Discussion 2: The Role of the RN/APRN in Policy-Making

Discussion 2: The Role of the RN/APRN in Policy-Making

Discussion 2: The Role of the RN/APRN in Policy-Making

Registered nurses and advanced practice registered nurses play crucial roles in the promotion of the optimum health and wellbeing of their populations. They are also increasingly involved in the formulation of policies that influence healthcare delivery in their organizations (Hajizadeh et al., 2021). Therefore, this paper examines two opportunities for these nurses to actively participate in policy-making and challenges associated with the opportunities. It also examines strategies for advocating or communicating the existence of these opportunities for RNs and APRNs.

Several opportunities exist for RNs and APRNs to actively participate in policy-making. One of them is policy assessment. RNs and APRNs have extensive experience in caring patients and addressing issues affecting their practice. As a result, they can utilize knowledge and skills gained from their experience to provide crucial insights in policy assessment. They can provide appropriate data for policy formulation. The other opportunity is policy formulation. RNs and APRNs can participate in the development of policies that address actual and potential needs in healthcare (Hajizadeh et al., 2021). They ensure the adopted policies align with the diverse needs of patients, healthcare providers, and healthcare institutions.

The above opportunities present some challenges for RNs and APRNs. One of them is the effect of organizational issues on RNs and APRNs involvement in policy assessment and formulation. Issues such as nursing shortage may limit the active participation of RNs and APRNs in policy-related issues. The other challenge is limited recognition of nurses’ role in policy-making. For a long time, nurses’ role in policy issues remains inadequate. This may affect their involvement in policy assessment and formulation in healthcare (Rasheed et al., 2020; Safari et al., 2020). Therefore, some of the effective strategies to address these challenges include educating nurses on their vital role in policy-making and advocating for the increased recognition of their vital role. RNs and APRNs have opportunities such as policy assessment and formulation in policy-making. These opportunities have challenges attributed to organizational issues and nurses’ recognition in policy-making. Evidence-based interventions such as training nurses should be adopted to address these challenges. Nurses’ involvement in policy-making ensures relevance and sustainability of the adopted policies.

 References

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses participation in the health policy-making process: A systematic review. BMC Nursing, 20(1), 1–9.

Rasheed, S. P., Younas, A., & Mehdi, F. (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.

Safari, M. B., Bahadori, M., & Alimohammadzadeh, K. (2020). The related factors of nurses’ participation and perceived benefits and barriers in health policy making. Journal of Nursing Research, 28(4), e103.

For healthcare legislation to be successful and be evidenced based it is imperative that RNs and APRNs be involved in the policy-making process. By being involved in the initial stages of policy-making, nurses advocate for improvements that benefit both themselves and patients, i.e., policies that increase the scope of practice for APRNs to increase patient access to primary care providers (Milstead & Short, 2019).

One avenue that nurses can use to be a part of the policy-making process is their participation in a professional nursing organization such as the American Academy of Nurse Practitioners (AANP). AANP members are involved in political advocacy committees that advocate policies like H.R 8812 ICAN Act which promotes improving patient access to health care by eliminating Medicaid and Medicare barriers to ARNP practice (AANP, 2022).

Another way nurses can affect the policy-making process is through community advocacy in local groups or within their own organizations. By being involved at a local level in healthcare issues nurses draw public attention and can positively influence public perception (Milstead & Short, 2019). While nurses are great advocates for patients, they face challenges in inserting themselves at the table of policy-making. The biggest challenge to overcome is the historically subservient nature of the nurse-physician relationship.

Nurses report feelings of powerlessness within political spheres related to a perceived preference for male voices over nurses’ opinions (Rasheed, Younas & Mehdi, 2020). Another challenge for nurses is our perception as good implementers of policy which is a passive role and not as a policymaker which is an active role. Nurses have historically had low participation as policymakers and as members of committees that affect policy, however through education and empowerment that could be changed.

To improve nurses’ ability to be effective policymakers, nurse leaders should promote participation in professional organizations and organizational committees to their fellow nurses. Nurses should be educated on the importance of their voices and views and how they can be used for the betterment of others.

When I first started with the VA, I didn’t participate in committees, and I wasn’t a part of a professional organization. However, as I moved to other positions within the organization, I came into contact with nurse leaders who both empowered and educated their nurses to be active in the policy-making process within our organization and would conduct training events to spread the word.

References

• Milstead, J. A. & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6^th ed.). Jones & Bartlett Learning
• Rasheed, S. P., Younas, A., & Mehdi, F. (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. https://doi.org/10.1111/jnu.12567

Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A word cloud is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.

