BOOK
Policy and Politics in Nursing and Healthcare - Revised Reprint - E-Book
Diana J. Mason | Judith K. Leavitt | Mary W. Chaffee
(2013)
Additional Information
Book Details
Abstract
Featuring analysis of healthcare issues and first-person stories, Policy & Politics in Nursing and Health Care helps you develop skills in influencing policy in today’s changing health care environment. 145 expert contributors present a wide range of topics in policies and politics, providing a more complete background than can be found in any other policy textbook on the market. Discussions include the latest updates on conflict management, health economics, lobbying, the use of media, and working with communities for change. The revised reprint includes a new appendix with coverage of the new Affordable Care Act. With these insights and strategies, you’ll be prepared to play a leadership role in the four spheres in which nurses are politically active: the workplace, government, professional organizations, and the community.
- Up-to-date coverage on the Affordable Care Act in an Appendix new to the revised reprint.
- Comprehensive coverage of healthcare policies and politics provides a broader understanding of nursing leadership and political activism, as well as complex business and financial issues.
- Expert authors make up a virtual Nursing Who's Who in healthcare policy, sharing information and personal perspectives gained in the crafting of healthcare policy.
- Taking Action essays include personal accounts of how nurses have participated in politics and what they have accomplished.
- Winner of several American Journal of Nursing "Book of the Year" awards!
- A new Appendix on the Affordable Care Act , its implementation as of mid-2013, and the implications for nursing, is included in the revised reprint.
- 18 new chapters ensure that you have the most up-to-date information on policy and politics.
- The latest information and perspectives are provided by nursing leaders who influenced health care reform with the Patient Protection and Affordable Care Act of 2010.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Policy and Politics in Nursing and Health Care | i | ||
| Copyright page | ii | ||
| About the Editors | iii | ||
| Contributors | v | ||
| Reviewers | xv | ||
| Dedication | xvii | ||
| Table of Contents | xix | ||
| Foreword | xxvii | ||
| Donna E. Shalala | xxvii | ||
| Richard H. Carmona | xxviii | ||
| Preface | xxix | ||
| What’s the Remedy? | xxix | ||
| What’s New in the Sixth Edition? | xxix | ||
| What’s Carried Over from the Previous Editions? | xxx | ||
| Using the Sixth Edition | xxx | ||
| Examples of Prominent Nurse Leaders | xxx | ||
| Reference | xxxi | ||
| Acknowledgments | xxxii | ||
| Unit 1 Introduction to Policy and Politics in Nursing and Health Care | 1 | ||
| 1 A Framework for Action in Policy and Politics | 1 | ||
| Policy and the Policy Process | 3 | ||
| Forces that Shape Health Policy | 4 | ||
| Values | 4 | ||
| Politics | 5 | ||
| Policy Analysis and Policy Analysts | 5 | ||
| Advocacy and Activism | 5 | ||
| Interest Groups and Lobbyists | 5 | ||
| The Media | 6 | ||
| Science and Research | 6 | ||
| Presidential Power | 6 | ||
| The Framework for Action | 6 | ||
| Sphere of Influence 1: The Community | 7 | ||
| Sphere of Influence 2: The Workforce and Workplace | 8 | ||
| Sphere of Influence 3: The Government | 9 | ||
| Sphere of Influence 4: Associations and Interest Groups | 9 | ||
| Health | 10 | ||
| Health and Social Policy | 10 | ||
| Social Determinants of Health | 10 | ||
