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NURS 6050 The Role of the RN/APRN in policy-making

DQ :The COVID-19 pandemic brought nursing in the spotlight

The COVID-19 pandemic brought nursing in the spotlight and demonstrated nurses'
powerful voice in addressing current issues in health care system. Nurses have been on the front
line witnessing the challenges of health care delivery system and their personal stories can influence
policy designs (Milstead & Short, 2019). Nurses have proven their expertise and dedication to
provide direct care to patients and their families during the pandemic, and also demonstrated
leadership in effecting change locally and globally.  This is the reason why for 18th year in a
row, the public perceives nursing as the most honest and ethical profession far above the medical
doctors (Gallup, 2020).  The positive perception of nursing is an opportunity for RNs and
APRNs to engage in the political process, champion the health care agenda and propose policies
to improve patient care and the nursing profession (Vandewaa, et al., 2019).
Nursing is the largest health care profession in the nation, with more than 3.8 million
RNs nationwide and comprises one of the largest segment of the U.S. workforce (American
Association of College of Nursing, 2019). According to Milstead and Short, "Nurses bring the
power of numbers when they enter the the policy arena" (2019, p7 para 4). Nurses have the
opportunity to profoundly influence policy and politics by joining their voices together so they
can be heard and be able to persuade policymakers.
The International Council of Nurses, the World Health Organization and other important
bodies are challenging nurse to rise up and get more involved in leadership, policy development
and advocacy (Turale & Kunaviktikul, 2019). This campaign is another opportunity for nurses

globally to stand tall among other professionals in shaping health policies. The call for political
participation among RNs and APRNs is a shift from being the recipient and implementers of
health policy decisions to being leaders with a strong voice in the development or reform of
policy.
With all these opportunities for nurses to actively involved in policymaking, review
showed that nurses have not improved in their political participation (Rasheed et al., 2020).  The
political power of RNs and APRNs are largely unused despite their significant qualifications to
influence health policies. Rasheed, Younas and Mehdi (2020), identified specific challenges for
the nursing profession and these are as follows: lack of nurse's motivation and lack of interest in
politics and policymaking; lack of educational preparedness, time and resource constraints; and
lack of mentorship from exemplary nurse leaders.
Moving nurses to become leaders will take concerted, strategic effort to address these
challenges. Kurale and Kunaviktikul (2019) proposed to nurse leaders to provide RNs and
APRNs with access to a well-thought-out policy training programs. There is a gap in the nursing
education that failed to prepare nurses  in policy, politics and advocacy. (Kurale & Kunaviktikul,
2019). Training at all levels of nursing education will teach nurses to be politically savvy and
motivate nurses to take their place at decision-making tables.
Joining professional organization can  boost the nurse's confidence. Nursing organizations
can provide information on political processes, nursing issues in Congress and resources to help
nurses get involved (Vandewaa, 2019). Associations are guided by values like empowerment,
stewardship, inclusivity, and innovativeness that could influence the character and attitude of the
nurse. Other benefits of membership include opportunities for mentorship, professional support
and service to the profession and advocacy (Echevarria, 2018).
To communicate these opportunities in policymaking to fellow nurses, I intend to use
social media to disseminate informations. Social media is a powerful communication tool to
reach and engage nurses. The millenial nurses can relate well to this digital technology where
people can have an open virtual community to discuss and share informations. Another strategy
is by taking an active role in policymaking in the employment setting. As a MSN student, I can
leverage my education to influence fellow nurses within the organization in voicing their
opinions in formulation of nursing policies.

References

American Association of College of Nursing. 2019. Nursing fact
sheet. https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet
Echevarria, I.M. (2018). Make connections by joining a professional nursing
organization. Nursing, 48(12), 35-38. doi: 10.1097101.NURSE.0000547721.84857.cb.
Gallup News. (2020). Nurses continue to rate highest in honesty,
ethics. https://news.gallup.com/poll/274673/nurses-continue-rate-highest-honesty-ethics.aspx

