Professional nurses are well versed in the nursing process of assessment, planning, implementation, and evaluation processes and, in direct contact with patients, represents valuable data for improved outcomes. The Affordable Care Act (ACA) of 2010 emphasizing nursing in the promotion of leadership toward quality care of patients, including population health, dealing with economic disparities, and employment satisfaction among healthcare workers (Milstead & Short, 2019). These concepts are also mirrored with the Institute of Medicine’s (IOM) report, The Future of Nursing, that nurses should redesign the healthcare systems in partnership with physicians and other healthcare providers in terms of research, advocacy, and policy planning (Milstead & Short, 2019). Perhaps a critical aspect of policy advocating has to do with motivating others toward positive results, which can improve access to care, increased efficiency, cost savings, and positive patient outcomes; that is, efficacy (Glasgow, Lichtenstein, & Marcus, 2003). Telehealth is one example of the care that is delivered in a safer environment, such as COVID-19 pandemic. Teleneurology gives stroke patients access to a neurologist instantly with faster treatment preserving brain tissue, thus improving outcomes.
Nurses participate in policy review at the workplace, also outside in terms of local, State, and Federal legislation.
In terms of political policy review, which would benefit the nursing profession can be accomplished by joining organizations. The policy-making process ultimately benefits both patients, and the profession as individual and inter-professional efforts are essential (Milstead & Short, 2019). The main reasons why people join nursing organizations have to do with professional benefit (21.4 percent), networking (21.4 percent), increase knowledge (22.1 percent), mentoring opportunity (7.9 percent), and gaining CEUs (17.1 percent). Social interaction, with 9.3 percent, and job requirement, 0.7 percent, are other reasons for joining (White & Olson, 2004).
Challenges joining a professional organization
Main barriers include family responsibilities (25.0 percent), too time-consuming (17.9 percent), lack of information on meetings (17.9 percent), no benefit to membership (8.9 percent), politics in the organization (7.1 percent), and 12.5 percent surveyed said it was too expensive. 10.7 percent said the meetings were too far away, being a location or transportation barrier (White & Olson, 2004).
A pressing issue for nursing organizations is self-evaluation. With so many organizations, what the organization must present should represent a positive, helpful experience for the nurse fostering empowerment and unification of a single cause for pressing, serious issues. So nursing meetings should also focus on itself for improvement, which would foster more members. Suggestions appear to increase satisfaction within an organization and electing effective leaders to give a clear direction and be very precise with information to avoid confusion (White & Olson, 2004). Further leaders should encourage individual nurses to cultivate their leadership skills to create, question, or refine policies (White & Olson, 2004). I am fortunate I live in Polk County, Florida, which has a local organization called the Polk County Advanced Practice Nurse’s Association (PCAPNA). Hence, distance is not unreasonable, with affordably priced membership, especially for students. If the organization is not a positive experience, they will lose members. So policy review should be geared toward itself as well as advocating political matters such as the scope of practice for state and Federal policies. This is entirely nurse-driven.
Policy Review at the Workplace
Nurses not only advocate for patients, but they must function in an environment that is satisfying, safe, and empowering (American Nurses Association [ANA], n.d.). Leaders and stakeholders should foster open communication, exchange of ideas in a non-threatening manner, which the World Health Organization describes as a physical, mental and social environment supporting safety and health (ANA, n.d.). This goes back to the Nurse Practice Act (NPA), in which each state governs nursing defining the legal scope of nursing practice. The NPA serves as a guide to protect nurses and patients in performing duties (ANA, n.d.). The nurse must work in a non-intimidating environment.
Nurses can become empowered in the workplace. For example, take a common problem such as workplace violence. Workplace violence consists of not only physical, but psychological damage in an environment full of vulnerable patients, which was defined by the National Institute for Occupational Safety and Health (NIOSH), and is increasing yearly (ANA, 2019). Many nurses have been through it–hospitals tolerate rude, disrespectful, and even belligerent doctors because they bring in much revenue, and nurses are seen as dispensable. Addressing the issue of workplace violence can be shared in meetings. Challenges occur when there is poor leadership; they will ignore these intimidating healthcare providers, as it erodes and destroys staff, and compromises patient safety. Rude, intimidating behavior in healthcare is very dangerous as it undermines staff morale, increases staff absenteeism, resignations, fostering additional hostile work environments. Ultimately nurses can feel afraid to contact the doctor when patients have problems to incur their wrath leading to patient harm (Grissinger, 2017). For nurses to protect their patients, rude, unprofessional, and intimidating doctors should be reported as an official incident report. Abusive behavior violates The Joint Commission and is viewed as a Sentinel Event violating the culture of safety (The Joint Commission, 2020); hospitals that tolerate hostile doctors should be reminded of this at meetings. Perhaps even with incident reports and still nothing is done about chronic rude and irresponsible, unprofessional behavior, an official complaint can be sent to the Joint Commission for a formal investigation.
Two tools to cause policy review can be seen as using reporting tools such as incident reports and stakeholder meetings. Education is another tool that should be readily disseminated among staff and patients. Nurses have a lot of influence and empowerment, simply because we are nurses and it is expected of us to advocate for our patients, communities in all matters that affect human health and well being.
American Nurses Association. (n.d.). Healthy work environment. https://www.nursingworld.org/practice-policy/work-environment/
American Nurses Association. (2019, June 1). Workplace violence. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/state/workplace-violence2/.
Grissinger, M. (2017, February 1). Disrespectful behavior in health care. PT, 42(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265230/.
The Joint Commission. (2020). Sentinel event alert 40: Behaviors that undermine a culture of safety. Retrieved from https://www.jointcommission.org/en/resources/patient-safety-topics/sentinel-event/sentinel-event-alert-newsletters/sentinel-event-alert-issue-40-behaviors-that-undermine-a-culture-of-safety/.
Milstead, J.A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
White, M. J., & Olson, R. S. (2004). Factors affecting membership in specialty nursing organizations. Rehabilitation Nursing, 29(4), 131-137. https://doi-org.ezp.waldenulibrary.org/10.1002/j.2048-7940.2004.tb00331.x