What allows a nurse to exert legitimate power over a client when providing nursing care

Nursing is the largest medical profession in the world with nearly 4 million nurses in the United States alone. As such, nurses have the potential to profoundly influence policy and politics on a global scale. In fact, it is the moral and professional obligation of nurses to be engaged in legislation that impacts their patients. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Unfortunately, nurses have historically had little involvement in policy that affects healthcare delivery.

There are several reasons for the limited nursing participation in policy and politics. Lack of awareness, inadequate skills, and little opportunity for involvement are just a few factors. Another barrier is the limited formal health care policy education in nursing. Time and resources are further obstacles to the nursing profession’s participation in politics. Additionally, studies show that nurses are not given sufficient support to generate the evidence needed to influence healthcare policy.

Regardless of the multiple factors limiting the nursing profession’s potential impact on politics, the fact remains that nurses are vital to the development and implementation of healthcare policy. As the largest medical profession in the world, nurses should be leading the way in redesigning the healthcare system. But in order to do so, they will need to partner with members of other medical professions such as physicians. For this to happen, nurses must be skilled in patient care as well as in interdisciplinary teamwork, informatics and technology, implementing evidence-based practice, and quality improvement.

All too often, nurses become frustrated by policies affecting nursing practice, particularly when those policies are written by individuals with limited healthcare knowledge and experience. This frustration often leads to negativity, disillusionment, bitterness, and burn-out. Instead, nurses should channel their frustrations into making a positive difference in their profession. As Oestberg states, “As nurses, we need to think of policy as something we can influence, not just something that happens to us.”

The truth is, any nurse can influence policy and politics at the local, state, and federal levels. Locally, nurses can become politically active by assuming leadership positions in the healthcare system or contacting elected officials about legislation affecting the industry. Nurses can obtain formal training in politics, become involved in city councils and committees, or even run for local office. And something as simple as exercising the right to vote can impact healthcare policy.

At the state and federal level, nurses can get involved in policy and politics by joining a professional nursing organization. These organizations often have lobbyists that bring nursing issues to Capitol Hill. Nurses can also write their state representatives regarding healthcare policy. Nurses can undertake internships with elected officials to personally work on matters affecting healthcare. And nurses can even run for state office — there are two nurses currently serving in the Florida State Legislature.

As Oestberg so succinctly points out, “If nurses don’t stand up for issues that are important to us, those with competing interests in healthcare may be the only ones whose voices are heard.” By joining their voices together, American nurses can influence the policy and politics that affect healthcare. Marquis and Huston define politics as “the art of using legitimate power wisely.” The nursing profession has significant power to profoundly impact healthcare policy on a global scale. Additionally, the nurses of today are younger, more educated, and more diverse. They bring more energy, more ideas, and more ingenuity to the nursing profession. Perhaps they will even bring more political activism.

However, nurses need support in order to effect change. And that support starts at home. Families and friends of nurses need to encourage political activism. Nursing schools need to include healthcare policy education as part of the curriculum, as well as encourage some level of political involvement from nursing students. Furthermore, the faculty of nursing schools should also participate in policy changes, thereby acting as role models for their students. Finally, employers need to provide staff nurses with the time, resources, and opportunities to influence local, state and federal policy. After all, healthcare legislation ultimately affects us all.

Jennifer J. Brokaw is a wound and ostomy specialist at Tampa General Hospital in Tampa, Florida.

Selected references

American Nurses Association. nursingworld.org/NurseLegislatorDirectory.aspx. 2016.

Budden JS, Moulton P, Harper KJ, Brunell ML, Smiley R. The 2015 national nursing workforce survey. J Nurs Regulation. 2016;7(1): s1-s92.

Falk NL. A health policy resource guide for nurses. J Contin Educ Nurs. 2014;45(5):203-4.

International Council of Nurses (2012). Going, going, gone: nurses in policy-making positions at WHO. Int Nurs Rev. 59(2), 155-158.

Kunaviktikul, W. (2014). Moving towards the greater involvement of nurses in policy development. Int Nurs Rev. 61(1), 1-2.

Marquis BL, Huston CJ. Leadership roles and management functions in nursing: Theory and application. Philadelphia: Wolters Kluwer. 2015.

Oestberg F. Policy and politics: why nurses should get involved. Nursing. 2012;42(12): 46-49.

Pamela, A. J., Edwards, N., & Spitzer, D. Kenyan nurses involvement in national policy development processes. Nurs Res Pract. 2014. http://dx.doi.org/10.1155/2014/236573

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