This paper needs to be rewritten. The paper that I received is written on nurse practitioners. The paper I requested was to be on safe nurse staffing which Administration Simon confirmed was toldoing to the writer. I need this paper rewritten and returned - Management
This paper needs to be rewritten. The paper that I received is written on nurse practitioners. The paper I requested was to be on safe nurse staffing which Administration Simon confirmed was toldoing to the writer. I need this paper rewritten and returned back to me within 48 hours. I had used the chat feature over two weeks ago to have this paper corrected but there seems to have been miscommunication. Please confirm this is received and understood and will be done on correct the topic.
Running head: HEALTH, POLICY AND POLITICS TRENDS 1
HEALTH, POLICY AND POLITICS TRENDS 17
Health, Policy and Politics trends
Name:
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Health, Policy, and Politics Trends
Reflective Essay on the Ethics and the Public Policy Issue
Analysis of the public health problem that requires policy change
The modern health care system is in trouble, and it needs change. Additionally, the experiences of many nurse practitioners in the modern healthcare world are playing a very crucial role in motivating them to undertake some form of advocacy to influence policy changes, laws, or regulations that rule the larger health care system (Hofrichter et al., 2010). I believe that this type of advocacy requires stepping beyond our practice setting into the world most of us are less familiar with. In simple terms, this unfamiliar world revolves around politics, policies and basically, the world in which most nurse practitioners do not feel comfortable to operate efficiently. Moreover, the location of decision making in both private and public sector, and the nature of the health care policy, both have an implication on the characteristics and attributes of any healthcare system (Hofrichter et al., 2010). Furthermore, with the few years I have experienced as a nurse practitioner, I have come to realize that, most of the healthcare policies are influenced and impacted by the preferences of leaders in politics.
Relevance of the Public Policy Issue Of Health and the Nursing Profession
The current healthcare environment is filled with a myriad of healthcare policies, regulations, and laws imposed by private sectors, government agencies, and insurance institutions as well. In this case, these multiple strategies challenge both patients and nurses who are in most cases caught between the constraints revolving around costs as well as accessibility to efficient and quality health care. For instance, the United States Census Bureau that was collected in the year 2005 reported that the number of insured people has grown to 46.6 million while the health care cost continues to rise (Hofrichter et al., 2010). Another notable example is the report compiled by the Commonwealth Fund which acknowledges that a high-quality health care is in most cases delivered by a system of government that is poorly coordinated thus driving up costs while at the same time putting patients at risk. Therefore, because the modern world is characterized by rising costs, variable quality, and deteriorating costs, I believe improving the legislative health care policy performance is an issue that requires national urgency (Hofrichter et al., 2010).
According to me, these reports are not surprising. As I interact with patient families and patients, as a nurse, I am always the first provider to have a clear view of when and how the system of healthcare is insufficiently meeting the needs of its patients. In this case also, we are always positioned every day, to see not only the effect of the health care policies for individual patients but also the much-needed change when it comes to healthcare delivery. In this circumstances, it is not only the patients and their families that suffer but the community as well.
Financial Impact of the Policy On Health on the Community
One notable example in which the community is involved in addressing inadequate healthcare delivery is through the cost of prescription drugs. In this case, I believe so many healthcare providers can bear witness and share how so many patients have requested them to limit or reduce the frequency in which their prescriptions are awarded. Because they have inadequate funds or in other words, they simply lack information and knowledge on how to get discounts or community resources to enable them to fill their discounts. The leaders in politics should be able to formulate policies that offer training and education to patients in matters revolving around health are a system so as to increase their awareness when it comes to prescription and the economic resources available.
Owing to the global legislative health care policy, I believe nurses are in a better position to provide the much-needed information about the healthcare practices. As a member of the nursing community, I think each and every member of the society has an opportunity and the responsibility to offer accurate and up-to-date information. Additionally, any nurse practitioner who has a passing interest in influencing the policy process even if they possess limited resources and time can always find a way to establish themselves as confident advocates. In other words, it is up to a nurse as an individual to decide on potential strategies they think will be efficient and they feel comfortable using given their time and energy.
