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The legal and professional policies influencing healthcare decisions.

The legal and professional policies influencing healthcare decisions.

Differentiate the legal and professional policies influencing healthcare decisions.


You recognize your role as a client advocate and have decided to work with the American Nurses Association related to health policy issues. You choose to write a letter to your national legislator in your voting district addressing legal policies associated with genetic discrimination that you have seen either in person or in the news. Write a professional letter to your federal senator (FL – Rick Scott, Marco Rubio) demonstrating your client advocacy about genetic discrimination and how it correlates to legal and professional policies.


Include the following in your message:

Describe the background of genetic discrimination of your choice to include the significance of this specific problem.
Discuss how the Genetic Information Nondiscrimination Act of 2008 applies to the genetic discrimination you identified.
Include in your letter how clients, families, and communities could benefit from your recommendations.

Well being systems are rapidly creating and shifting. Nurses, as a part of this system, should move forward along with these changes.[1] For this purpose, nurses need to influence the formulation of health policies rather than just implementation of them. Then, they need to be active in the development of health policies to be better able to control their practice.[2] In this process, nurse leaders have a very important role. They need to acquire policy-making skills in order to address professional challenges.[3] Because of their values, professional ethics, advocacy skills, and experiences, nurse leaders have unique and valuable views toward health policies.[2] There has been increasing growth toward nurses’ presence, role, and influence in health policies during recent decades. Nurses are expected to identify the issues deliberately and work with other decision makers to advance health care policies. They should understand the levels of power, and know who controls the resources of health services in their organizations.[4] Therefore, we can go ahead and say that nurses have to be involved in policies which affect patients, families, themselves, and the whole health care system.[5]

Nurses’ affect in health polices guards affected individual basic safety, improves good quality of care, and facilitates their accessibility essential assets and promotes top quality medical care.[4,6] Consequently, the thought of plan influence in nursing is really a new and essential idea, but there is however deficiency of conceptual lucidity pertaining to what this concept really represents. Dowswell et al. (2002) in their study showed that most primary care groups in primary care centers consulted with local nurses about the key fields in care services and they believed that consultation with nurses had been effective.[2] On the other hand, results of a survey about the health managers’ and authorities’ perceptions of the effect of various health professions on revision of health affairs reveal that nurses are in the sixth (the last) grade with a dominant point interval in comparison to other health professionals.[7]

There is an unclear position here if what Dowswell et al. (2002) reported as consultation with nurses in local fields really represents nurses’ policy influence. It seems that the extent of applying this concept is wide and not clearly addressed in literatures. On the other hand, we should state that health systems’ policies settle within three levels: Micro, macro, and meso. In the micro level, policies are just for especial parts, fields, or groups, and have not been made essentially by the government, whereas in the macro level, policies are for the whole country and have been made essentially by the government.[8] The meso level policies settle between micro and macro levels and have usually been made by official organizations.[9] Now can we call what happens in all these three levels as policy influence? So, clarifying and defining this concept in order to develop it, especially in different levels of nursing management is essential. By clarifying this concept, we can reach a common language and help to increase the credibility of future studies.

Along the way recommended by Walker and Avant, the foremost and second amounts are identifying the right strategy for evaluation then identifying its function.[10] As said before, the degree of using nurses’ plan impact as a thought is not identified obviously. This means it is not clear whether we can address consultation with nurses from operational levels of nursing care about health and nursing issues as influencing the policies or this is a concept that just addresses high levels of nursing management and leadership. It is not clear which one of activities carried out in these extended levels can be introduced as policy influence. Thus, this is a new and valuable concept for nurses. The principal purpose of this concept analysis is to clarify and develop the concept and to propose a definition for it, through which nurses can better understand the importance of policies in health care system and the necessity for their involvement in policies and to have their influence on them.

