Context and Process of Policy Making Related to Healthcare
Policy and Healthcare Policy | Nursing, Policy Development, and Policy Making | Ethics and
Healthcare Policy | Summary | References
Welcome to our first week of healthcare policy! During this first week, we will look at types of policies...
Context and Process of Policy Making Related to Healthcare
Policy and Healthcare Policy | Nursing, Policy Development, and Policy Making | Ethics and
Healthcare Policy | Summary | References
Welcome to our first week of healthcare policy! During this first week, we will look at types of policies
and their relationship to healthcare policy. We will then take a look at the relationship of values to
politics and consider the spheres of political action in nursing. It also is important to examine the
history of policy development and policy making in nursing. Finally, we will link basic ethical
principles to issues related to healthcare policy.
When you think about policy, and especially healthcare policy, what comes to mind? Consider
possible changes to our American healthcare policies with new leadership in Washington. In
addition, consider the impact these new policies will have on nursing practice in your community,
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state, and country, as well as the global community.
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As you begin this course, notice that the conclusions of several chapters in the textbook contain
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special features, such as Vignettes, Policy Spotlights, and Taking Action. Some of these features are
assigned as added reading that serve to provide specific life examples of the topics discussed in the
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individual chapters. Take a look at the contents of these special features, whether assigned or not,
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and you may see that some apply directly to your chosen policy priority. The assigned journal articles
further enhance the content of the readings and lesson. The many websites for various professional
organizations found in the Webliography will help you with tracking various policy issues, and they
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will list important contact information, as well as examples of position statements and briefs. Finally,
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the video links provide presentation examples and ideas, as well as the video clips, that give you a
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broad understanding of healthcare policy issues impacting the United States and the global
community.
Policy and Healthcare Policy
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It is important to consider a basic definition of policy when embarking upon any discussion of policy
in general and healthcare policy in particular. Policy is a means to make a change in governing
principles. Although this represents a fairly broad definition of policy, we can all consider, based on
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our experiences as citizens and professional nurses, examples of both positive and negative policy
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consequences.
Various policies can have far-reaching effects. Consider the ripples that emerge when a pebble is
dropped into a pool of standing water. When the pebble is dropped into the water, small ripples begin
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developing around where the pebble was dropped, and a series of larger ripples follows with an
increasingly wider radius.
In the complex adaptive systems theory, systems are examined in terms of the constant adaptation
of their interrelated parts and the survival of the system as a whole. The healthcare system is an
example of a complex adaptive system. Nurses are very familiar with the vast number of related and
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, interrelated parts of this system. As an example of how the healthcare system is constantly adapting
in order to survive, one need only consider the current crisis with the vast (and ever-increasing)
number of uninsured Americans. Think about what measures have been instituted in your own work
environment to provide care for the uninsured.
With limited resources, higher costs, an escalating number of older individuals requiring complex
care, and the uninsured and underinsured, how is basic care provided? What hard decisions are
made by us and for us? What corners are routinely cut? Who is forced to do without basic care, as
well as life-saving care? All parts of our current healthcare system are being severely stressed in
order for the system as a whole to survive.
There are five broad categories of policy, some or all of which may operate in the context of your
own professional and personal experiences. First, consider each of these policy types in terms of the
complex adaptive systems theory. Then, think of specific examples and note how the types
interrelate. Last, trace the processes involved by which these policies are created, regulated, and
enforced.
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Institutional
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Organizational
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Health
What would a discussion on policy be without a discussion about politics? Politics, being a neutral
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term, refers to the process of influencing the allocation of scarce resources (Mason, Leavitt, and
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Chaffee, 2007). Therefore, politics involves conflicting values and limited resources.
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Is it any wonder that the very word—politics—often sparks such powerful emotions? It is easy to
confuse personal values with facts. Everyone feels passionate about their own values, attitudes, and
beliefs, particularly when they have had an up close and personal experience with an issue.
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However, compromise and alternative solutions must be part of the political process in order for a
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system to survive.
Nursing, Policy Development, and Policy Making
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As nurses, we have been consistently judged as one of the most trusted professions. Strong nurse
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leaders, such as Lillian Wald, Margaret Sanger, and Lavinia Dock, worked tirelessly to promote
health and change the lives of millions of people in this country. Yet, their actions occurred in spite of
being women at a time in our history when women's roles were those of homemaker and mother
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without even the right to vote! Oftentimes, these women were persecuted and even risked jail in
order to pursue their agendas of public health, social welfare, and community service.
Professional nursing as we know it today was started by Florence Nightingale in the mid-1800s.
When she opened the nurse-training program in England, her intention was to promote health, as
well as the autonomy of nursing and women. When Nightingale's model was first applied to schools
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