| summary | 10 | ||
| References | 11 | ||
| 2 A Historical Perspective on Policy, Politics, and Nursing | 12 | ||
| Political Awakening and the Modern Nursing Movement | 12 | ||
| Professional Education and Nurse-Training Schools | 13 | ||
| Political Action and the Rise of Professional Organizations | 13 | ||
| National League for Nursing | 13 | ||
| American Nurses Association | 13 | ||
| National Association of Colored Graduate Nurses | 14 | ||
| National Organization for Public Health Nursing | 15 | ||
| Organized Nursing and Suffrage | 15 | ||
| Shaping Health and Public Policy | 16 | ||
| Alliances with the Women’s Movement: The 1960s to the Present | 17 | ||
| References | 18 | ||
| 3 Learning the Ropes of Policy, Politics, and Advocacy | 19 | ||
| Political Consciousness-Raising and Awareness: The “AHA” Moment | 19 | ||
| Getting Started | 20 | ||
| Advocacy and Activism | 20 | ||
| The Role of Mentoring | 20 | ||
| Finding a Mentor | 21 | ||
| Collective Mentoring | 21 | ||
| Educational Opportunities | 22 | ||
| Programs in Schools of Nursing | 22 | ||
| Degree Programs and Courses in Public Health, Public Administration, and Public Policy | 22 | ||
| Continuing Education | 23 | ||
| Workshops | 23 | ||
| Learning by Doing | 23 | ||
| Internships and Fellowships. | 23 | ||
| Volunteer Service. | 23 | ||
| Professional Association Activities. | 23 | ||
| Self-Study | 24 | ||
| Professional Journals. | 24 | ||
| Books. | 24 | ||
| Newspapers. | 24 | ||
| Television. | 24 | ||
| Radio. | 24 | ||
| Internet. | 25 | ||
| Applying Your Political, Policy, Advocacy, and Activism Skills | 25 | ||
| References | 28 | ||
| 4 Taking Action: How I Learned the Ropes of Policy\rand Politics | 29 | ||
| 5 Advocacy in Nursing and Health Care | 31 | ||
| The Definition of Advocacy | 31 | ||
| The Nurse as Patient Advocate | 32 | ||
| Consumerism, Feminism, and Professionalization of Nursing: The Emergence of Patients’ Rights Advocacy | 32 | ||
| Philosophical Models of Nursing Advocacy | 33 | ||
| Gadow | 33 | ||
| Curtin | 33 | ||
| Kohnke | 33 | ||
| Advocacy Outside the Clinical Setting | 34 | ||
| Issue Advocacy | 34 | ||
| Community and Public Health Advocacy | 35 | ||
| Professional Advocacy | 35 | ||
| Barriers to Successful Advocacy | 36 | ||
| Education and Training | 36 | ||
| Institutional Barriers and Fear of Retribution | 37 | ||
| summary | 37 | ||
| References | 38 | ||
| 6 A Primer on Political Philosophy | 39 | ||
| Political Philosophy | 39 | ||
| The State | 40 | ||
| Individuals and the State | 41 | ||
| Thomas Hobbes. | 41 | ||
| John Locke. | 41 | ||
| Jeremy Bentham. | 41 | ||
| Political Ideologies | 42 | ||
| Liberalism | 42 | ||
| John Stuart Mill. | 42 | ||
| Conservatism | 43 | ||
| Socialism | 43 | ||
| Karl Marx. | 43 | ||
| Contemporary Conservatism and Liberalism | 44 | ||
| The Welfare State | 46 | ||
| Types of Welfare States | 46 | ||
| Health Care and the Welfare State | 47 | ||
| Consumption. | 47 | ||
| Provision of Care. | 47 | ||
| Development and Use of Technology. | 47 | ||
| Political Philosophy and the Welfare State: Implications for Nurses | 47 | ||
| References | 48 | ||
| 7 The Policy Process | 49 | ||
| Creating Policy: Seeking Solutions to Societal, Workplace, and Organizational Challenges | 49 | ||
| Conceptual Basis for Policymaking | 51 | ||
| Incrementalism | 51 | ||
| Policy Streams Model | 51 | ||
| The Stage-Sequential Model | 52 | ||
| Rational Decision Making | 52 | ||
| The Advocacy Coalition Framework | 52 | ||
| Steps in the Policy Process | 52 | ||
