The role of a nurse in health care and health policy

The legislative process is a pivotal process that shapes the health care policy within the country. The US healthcare system requires a lot of influencing and lobbying in order to adopt or to implement the necessary health care reform policies. The nurses are the relevant people to push for these reforms through their associations or alliances e.g. The Nursing Organizations Alliance (NOA).

The nurses hold the most influential position in driving for the necessary healthcare reforms; this is because of their numbers, expertise and also their positions. The evidence of these numbers is demonstrated by a statistical report which shows that in every 44 female voters in the US there is one nurse. Secondly, in every 100 voters there is one nurse. Finally, there is evidence that there are 100,000 nurses in every congressional district (source: Leavitt, 2003).

Given the position and the well earned respect for nurses by the American public (The Gallup poll has shown that nurses are top ranking when it comes to 'Honesty and Ethics in profession').All these factors are evidence that the nurses can indeed influence the healthcare policy and the policy makers. There is need for nurses to develop an interest and an understanding in the legislative process if they are to be knowledgeable of the political environment, which is a determinant in the making of the health care policies.

Nurses play a very important role in advocating for the rights of their patients, this is so because they are at the best position of understanding the healthcare needs of the patients and this therefore gives them the authority to advocate for better health care reform policies for these patients.

Nurses must therefore move from the reactive response approach to a more strategically planned approach with regard to the changing healthcare policies. Another role of a nurse in health policy is to understand these policies; this directly implies that nurses must know the people to influence, how to influence these people and the right time to influence these people. A nurse also needs to be politically aware in order to stay abreast with the changing issues in the political environment and this is done through a network of nursing organization that keeps the nurses informed of the changing political affairs.

The nurses must also form strategic alliances with other organization in order for them to remain influential and to have a stronger voice in advocating for reforms. The alliances create or result to the creation of a bigger impact. Nurses must be very decisive in their approach to health care policies and this can be done through them taking an active role in making recommendations to health care bills when they are brought to the public for consultations. The nurses also have a responsibility in being or holding positions where they can be consulted with regard to health care policy issues e.g. there are three nurses in the US congress namely Eddie Bernice Johnson, Carolyn McCarthy, and Lois Capps.

The current issues and problems

The American healthcare system has been facing numerous challenges. The sudden paradigm shift from a healthcare system based on provision of quality care to one that is guided by the market based economic models, has led to the urgent need for the health care reforms. One of the major problems that were faced by the US healthcare system was the increasing customer demand for reduced healthcare costs and the adoption of a structured business plan, played a role in the erosion of the public's concept of an ideal healthcare as that of humanitarian service.

This particular flawed model led to increased nursing malpractice law suits and even patient errors (This was described by the American Hospital Association as the 'worst disaster to hit the American hospitals', and this was in the year 1995.There have been many institutions taking the fore front in looking at the American healthcare flawed system and these include the Health Research and Service Administration (HRSA) and the Institute Of Medicine (IOM).Another problem is the increased number of American deaths due to avoidable medical errors and these numbers are estimated to stand at a staggering 98,000.

It can be argued that the current healthcare system is on the brink of collapse and all the positive aspects of this system maintained. It is also undeniable that the registered nurses (RN) are the key ingredient to a better health care policy. They also form the largest number of healthcare professionals (are about 2.4 million).There is a developing trend in terms of shortage in the number of qualified nurses; this has tampered with the efficient access to safe and quality health care. The supply of new nurses getting into the healthcare system is incomparable to the number of RNs demanded by the healthcare system (There are fewer RNs compared to the new ones getting into the market)

It would be too general and maybe inaccurate to claim that the health care system is in need of more nurses but it would be accurate to point out the fact that the healthcare system is in need of highly educated and very professional nurses who are in tune with the ever changing health care industry (the technology, advanced medical practices et cetra).

The projection made by the US bureau of labour Statistics Statistics has estimated that there will be an increased need of more than one million new and replacement nurses by the year 2016. (This increase will help deal with the increased demand for the nurses within the healthcare system. The other problem is the Nurse faculty Shortage, , the nursing educational system is also equally strained, and this is mainly due to the limitations in capacity within this learning institutions. Last year alone there were 40,285 qualified applicants who were denied student positions within the baccalaureate and nursing programmes. The reason for this is because of limited faculty positions of about 7.6% (source: Special Survey on Vacant Faculty Positions by AACN in July 2008)

Ways of solving these problems

The problem of the nursing shortage can be resolved through the following measures

Increasing the number of qualified and highly educated nurses (specifically those with a baccalaureate degree or possible higher) ); the reason for this recommendation is because of the increase in acute patients who suffer from multiple health complications e.g. (diabetes, obesity) and therefore demand more independent nursing personnel who are more critical in their decision making, take the place of traditional care givers and also train patients on ways of maintaining good health.
Recommendations have also been made by the National Advisory Council on Nurse Education and Practice, the US Secretary for Health and Human Services and also by the policy advisors to the congress on the need for About two thirds of the practicing nurses to hold a baccalaureate degree or higher (in the nursing profession) by the year 2010.Only 47.2 % of nurses are holders of degrees at the baccalaureate level or above. There are also efforts from the AACN, ANA (American nursing association) and also the American Organization of Nurse Executives to have the RNS to get education at the baccalaureate level or even more.

The second solution is to Reauthorizing the Title VIII Nursing Work force Development Programmes (they are authorized under the Public Health Service Act (42 U.S.C.296 et Seq).The Nursing Workforce Development programs have in the past addressed various issues of nursing shortages which range from retention, recruitment to education. The Title VIII program usually Award education grants to schools of nursing and also more direct support to nursing students through loans, scholarships, and traineeships. This ensures that qualified nurses are available to give qualified health care.


America Association of Colleges of Nursing (AACN) policy brief 2008.


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