TD NR 506 Healthcare Policy
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
,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).
References: