Nursing & Health-Care-Policy
Analyze the history, structure, and process of health-care-policy and politics in nursing and the health care delivery systems in the United States.
Submission Instructions:
- Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
Nursing and Health-Care Policy: History, Structure, and Process in the United States
Health-care policy is a vital component of the U.S. health system, shaping the way care is delivered, funded, and accessed. Nurses, who constitute the largest segment of the healthcare workforce, are uniquely positioned to influence and implement these policies. Understanding the history, structure, and policy process is essential for nurses who aim to advocate for change and improve outcomes for individuals and populations.
Historical Perspective of Health-Care Policy in Nursing
The intersection of nursing and health-care policy dates back to Florence Nightingale, who used statistical evidence and advocacy to reform military hospitals during the Crimean War. In the United States, nurses began participating in policy discussions during the early 20th century, particularly through the establishment of professional organizations such as the American Nurses Association (ANA) in 1896. These organizations provided a platform for nurses to advocate for licensure laws, better working conditions, and patient safety standards (Mason et al., 2021).
Significant policy milestones include the creation of Medicare and Medicaid in 1965, which increased access to care and allowed nurses to play a greater role in the management of chronic diseases. In recent decades, the Institute of Medicine’s (IOM) 2010 report The Future of Nursing called for nurses to be full partners in health policy development. This report emphasized the importance of advanced education and leadership training to prepare nurses for policy advocacy and decision-making roles (National Academies of Sciences, Engineering, and Medicine, 2021).
Structure of Health-Care Policy
Health-care policy in the U.S. operates within a complex and multi-layered structure involving federal, state, and local governments. At the federal level, agencies such as the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), and the Food and Drug Administration (FDA) play pivotal roles in regulating health-care delivery and reimbursement. States regulate professional licensure, scope of practice laws, and Medicaid implementation, which directly impacts nursing practice and patient access to care (Milstead & Short, 2019).
Professional organizations, such as the ANA and specialty-specific groups like the American Association of Nurse Practitioners (AANP), contribute to the policy landscape by lobbying legislators, developing policy briefs, and participating in advisory panels. These organizations often collaborate with policymakers to advocate for issues like nurse staffing ratios, full practice authority, and public health initiatives.
The Policy Process in Health Care
The health policy process typically follows a cycle: problem identification, policy formulation, policy adoption, implementation, and evaluation. Nurses engage in every phase of this cycle, from identifying practice-based challenges to evaluating policy outcomes. For instance, a nurse working in a rural community may notice high rates of hospital readmissions due to limited access to primary care. This observation can lead to policy proposals for expanding nurse practitioner roles in underserved areas.
Policy formulation often involves collaboration among stakeholders, including legislators, health-care providers, patients, and advocacy organizations. Nurses can provide testimony, draft position statements, and participate in advisory committees. Once a policy is adopted, implementation may involve changes in practice protocols, funding allocations, or educational requirements. Nurses are critical to ensuring that these changes are effective and sustainable at the bedside and within communities.
The Role of Nurses in Shaping Health-Care Policy
Nurses are increasingly recognized as key players in health-care reform. Their direct patient care experience provides valuable insight into the real-world implications of health policy. Nurses serve in leadership positions, on hospital boards, and as elected officials, using their expertise to advocate for evidence-based policies that promote equity, quality, and patient-centered care.
However, barriers remain, including limited formal training in policy advocacy and underrepresentation in policymaking bodies. To address this, nursing education has begun to incorporate health policy and leadership into curricula, encouraging nurses to develop the skills necessary to influence policy at all levels.
Conclusion
The history, structure, and process of health-care policy in the U.S. demonstrate the vital role that nurses play in shaping the health-care system. From early reforms to modern legislative advocacy, nurses have continually contributed to policies that affect patient care, access, and health outcomes. As health-care challenges evolve, it is imperative that nurses are equipped and empowered to lead policy initiatives that reflect the needs of the populations they serve.
References
Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (2021). Policy & Politics in Nursing and Health Care (8th ed.). Elsevier Health Sciences.
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
National Academies of Sciences, Engineering, and Medicine. (2021). The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity. The National Academies Press. https://doi.org/10.17226/25982
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