Role of Advance Practice Nurses in Affecting Health Policy Formation and Implementation
Nursing profession has become an essential part in the society primarily in terms of its health care contributions. Throughout the years, it has continued to actively take part its leadership role in health care services towards the society and various public needs. The emerging complexity of health care systems offers challenges for advance practice nurses in their influence with the political aspects in terms of policy making and implementation of health care laws.
The term “advanced practice nurse”, also called “advanced practiced registered nurse” (APRN) refers to nurses with formal post baccalaureate preparation in one of the four roles: clinical specialists, nurse anesthetists, midwives, and nurse practitioners (Mirr & Zwygart-Stauffacher, 2006). Their acquired critical thinking ability and experiences in applying health care theories and principles are necessary in achieving a system transformation.
According to Gourdreau and Smolenski (2014), each of the four roles of APNs has definite competencies within their core documents regarding their role and activities in policy advocacy. Their leadership role evaluates the policy decisions to be made in order to positively response the issues they are going to address, whether as an individual or as a group. In order for the policy to be made, APRNs must demonstrate to policy makers the kind of work that would result positive and visible outcomes. Their interactions with the different policy-making bodies and government branches as they present their advocacy will generate influence. For example, in the issue of providing reimbursement in nurse practitioners, the importance of eliminating financial barriers and improving access to care for families can be discussed towards the legislators (Nagelkerk & Huber, 2006). Another example comes from APNs perspective in providing quality care for their patients. By this desire of partnership, they provided a tool called Consumer Assessment of Health Plan Survey (CAHPS) that lists consumer experiences about health-care quality (Joel, 2009). These health care assessments are now widely used by government agencies and private sectors.
Historical events contribute a major impact that shapes the evolution and development of healthcare systems nowadays. The industrial revolution is one of the significant events that marked a difference in the field of medical profession. Technological advancement has influenced the worldwide economy during this time. It has changed the people’s lifestyle, and migration in the cities due to employment opportunities has become common. This has resulted to an increase population and overcrowded working conditions. It is during this period that the society has become aware of the relationships between hygiene and health (Klainberg & Dirschel, 2010). This has led to government’s efforts to provide the society a health care system. According to Klainberg and Dirschel (2010), other discoveries are made including the invention of eyeglasses, the improvement of microscope in identifying body cells and bacteria, and especially the establishments of nursing schools as nursing roles have been acknowledged.
Another historical event that has made advancement in healthcare system especially in emergency medical services is the U.S. Civil War. According to Beebe and Funk (2001), the discovery of ambulances for the treatment and transportation of the wounded soldiers during the Battle of Bull Run has been organized by Dr. Jonathan Letterman. As of today, the concept of immediate response and action in treating injured individuals and sending them in the nearest hospital has continued.
Another contributor in the field of emergency medical services is Clara Barton. Her passion in actively helping the affected soldiers during the war displayed thoughtful and selfless service. Beebe and Funk (2001) also added that she is best known as the founder of American Red Cross, an organization that trains civilian in first aid and cardiopulmonary resuscitation.
Political factor is one of the many things that influence and shape the implementation and policy formation of the health care system. One example is the kind of political system in which the policy cycle operates. Health care system is a combination of contributions from the different branches of government and private sectors in the society, thus, it reflects the kind of values and interests cultivated by the varying establishments. According to Patel and Rushefsky (2014), the public philosophy of interest-group liberalism combined with constitutionally guaranteed freedom of speech, association, and petition allow a variety of interest groups to promote policies for private profit and to successfully defeat policies they perceive harmful to their interests. A health care policy becomes effective when it has undergone thorough research, gathered scientific evidences, and discussed by different parties. In that process, the nature of the issue is clearly identified and corresponding action is taken, resolving the problem accordingly. However, there are instances when organizations fail to disclose some information because of societal conflicts they may cause. Such conflicts can be observed in the political controversy that surrounds the topic of climate change, theory of evolution, and stem cell research in American politics (Patel & Rushefsky, 2014). Another particular example of how political factor affects policy formulation is the account on how United States Department of Health and Human Services/Department of Agriculture Dietary Guidelines for American, the federal policy statement on diet and prevention, has been watered down, as a result of food lobbyist activities, to suit the interest of the food industry (Nestle, 1994, cited in Gochman, 1997). This kind of process caused by underlying political issues and selfish interests results to an ineffective formulation of health care system. In order to achieve the vision which everyone promotes, it is important to understand the varying concepts that evolve within.
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