Question

What types of local, state, and federal health policies currently affect your nursing practice?

Answer 1

Nurses work in a broad range of settings, and so theyexperience health policies originating from a variety of sources. It is often difficult for even veteran nurses todistinguish clearly where new policies come from, for example, their employer, federal regulations, JointCommission, state law, or the Centers for DiseaseControl and Prevention. Nurses may or may not know what forces or catalysts created the policies..

Additionally, some organizational policies are micro in scope (e.g., how to administer and track nar-cotic medications) whereas others are macro (e.g., theWorld Health Organization’s [WHO] guidelines for treating infectious diseases). The ability of an individual nurse to influence policy is greater in the micro than the macro context. It is a law of efficac treating infectious diseases; WHO.. The ability of an individual nurse to influence policy is greater in the micro than the macro context.

It is a law of efficacy that the nurse seeking involvement with policy initiatives tar- get decision makers potentially responsive to his or her individual efforts. The macro context will almost always demand greater numbers of and organization by nurses. Working with colleagues or professional organizations will extend an individual nurse’s potential impact into larger contexts. Any nursing strategy for policy change requires that the nurse know how that policy came into existence, what body or bodies perpetuate it, and where the opportunity for policy change rests.

While the policy process has been extensively explored by many different disciplines the sources of policy specific to health care are in general only identified implicitly. Because of this,as well as the number and diversity of sources, nurses do not readily understand or envision how policies are created. The authors believe that by explicitly identifying where and how decisions are made that trigger new health policies, the mystery and ambiguity associated with this domain can be reduced. Greater clarity about sources could help nurses expand their access to decision makers and find opportunities for timely input.