RN as Healthcare Policy Leader (graded)
As a health policy expert leader, communicating with lay audiences is an important skill in promoting the health of the community for master prepared registered nurses. Develop a concise position statement regarding research findings and recommendations by experts as they relate to workplace support for, medical marijuana services in the community, genetic testing or applications of stem cell research or a community service administered by Family Nurse Practitioners (if you pick this one to be specific about the type of community service).
Reference
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (Eds). (2016). Policy & politics in nursing and healthcare (7th ed.). Retrieved from https://online.vitalsource.com
?Chapter 74: Professional Nursing Associations: Operationalizing Nursing Values
?Chapter 77: TAKING ACTION: The Nursing Kitchen Cabinet: Policy and Politics in Action
?Chapter 79: TAKING ACTION: Campaign for Action
?Chapter 81: Where Policy Hits the pavement: Contemporary Issues in Communities
?Chapter 82: An Introduction to Community Activism
?Chapter 85: TAKING ACTION: From Sewage Problems to the Statehouse: Serving Communities
Auerbach, J. 2015. Creating incentives to move upstream: A diversified portfolio of population health measures within payment and healthcare reform. American Journal of Public Health, 105(3) : 427-431. link to article
Doody O. and Doody, C. (2012). Transformational leadership in nursing practice, British Journal of Nursing, 21(20): 1212-1218. link to article
Freudenberg, N. & Tusi, E. (2014). Evidence, power, and policy change in community-based participatory research. American Journal of Public Health, 104(1), 11-14 doi: 10.2105/AJPH.2013.301471 link to article
HealthForum. (2015). Population health: a look at the strategy and impact of consumerism. Hospital & Health Networks, 9(89): 47-57 link to article
Butterfield, P. (2002). Upstream reflections on environmental health: an abbreviated history and framework for action. Advanced Nursing Science, 25(1) 32-49. link to article
Laderman, M. & Whittington, J. (2015). Assessing community health needs. Healthcare Executive, SEPT/OCT: 70-73. link to article
Page or paragraph numbers must be included with quotes per APA. See APA re how to format references and in-text citations i.e. capitalization issues and use of the ampersand versus the word (“and”).
Including at least one in-text citation and matching reference.
Check for grammar and spellings
Introduction
By now you should have a good understanding of the components of a healthcare policy analysis with subsequent recommendations for change to make a positive impact upon the health of your community and nation. We have covered much material related to the role of nursing in policy making, policy analysis, health care economics, legal issues relating to public health, ethics and the right to health care, and advocating for populations as leaders in public health. This week we will further examine the role of nurses as leaders in developing and promoting policy. We will look at the impact of networking with the community in promoting the holistic health of our nation. We will also target contemporary issues in healthcare that will likely play key factors in policymaking today and tomorrow.
Nurses as Leaders in Healthcare Policymaking
It is very important that nurses play a key role in healthcare policymaking as they are at the grassroots level of understanding patient needs and best outcomes of care on a daily moment-to-moment basis. Of all healthcare professionals it is nursing who is most at the patient’s side and in tune to patient needs. Hence, as a profession, nursing brings its caring experience as both art and science to the policy table. In addition, nursing must also continue to ensure that their professional input is an integral part of what occurs in healthcare policymaking as a standard of maintaining a position of autonomy in practice. As a profession and discipline we must continue to respect the power of policymaking and speaking in one voice.
Roads to Nurse Leadership in Healthcare Policy
The roads to nurse leadership in healthcare policy are varied but key factors cited below are foundational for success in this area (Doody & Doody, 2012):
Environment
It is important as a policy maker to pay attention to what is going on around you. From environmental physical conditions to public opinions to state of the milieu (home turf). Some are more obvious than others. Nurse leaders as policymakers should recognize that all these factors play into the feasibility and success of any policy.
Communication Skills
Be aware as a nurse leader in policymaking that non-verbal skills are probably some of your most important talents. Of note, listening is not only an art but a key driver in policy making. Listening lets your constituents know they have been heard and that you are interested in what they have to say; it indicates caring.
Type of Leader
A transformational leader uses personal strength and power to motivate others to meet their goals. That the leader can be trusted seems key to the followers (Doody & Doody, 2012). This leads to followers acting to sustain the greater good rather than serving their own interests.