Ethical Principles Impact My Position on the Policy Issue
The Principle of Nonmaleficence which requires nurses to do no harm is one reason I advocate for the improvement of legislative policies. In other words, the primary fundamental objective of most nurse practitioners is to protect the safety of their patients by increasing the quality of care and facilitating their access to the needed resources as well as promoting quality health care. In this case, health care systems are developing and changing rapidly. Therefore, leaders in politics and nurses should practice the principle of autonomy to perfume their activities with self-determination when evolving with these changes. As a result, nurses also needs to employ the principle of beneficence to influence the formulation policy revolving around health care systems postulated by local politicians rather than just helping in the implementation process. In so doing, the quality of healthcare both locally and globally will improve tremendously regarding service delivery, prescription cost, and patient knowledge of healthcare resources and medicine.
Policy Brief for the Policy Issue
Identification of the Decision Maker
Political and professional courage is needed amongst nurse practitioners and professional nursing organization’s managers to steer nursing towards curbing the dualisms of individuals versus the acknowledged collective health, as well as, medical versus social health model. Additionally, having a vision of an activist, informed nursing profession, can play a primary part in improving the level of the nursing discourse in the community. In this case, according to the legislative policy, activism can offer to mean to a nursing inquiry such that the work of nurses must interconnect with the work of the larger community. The local political leaders and healthcare managers need to provide the suitable conditions for Nurse Practioner to possess the responsibility and right to act as political elements in both national and political arenas. Moreover, the nurses as activists need to formulate an approach that makes them resourceful to policy makers and community members. In other words, for this policy advocacy to be successful, nurses as interpreters of science and advocates, must feel free and empowered to raise their voice in support of a healthcare policy. In this case, the legislative healthcare policy requires the attention of the local political leader who in this case, is Honorable Donald Trumpet because it is only through him that the nurses will feel empowered to influence the legislative policy decisions.
Reasons Why the Legislative Policy Requires the Attention of the Political Leader
Previous research indicates that Honorable Donald Trumpet and nurse practitioners participating in the legislative policy advocacy process will need to deliberate on their very own professional goals revolving around the particular societies within their working jurisdiction. Additionally, this goal may encompass challenging healthcare delivery, proposing different methodologies for research, challenging social policy, and regulating and promoting the democratization of the institutions which in one way or the other determine research policy and priorities. Moreover, the legislative policy will require the attention of the political leader because; it will motivate nurse practitioners to venture and step out into the modern and unfamiliar politics world. In this case, being politically active does not necessarily mean that they take the initiative, but it needs a network that can advise nurses when they need political leadership and response at the appropriate time. However, having a legislative sponsor or leader for a piece of legislation policy does not necessarily ensure that the implication of the policy will be smooth. In most cases, on significant but controversial elements, it is universally acknowledged that there are equal numbers of individuals who are trying to mobilize their forces to oppose the policy or the element at hand. Therefore, the political leader of the individuals who will receive the policy from the nurse Practioner should be able to make the nurse practitioners to understand that the legislation process requires adequate negotiation and consensus.
A study conducted by Institute of Medicine that revolved around the “Future of Nursing; Leading Change, Advancing health”, released in the year 2010. It is acknowledged that political leaders should review the legislative health care policies to transform the nursing profession to enhance the value and quality of healthcare services in America (Israel, 2013).. As a political leader, research indicates that Honorable Donald Trumpet should be able to campaign and advocate for laws and regulations that are meant to improve the quality of the healthcare services.
