Nursing and Policy Development

Fundamentals of nursing
06/14/2021 FON 2020 1

DEFINITION
Policy is defined as a “course of action to
be followed by a government, business, or
institution to obtain a desired effect”
(Nies and McEwen, 2011, p. 200)
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Introduction
As we begin a new transition in the health

care delivery system, a variety of
economic, social and political issues will
necessitate the nursing profession's
involvement in policy development.
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As with the rich past of nursing leaders,
such as Florence Nightingale who wrote
letters for the improvement of
environmental conditions to enhance
health, to nursing’s role in social reform
in the 1900’s, the involvement of nursing
presence has been instrumental in change
and advocacy.
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Cont’d
At a time of rapid change in the health care
arena, the need for clear and concise
policies is essential to promote
communication between and within
organizations to promote population health.
 The non-visible skill of nursing practice,
such as policy development, serves as an
intervention for improving health care
outcomes.
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Cont’t
Health policy refers to “public
and private policies directly
related to heath care services
delivery and reimbursement”
(Mason, Leavitt & Chafee, 2007,
p. 76.)
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Cont’d
Leavitt (2009) expands on this
definition by stating, “health
policies are decisions about the
health of individuals and
communities”( p. 73).
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WHO definition : Health policy
refers to decisions, plans, and
actions that are undertaken to
achieve specific health care goals
within a society.
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Cont’d
An explicit health policy can achieve
several things:
it defines a vision for the future which in
turn helps to establish targets and points
of reference for the short and medium
term.
It outlines priorities and the expected
roles of different groups; and it builds
consensus and informs people.
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The purpose
The purpose of evidence-based
policy is to improve public health
outcomes.
Education program focuses on
preparing students to provide
policy leadership in a variety of
settings.
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Graduates will be prepared to:
 identify and critically analyze laws,
regulations and policies at the
institutional, local, state and national
levels; to use in-depth knowledge of the
history, structure, theory and process of
health policymaking in the United State;
and to plan, implement, and evaluate
policies.
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Cont’d
In addition, they will understand the
economic, ethical, and social
implications of policy decisions for
various affected groups, and be
prepared to creatively and effectively
advocate for policy change.
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Implementation of policy development into
nursing practice is still evolving as part of the
role of the nurse.
 The need for policy development “is more
than that of an academic enterprise, it is vital if
effective care is to be delivered and resources
used efficiently” (p. 641).
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Cont’d
 Few nurses are engaged in policy
development and they need to be
“policy-competent,” but are not
involved because they lack clear
guidance on how to accomplish it
(Hewison, 2007; Leavitt, 2009).
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The Role of Nursing in Policy
Development
Why nursing? Nurses are trusted by the
public and known for ethics and honesty
(Ulrich, Cunningham, and Wright, 2010).
 As identified by Wright (2010), trust and
power are closely related.
Other traits that are vital to policy
development are noted by Leavitt (2009)
and include knowledge and credible
voice.
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Furthermore, additional qualities such as
expertise, commitment, persistence,
compassion, vision are described by Wright
(2010).
 These attributes, in addition to roles in
leadership, advocacy, and as change agents
(McCracken, 2010); contribute to nurses
involvement in policy development through
the use of the nursing process.
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Leader
The role in leadership described by Wright

(2010) is that of being “influential.”
The leadership role expands as a role model to
students as community planners who mobilize
groups to access resources and reform of health
policy (Pauley, MacKinnon and Varcoe, 2009).
Fyffe (2009) relates the development of nurse
competency in the area of policy development
as necessary for nursing leadership.
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Advocate
Social justice, access to health care,

concerns for vulnerable populations, and
concerns for health equity have been the
passion that has driven community/public
health nursing practice.
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Healthy People 2020 (Department of
Health and Human Services, 2010)
identified the need for building skills in
policy development for the purpose of
caring for vulnerable populations.
 Brownson, Seller and Eyler (2010) call
for the elimination of health disparities
as a policy priority.
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Change Agent
Nurses need to take an active role in

policy development so others do not speak
for nursing practice.
 Public health nursing talents are in
prevention-focused health care and it is
essential for our voices to be at the policy
table whether in government, workplace,
or in our community (Leavitt, 2009,
Hewison, 2007).
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Career Possibilities
Nurses with policy expertise are

employed by health services
research firms, work in legislative
and regulatory offices at the
county, state and federal levels, or
hold elective or appointed office.
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Others work in the legislative or policy offices
of health maintenance organizations, advocacy
organizations, health care companies or health
care provider associations, or consult for these
and other organizations.
One can also find nurses with careers in policy
and program planning at international
government health organizations and non-
governmental organizations.
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Barriers to Nursing Involvement in
Policy Development
Nursing continues to be a female-
dominated profession.
Fyffe (2009) reports nurses are reluctant
to enter into politics, and the political
arena of policy development.
 Nurses may fear disclosing the
confidentiality of the nurse-patient
relationship in open discussion.
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Cont’d
Cunningham cites a Gallop Poll of 2009 by
the Robert Wood Johnson Foundation
survey titled Nursing leadership from
bedside to boardroom; opinion leaders
perceptions, which supports the opinions
by leaders that nurses lack a structure for
nurses to be heard, have limited
leadership opportunities, no strategic
vision, and differing levels of education.
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The survey results find that nursing is last
out of seven possibilities which will
influence health reform in the next five to
ten years.
McCraken (2010) supports this finding by
remarking that nurses “seldom use their
knowledge and skills to be advocates in
policies that support health,” in
particular to older adults (p. 15)
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Education in the area of policy
development is limited in academic
programs, and the importance of nurse
leaders as role models for students should
be emphasized (Pauly, et al 2009).
 Academic preparation has been
suggested as a mechanism to assist nurses
in valuing and identifying political
involvement (Primomo, 2007).
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It is a challenge for nurse educators to teach
students how to translate policy (Leavitt,
2009), because limited time in clinical
experiences prevents immersion experiences
in policy development.
 Nursing role models, preceptors, and leaders
are needed to advance learning in the area of
policy development skills for all professional
nurses.
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Conclusion
Policy development is integrated into the

scope of practice for nursing.
 It is part of our rich history and destiny.
 Nurses must play a role in having their
voices heard through policy development.
 We are the ‟master of our ship‟ –Now
is the time to take the helm!
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References
American Nurses Association. (2007). Public

health nursing: Scope and standards of
practice. Silver Spring, MA: Author.
American Nurses Association. (2005). School
nursing: Scope and standards of practice.
Silver Spring, MA: Author.
Cunningham, J. (2010). Survey says: Nurses‟
influence on health care is untapped. Texas
Nursing. Winter 2010, 12-13.
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END
THANK YOU!
06/14/2021 FON 2020 30

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Fundamentals of nursing

06/14/2021 FON 2020 1

06/14/2021 FON 2020 2

As we begin a new transition in the health

06/14/2021 FON 2020 3

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The role in leadership described by Wright

Social justice, access to health care,

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Nurses need to take an active role in

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Nurses with policy expertise are

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Policy development is integrated into the

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American Nurses Association. (2007). Public

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