Health policies change rapidly at the national, state, and community level and are especially critical during times of international health crises. Nurses are positioned on the front lines of both health care delivery and health policy development. In particular, advanced practice registered nurses (APRNs) have a unique perspective that allows them to offer meaningful input at many levels. Nurse practitioners play a significant role in shaping health policies, including:

  • Health care access
  • Health care equality
  • Health care legislation
  • Nursing scope of practice
  • Community-wide disease response

Nurses are an essential part of informing health policies, educating the public, and applying health policies in practice. 

National Health Policy

Strong nurse leaders represent their communities and patients across the nation. Nurse practitioners who engage in health policy development at the national level may work with other health professionals to adopt or change guidelines put forth by the Centers for Disease Control and Prevention (CDC), Food & Drug Administration (FDA), Center for Medicaid and Medicare Services (CMS), and the U.S. Health Resources and Services Administration (HRSA). These policies guide decisions for the creation of public health guidelines that affect the entire nation. With their background in direct patient care, nurse practitioners offer a wealth of knowledge and clinical insight to help inform the development of new health policies and improve existing policies. Health care issues that are addressed at the national level include:

  • Access to care
  • Quality of care
  • Cost of care
  • Public health crises
  • Legislative decisions

National nursing organizations such as the American Academy of Nurse Practitioners (AANP) and the American Nurses Association (ANA) lobby extensively for policy change and advocacy for all nurses at the national level. As strong advocates for the entire profession, nurse practitioners demonstrate an understanding of the necessary details to create health policies that help, rather than hinder, nurses working in direct patient care. With this first-hand experience in patient care, nurse practitioners serve as invaluable advisors for educators, policy makers, and lobbyists. Nurses can help create legislation that affects both national and state-level laws regarding nursing practice, patient safety, and access to health care. Nurses are also able to review proposed health care legislation to help determine changes that promote best practices.

State Health Policy

Changes in global health policies impact health care delivery at the state level. For example, state-specific guidelines regarding telehealth practices were implemented to help maintain access to health care during COVID-19. This required rapid action by policy-makers—including nurses. As officers in state nursing organizations, nurse practitioners can directly influence policies that relate to both scope of practice and education standards. By understanding the training and education involved in the profession, policies that aim to allow nurses to use the full extent of their training are essential. Nurse practitioners can express with certainty which policies will affect nurses, other health care providers, and the general population.  

Local Health Policy

Through direct observations in their own communities, nurse practitioners have a unique advantage in recommending guidelines for community-wide, school, and even environmental health issues. Nurse practitioners can also be involved in advisory boards for city and county planning regarding water conservation, hazardous waste disposal, and ongoing public safety concerns. Policies that affect the natural environment directly influence the health of residents, and nurses can play a key role in advocating for the public and keeping the community safe.

Facility Health Policy

Health policy also impacts the operation of hospitals, outpatient health centers, long-term care facilities, and schools in communities nationwide. Health policy nurses bring their expertise to understand the challenges and risks facing the public and health care workforce. Once the challenges are identified, nurses can offer meaningful solutions based on clinical insight from direct interaction with patients. Additionally, nurses can influence facility policies such as patient care standards, the use of electronic medical records, and guidelines regarding specific populations.

Research in Health Policy

Master’s degree or doctorate-prepared nurses play a crucial role in both qualitative and quantitative health research. This includes working directly with medical, pharmaceutical, and environmental agencies to identify and understand gaps in health care knowledge. This may include gaps in health care delivery, a lack of current guidelines for specific health concerns, or the ways that environmental toxins affect population health. Nurse-led research involves real-world problems that affect individuals in their own practices. Quality research results are critical to passing health care legislation, improving patient care, and advancing the nursing practice. 

Nurse practitioners take direct clinical experience to the local, state, and national level to identify key challenges, inform decisions, and solve health care-related issues. In order to influence health policies and guide communities through times of crisis, it’s important for nurses to offer their unique skills in understanding and caring for patients. A strong presence of nurses in legislative review and health policy planning is critical to promote change and ongoing improvements in health care across communities. 

Kelly Coloff, MSN, FNP-C
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