Milstead J.A. & Short, N.M. (2019). Health policy and politics a nurse's guide (6th edition).
Jones & Bartlett learning.
Rasheed, Subia Parveen,M.N., R.N., Younas, Ahtisham,M.N., B.S.N., & Mehdi, Fahmida,M.Sc, R.N.
(2020). Challenges, extent of involvement, and the impact of nurses' involvement in politics and
policy        making in in last two decades: An integrative review. Journal of Nursing
Scholarship, 52(4), 446-455. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1111/jnu.12567
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
Vandewaa, E. A., Turnipseed, D. L., Lawrence, S. (2019). A leadership opportunity: Nurses' political
astuteness and participation. The Journal of Nursing Administration, 49(12), 628-630. https://doi:
10.1097/NNA.0000000000000827
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1 year ago
Jennifer Martin
RE: Discussion – Week 8
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Hi Ma Melissa,
Thank you for your great post!
COVID 19 was a prime example of how we need to have policies not only for the acute care
setting but the outpatient setting, in my opinion, is where COVID 19 needs to be intercepted
from getting worse. More nurses need to be trained and prepared in public health settings with
community-based health promotion, epidemiology, and contact tracing (Kovner, 2020). We
should create a policy on how to stop COVID 19 from becoming worse. Nurses have a unique
place in redesigning the future of healthcare, particularly after experiencing health policy failures
with the coronavirus disease 2019 pandemic (Anders, 2020). Focusing on public health could be
a large part of rebuilding our public health infrastructure and improving our handling of
pandemics.
Reference
Anders, R. L. (2020). Engaging nurses in health policy in the era of COVID‐19. Nursing
Forum, 56(1), 89–94. https://doi.org/10.1111/nuf.12514
Kovner, C. (2020). Policy, Politics, Nursing Practice, and COVID-19. Policy, Politics, &
Nursing Practice, 21(2), 55. https://doi.org/10.1177/1527154420933016
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1 year ago
Kristen Everett
RE: Discussion – Week 8
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Hi Ma Melissa,
Great job with your post It is very informational. The involvement in health policy is
the most important role an NP can have in impacting positive change in health care
that will benefit multiple generations of patients across in situations, states, the nation
and even globally (Chilton, 2015). The importance of being involved in health
policies is to implement new policies to help improve patient outcomes. Select a
legislator to get started, become familiar with policymaker’s interests and position,
develop and ask questions, engage with those affected by policy issues, arrange
meetings, belong to a professional organization, serve on advisory board, speak
publicly, network on social media (Kostas-Polston, 2014). All of these are ways to
being involved in health policies.

References

Chilton. (2015). Nurse Practitioners Have an Essential Role in Health Policy. The
Journal for Nurse Practitioners. https://www.npjournal.org/article/S1555-
4155(14)00687-4/pdf
Kostas-Polston. (2014, September 21). Advanced practice nursing: Shaping health
through policy. Journal of the American Association of Nurse Practitioners.
https://my.enmu.edu/c/document_library/get_file?uuid=f708593a-4dd7-47b9-b3a5-
8452560a05ed&groupId=4153058&filename=sbkostas-nur425.pdf

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1 year ago

Mia Hunter
RE: Discussion – Week 8
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Ma Melissa, good post. It is a good idea to join many of the international groups such as the
World Health Organization as well as others. The W.H.O is to support, convene and harness the
capacities of its global, regional and national partners and members, working across the multiple
dimensions of HRH – whether in health, education, finance, or labor sectors. World Health
Organization, 2021). This is a great organization as well as the International Council of Nurses.
There are many local organizations such as the American Nurses Association that can help
change policy in your state versus internationally. The American Nurses Association (ANA)
works to advance the nursing profession and improve health and health care for all. One of the
primary ways we achieve this is by advocating on behalf of registered nurses at the top levels of
government as policies are conceived, debated, and implemented. (American Nurse Association,
2021). It will refer you to your state organization, such as the Texas Nurse Association for the
state I live in. It can help me state-wise or nationally.
You can also reach through your local facility and get involved with new policies. Many policies
are often attached to your state Nurse Practice Act. Safe, competent nursing practice is grounded
in the law as written in the state nurse practice act (NPA) and the state rules/regulations.
Together the NPA and rules/regulations guide and govern nursing practice. (National Council on
State Board of Nursing, 2021)
These are all things that can work well along with the many things that you have mentioned.
There are so many organizations that can help all of us as nurses to help make this profession
even safer and more efficient in every state and internationally.

References
American Nurse Association. (2021, July 10). APRN state law and regulation. ANA. Retrieved
July 10, 2021, from https://www.nursingworld.org/practice-policy/advocacy/state/aprn-state-law-
and-regulation/
National Council on State Board of Nursing. (2021, July 21). National Nursing Workforce Study.
NCSBN. Retrieved July 21, 2021, from https://www.ncsbn.org/workforce.htm
World Health Organization. (2021, July 21). About the alliance. Global Health Workforce
Alliance. Retrieved July 21, 2021, from https://www.who.int/workforcealliance/about/en/
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1 year ago
Lance Nesle
RE: Discussion – Week 8
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With over 3.8 million registered nurses, nursing is the largest
professional healthcare profession, making up the largest
constituent of the workforce (Smiley et al., 2018). It is
undeniable that nurses hold a considerable influence in shaping
healthcare policies. We mentioned that policies must be
evidence-based to ensure effectiveness in addressing the
nation’s problems. I believe in having someone who has the
first-hand experience upon which these policies are concerned.
Policies shape the way healthcare is delivered, so “policies must
exist that define and integrate appropriate standards of care and
address conditions necessary for that care to occur” (Burke,
2016, para. 3). Nurses are healthcare advocates and involvement
in policymaking is one understated form of advocacy. Milstead
et al. (2019) mentioned some of the hindrances that affect the
nurse’s participation in shaping health policies. A few of them
are the investment of money and commitment of time. Being in
the policymaking scene means total commitment. “If you are not
on the table, then you are on the menu.”
A nurse can be involved in the policymaking arena by being a
proactive member of private nursing organizations like the
American Nurses Association or the American Association of