Challenges Involved In Addressing the Health Care Policy Issue
In spite of the ongoing severe nursing shortage, the aging nursing workforce, wide-spread dissatisfaction among some bedside nurses, nurse conflicts with physicians coupled with the lack of opportunities to successfully diversify the nursing profession demographically, the nursing profession is believed to have not actualized their collective power. In other words, realizing the objective of the legislative health care policy may be more challenging because; nursing has not grown into a powerful, cohesive professional force that could act as a counterweight to the medicine in the global policy arena (Israel, 2013). Additional when it comes to matters of advocacy, it is acknowledged that not so many nurses can collaborate with political leaders in issues revolving around other health professional policies. Another challenging aspect when it comes to this policy is the fact that both nurses and the local political leaders are very busy people. In other words, nurses are occupied by health care homes, families, children or elderly care homes hence time for political connection is very limited and rare.
Some factors restrain the potential power of Nurse Practioner to collectively and individually to influence the decisions of the politicians in matters revolving around legislative health care policy. First, failure to convey a very clear message that may encourage a larger number of Nurse Practioner to exercise their valuable right when it comes to choosing of leaders. Second, there is inadequate nurse membership in professional organizations that advocate collectively for health care policy matters. Finally, lack of primary education in issues revolving around health advocacy issues that can play a very crucial role in influencing the political arena.
Primary Options and Interventions for the Decision Maker
Any political leader and a Nurse Practioner who has an interest in influencing the policy making the process even if they possess very limited resources and time can quickly establish a way of becoming a confident advocate. Additionally, there are quite some very simple ways of intervening in the legislative policy decision-making process. One is writing a very official but simple letter to the ministry of health. Second is making a telephone call and finally, being elected or nominated for a political office. Once the policy maker is aware of the situation in which a legislative policy will improve the delivery system of the healthcare environment, one can move to explore the advantages and disadvantages of possible solutions and afterward, work to get others to get involved and interested in the social advocacy issue. Moreover, depending on the policy maker’s level of confidence, they may also campaign and testify about the problem or work with media channels in bringing attention to the advantages of the healthcare policy decision.
Persuasive call of action for the decision maker
Many policies making issues may be too complex to be easily resolved by just making phone calls or even be solved by the dedicated efforts of an individual. Additionally, in reality, there are very few policy changes that have occurred without collective efforts of many social policy change advocates. Therefore, to solve the challenges associated with this policy change, to join a professional nursing advocacy organization is a very crucial way to enhance the policy maker’s individual advocacy efforts. Moreover, nursing professional associations possess more resources and are in a better position to effectively strategize to bring the perspectives to legislative decision policymakers than those nurses acting individually. In other words, the professional nursing organizations are better placed to monitor public policy and in the process, provide ways for its members to learn and know more about health decision makers. Furthermore, the challenges revolving around the nursing political affiliation can be easily solved by professional nursing organizations because they provide tools and information to ensure that those political candidates who are supportive of legislative health care are re-elected into office. Another common persuasive mode will revolve around how active the advocate can practice and demonstrate effective communication skills so as to convince others to listen and benefit from the perception of others. In such cases, repeated and constant communication with legislators as well as their staff members in a very straightforward manner would significantly increase the likelihood that the legislative health care policy and information postulated by an individual would be able to be understood and heard.
How to Evaluate the Success of the Policy Brief
Governance institutions play a vital role in developing policy implementation strategies needed to manage risks as well as build adaptive capacity starting from the national level to household level or the project that concerns the decision makers and the people. The legislative health care policy will clearly be a success if it is showcasing consistent and clear goals that are articulated by the top government officials or the political leader (Israel, 2013). Additionally, the implementation process of the policy would be advantageous if the nurses involved are showing clear knowledge and understanding of the pertinent consequences of the policy regarding causes and effects of the potential solutions to the ongoing problem. Moreover, the legislative policy should also have a clear hierarchy of authority with most of the policy decision established at the top leadership level, and the system itself is aligned with the existing rules. In other words, the top-down approach is the rational, comprehensive approach to policy planning. In this case, the legislative health care policy will only be a success if the policy is consistent with an overhead democracy such that the elected government officials delegate implementation duties and authority to those public servants who are non-elected but are accountable to those democratically appointed leaders. In this instance, it is succinct that the policy implementation process will also include the modification and evaluation stage where the already existing policies are revisited and amended according to the changing circumstances.