| Define the Problem and Get It on the Agenda | 52 | ||
| Research the Problem | 52 | ||
| Develop Policy Option | 53 | ||
| Involve Interest Groups and Stakeholders | 53 | ||
| Implement the Selected Policy | 54 | ||
| Evaluate the Impact of the Policy | 54 | ||
| Modify, Repeal, or Leave the Policy Alone | 54 | ||
| Communicate Policy Options | 54 | ||
| Engaging in Analysis | 54 | ||
| The Evidence Base for Health Policy | 56 | ||
| Policymaking as Practice | 56 | ||
| References | 57 | ||
| 8 Political Analysis and Strategies | 65 | ||
| Components of Political Analysis | 65 | ||
| The Problem | 65 | ||
| Proposed Solutions. | 65 | ||
| Background | 66 | ||
| Political Setting | 66 | ||
| Stakeholders | 68 | ||
| Values Assessment | 69 | ||
| Resources | 69 | ||
| Power | 70 | ||
| Creating a Plan of Action | 71 | ||
| Incremental versus Revolutionary Change | 71 | ||
| The “Pilot” Approach. | 72 | ||
| Strategies for Success | 72 | ||
| Look at the Big Picture | 72 | ||
| Do Your Homework | 73 | ||
| It’s Not What You Say, It’s How You Say It | 73 | ||
| Read Between the Lines | 73 | ||
| It’s Not Just What You Know, It’s Who You Know | 74 | ||
| Quid Pro Quo | 74 | ||
| Strike While the Iron is Hot | 74 | ||
| United We Stand, Divided We Fall | 74 | ||
| Nothing Ventured, Nothing Gained | 75 | ||
| The Best Defense is a Good Offense | 75 | ||
| Summary | 76 | ||
| References | 76 | ||
| 9 Health Policy, Politics, and Professional Ethics | 77 | ||
| Case Study I: A “No-Admit” List | 77 | ||
| Case Study II: Death with Dignity | 78 | ||
| Case Study III: Health Reform Legislation | 78 | ||
| The Ends and the Means | 79 | ||
| A Few Things That must be Said | 79 | ||
| Ethics, Right and Wrong | 80 | ||
| Professional Ethics | 81 | ||
| Principles of Distributive Justice | 82 | ||
| The Nitty Gritty | 83 | ||
| The Case of Barbara Howe | 84 | ||
| The Case of Terri Schiavo | 85 | ||
| References | 86 | ||
| 10 Using the Power of Media to Influence Health Policy and Politics | 88 | ||
| Seismic Shift in Media: One-to-Many and Many-to-Many | 89 | ||
| Mass Media: The One-to-Many Model | 89 | ||
| Many-to-Many: User-Generated Content and the Rise of the “Prosumer” | 89 | ||
| The Power of Media | 90 | ||
| Who Controls the Media? | 91 | ||
| Distributed Campaigns | 92 | ||
| Getting on the Public’s Agenda | 92 | ||
| Media as a Health Promotion Tool | 93 | ||
| Media Advocacy | 93 | ||
| Framing | 94 | ||
| Focus on Reporting | 95 | ||
| Effective Use of Media | 96 | ||
| Positioning Yourself as an Expert | 96 | ||
| Gain Credentials. | 96 | ||
| Become an Expert in Your Field. | 96 | ||
| Use Personal Experience. | 96 | ||
| Create Your Own Brand of Expertise. | 97 | ||
| Getting Your Message Across | 97 | ||
| Blogging and Microblogging | 97 | ||
| Facebook and Myspace: Using Social Networking Sites (SNS) | 99 | ||
| Building Community and Working with Partners | 100 | ||
| Analyzing Media | 100 | ||
| What is the Medium? | 100 | ||
| Who is Sending the Message? | 100 | ||
| What is the Message, and What Rhetoric is Used? | 101 | ||
| Is the Message Effective? | 102 | ||
| Is the Message Accurate? | 102 | ||
| Responding to the Media | 102 | ||
| Conclusion | 103 | ||
| References | 103 | ||
| 11 Communication Skills for Success in Policy and Politics | 105 | ||
| Communication Basics | 105 | ||
| Persuasion | 105 | ||
| Listening: A Critical Communication Skill | 105 | ||
| Effective Communication “In Person” | 106 | ||
| First Impressions | 106 | ||
| Attire | 106 | ||
| Mingling at Social Events | 106 | ||
