History and Healthcare Policy in Nursing

Meg Fitzgerald 

 The policies in nursing have been largely influenced by history and politics within the larger healthcare ecosystem. Today there are close to 4 mm nurses in the U.S representing a formidable voting block but on issues close to home the profession doesn’t yield the same power and influence. Despite the history, obstacles and politics nurses are revered and valued members of the healthcare system. They own a strong position that should be leveraged for practice and pay gains.

 Data shows that in healthcare policy creation nurses face many barriers to entry. These barriers include being involved in policy development, having the right knowledge and skills, the negative image of nursing structures and processes which enhance seclusion. (Sharif, 2014). And these barriers have followed the practice of nursing since its inception.   

 The genesis of the nursing profession dates back to 300 AD when the Roman Empire built hospitals which required doctors. Those doctors needed assistance requiring a new role; the nurse. This is likely when the politics and branding around a nurse as a deputy or subordinate took hold. This structure and dynamic continues to challenge and hinder policies in the field today.

 Over the last century, the nursing profession has evolved into a more important and visible practice due some help from the Catholic Church which built hospitals to care for any sick individual. This mission aligned well with values of nursing and remains dominant theme in many of the policies supported by the profession. Many of these mission driven hospitals provided nurses the autonomy to provide a range of medical care services. Many feel these early models served as the policy jump off point for nursing policy and likely plays a role for the broad services the nurse performs today.  

 And in New York City, Lillian Wald followed this playbook harnessing the support of those in power to establish the field of public health nursing which went on to establish the National Organization of Public Health Nursing in 1912 (Mason 2016). What is remarkable about Lillian aside from her clinical leadership was her policy and business skills. Her public health efforts were cemented with the creation of powerful alliances like the American Red Cross, coupled with her fundraising and wooing of wealthy donors and foundations.  

The intersection of clinical value and policy making that Lillian pioneered is an important lesson for nurses looking to affect policy today. When the ACA was established, public health advocates and nurses used this bill to increase access to care, contain costs and push the promotion of alternative sites of care and expand the scope of nurse practitioners. Whenever there is a major policy change or upgrade from Health and Human Service, the practice of nursing needs to be close shaping the debate.

And at every turn in the history of healthcare policy, the most important factor was research and evidence. Data is the currency of healthcare policy. And it’s an area all in nursing must embrace and advance.

Nursing research has changed dramatically in the past 150 years starting with Florence Nightingale but it was not until the 1950s that nursing research began the advancement that has been seen in the past three decades (Stolley, 2000). When nursing decided to put a premium on the advanced degree the foundation for research began. And as a result of this research, funding and political support was attracted to the cause.

The profession of nursing has evolved throughout history and today nurses own the most important position in politics; trust. However, there is a growing recognition from peers, policy makers and payors that nurses need to publish and promote their value more. Every time we move forward in our practice, we must back it up with data to advance  policies that lift us. If we continue to prove that our industry drives cost savings, quality and access then money and political capital will flow our way .

                                                                              References

Mason, Diana J. Policy and Politics. In Nursing and Health Care. 7th edition 2016.

Shariff N. (2014). Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development. BMC nursing, 13, 20. https://doi.org/10.1186/1472-6955-13-20

Stolley, J. M., Buckwalter, K. C., & Garand, L. (2000). The Evolution of Nursing Research. Journal of the neuromusculoskeletal system : JNMS : a journal of the American Chiropractic Association, Inc, 8(1), 10–15.

In the final part of your assignment, you will create a presentation to share the results of your study. You may choose to create either a PowerPoint presentation or a brochure. Whichever you choose, please make sure that it is visually appealing – include appropriate graphics, color schemes, etc. It must include the following information:

1. Title (be creative)
2. PICO(T) question
3. Reference list of sources reviewed in APA format (you do not need to discuss each one individually)
4. Brief overview of the general findings
5. Overall strength of evidence
6. Your practice recommendations, strength of recommendations
7. List of key stakeholders
8. How you plan to evaluate the intervention

   

In an APA format paper, approximately 2-4 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1, 2, 3, 4, and 5 of this assignment

Based only on the evidence you gathered, make at least 2 practice recommendations (these can be either positive – we SHOULD do this, negative – we SHOULD NOT do this, or recommendations to gather more data if the evidence is insufficient) and grade the strength of your recommendations using the GRADE criteria (see GRADE working group for more information on grading your recommendations). You should reference the GRADE criteria as it relates to the strength of your recommendations

*DUE IN THE NEXT 15HOURS PLEASE!

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.   

Draft a 1,000-1,250 word paper in which you:

1. Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.
2. Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.
3. Include in your explanation a specific example as a nurse of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.
4. Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.