The third phase is article on literature. According to Walker and Avant, review of literature should not be limited to nursing literatures to prevent bias in understanding the concept.[12] In the search strategy, we searched various databases including PubMed, Science Direct, Elsevier, CINAHL, and also Google Scholar as an internet search engine, using relevant key terms, “nursing AND policy involvement,” “nursing AND policy influence,” “nursing AND policy making,” and “nursing AND decisional involvement.” Only English articles published between 1999 and 2013 were reviewed. Finally, 24 articles related to nurses’ policy influence were selected. We also searched English dictionaries, the textbooks about nursing management, and nurses’ guide to health policies manually. Here is a summary of this review:

Looking back at the medical track record from the 1800s, we find health care worker executives such as Florence Nightingale, Sojourner Real truth, Lillian Wald, and Margaret Sanger that have experienced extraordinary functions in the creation of policies, especially in women’s, newborns’, university children’s, and ecological overall health.[4] In 1991, the American Relationship of College or university of Nurses (AACN) introduced that it is necessary to put well being plan schooling to the realm of nursing jobs at Master’s degree.[5] We found nursing jobs programs using the information of policies in baccalaureate diploma applications following the year 2000.

Consequently, apparently nursing staff needs to be knowledgeable about all troubles associated with overall health system, and not simply thoughtful problems. Certainly, days of just carrying out the prescribed orders are over for nurses globally. Now it is time for nurses to be health legislators and develop practical policies.[13] Kowalik and Yoder point to health care organizations which have identified the importance of nurse leaders’ participation in decisional affairs. They believe that the outcomes of having strong voice in the fields of decision making will enhance the quality of patients’ care.[14]

However, the managerial roles of nurse leaders, such as decision making, analyzing, control, and budgeting, are still considered as less valuable from the viewpoint of health system managers.[15] Nurses should know that the political ideology of health care system and policy-making process will shape nursing leadership, whether it is a political, clinical, academic, or management leadership.[16]

There are two words in the lexicon (2006) including “policy” and “politics,” which need to be defined. Although these two words are different, because of their similar tone, they infer same concepts and are usually used interchangeably. In order to wildly define these two words, both as a general and as a management and health concept, analysts have referred to dictionaries, articles, and books with the approach of nursing policy and nursing management.

The word “policy” comes from “politia” which is a Latin word. Policies are decisions which are made by people who have power and authority. On the other hand, policy sometimes means regulations for how to behave.[17] Thus, we can define policy as, “practical ways or principles accepted or suggested by a government, group, profession, or an individual.”[18] Meanwhile, Mason, Leavitt, and Chaffee are nurses who define policy as, “choices of society or a part of society or organization, with consideration of purposes, health priorities, and ways of resource supply in order to reach purposes.”[19] In management books, policies are guidelines for procedures and helping people for decision making. What is important for management’s authorities is to understand how policies can support effective leadership.[20]

The word “politics” is derived from “politica,” a Greek word which means “related to citizens.” In fact, this word has been driven from Aristotle’s book named “Citizen Affairs” which is about government and how to govern. For the first time in 1430, this word with the title of “politiqu” was imported to English, and in 1520, was changed to “politics”. Politics is the art and science of governing. Politics refers to people’s affairs and authority of government. As we see, polities is always related to organizational process and government function, while policies sometimes are principles and acts for how to behave. Finally, politics refers to the ways and techniques for regulation and using policies.[17] Mason et al. define politics as the art of influence to supply rare resources such as money, time, personnel, and materials.[19] From management point of view, “politics” is the art of influencing others; it is a means to get ends.[20]

To better clarify the concept of policy influence, we also need to define the concept of “influence.” In Webster’s dictionary (1977), influence is defined as affecting others without any force or pressure.[21] As previously mentioned, some authorities of management define politics as the art of influence. Thus, the words “influence” and “politics” or “influence” and “policy” are very much related to each other. In fact, without influence, many wise policies are operationally unusable. For example, imagine a person who has a lot of important and consistent views and opinions about one of the patient care issues, but the people working with him/her think contrary. Here, we should ask the questions of how we can influence others to make them come in our direction and what kind of power we can use.[20] Also, the concept of influence has a very near association with the concept of power. We will discuss about it more in this article.