| Making Conversation (“Small Talk”) | 106 | ||
| Etiquette | 107 | ||
| Networking in Person | 107 | ||
| Business Cards | 107 | ||
| Brief Biography | 107 | ||
| Skills to Improve Communication Effectiveness in Person | 107 | ||
| Ask for What You Want | 107 | ||
| Shake Hands | 108 | ||
| Be Culturally Sensitive | 108 | ||
| Gestures. | 108 | ||
| Handshakes. | 108 | ||
| Personal Space. | 108 | ||
| Jokes. | 108 | ||
| Express Your Gratitude | 108 | ||
| Speak Effectively in Public | 109 | ||
| Practice. | 109 | ||
| Keep Focused. | 109 | ||
| Know Your Audience. | 109 | ||
| Meet and Greet Your Audience. | 109 | ||
| Observe the Experts. | 109 | ||
| Watch the Clock. | 109 | ||
| Provide an Effective Briefing | 109 | ||
| Know Your Topic. | 109 | ||
| Present the Topic in a Concise and Logical Manner. | 109 | ||
| Be Prepared for Questions. | 109 | ||
| Make Yourself Available for Follow-up. | 109 | ||
| Don’t Forget Your Non-Verbal Communication | 109 | ||
| Your Signals | 110 | ||
| Reading Body Language in Others | 110 | ||
| Sexual Messages | 110 | ||
| Tools for Effective Communication in the Digital World | 110 | ||
| The Phone | 110 | ||
| Voicemail | 110 | ||
| Using the Fax | 111 | ||
| 111 | |||
| Social Media | 112 | ||
| Website. | 112 | ||
| References | 113 | ||
| 12 Conflict Management in Health Care: | 114 | ||
| Managing Conflict through Alternative Dispute Resolution | 114 | ||
| Health Care: The Last Frontier in ADR | 115 | ||
| The Tipping Point Arrives | 115 | ||
| The Institute of Medicine Focuses on Safety, Creates a Movement | 116 | ||
| The Joint Commission | 116 | ||
| Front Runners Advocating for ADR in Health Care | 117 | ||
| Nurse Leaders in Conflict Engagement | 118 | ||
| And There is Still Much to be Done | 119 | ||
| Emerging Insights | 119 | ||
| References | 121 | ||
| Unit 2 Health Care Delivery and Financing | 122 | ||
| 13 The United States Health Care System | 122 | ||
| Characteristics of Systems | 122 | ||
| Evaluation of the Health Care System | 123 | ||
| Quality | 123 | ||
| Patient Safety. | 124 | ||
| Healthy Life Years. | 124 | ||
| Access | 124 | ||
| Equity. | 125 | ||
| Cost | 125 | ||
| Efficiency. | 125 | ||
| Fragmentation in Care Delivery | 126 | ||
| The Technology Imperative | 127 | ||
| Health Information Technology | 127 | ||
| Socio-Economic and Political Trends | 127 | ||
| Challenges for the U.S. Health Care System | 128 | ||
| Changing Models of Care Delivery | 128 | ||
| Controlling Fraud and Abuse | 129 | ||
| Administrative Overhead | 129 | ||
| Malpractice | 129 | ||
| Health Care Reform | 129 | ||
| Benefits | 131 | ||
| Cost of Reform | 131 | ||
| Savings from Existing Programs Such as Medicare and Medicaid. | 131 | ||
| New Revenues from Sources within the Health Care System. | 132 | ||
| New Revenues from Sources Outside of the Health Care System. | 132 | ||
| Opportunities and Challenges for Nursing | 132 | ||
| References | 133 | ||
| 14 Financing Health Care in the United States | 135 | ||
| Historical Perspectives | 135 | ||
| The Problem of Continual Rising Costs | 136 | ||
| Why Are Costs Rising? | 137 | ||
| Cost-Containment Efforts | 138 | ||
| Regulation versus Competition | 138 | ||
| Prospective Payment versus Fee-for-Service Financing | 138 | ||
| Managed Care | 139 | ||
| Public/Federal Funding for Health Care in the United States | 139 | ||
| Medicare | 140 | ||
| Fee-for-Service versus Managed Care Medicare | 140 | ||
| Medicare Reform | 141 | ||
| Medicare Medical Savings Accounts (MSAS) | 142 | ||
| Federal/State/Local Financing Programs | 142 | ||
