Starting Early: Influencing Change Through Nurse Engagement in Health Policy

Introduction

Nurses are the largest professional group within healthcare and have been voted the most trusted profession by the public for over 14 consecutive years (Tomajan, 2012). Capitalizing on this fact to influence as well as become a catalyst for change when opportunities present themselves would result in substantial advancement in the profession in addition to the populations they care for. The issue is nurses are indifferent about policy issues and are taught to focus on individual patient advocacy as opposed to population based advocacy despite being able to contribute significant information and wisdom on a variety of issues, initiatives, policies, etc. It has been suggested the reason some nurses are indifferent about policy issues may be due to a lack of knowledge and preparation to assume these roles as well as understanding their influence can produce results (O’Brien-Larivee, 2011).

                                                            Evidence

 Nursing students are socialized into the profession during their initial educational experience (O’Brien-Larivee, 2011, p. 333). Reutter and Wil­liamson (2000) proposed that health policy should be intro­duced at the baccalaureate level to promote an understanding of policy and advocacy, to move beyond an individual focus of health care, and to begin the process of “thinking policy” (as cited in O’Brien-Larivee, 2011, p. 333).  A toolkit was created to address this issue by revising Bachelor of Science in Nursing (BSN) curriculums to reflect the integration of clinical and classroom learning consistent with the American Association of Colleges of Nursing’s (AACN) essentials of Baccalaureate Education for Professional Nursing Practice framework (2008). The framework states a BSN program should prepare their students to participate as a nursing professional in political processes and grassroots legislative efforts to influence healthcare policy as well as advocate for consumers and the nursing profession (AACN, 2008). Once engaged, nurses seldom turned their backs on the world of policy-making (Gebbie, Wakefield & Kerfoot, 2000). According to (Zauderer, Ballestas, Cardoza, Hood, & Neville (2009), incorporating political education into the general nursing curriculum, educators can show students how they can be instrumental in influencing the political process. Nurse educators can facilitate this process by being role models and presenting opportunities to teach nursing students how to get involved, advocate and use their credentials to make an impact wherever they choose to practice.

                                                            Solution

A toolkit was created for nurse educators to implement a public health education intervention program on a cohort of nursing students to educate and actively engage them on how they can use their role as a nurse citizen to advocate on relevant issues their populations are facing. The toolkit essentially translates nursing skills acquired during their education and clinical practice such as communication, persuasion, patient education, critical thinking, analysis, collaboration and advocacy to be utilized in the political and policy arena. The toolkit presents 4 options on how nurse educators can revise their entire curriculum, their public health or nurse leadership course, create a forum or utilize one 3 credit hour course (3 hours) to engage students in policy. The option chosen will be dependent on available resources and program type to assist in modifying the BSN programs. The students are taught how to use evidence based practice to present the problem as well as support their proposed solution and the RIATA Asking Criteria to effectively communicate with their legislators and other policy makers when supplicating their requests.

                                                            Conclusion

As our rapidly changing healthcare environment continues to create new policies, it is imperative nurses are included in the process providing their expertise, insight, and recommendations. The toolkit ensures that regardless of what option is chosen by the nurse educators; students will learn and apply everything that is taught to get a firm understanding and become empowered to continue engaging after graduation.  Equipped with the knowledge on how to translate their skills from the toolkit, nurses can become engaged in the varying levels of activity in advocacy through the roles of a nurse citizen, nurse activist and nurse politician to make a change in wherever they choose to practice, the nursing profession and their communities.