Nurse Practitioners. Engaging in nursing organizations is one
strategy for nurses to play their role in the health policy arena
(Catallo et al., 2014). These nursing organizations play an
essential role in policymaking by educating nurses and involving
them in the current agendas. They advocate the nursing
profession in the policymaking arena; however, their work is not
enough without the support of the nurses themselves.
The other way nurses can influence policymaking is by writing
to legislators directly involved in healthcare policies. Writing
form letters to address issues that concern the profession is
highly encouraged by organizations. Nurses have the most
exposure to how healthcare policies affect the delivery of care to
the public, so opening about personal stories “put a face and a
story to an issue” (Oestberg, 2013). According to Milstead et al.
(2019):

Nurses have many personal stories that illustrate
health problems and patients’ responses to them.
These stories have a powerful effect when a nurse
brings an issue to the attention of policymakers.
Anecdotes often make a problem more understandable
at a personal level, and nurses are credible storytellers.
(p. 7)

 

References

Burke, S. (2016, June 2). Influence through policy: Nurses have
a unique role. Sigma Nursing.
https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-
a-unique-role

Catallo, C., Spalding, K., & Haghiri-Vijeh, R. (2014). Nursing
professional organizations. SAGE Open, 4(4),
215824401456053. https://doi.org/10.1177/2158244014560534
Milstead, J. A., & Short, N. M. (2019). Health policy and
politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
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
Smiley, R. A., Bienemy, C., Shireman, E., Reneau, K. A., &
Alexander, M. (2018). The 2017 national nursing workforce
survey. Journal of nursing regulation, 9(3), S1–S54.

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1 year ago
Quincie Finney
RE: Discussion – Week 8
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Great post, Lance! “With a common understanding of nurses’ policy influence as a concept,
nurses will recognize the importance of policy making in the health sector and their influence on
this process and also on patients’ outcomes” (Arabi et al., 2014). Nurses involved in policy
making will shape the way policies are made and their outcomes on nurses and patients. Nurses’
can also be involved on the state level in policy making. Most states have a nursing association
they can join to get involved with to help with policy-making. This gives nurses the chance to

stand up for and advocate for patients and nurses. Nursing organizations with legislative
departments provide analysis on issues in health policy and tips on how to communicate and
reach local legislatures, they also typically offer nursing advocacy workshops (Fredrik, 2013).
Some challenges nurses may face getting involved in policy making is education differences,
lack of awareness of how to get involved, inadequate skills in policy making, little opportunity
for involvement, time barriers, and little support nurses receive when getting involved (Brokaw,
2016).

References

Arabi, A., Rafii, F., Cheraghi, M.A., and Ghiyasvandian, S. (2014). Nurses’ policy influence: A
concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(3), 315-322.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/
Brokaw, J.J. (2016). The nursing profession’s potential impact on policy and politics.
https://www.myamericannurse.com/nursing-professions-potential-impact-policy-
politics/#:~:text=There%20are%20several%20reasons%20for%20the%20limited%20nur
sing,limited%20formal%20health%20care%20policy%20education%20in%20nursing.
Fredrik, O. (2013). Getting involved in policy and politics. Nursing Critical Care, 8(3), 48.
10.1097/01.CCN.0000429392.92546.6f

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1 year ago
Lawren Sah
RE: Discussion – Week 8-
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Hello Lance

I agree with you that nursing is the largest healthcare profession that constitutes
approximately 3.8 million registered nurses. Therefore, nurses are considered to have greater
influence in shaping healthcare policies that should be evidence-based to ensure effectiveness
(Lehane et al., 2019). What are some of the reasons why you consider that nurses’ involvement
in policymaking is understated? I appreciate that you have indicated why nurses are involved in
the policymaking arena, including being proactive members of the private organization.

The role of nursing organizations is to educate nurses and help them understand the
process of involvement in policymaking. Therefore, nurses should ensure that they show enough
support to the organization, making the policymaking process effective by ensuring that patient
care is quality (Hudson et al., 2019). I have gained insight about nurses writing directly to the
legislators to be involved in healthcare, which the organizations greatly encourage. Nurses
participating in policymaking will address the impact they encounter when delivering patient
care based on their personal experience.

References

Hudson, B., Hunter, D., & Peckham, S. (2019). Policy failure and the policy-implementation
gap: can policy support programs help?. Policy design and practice, 2(1), 1-14.
https://doi.org/10.1080/25741292.2018.1540378

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … &
Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an
expert view. BMJ Evidence-Based Medicine, 24(3), 103-108.

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