| Medicaid | 142 | ||
| Current Financing for Medicaid | 143 | ||
| State Health Care Financing | 143 | ||
| Local/County Level | 144 | ||
| Private Health Care System | 144 | ||
| Nursing and National Health Reform | 144 | ||
| summary | 145 | ||
| References | 145 | ||
| 15 Could a National Health System Work in the United States? | 147 | ||
| Possible Approaches to a National System | 148 | ||
| Universal Payment | 148 | ||
| National Tax. | 148 | ||
| Multiple Payers. | 148 | ||
| Universal Care | 149 | ||
| National Health System. | 149 | ||
| State-Based System. | 149 | ||
| The Participants | 149 | ||
| Barriers to Resolving the Lack of Universality | 150 | ||
| American Enterprise | 150 | ||
| Incrementalism | 150 | ||
| Political History | 150 | ||
| Potential Positive Forces | 151 | ||
| A Balancing Act | 151 | ||
| Economics Matter | 151 | ||
| The Public’s Role | 152 | ||
| References | 152 | ||
| 16 A Primer on Health Economics | 153 | ||
| Economic Theory and Reality in Health Care | 153 | ||
| The Demand for Health Care | 154 | ||
| The Supply of Health Care | 156 | ||
| The Market for Hospital Services | 157 | ||
| The Market for Nurses | 158 | ||
| Clinical Economics: Evaluating Health Care Performance | 159 | ||
| Reform of The U.S. Health Care System and The Future of Nursing | 160 | ||
| References | 161 | ||
| 17 Reforming Medicare | 162 | ||
| The Issue | 162 | ||
| Initial Intent and Evolution of the Medicare Program | 162 | ||
| The Medicare Program Today: The Basics | 163 | ||
| Medicare Parts A, B, C, and D | 163 | ||
| Part A (The Hospital Insurance Program) | 163 | ||
| Part B (Supplemental Medical Insurance) | 163 | ||
| Part C (Medicare Advantage) | 163 | ||
| Part D (Prescription Drug Benefit Program) | 164 | ||
| Driving Forces for Change in Medicare | 164 | ||
| Changes in the Medicare Program under Health Care Reform | 165 | ||
| Medicare Savings and Financing | 165 | ||
| Medicare Improvements | 166 | ||
| Better Prescription Coverage. | 166 | ||
| Better Coverage of Prevention Services. | 166 | ||
| Innovations | 166 | ||
| Workforce | 167 | ||
| Implications | 167 | ||
| References | 168 | ||
| 18 Children’s Health Insurance Coverage: | 169 | ||
| Health Insurance Coverage for Low-Income Children | 169 | ||
| Public Health Insurance Coverage for Children | 169 | ||
| Medicaid | 169 | ||
| Children’s Health Insurance Program | 170 | ||
| “The SCHIP Dip”. | 171 | ||
| The Children’s Health Insurance Program Reauthorized | 171 | ||
| Federal Health Care Reform and Chip | 174 | ||
| Summary and the Future for Children’s Coverage | 174 | ||
| References | 174 | ||
| 19 The United States Military Health System: | 176 | ||
| Organization of Care | 176 | ||
| Direct Care | 176 | ||
| Tricare | 176 | ||
| Humanitarian Efforts and Medical Diplomacy | 177 | ||
| Leadership and Vision | 177 | ||
| The MHS Budget | 178 | ||
| Major Policy Issues in the MHS | 178 | ||
| Combat Injuries Causing PTSD and TBI | 178 | ||
| PTSD | 178 | ||
| TBI | 178 | ||
| Suicide | 179 | ||
| Base Realignment and Closure/Integration | 179 | ||
| Personnel | 179 | ||
| Tobacco Use | 180 | ||
| Emergency Contraception | 180 | ||
| References | 180 | ||
| 20 The Veterans Administration Health System: | 182 | ||
| Mission and Organization | 182 | ||
| Patient Population and Changing Demographics | 183 | ||
| Quality and Safety: “The Best Care Anywhere” | 183 | ||
| The Patient-Centered Medical Home | 183 | ||
| Health Care Issues of the Newest Veterans | 184 | ||
| The Electronic Medical Record | 184 | ||
