huge role to play in influencing policy. Health policy develops in a living, working environment, such as in a clinic or hospital. Nurses are the eyes and ears of health care. We observe first-hand what works and what doesn’t. We are well-positioned to advise people in authority about changes to make and policies to pursue.