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Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.

What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?

To Prepare:

Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making. 

Good post. I agree that it can be a challenge for nurses to join hospital-wide committees due to there being a lack of information on why it is important for nurses to participate in these committees, a lack of time and energy due to working long shifts, prioritizing self-care and sleep to prevent burn out, and taking care of personal matters. Shared governance in nursing is crucial for healthcare policymaking as it empowers and encourages nurses to actively participate in decision-making processes that can lead to more collaboration and employee engagement in the workplace, leading to new policies’ development (Brennan & Wendt, 2021, para 2). Creating a supportive and inclusive committee culture, where nurses’ contributions are valued and recognized, can make participation more appealing. Hospital organizations can also incentivize nurses to join their committees by providing tangible incentives, such as continuing education credits, recognition awards, and/or financial compensation for committee work and member fees for joining professional nursing organizations. Meetings can be recorded and shared with night shift nurses or other nurses that couldn’t attend the live meeting through Microsoft Teams to watch at a later time to encourage participation.

In addition to joining a hospital committee or a professional nursing organization, RNs and APRNs can actively participate in policy-making by doing research. Health policy research focuses on improving access to care, the quality and cost of care, and the efficiency of care. The research framework should focus on improving the focus and design of research and better explicating the connection between research evidence and policy (Ellenbecker & Edward, 2017, p. 208). Nurses can conduct research and then share their findings with other healthcare professionals and policymakers. I like how you mentioned that it’s important to recognize that all parties provide different perspectives because of the roles they play. Therefore, working as a team, policies can be revised or new policies can be created based on different thoughts and research evidence, which can improve patient safety and care, and can increase nurse satisfaction as their voices are heard.

Thanks for your post!

By Day 3 of Week 8

Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.

Discussion 2: The Role of the RN/APRN in Policy-Making

By Day 6 of Week 8

Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

*Note: Throughout this program, your fellow students are referred to as colleagues.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 8

To participate in this Discussion:

Week 8 Discussion

NRSE 6050 Week 8 Discussion

Potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

The Role of the RN/APRN in Policy-Making

Nurses may affect policies in a particular way. Nurses are solvers and communicators of the issue and are capable of collecting information, mobilizing communities, and making demands of normal policy-makers for nursing. By informing and influencing lawmakers, nurses may engage in decision making to alter laws and promote legislation.

Each nurse will take an interest in policy-making since they are influenced by most policies implemented (Williams & Phillips, 2018). APRNs and RNs will take an active part in policy-making in different ways. APRNS and RNs will be active in decision formation for the first time by advocacy. By the principles of advocacy, any person affected by a particular policy has the right without limits to express an opinion.

APRNs and RNs should comprehend that they have the opportunity to communicate their assessments on any policy that may influence them. The advocacy opportunity guarantees that there is no any nurse who is denied the opportunity to communicate his/her assessment on a specific policy. The subsequent opportunity held by the APRNs and RNs to be engaged with policy-making is through leadership.

An APRN or RN has a leadership job that requests cooperation in policy-making (Chilton, 2015). APRNs and RNs should scrutinize the policy detailing, usage, and some other policy processes certainly. If an APRN or an RN has any issue or question concerning a specific policy, he/she can educate the leaders about it.

Various challenges will undoubtedly confront the advocacy opportunity for APRNs and RNs. To begin with, there are issues with gender equality concerning advocacy. There are times when male APRNs and RNs can be precluded the opportunity from securing communicating their thoughts and suppositions on a given policy, particularly on the off chance that it is intended for ladies. Besides, there is the challenge of rivalry for assets about the advocacy opportunity (Williams & Phillips, 2018).

The opportunity for leadership jobs held by APRNs and RNs likewise has its challenges. To begin with, there is the challenge of changing leadership styles and abilities as various leaders have different leadership styles and accept. Additionally, there is the challenge of communication as certain associations might not have the correct communication channels where the APRNs and RNs can air their interests concerning a given policy.

Various recommendations can be utilized to advocate better or impart the presence of the opportunities for APRNS and RNs in policy-making. To begin with, there is powerful training. It is significant for all the nurses to be prepared and taught on the rights that they have about policy-making. Also, nurses should consistently advance and promote good leadership (Joel, 2017). With great leadership, the APRNs and RNs have the space to air their sentiments and thoughts with regards to policy-production.

Third, nurses should be searchers of data and guarantee that they utilize their expert gatherings to air their sentiments and thoughts with regards to policy-production. It is significant that nurses bolster other medicinal services experts and lawmakers through teaching and pushing for a policy that best serves our patients, families, and communities.