| Nursing Issues | 184 | ||
| The Clinical Ladder | 185 | ||
| Growth of Advanced Practice Roles | 185 | ||
| The VA Nursing Academy | 185 | ||
| Summary | 186 | ||
| References | 186 | ||
| 21 The Uninsured and Underinsured— On the Cusp of Health Reform | 187 | ||
| Holes in the Health Insurance System | 187 | ||
| Employer-Sponsored Health Insurance | 188 | ||
| Medicaid’s Role for the Nonelderly | 190 | ||
| Profile of the Uninsured | 191 | ||
| Health Insurance and access to Care | 192 | ||
| Health Insurance and Financial Security | 193 | ||
| Financing Care for the Uninsured | 194 | ||
| The Underinsured | 195 | ||
| Expanding Health Insurance Coverage through National Health Reform | 195 | ||
| References | 196 | ||
| 22 Policy Approaches to Address Health Disparities | 198 | ||
| Health Disparities Reports and Policies | 198 | ||
| Health Disparities in Infant Mortality: a Contemporary Example | 199 | ||
| Nurse Family Partnership | 200 | ||
| Children’s HEALTH Insurance Program | 200 | ||
| Summary | 200 | ||
| References | 201 | ||
| 23 The Rural Health Care Tundra | 202 | ||
| What Makes Rural Different? | 202 | ||
| Defining Rural | 203 | ||
| Rural Policy, Rural Politics | 204 | ||
| The Opportunities and Challenges of Rural Health | 204 | ||
| References | 205 | ||
| 24 Long-Term Care Policy Issues | 206 | ||
| Poor Quality of Care and Weak Regulatory Enforcement | 206 | ||
| Inadequate Nursing Home Staffing Levels | 207 | ||
| Nursing Facility Reimbursement Reform | 208 | ||
| Corporate Ownership Transparency | 209 | ||
| Home and Community-Based Services | 209 | ||
| Public Financing of Long-Term Care | 211 | ||
| Summary | 211 | ||
| References | 212 | ||
| 25 Home Care and Hospice: | 214 | ||
| The Home Care Industry | 214 | ||
| Key Influencers | 215 | ||
| Components of Home Care | 215 | ||
| Home Health | 215 | ||
| Hospice | 215 | ||
| Home Medical Equipment | 216 | ||
| Home Infusion Pharmacy | 216 | ||
| Private Duty | 216 | ||
| Rapid Growth | 216 | ||
| Impact of Population Changes | 216 | ||
| Competition for Talent | 217 | ||
| Reimbursement | 217 | ||
| Quality and Outcomes Management | 217 | ||
| Non-Profits versus for-Profits | 217 | ||
| Reimbursement Reform | 217 | ||
| The Role of Associations | 218 | ||
| The Role of Insurance Companies | 218 | ||
| The Role of Hospital Utilization and Readmissions | 218 | ||
| The Future Outlook: Home Care Leads the Health Policy Discussion | 218 | ||
| Technology Acceleration | 218 | ||
| The Nurses’ Role | 219 | ||
| References | 219 | ||
| 26 Achieving Mental Health Parity | 220 | ||
| Historical Struggle to Achieve Mental Health Parity | 220 | ||
| Meaning of Parity for Mental Health and Addiction Treatment | 221 | ||
| Gaps in the Mental Health Parity Law | 221 | ||
| State Level Implementation | 222 | ||
| Challenges in Implementing the Law | 222 | ||
| Challenges for the Future | 223 | ||
| Implications for Nursing: Mental Health Related Issues and Strategies | 223 | ||
| References | 223 | ||
| 27 Integrative Health: | 225 | ||
| Use of Complementary Therapies within Nursing | 226 | ||
| National Institutes of Health | 226 | ||
| The White House Commission on Cam Policy | 227 | ||
| Institute of Medicine Report on Cam | 227 | ||
| Education of Health Professionals | 227 | ||
| Integrated Care Delivery Systems | 228 | ||
| Third-Party Reimbursement | 228 | ||
| Regulation of Practice | 229 | ||
| Research | 230 | ||
| References | 230 | ||
| 28 Nursing’s Influence on Drug Development and Safety | 231 | ||
| Historical Background | 231 | ||