Shared Governance and Joint Decision Making
Nurse leaders in healthcare policy should foster teamwork (posited in professional organizations and coalitions) as the nature of healthcare policy takes place within a network of patients, professionals, politicians, and organizations. A focus on shared governance and teamwork is a sound leadership strategy in such a complicated milieu (Doody & Doody, 2012).
Evidence-Based Practice
Healthcare policy is effective (most persuasive) when based on research or active public (patient) opinion.
Diversity
Nurse Healthcare Policy Leaders are most effective as policymakers when they pay attention to diversity needs of the public and/or the people they work with or serve. Consensus is often one of the easiest ways to begin to approach diversity.
Upstream Thinking
Upstream thinking is a newer method to comprehensively consider the social, economic, and environmental origins of health problems of populations (Auerbach, 2015). Consider the classic analogy by Ashton and Seymour (1988) regarding the metaphor of rescue workers along a fast-moving river to explain manifestations of upstream thinking.
A Community in Crisis
Watch the following video. It depicts a community in crisis. People are complaining of severe GI symptoms; a primary reason for local hospitalizations. Cases of cholera are also being reported.
“Every so often a drowning person is swept along side. The lifesaver dives in to the rescue, retrieves the ‘patient’ and resuscitates them. Just as they have finished another casualty appears alongside. So busy and involved are the lifesavers in all of this rescue work that they have no time to walk upstream and see why it is that so many people are falling into the river.”
Here, the metaphor is used to argue that what is needed among healthcare workers is more “upstream” thinking that would reorient the health care system towards addressing and preventing causes of disease and disability.
In a similar manner, public health is influenced by numerous elements?some are local (i.e. outbreak of influenza) while some are more distance or upstream (i.e. state regulations of healthcare access). If only local elements impacting public health are consider, the long term impact from more far reaching elements maybe neglected (Kelly, 2014). Seeing beyond the local, to consider broader health elements such as incomes, education, social supports and housing will allow investment into long term elements that impact quality of life and therefore public health. (Kelly, 2014). Identification of “upstream” elements impacting upon the health of communities and neighborhoods may be a contemporary approach used in policymaking by Nurse Leaders as a means to promote the health of our nation.
Healthcare Policy and Communities
Learning about and becoming a part of one’s community is the best starting place for nurse-advocacy efforts, either individually or as a member of a nursing organization. The baccalaureate nursing curriculum requires that nurses take theory and clinical courses in community-health nursing with the intent to get nurses involved in their communities. The nursing process forms the foundation to gain an understanding of the issues affecting communities and the individuals living in them.
Exactly what is a community? A community is an environment with physical, social, economic, and political factors that is more than simply a neighborhood or a place because it is sustained by public policies. The quality of resources available and accessible within any given community directly affects the health of those living within it. Moreover, The Developing Healthy People initiative of 2020 (United States Department of Health and Human Services [USDHHS, 2010]) aims to decrease health disparities and promote health in the community setting. This initiative places nurses in key policymaking positions within their communities.
What kinds of resources and infrastructure are essential for healthy communities? A look at communities that have endured some type of disaster leads to an understanding of the critical importance of basic infrastructure. When H1N1 struck many communities at pandemic levels in 2009, what types of community resources were lacking or absent? Consider childcare, transportation, social support, sanitation, health, education, fire, and police services in this pandemic situation.
In addition, other important structures in a community, such as civic opportunities, help to build a sense of community and cohesion. The Big Brothers organization is an example of a successful civic organization. Efforts to promote healthcare professionals and services support the communities in which those professionals serve and live. Community bonds are part of a nation’s heritage; strong resources in a community build healthy families, communities, and nations.
Primary-care nursing activities are geared toward helping patients maintain and improve health while preventing future illnesses. These services are provided within the community rather than in a hospital setting. The role for nurses in primary care and community-based care focuses on community action. This encompasses developing the community members’ skills (train the trainer), building supportive environments, and creating health-oriented public policies.
