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Influence through policy: Four steps YOU can take

Kaitlin Olson | 11/4/2020

ISBAR and the nursing process are excellent policy-advocacy tools.


In her presidential call to action for the 2015-17 biennium, Cathy Catrambone, PhD, RN, FAAN, called all members of the Honor Society of Nursing, Sigma Theta Tau International (STTI) to “Influence to Advance Global Health & Nursing” in four areas: 1) advocacy, 2) policy, 3) lifelong learning, and 4) philanthropy. This third of a six-part series on President Catrambone's call addresses influence through policy.

Nurses are developing greater awareness of the impact of health policies on nursing and healthcare practice. Because nurses have a wealth of knowledge, skills, tenacity, and a firsthand view of healthcare challenges, members of the profession are ideal candidates for supporting and presenting health policy proposals to legislators.
Have you ever thought about using your knowledge as a nurse to advocate for improving public health? I see it as a four-step process.
Step 1 is to identify a problem. (Passion for the subject is important to sustain drive.)
Step 2 is to research the subject and select the most successful and appropriate evidence-based intervention. The framework provided by the Institute of Healthcare Improvement’s Triple Aim Initiative is one approach to consider. Elements of the three-dimensional plan include 1) improving the patient experience of care, including quality and satisfaction, 2) improving health of populations, and 3) reducing per capita cost of healthcare.
Step 3 involves networking to gain expertise. Examples of networking include meeting with experts, becoming involved in an organization, building relationships, and providing updates to those who support your advocacy efforts.
And finally, in Step 4, work to your full potential and take credit for your success. Anticipating moves, addressing potential barriers, and dedicating significant time to the task will help you achieve that success, and sharing your work with others may provide opportunities to formally present your advocacy goals.

Olson_Kaitlin_article_embed_SFWWhat nurses bring
Building and maintaining relationships with stakeholders and key contacts are crucial in bolstering support for an advocacy task or influencing policy. Nurses are excellent communicators and ideal correspondents with legislators because of communication skills developed in using the ISBAR method and nursing process. ISBAR, which stands for identify, situation, background, assessment, and recommendation, is used in patient handoff to provide essential information in a succinct, easy-to-remember sequence. This concise transfer of information allows the respondent to accurately provide feedback for assessment and recommendations for the situation. Nurses are also adept in applying the nursing process of assessment, diagnosis, planning, implementation, and evaluation to make policy decisions and to educate legislators.
The ISBAR communication method and the nursing process may be incorporated in conference calls, meetings, email correspondence, document editing, and determination of next steps. Don’t overlook timely email communication. Staying in touch with your workgroup and professional contacts is important as fast-changing developments may warrant equally speedy communication with those with whom you are working.
There is huge potential and demand for nurses to become politically active and work as public health advocates. In the United States alone, there are more than 3 million registered nurses, the nation’s largest healthcare workforce. Some in the profession are legislators. Healthcare workers interested in policy advocacy should identify such nurses, including those in advanced practice, to begin a conversation about introducing and supporting policy proposals. Repeatedly, Gallup polls rank nurses highest for honesty and ethical standards. Thus, we have credibility with legislators, who are likely to trust and be receptive to us.

Begin where you are
Networking with nurse leaders and administrators helps gather support for your advocacy goals while cultivating relationships. Because you already have relationships established in your workplace, that’s the easiest place to begin networking. A good place to start may be with your manager. A supportive manager can help create opportunities to spread the word to organizational leadership, especially if the advocacy task aligns with the organization’s model and mission.
How do you find the time to balance work with undertaking an advocacy task? It’s important to make time—time that benefits both the cause you advocate and your professional growth. Professional development occurs through advancing education, taking calculated risks, and demonstrating clinical and policy knowledge. To create innovative public health solutions, healthcare providers must re-examine how healthcare is delivered and, to bring about change, engage stakeholders, experts, and legislators.
The four P’s
When frustrations arise, remember the four P’s: passion, persuasiveness, persistence, and patience (Hulick, 2015). Your professional commitment to advance important policy changes can be pivotal in your career advancement, while helping you stay up to date on practice trends and acquire new experiences and skills.
By following the four steps to policy advocacy that I’ve outlined, you will have a more meaningful nursing career while achieving important gains for your profession and world health. Nurses are ideal to assume the roles of activists and lobbyists. Their skills in use of the ISBAR communication method and nursing process make them invaluable in networking and participating in workgroups. By becoming knowledgeable about legislative processes and procedures, nurses are well-prepared to become involved in advocacy. Those who invest time and energy to advocate for public health will gain personal satisfaction and fulfillment while achieving goals that positively affect their profession, the workplace, and patient populations. RNL
Kaitlin Olson, MSN, RN, CMSRN, is a critical care nurse at Hartford Hospital in Hartford, Connecticut, USA.

Read the other installments in the "Answering the call" series:

Influence through advocacy: Raising awareness, advancing change

Influence through policy: Nurses have a unique role
Influence through lifelong learning: I developed leadership skills I didn’t think I’d ever have! 

Influence through philanthropy: What philanthropy looks like

Influence through philanthropy: Giving back to pay it forward
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