References

• Chilton, L. (2015). Nurse Practitioners Have an Essential Role in Health Policy. Journal for Nurse Practitioners.
• Joel, L. A. (2017). Advanced Practice Nursing: Essentials for Role Development. F.A. Davis.
• Williams, S. D., & Phillips, J. M. (2018). Nurse Advocacy: Adopting a Health in All Policies Approach. OJIN: The Online Journal of Issues in Nursing.

Getting involved with a professional nursing organization is one of the simplest ways for a nurse to become involved in public policy. According to the American Nurses Association (n.d.), joining a professional organization leads to the creation of a unified voice on policy. This is vital, as changing policy involves multiple opinions that are established under one voice. Participating in policy-making can be overwhelming for an individual, so becoming a part of a larger organization can aid in overcoming that barrier.

However, this advocation opportunity can present a financial hurdle as professional organizations operate under a for-profit membership model. Additionally, time constraints and a lack of inclusion are challenges when joining a professional nursing organization. The potential lack of diversity among members and leadership may create a sense of not belonging. To assure that I actively participate in this opportunity, I would do my research to ensure that I was joining an organization that aligned with my personal and political values. Additionally, I would explore what my maximum time commitment could be.

The purpose of public policy involvement is to direct problems to the government’s attention (Milstead & Short, 2019). At a local level, nurses can become involved in policy-making by contacting their elected officials about potential legislation that affects the healthcare field. This is an opportunity that takes minimal time, and resources. Additionally, this allows nurses to communicate about the issues that truly matter and will impact them. However, this method of policy involvement may require some nurses to move outside their comfort zone. For those that are uncomfortable talking on the phone, reaching out to policymakers via email or mail may be preferable. The transformation of nursing practice is commonly done through the construction of shared professional governance infrastructure and distributive decision-making (Porter-O’Grady, 2019). As legislators hear nurses’ voices directly, laws will be changed and created to favor their opinions.

Communication is required to increase advocacy in our professional field (Barton, 2018). When joining a professional organization, I would discuss the membership process with coworkers and friends. I would regularly elaborate on the opportunities that the organization has afforded me while encouraging those around me to get involved in a professional organization themselves.

Moreover, I would advocate for others to get involved in policy-making by encouraging conversation related to the current issues within our professional field. By openly discussing the need for or impact of potential legislation more nurses will be encouraged to reach out to their local representatives.

American Nurses Association. (n.d.). Practice & advocacy. Retrieved from https://www.nursingworld.org/practice-policy/

Barton, A. J. (2018). Leadership and communication competencies in nursing: What are we missing?. The Journal of Nursing Education, 57(5), 259–260. https://doi.org/10.3928/01484834-20180420-01

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning

Porter-O’Grady, T. (2019). Principles for sustaining shared/professional governance in nursing. Nursing Management, 50(1), 36-41. https://doi.org/10.1097/01.NUMA.0000550448.17375.28

RE: Discussion – Week 8  

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“Nurses’ influence on health policy protects the quality of care by access to required recourses and opportunities” (Arabi et al., 2014). Registered nurses (RNs) and advanced practice registered nurses (APRNs) have an important role in policy-making. Nurses involved in policy-making are influential, professional, responsible, and are advocates for people and the healthcare system (Burke, 2016).  

There are ways that RNs and APRNs can get involved in policy-making. Per Milstead and Short (2019), nurses and APRNs develop contact with legislators by groups such as the House Nursing Caucus and the Senate Nursing Caucus. These groups have the responsibilities of educating legislators on the issues important and impacting issues impacting America’s health system and nursing as a profession (American Organization for Nursing Leadership, n.d.).

One international caucus nurse’s or APRNs can join is the American Organization for Nursing Leadership (AONL). These nurses or APRNs are shaping health care through innovation and expert nursing leadership, giving nurses the opportunity to work directly with legislators and voice their opinions and experience in policies impacting nurses throughout the United States (American Organization for Nursing Leadership, n.d.).

A state level way for Missouri nurses or APRNs to get involved in policy making is to join the Missouri Nurses Association (MONA). MONA gives RNs and APRNs in Missouri the ability to speak and act for the nursing profession to promote and enhance safe and accountable nursing practice (Missouri Nurses Association, n.d.). These nurses or APRNs work as a group to contact their local legislators and supply testimony in expert insight to advocate in support or opposition to policies affecting Missouri nurses, nurse practice, or healthcare.  

While being able to get involved with legislation and policy making as an RN or APRN, there are obstacles. Some of these challenges may include schedule, money, personal afflictions, varying education levels of the nurses involved, lack of diversity among the nurses involved, or lack of opportunities for advancement (Denker et al, 2014). Although there are barriers for these nurses or APRNs, there are ways to overcome these barriers.