Identification of the Professional Organization That Has Shown Interest in the Policy
It is universally acknowledged that nurses possess the high potential to contribute to the development of legislative health care policy by employing a political action. Additionally, those nurses who engage in policy advocacy often do so via participation in their employer’s change policy committees or by supporting already established nursing organizations (Israel, 2013). In other words, professional nursing organizations are believed to have processes and mandates for nurses to engage at one point in policy implementation. However, it is universally acknowledged that, despite the existence of some professional nursing organizations dealing with policy advocacy, it is still very challenging to encourage somehow professional nurses to be involved in politics actively and in the process of healthcare policy implementation for their very own known reasons. One major reason is the fact that most of the registered nurses believe that their primary role is to take care of patients hence failing to look at the greater picture which may include policy making (Israel, 2013).
This policy making process intends to collaborate with a professional nursing organization that is working towards the same objective of legislative policy advocacy. One best way of involving other members of the nursing profession is concerning an organization that encompasses nurses that are members of the ICN-International Council of Nurses (Israel, 2013). For instance, United Kingdom’s Royal College of Nurses (UKRCN) has already expressed interest in joining in the implementation of the legislative health care policy. UKRCN expressed its desire to get involved in the policy advocacy because it has established the tendency to give nurses a voice at the national level. At the same time providing nurses tools to have an impact on matters involving decision making and support on how to be active politically and lobby the top political leaders(Israel, 2013).
CBR principles and how to approach and collaborate with the interested organization and how their goals align with the policy
In community-based participatory research, it is acknowledged that partnerships provide an opportunity to bring together willing individuals who might not have a chance to work and collaborate and in so doing, it increases the participant’s skills (Israel, 2013). Given the fact that United Kingdom’s Royal College of Nurses (UKRCN) aims at giving nurse practitioners a voice regarding to policy making matters, it was very easy approaching them to (or “intending to”) advocate for the legislative policy. Their goal and objective of advocating for the rights of the nurses when it comes to patient care in political matters are very similar to the objective of the legislative policy advocacy. One of the essential elements that will ensure the success of the policy making process goals is effective leadership and proper management structure (Israel, 2013).
Actions steps to ensure success
The project leader will ensure that all the participating partners comprehend that their contributions to policy making are equally important. Therefore, there is a need to stress the participant’s equality so as to make both the uneducated and very educated members to feel free to work with each other. Moreover, clear and efficient communication of instructions and project requirements will be adequate for the realization of the policy making goals and objectives
Developing a unit of identity demands that the partners involved need to commit the emotional energy required to establish interpersonal and inter-organizational relationships. In this case, some of the partners from the organization including the supporting staff may be volunteering their availability and energy to get involved in the policy advocacy project and adding resources and time for the social element which adds unfunded time commitment for them (Israel, 2013).. In other words, this time, element relationships among organizations workers will be very crucial in the success of the legislative policy advocacy. It should be discussed and explained openly to all the participating staff members of United Kingdom’s Royal College of Nurses (UKRCN) as well as the legislative leaders, and nurses are participating in the policy making process.
Roles and responsibilities
It is acknowledged that not everybody possess equal skills to others. Therefore, those individuals who choose to work independently would, therefore, be required to help in the collection of data from patients and their families. In such cases, the board members of the policy making partnership will have to draft a list of participants who are willing to aid in the policy implementation process. Capacity building activities and project capacity building team will include registered nurses, project investigators, health care experts, academician, gerontology nurse, and the assisted living nurses from both sides of the partnership.