| Current Drug Approval Framework | 232 | ||
| Postmarketing Surveillance | 234 | ||
| Nurses as Advocates to Improve Drug Safety | 236 | ||
| Nursing Leadership: Policy and Practice | 237 | ||
| References | 238 | ||
| 29 Chronic Care Policy: | 240 | ||
| The Experience of Chronic Care in the United States | 240 | ||
| A Call for Chronic Care Delivery Reform | 241 | ||
| Medical Homes | 241 | ||
| The Role of Nursing in Medical Homes | 242 | ||
| SUMMARY | 245 | ||
| References | 245 | ||
| 30 Family Caregiving and Social Policy | 247 | ||
| Unpaid Value of Family Caregiving | 247 | ||
| Caregiving as a Stressful Business | 247 | ||
| Supporting Family Caregivers | 248 | ||
| Health Care Homes | 248 | ||
| Care Coordination | 250 | ||
| Home and Community-Based Services | 250 | ||
| Fund Caregiver Assessment | 250 | ||
| References | 250 | ||
| 31 Retail Health Care Clinics: | 252 | ||
| A New Approach to Accessing Care | 252 | ||
| Consumer Response | 253 | ||
| Reactions from the Health Care Community | 254 | ||
| Third-Party Payers. | 254 | ||
| Nurse Practitioners. | 254 | ||
| Physicians. | 254 | ||
| Legislative and Regulatory Issues | 255 | ||
| Barriers to Success | 256 | ||
| Financial | 256 | ||
| Limited Availability of Practitioners | 256 | ||
| Regulatory | 257 | ||
| Future Directions and Policy Implications | 257 | ||
| References | 258 | ||
| 32 Nurse-Managed Health Centers | 260 | ||
| The Nurse-Managed Health Center Model | 260 | ||
| Quality of Care in Nurse-Managed Health Centers | 261 | ||
| The Role of Nurse-Managed Health Centers in Health Workforce Development | 261 | ||
| Challenges to Sustainability | 262 | ||
| Availability of Federal Funding | 262 | ||
| Insurer Policies Regarding Nurse Practitioners | 263 | ||
| Expanding the Reach of Nurse-Managed Health Centers | 263 | ||
| State-Level Approaches to Support Nurse-Managed Health Centers | 263 | ||
| Federal-Level Approaches to Support Nurse-Managed Health Centers | 264 | ||
| SUMMARY | 264 | ||
| References | 264 | ||
| 33 Community Health Centers: | 266 | ||
| The Creation of the Neighborhood Health Center Program | 267 | ||
| Program Survival and Institutionalization | 268 | ||
| Continuing Policy Advocacy | 269 | ||
| The Expansion of CHCs Under a Conservative President | 269 | ||
| Community Health Centers in the Obama Era | 270 | ||
| Lessons Learned | 271 | ||
| References | 272 | ||
| 34 Taking Action: Setting Health Care in Its\rSocial Context | 273 | ||
| 35 Taking Action: Reimbursement Issues for Nurse\rAnesthetists: A Continuing Challenge | 279 | ||
| Nurse Anesthesia Practice | 279 | ||
| Nurse Anesthesia Reimbursement | 279 | ||
| Advocacy Issues in Anesthesia Reimbursement | 280 | ||
| Tefra: Defining Medical Direction | 280 | ||
| Physician Supervision of CRNAs: Medicare Conditions of Participation | 282 | ||
| Summary | 284 | ||
| References | 285 | ||
| 36 The Role of Foundations in Improving Health Care | 286 | ||
| Foundations: what They are and what They Fund | 287 | ||
| Private Foundations | 287 | ||
| Public Foundations | 287 | ||
| Operating Foundations | 287 | ||
| Corporate Giving Programs | 288 | ||
| How Funders Make Decisions | 288 | ||
| What is funded? | 289 | ||
| Evaluating the Proposal | 289 | ||
| What’s the Impact? | 289 | ||
| What’s the Applicant’s Capacity? | 289 | ||
| A Budget that Works | 289 | ||
| Developing a Funding Strategy: How to Work with Foundations | 290 | ||
| References | 291 | ||
| 37 Social Security: | 292 | ||
| A Brief Overview of the Development of Social Security | 292 | ||
