The need for nurses to become familiar with and engaged in the policy-making process has never been greater. While nurse leaders throughout time have emphasized the need for nurses to become more involved in advocating for patients and the profession, the passage of the Affordable Care Act (ACA) and the release of the Institute of Medicine’s The Future of Nursing report both call for the transformation of health care delivery and underscore opportunities for policy engagement.
The renewed interest in policy engagement for nurses is further evidenced by the proliferation of health policy books and resources for the nursing profession and the increased emphasis on including health policy content in nursing education programs. In fact, the American Association of Colleges of Nursing developed a set of core competencies for integration into nursing education programs, all of which emphasize the need for nurses to develop competencies in this area.
Practice, Research, Policy: Connecting the Dots
I recall the aha moment when I realized the importance of identifying the policy implications of my practice and research. While I had worked in underserved communities for many years, it was not until I started conducting breast cancer disparities research with underserved women that it occurred to me that someone (e.g., survivors or cancer organizations) was advocating for legislation to improve access to cancer screening services. Concurrently, the Breast and Cervical Cancer Mortality Prevention Act of 1990 directed the Centers for Disease Control and Prevention to establish the National Breast and Cervical Cancer Early Detection Program to assist low-income and uninsured women in gaining access to breast and cervical cancer screening and diagnostic services. Expanding on the need for follow-up care, the Breast and Cervical Cancer Prevention and Treatment Act was signed into law in 2000, helping to ensure access to breast cancer treatment services for low-income and uninsured women diagnosed with breast cancer.
As a volunteer for the American Cancer Society and the chair of public policy for the Chicagoland Affiliate of Susan G. Komen for the Cure, I started participating in lobby days advocating for more affordable and accessible cancer prevention and treatment services.
Building on my desire for more engagement, I began lobbying with my professional nursing organizations to advocate for funding to support nursing education and research. Thankfully, I realized the strong connection between practice, research, and policy—and now encourage nurses to do the same.
To Get You Started, Suggested Activities Include the Following:
• Complete a health policy course during your nursing education and your nursing career.
• Become more involved through your professional and specialty organizations.
• Attend state lobby days sponsored by your nursing organizations or home institutions.
• Participate in virtual lobby days.
• Invite congressional leaders to tour your nursing program, professional meetings, or community activities.
• Look for policy implications in presentations, publications, and textbooks.
• Seize the opportunity to identify public policy implications in your everyday practice.
• Incorporate a policy component into your clinical experience (e.g., student interviews with state lawmakers and city council members, and student attendance at public hearings).
• Tap into your institution’s Office of Government Relations.
• Read policy-related journals (e.g., Nursing Outlook or Policy, Politics, and Nursing Practice).
• Become familiar with websites that offer health policy resources (e.g., National League for Nursing, American Nurses Association, and the American Public Health Association).
• Tap into your professional organization’s resources for policy development.
• Share your personal experiences in the policy arena.
Regardless of practice setting, there are public policies and legislative initiatives that influence the scope of nursing practice or the amount of available resources to provide patient care or support nursing education. For example, the recent push toward full scope of nursing practice has already influenced the way advanced practice nurses practice in each state. Members of the nursing community, along with a number of stakeholders, are working with state and federal legislative officials to see what legislative and regulatory actions are needed to ensure that nurses are practicing to the full extent of their preparation. The outcomes of these efforts will have huge implications for the nursing profession and the patients we serve. Akin to this are the provisions outlined in the ACA, many of which have direct implications for nurses. Key provisions focused on primary workforce, patient-centered care, nurse-managed health centers, school-based clinics, quality improvement, and patient safety, to name a few. These provisions present opportunities for nurses to pursue leadership roles that will enable them to help implement aspects of the ACA legislation.
What a great time for nurses to contribute to the policy discourse that is taking place on the local, state, and federal level. From the new grad to the more seasoned professional, nurses are encouraged to become familiar with the policy-making process and identify ways in which they can make a meaningful contribution to improving the quality of patient care and advancing the profession through advocacy and political activism.
Health Policy Resources
American Association of Colleges of Nursing Government Affairs
American Nurses Association Policy & Advocacy
Center on Budget and Policy Priorities
GovTrack (site for tracking legislative bills)
Kaiser Family Foundation
National Conference of State Legislatures
National League for Nursing Advocacy & Public Policy
Office of Legislative Policy and Analysis
Office of Minority Health
and the director of nursing research and health equity at Rush University Medical Center.
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