Primary elements of developing a collaborative evaluation plan
The joint assessment plan will be developed using the following key elements and guiding principles. The first working and guiding principle of partnering with the United Kingdom’s Royal College of Nurses (UKRCN) is acknowledging the collaboration as a unit of identity. In other words, this character can be created as a condition for funding the research (Israel, 2013). Another guiding principle that will ensure that the collaboration with the organization is swift and efficient is establishing or forming a legal corporate identity. However, our collaboration with the United Kingdom’s Royal College of Nurses (UKRCN) did not necessarily need to take this path because there was no need to hire researchers and their staffs, sign space rental contracts or perform any other activities that are typical of start-up partnerships. In such cases, the joint evaluation plan may be built on the resources and the strengths of the participants in the policy making process. In simple terms, promoting a core-learning as well as capacity building among the participating partners is also crucial in determining the collaboration evaluation plan (Israel, 2013).
Evaluation plans process
The best approach that can be used in this process is the bottoms-up approach. It assumes that the people on the ground or rather at the household level can generate knowledge and skills based on their very own frameworks and categories before the information is passed to the top management level which in this case, is the local political leader, Honorable Donald Trumpet. In other words, people at the household level will be essential in delivering and producing more accurate and richer data that will help in establishing precise results of the inquiry process. As a consequence, will assist in stabling greater commitment to the legislative health care policy and their commitment to change (Chiranjeewee & Harald, 2011). One of the advantages of bottoms –up approach is that people can identify what affects them most and in the process, they can identify with the policy making process decisions.
Analysis of the strengths and challenges of the bottoms-up approach and the Top-bottoms approach
Advantages of Top-bottoms evaluation process
The policy making process realizes a total employment of resources from the applications managed by individuals at the household level (Chiranjeewee & Harald 2011).Additionally, the first stage of implementation acts as a guiding principle of the policy making process. Moreover, after completing the policy-making process, this approach is believed to help in the implementation of more mature, accurate, and broad system solutions
Disadvantages of top bottoms approach
It is believed that this approach provides a limited coverage during its first phases of implementation. Additionally, a subtle percentage of policies affecting the user accounts are managed during its first implementation stages (Chiranjeewee & Harald, 2011). Moreover, it requires individuals at the household level to adapt to the ongoing implementation process during its first phase. Furthermore, the community will not realize the importance of the policy rapidly. Besides, the cost of implementation as far as resources and time involved are more likely to be higher.
Merits of Bottoms-up approach
Benefits of the policy are realized during its first implementation –phases because the users are aware of the policy at the household level. Additionally, there is no need for developing custom adapters for its users since they helped in the formulation of the policy (Chiranjeewee & Harald 2011).Moreover, during the first phase, the participants, as well as the organization, broadens its identity skills and understanding of the policy
Disadvantages of the bottoms-up approach
The policy making process may have to undergo some changes during a later roll-out phase. Additionally, because the users at household level will start feeling the implication of the policy during its earlier stages, the roll-out stage may cause severe adverse consequences (Chiranjeewee & Harald 2011).Moreover, it is driven by existing demands and structures at the community level rather than the policy-making process itself.
Analysis of the best approach
Given the fact that, the objective of the policy is to benefit patients by the nursing care, bottom-up approach is the best alternative because it produces earlier benefits to the users, and there is high visibility of changes (Chiranjeewee & Harald, 2011). Additionally, bottoms-approach approach causes greater impact to the organization regarding returns and high deployment coverage during its early phases of implementation. Therefore as compared to a top-bottoms approach which has delayed returns and lower impact on the users and the organization, bottoms approach is a much better alternative given limited resources and time.
References
Chiranjeewee K. & Harald V., (2011).Comparing a top-down and bottom-up approach in the identification of criteria and indicators for sustainable community forest management in Nepal. Retrieved from: http://forestry.oxfordjournals.org/content/85/1/145.full?sid=8ecb647d-3306-47a1-ab77-b3404c68e8a6
Hofrichter, R., Bhatia, R., & National Association of County & City Health Officials (U.S.). (2010). tackling health inequities through public health practice: Theory to action. Oxford: Oxford University Press.
Israel, B. A. (2013). Methods for community-based participatory research for health. San Francisco: Jossey-Bass.
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