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Exam (elaborations) NR 506 HEALTHCARE POLICY TD

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Week 1, TD1 The Four Spheres of Political Action in Nursing. Please discuss the four spheres of political action in nursing. In addition, please develop a brief argument sharing how these spheres are interconnected and overlapping by applying an example from your practice. Nursing should not consist of only the monotonous tasks completed to provide basic patient care, but rather nursing today is multidimensional where nurses are responsible for the protection, promotion, and prevention of disease or injury for individuals, families, communities, and population. For this reason, nurses have the opportunity to become politically involved impacting and improving the level of care that they are able to provide. According to Chaffee, Mason, & Leavitt (2014), the four spheres of political action in nursing include workplace or workforce, government, professional organization, and community. Each of these sphere have their own independent functions, but they can also overlap and affect the other sphere working together to create changes. Workplace sphere addresses issues regarding jobs and patient care, as well as influencing policies and procedures. It can be in any setting like acute care, home care, nursing homes, school based clinics, occupational health clinics, and physician’s office. Government sphere addresses laws and regulations regarding practice, as well as influencing local, state, and national policies. Government actions can consists of laws requiring to keep birth records, immunizations, legal establishment of drinking age, laws determining what health services people are eligible for at certain age. Government has grown bigger and centralized, which plays a important role in nursing. Government also influences systems for healthcare, and nursing service, and determines who receives what type of health services. Professional organizations sphere addresses the many areas that shape the practice of NR 506 HEALTHCARE POLICY TD nursing, as well as influence practice standards, and credentialing. Professional organizations should be a visible force within its community, and must have a national presence. Professional organizations take a leadership role on calling for the development of policies that can improve the health of the communities, and ensure the provision of quality nursing care. Community sphere addresses issues regarding community health as well as influencing the activity throughout the community. Community includes special interest organizations like habitat for humanity, food banks, community organizations, and county workforce centers. Nurses have the responsibility to promote the welfare of the community, and its members. Nurses visible in the community represent the entire profession. Nurses are capable of influencing policy making in order to improve problems in the community and healthcare system. Literature often shows that nurses view themselves as politically powerless. They see their role at the bedside as a technical activity, not a political opportunity. What nurses do not realize is the very act of being a nurse makes one politically involved (Cameron, Ceci, & Salas, 2011). An example from my practice is banned smoking at the campus of my hospital, which is a community hospital. Political spheres includes the workplace and community, possibly government with the federally mandated health insurance laws rolling out. This is important as the negative effects of smoking and second hand smoke are well documented, and patients requiring hospitalized care do not need to be exposed. Reference: Cameron, B., Ceci, C., & Salas, A. S. (2011). Nursing and the Political. Nursing Philosophy, 12(3), 153-155. doi:10.1111/j.1466-769X.2011.00499.x. Chaffee, M. W., Mason, D. J., & Leavitt, J. K. (2014). A Framework for Action in Policy and Politics. Policy & Politics in Nursing and Health Care, 1. Week 1, TD2 A wave of pandemic illness can host a variety of ethical considerations. Please apply the importance of ethics to the process of policymaking regarding pandemic outbreak and other future pandemic issues. Ethical consideration during a wave of pandemic illness involves critical reflection on moral or ethical problems faced in health care setting. It is a collective forethought and a broad consensus in place to tackle moral and ethical dilemmas that may arise in situation of a pandemic illness. According to Cooper (2012), there are many ways to define ethics, some are more technical and precise than others. Ethics can be defined as the attempt to state and evaluate principles by which ethical problems may be solved (Cooper, 2012). Government and health care leaders make decision based on the ethical values in case of a catastrophe. Ethical framework acts as a guide in decision making during a pandemic by guiding the ethical decision making process, and informed by ethical values. The topic of ethics comes up whenever there is pandemic illness outbreak. Some of the ethical issues of concerns regarding pandemic illness include healthcare workers being exposed to illness, prohibiting travel to prevent spread of illness, and access to healthcare with an increase in demand and potential shortage of healthcare workers. In the event of a pandemic a pandemic illness the Centers of Disease Control and Prevention (CDC) has worked with the Ethics Subcommittee of the advisory committee to develop a plan of care. Professional colleges and associations should provide, by way of their codes of ethics, clear guidance to members in advance of a major communicable disease outbreak, such as pandemic flu. Existing mechanisms should be identified, or means should be developed, to inform college members as to expectations and obligations regarding the duty to provide care during a communicable disease outbreak. In a study on influenza pandemic by Devani, M., Gupta, & Devani, B.(2011), there were three main ethical consideration for planning and response: ethical allocation of scarce resources, obligations and duties of healthcare workers to treat patients, and the balance between conflicting individual and community interests. Most challenging part was identified as how to allocate scarce life saving resources in case of a pandemic (Devani et al., 2011). Indication of clear goal for possible future pandemics is essential in making difficult choices (Devani et al., 2011). Also the important issues between duty to save the patients and protecting own life were also identified as a key issue (Devani et al., 2011). This study also threw light on how to strike balance between civil liberties and individual freedom (Devani et al., 2011). Pandemic planning for current and future outbreaks should be a cooperative and shared responsibility that balances community and individual interests (Devani et al., 2011).

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