If schedule, money, or lack of opportunities for advancement is an issue, these nurses could seek out a job that directly involves them in the policy making process, making it a career for these nurses. If these barriers were an issue for me, I would try to seek out a position within my current hospital that would directly involve me in policy implementation within the hospital system. This would give me the opportunity to focus on policy making within legislation and be more up-to-date and relevant with the information. Nurses involved in policy making need to have a single, strong voice.

To overcome personals afflictions, it is important to work as a strong coalition (Denker et al., 2014). Considering everyone has their own personal opinions, it is important to consider what is best for all nurses, not just one. As David Benton said, “If each nurse would take every opportunity to learn from the experiences of colleagues throughout the world and to initiate and influence policy development, we would have the expertise, strength, and knowledge to lead the world to better health” (Denker et al., 2014). To overcome diversity and varying education level issues, these positions need to be inclusive with well-defined roles for all people, men, women, people of other races, and those of different education levels.  

To advocate or communicate these opportunities for nurses or APRNs to be involved in policy making, I would help to advertise for MONA and recommend MONA and getting involved with these organizations. Many people do not know about these opportunities for involvement. When I was in nursing school obtaining my bachelor’s, we were required to join MONA for a day. I had no idea what MONA was or the purpose of it, but getting involved and speaking with legislators, I understood the importance for nurses to get involved. MONA is not well advertised in Missouri.

Promoting MONA beyond colleges and schools would be to advertise it at nursing facilities and have the Missouri State Board of Nursing continue to add information about MONA in their newsletter and their website. Next, I would promote these opportunities to nurses who are uncomfortable with new legislation or requirements for nurses. Those who feel directly affected by legislation should become involved so they can feel like they are helping with adequate policy for nurses.   

References 

American Organization for Nursing Leadership. (n.d.). Congressional nursing caucus. https://www.aonl.org/advocacy/resources/congressional-nursing-caucus 

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. 

Burke, S.A. (2016). Influence through policy: Nurses have a unique role. https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role#:~:text=Through%20policy%20work%2C%20nurses%20can%20and%20should%20influence,impact%20resource%20allocation%20to%20support%20delivery%20of%20healthcare. 

Denker, A., Medina, P., Yore, M., Leonard, T. (2014). Addressing barriers in leadership for nurses: A toolkit for nurses to shape the future of healthcare through nursing leadership. https://campaignforaction.org/wp-content/uploads/2016/04/Addressing-Barriers-in-Leadership-for-Nurses-FL.pdf#:~:text=not%20present%20%20%20Question%20%20%20,%205.57%25%20%20%2012%20more%20rows%20 

Milstead, J.A., and Short, N.M. (2019). Health policy and politics: A nurse’s guide (6^th ed). Burlington, MA: Jones & Bartlett Learning.  

Missouri Nurses Association. (n.d.). Welcome to the Missouri nurses association! https://missourinurses.org/  

 

Given that there are more nurses than any other profession in healthcare, it is only natural that nurses should play a larger role in creating healthcare policy. Key organizations are articulating the need for nurses to become more involved in leadership, advocacy and policymaking. Consequently, the need for nurses to receive more training about leadership in connection to their role for influencing health policies is emphasized. There also needs to be a greater effort to grow a cadre of health policy nurses and help everyone in the nursing profession understand how nurses can effectively impact health policy.

According to Sigma Theta Tau International Honor Society of Nursing, more than ever, nurses are present in every healthcare setting and possess a unique role in formulating policy. The Institute of Medicine’s 2010 report, The Future of Nursing: Leading Change, Advancing Health, recognized the importance of involving nurses in healthcare policy creation and called for nurses to take leadership in improving the quality of healthcare. Being actively involved in policy formulation is something that most leading nursing organizations advocate. Sigma also provides the examples of how the American Association of Colleges of Nursing emphasizes the role of nursing in policy and identifies, in its “Essentials” documents, the expected policy involvement that should be addressed in educational programs at the baccalaureate, master’s, and doctoral levels of professional nursing, including advanced practice.

That being said, nurses nevertheless play an important role in health policy making. Nurses can use their local and state resources or national nursing advocacy groups to gain an understanding of current issues and learn how they can become involved. Many specialty nursing organizations have policy experts available as resources to beginning nurse advocates. They can help with preparing written or oral statements for hearings and may accompany nurses to hearings at the local state house or even on Capitol Hill.

