“To lead change and innovation in healthcare, nurses need to be active and competent in assessing and redesigning/reshaping the policy environment that impacts safe, effective, patient-centered, timely, efficient and equitable care of individuals within health systems” (Staebler, Campbell, Cornelius, Fallin-Bennett, Fry-Bowers, Kung, LaFevers & Miller, 2017, p. 351). Author 1 & Author 2 (2016) identified that a budget course built upon the competencies identified by the AONE and the Essentials of Master’s Education in Nursing by AACN was beneficial to students when providing real world experiences in the development of a business case and proficiency with spreadsheet preparation and interpretation for presentation of financial data. The course assisted graduate students in developing competence in discussing the financial aspects of health care. This presentation expands the discussion of preparation of nurse leaders to explore the benefits of including health law and integrating health policy directly into the course. The integration of health policy, finance and law provides emerging nurse leaders with a strong curricular foundation that encourages sustained involvement of nurse leaders at the health policy table while ensuring executive competence in finance, regulatory affairs and legal implications of administrative practice.
AACN is the national force influencing the direction of nursing education and the nursing profession by setting educational standards and policy agendas for baccalaureate and graduate nursing education (Staebler, Campbell, Cornelius, Fallin-Bennett, Fry-Bowers, Kung, LaFevers & Miller, 2017; AACN, 2016). The AACN supports and has been a catalyst for the addition of health policy to nursing curriculum (Staebler et al, 2017). Despite the identified importance of developing nurse leaders to become strong and sustained participants in the policy process, public policy advocacy is not integrated into nursing culture in academic and workplace environments and (Taylor, 2016) and students perceive lack of time, interest and relevance (Staebler et al, 2017). As such, significant barriers to sustained nurse engagement with policy initiatives and lack of application of financial, legal and policy literacy remain challenges that can be addressed through the integration of these courses in preparing nurses leaders.
The health care law course addressed three skills related to laws impacting nurses as health leaders: the regulatory requirements, applications of criminal, civil and statutory law and policy implications of healthcare law. The course design encouraged group interaction using the language and tools of the current health care executive through web-based discussions, presentations and development of an organizational policy based on case study analysis. Content was presented online using videos, PowerPoint, discussions, web resources, literature reviews, and self-assessments.
In section one, students were introduced to the regulatory requirements of professional licensure and health system licensure. Students visited state resources for state based laws and used the Code of Federal Regulations and United States Code for sources of federal law. Students applied this information in case studies and discussed various situations where liability potentially arose for organizations and personnel through discussion boards. Students became proficient in the use of policy and legal language through self-paced quizzes and individually created lexicons.
In section two, students acquired introduction of legal theory in criminal, civil and statutory law via reading, case study analysis, and completion of policy analysis, discussion of the elements of law and corresponding organizational climates. Students became proficient with the elements of legal analysis and application of problem solving frameworks.
In section three, students began preparation of an organizational policy of their choosing that was derived from a complex case study provided by the instructor. This capstone project provided for students to synthesize and integrate theory and concepts in health law, policy/regulatory integration, and organizational financial impact into a comprehensive organizational policy. Student feedback has been overwhelmingly positive with 100% of participants responding that they learned valuable information from this course. 100% of the students passed the course with a A or higher. 100% of students taking the Healthcare Law for Nurse Managers course concurrently with their Management Practicum utilized concepts of the course to reinforce professional journal writing for their management practicum. Students felt as though they were well prepared for current and future work experience. They provided strong positive comments on course evaluations as well as extemporaneous correspondence with the faculty coordinator regarding their satisfaction with the course.
The Institute of Medicine (IOM, 2011) affirms that nurses “must speak the language of policy, engage in the political process and work cohesively as a profession” if they are to lead change (pp.5-; Taylor, 2016, p. 236). The ability to integrate and speak to legal concepts and financial concepts is a part of of the policymaking process. Through the introduction of a progressive graduate-level leadership curriculum that integrates policy, law and finance, students in our organization felt prepared to address entry into executive practice. Students remained 100% satisfied with the Budget Course. Students within the concentration of Health Management identified that the addition of the legal course provided an extension in their understanding of the fit between regulation, finance and policy.