Partnerships are important in communities. Community partnerships for health include initial embedding within the community in order to identify the community health workers who can act as catalysts in setting up basic services. Community health workers are leaders within the community who have the trust of community members, an important consideration in communities made up of ethnic groups. Many times, predominately ethnic communities are more effectively approached by a member of the particular ethnic group. Community health workers (also known as outreach advisors and workers) work to empower members of the community to develop plans based on identified needs and to implement solutions appropriate for their specific needs.
Nursing policy advocacy efforts must be aimed at local, state, and national levels in order to effectively set up services that can endure. Nurses can strategically position themselves within communities as members of that community and act as liaisons between policymakers and community health workers. Within the community, nurses can work with groups of patients (such as women with children or adolescents) to identify health priorities and provide primary healthcare services. It is through this sense of shared community membership that nurses gain trust and support.
It only makes sense to approach any healthcare-related problem from within one’s own community and to approach healthcare from health promotion and prevention levels rather than after illness has already occurred. Nurses need to focus on the whole of the community, especially at the outset, rather than merely concentrating on pieces within it. Policies that nurses can partner to impact within communities include the following.
? Housing
? Food
? Labor
? Aging
? Environmental
? Social
? Educational
? Safety
The following case study illustrates the interrelationships involved in community health issues and levels of public policy making appropriate for nurse advocates.
Population Health
Population health is a progressive community oriented effort to focus care on health promotion, prevention, and treatment services targeted at patient populations (age, diagnosis, consumer needs, etc.). Healthcare needs are based on a holistic community assessment of services and infrastructures available to the patient. Prevention, curative, and rehabilitative services would be available as needed with the basic goal of keeping the patient out of the hospital and stable at home. Population health as we shall see in the following discussion takes on the persona of consumer needs and preferences for healthcare.
Consumer Considerations
The Patient as consumer of services will be a key player in the future of Population Health as a service model of care. Nurse Leaders wishing to implement progressive policymaking that positively impacts upon the public should reflect on the following (Health Forum, 2015):
? Future successes of population health will call for consumer friendly hospitals and adjunct health services that reflect the consumer’s mindset (for example even terminology will likely be more patient friendly; consider “health home” instead of “nursing home”);
?Patients as consumers want convenient access to healthcare and a constellation of services in some sort of systematic user friendly way that they can use (for example easy connections to adjunct services such as outpatient pharmacy, home medical equipment, and mobile diagnostic screening units, outpatient rehabilitation services, etc.);
? User friendly informatics (can the older population use the admission electronic keyboard?);
? Quality transitional care models from hospital to home must be in place (look at admission and discharge processes and home care as well as hospice services);
? Consumer engagement over the lifetime in terms of shared decision making and shared plans of care (what qualities of service provoke consumer loyalty?);
? Family engagement in terms of shared decision making and shared plans of care;
? Wellness focus (weight reduction and smoking cessation, for example); and a
? Patient education focus (a self-care focus with new dimensions and definitions of health that continue to be shaped by technology and advances in medicine as well as a public expanding consciousness of self).
Summary
The content in this lesson was designed to empower you to be a more effective nurse leader in healthcare policymaking. An awareness of the opportunities of networking with the community is a good step in this process. It is also good to remember that utilization of upstream thinking and consideration of consumer preferences when developing healthcare models of service delivery may provide rich ground for policymaking.
Next week, the focus will be on examining nursing and healthcare policy in the global context as we wrap up this course. The international community will be the canvas for understanding how policy and policy making come together in a larger sense and how all aspects of healthcare and healthcare policy are interrelated to some extent.
If you would like to explore this week’s assignment a little more in depth, the Week 7 Policymaker Visit Assignment Guidelines and Rubric are discussed below.
References
Ashton, J., and Seymour, H. (1988). The new public health. Philadelphia: Open University Press.
Auerbach, J. 2015. Creating a diversified portfolio of population health measures within payment and healthcare reform. AJPH 105(3) : 427-431.
Butterfield, P. (2002). Upstream reflections on environmental health: an abbreviated history and framework for action. Advanced Nursing Science, 25(1) 32-49.
Doody O. and Doody, C. (2012). Transformational leadership in nursing practice, British Journal of Nursing, 21(20): 1212-1218.
U.S. Department of Health and Human Services (USDHHS). (2010). Healthy people 2020. Retrieved from http://www.healthypeople.gov