Nurses are encouraged to participate in health policy for three reasons. First, nurses closely deal with patients and their families in a variety of settings; therefore, their comments can be considered as valuable sources for policy development. Second, different health policies have direct effects on nurses. Thus, policies should ensure a supportive work setting. Third, nurses play key role in professional development and can highly contributed to the formation of appropriate and efficient health policies.

 

There are many opportunities for RNs and APRNs to actively participate in policymaking, but there are also many obstacles that can prevent them from doing so. Due to their expertise and knowledge-base background, nurses are taught to always advocate. This enables the political context to have an impact on the decision-making process regarding alterations in health care. In most cases, nurses have improved their communication and collaboration skills with other healthcare professionals, thereby enhancing the treatment provided to patients.

The opportunities in which both parties can engage are as follows: American Nurses Associations is a wonderful organization that allows nurses to be involved in policy changes that can enhance their working environment. There are numerous other nursing organizations, but I selected this organization because it enables nurses to express their concerns about their employment and propose changes that could be advantageous to them. If the policies are to be modified, the new policy will take effect promptly following the review process.

The second possibility I observed is the workplace. Both RNs and APRNs work together to provide high-quality patient care, and both have the responsibility to influence healthcare programs in the workplace.  The responsibility of RNs and APRNs is to promote and advocate for a patient’s health improvement. In order to provide care to patients, the workplace environment must be optimized, and care delivery must be efficient. This can provide the opportunity for senior management to participate in certain policy revisions.

Constraints: an organization’s ongoing membership fees like ANA, which can be annual or monthly, are a disadvantage. This can be a disadvantage if a nurse does not always have the opportunity to be actively involved and engaged due to personal obligations. To retain nurses, fees should be waived, and you should only pay when you are able to be active. Like a pay as you go plan.

There is occasionally a lack of communication from senior management regarding policy revisions, which can be indicative of poor leadership. This can have a negative impact on nurses because, if the communication is effective and policy changes are implemented without addressing the nurses’ concerns, they may not want to participate in future decision making. Through email, memos, meetings, etc., some solutions are constantly informing employees of any policy changes. Permit staff participation in order to foster confidence and excellent collaboration rapport.

Effective communication through increased staff meetings and trainings. I’ve observed that when nurse managers conduct more effective staff meetings that allow participation from all staff and build confidence. Additionally, more trainings provide nurses with the opportunity to advance their careers, preparing them for leadership opportunities and advancement, which enables them to question policies that can promote better health and well-being for their patients and themselves.

Promotion of effective leadership in these facilities and organizations. If these organizations are able to reduce their membership fees to a reasonable level, additional nurses will be more inclined to participate. This can enrich organizations with diverse perspectives on ideas and knowledge, which can lead to improved patient care and social changes.

 

For healthcare legislation to be successful and be evidenced based it is imperative that RNs and APRNs be involved in the policy-making process. By being involved in the initial stages of policy-making, nurses advocate for improvements that benefit both themselves and patients, i.e., policies that increase the scope of practice for APRNs to increase patient access to primary care providers (Milstead & Short, 2019).

One avenue that nurses can use to be a part of the policy-making process is their participation in a professional nursing organization such as the American Academy of Nurse Practitioners (AANP). AANP members are involved in political advocacy committees that advocate policies like H.R 8812 ICAN Act which promotes improving patient access to health care by eliminating Medicaid and Medicare barriers to ARNP practice (AANP, 2022). Another way nurses can affect the policy-making process is through community advocacy in local groups or within their own organizations. By being involved at a local level in healthcare issues nurses draw public attention and can positively influence public perception (Milstead & Short, 2019).

While nurses are great advocates for patients, they face challenges in inserting themselves at the table of policy-making. The biggest challenge to overcome is the historically subservient nature of the nurse-physician relationship. Nurses report feelings of powerlessness within political spheres related to a perceived preference for male voices over nurses’ opinions (Rasheed, Younas & Mehdi, 2020). Another challenge for nurses is our perception as good implementers of policy which is a passive role and not as a policymaker which is an active role. Nurses have historically had low participation as policymakers and as members of committees that affect policy, however through education and empowerment that could be changed.

To improve nurses’ ability to be effective policymakers, nurse leaders should promote participation in professional organizations and organizational committees to their fellow nurses. Nurses should be educated on the importance of their voices and views and how they can be used for the betterment of others. When I first started with the VA, I didn’t participate in committees, and I wasn’t a part of a professional organization. However, as I moved to other positions within the organization, I came into contact with nurse leaders who both empowered and educated their nurses to be active in the policy-making process within our organization and would conduct training events to spread the word.