According to Sigma, formerly known as Sigma Theta Tau International Honor Society of Nursing, "More than ever, nurses are present in every healthcare setting and possess a unique role in formulating policy. The Institute of Medicine's 2010 report, The Future of Nursing: Leading Change, Advancing Health, recognized the importance of involving nurses in healthcare policy creation and called for nurses to take leadership in improving the quality of healthcare." Being actively involved in policy formulation is something that most leading nursing organizations advocate. Sigma also provides the examples of how "the American Association of Colleges of Nursing emphasizes the role of nursing in policy and identifies, in its "Essentials" documents, the expected policy involvement that should be addressed in educational programs at the baccalaureate, master's, and doctoral levels of professional nursing, including advanced practice. The National League for Nursing and the American Nurses Association also expect nurses to address policy as part of their professional role."
Given that there are more nurses than any other profession in healthcare, it is only natural that nurses should play a larger role in creating healthcare policy. An article in International Nursing Reviewoffers that "key organizations around the world are voicing the need for nurses to become more involved in leadership, advocacy and policymaking." In addition, the need for nurses to receive more training about leadership, especially connected to in role for influencing health policy, is something the article emphasizes. There also needs to be a greater effort to grow a cadre of health policy nurses and help everyone in the nursing profession understand how nurses can effectively impact health policy. The authors of the article insist that nurses around the globe need "to take their place at decision‐making tables and to be rightfully engaged in policy, health reform and advocacy, [and] nurse leaders need to provide them with access to well‐thought‐out policy training programs. This access needs to be wide‐ranging, from exposure to policy knowledge in undergraduate education to more specialized graduate programs focused in every specialization on some aspects of policy, through to a variety of continuing educational opportunities."
Relative to other healthcare professions, nurses currently are far less involved in creating policy. The International Nursing Review article identifies "a lack of support, resources and time for nurses to do so in their workplaces." Also, "Sometimes there are real bureaucratic walls which act as barriers to nurses being denied opportunities to openly voice their policy concerns, for example because they are government employees. And too often nurses lack confidence and skills in policymaking and do not understand the differences or connections between policy and politics." The creation of policy at multiple levels needs to be a more prominent part of all nurse leadership education. Likewise, having more nurses engaged in health policy research is a way to foster "skills in developing and proposing new healthcare policies and implementing" them. Through policy research, "nurses can gain skills to be accepted, respected and better informed where it matters, to be recognized as health professional with policy and advocacy skills." As nursing informatics grows as a specialty, it's possible that the data-oriented skills involved can also drive policy development.
That being said, nurses nevertheless play an important role in health policy change. According to minoritynurse.com, here are examples of nursing led policy change efforts at multiple levels, from national healthcare policy down to local institutions:
National Health Policy – Larger countrywide nursing organizations like "the American Academy of Nurse Practitioners (AANP) and the American Nurses Association (ANA) lobby extensively for policy change and advocacy for all nurses at the national level." Also, "Nurses can help create legislation that affects both national and state-level laws regarding nursing practice, patient safety, and access to health care. Nurses are also able to review proposed health care legislation to help determine changes that promote best practices."
State Health Policy – An important recent example of policy at the state level involves "guidelines regarding telehealth practices [that] were implemented to help maintain access to health care during COVID-19. This required rapid action by policy-makers—including nurses. As officers in state nursing organizations, nurse practitioners can directly influence policies that relate to both scope of practice and education standards."
Local Health Policy – On the local level, nurses "have a unique advantage in recommending guidelines for community-wide, school, and even environmental health issues. Nurse practitioners can also be involved in advisory boards for city and county planning regarding water conservation, hazardous waste disposal, and ongoing public safety concerns."
Facility and Organizational Policy – It is very common for nurses to be involved with policy creation in the facilities where they work, where they "can influence facility policies such as patient care standards, the use of electronic medical records, and guidelines regarding specific populations."
The need for providers to develop new leaders is what inspired HealthStream to develop the Rising Nurse Leader Pathway, focused on every part of the effort to Identify and develop nurse leaders to address future leadership needs.
Many health care organizations struggle to maintain a consistent approach to leadership competency assessment and skill development that results in preparing the existing workforce for leadership. The Rising Nurse Leader Pathway begins with an assessment of a target population of nurses, their strengths and gaps are identified, followed by a recommended learning path. From there, organizations can pull from the library of nurse leadership development facilitator guides, to offer ongoing learning to further skills and confidence in their future leaders.
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