| Underlying Concepts that Contribute to Social Security’s Success | 293 | ||
| The Benefits of Social Security | 293 | ||
| Retirement Benefits | 295 | ||
| Survivor Benefits | 295 | ||
| Disability Insurance | 296 | ||
| The Supplemental Security Income Program (SSI) | 296 | ||
| Social Security: a Program Especially Important for Women | 296 | ||
| Social Security: Especially Important for Ethnic and Racial Minorities | 296 | ||
| Social Security: Fund Solvency | 297 | ||
| Social Security: Politics and Policy | 297 | ||
| SUMMARY | 298 | ||
| References | 298 | ||
| 38 The United Kingdom’s Health System: | 300 | ||
| Fundamentals: Philosophy and Values | 300 | ||
| Myths | 301 | ||
| Realities | 302 | ||
| Private Versus Public | 303 | ||
| Politics Shaping the NHS Structure and Organization | 304 | ||
| The 1974 Reorganization of the NHS | 304 | ||
| The 1990 Thatcherite Reforms | 304 | ||
| The Effects of Political Devolution | 305 | ||
| References | 305 | ||
| Unit 3 Policy and Politics in Research and Nursing Science | 307 | ||
| 39 Science, Policy, and Politics | 307 | ||
| Politics and Science: the Definitions | 307 | ||
| The Relationships among Science, Politics, And Policy | 307 | ||
| Examples of Collisions Between Politics and Science | 308 | ||
| Phenylpropanolamine (PPA) | 308 | ||
| Evolution and Intelligent Design | 310 | ||
| Mammogram Guidelines | 310 | ||
| Health Disparities | 310 | ||
| Lyme Disease Clinical Practice Guidelines | 310 | ||
| Premenstrual Dysphoric Disorder | 311 | ||
| The Death of AHCPR and the Birth of AHRQ | 311 | ||
| Controversies during the George W. Bush Administration | 311 | ||
| Global Warming | 312 | ||
| Questions Raised by the Union of Concerned Scientists | 312 | ||
| How Can Science be used to Shape Health Policy? | 312 | ||
| What Can be Done to Ensure a Healthy Partnership between Science and Politics? | 312 | ||
| Critique Research Findings | 312 | ||
| Maintain Scientific Integrity | 312 | ||
| Translate Research Findings so they can be Applied in Policymaking | 314 | ||
| Use Appropriate Data to Shape Policy | 314 | ||
| SUMMARY | 314 | ||
| References | 314 | ||
| 40 Research as a Political and Policy Tool | 316 | ||
| So what is Policy? | 316 | ||
| What is Research when it Comes to Policy? | 316 | ||
| The Chemistry between Research and Policymaking | 317 | ||
| Using Research to Create, Inform, and Shape Policy | 317 | ||
| Research and Political Will | 318 | ||
| The Strategic Researcher | 319 | ||
| Research—not just for Journals | 320 | ||
| References | 320 | ||
| 41 Health Services Research: | 322 | ||
| Defining Health Services Research | 322 | ||
| HSR Methods | 323 | ||
| Quantitative Methods and Data Sets | 323 | ||
| Area Resources File (ARF). | 324 | ||
| Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). | 325 | ||
| National Health and Nutrition Examination Survey (NHANES). | 325 | ||
| Healthcare Cost and Utilization Project (HCUP). | 325 | ||
| National Database of Nursing Quality Indicators (NDNQI). | 325 | ||
| Dartmouth Atlas. | 326 | ||
| Qualitative Methods | 326 | ||
| Professional Training in Health Services Research | 326 | ||
| Competencies | 326 | ||
| Educational Funding | 326 | ||
| Journals | 327 | ||
| References | 327 | ||
| 42 Politics and Evidence-Based Practice and Policy | 329 | ||
| The Players and Their Stakes | 329 | ||
| The Role of Politics in Generating Evidence | 330 | ||
| Comparative Effectiveness Studies | 331 | ||
| The Politics of Research Application in Clinical Practice | 331 | ||
| Individual Studies | 331 | ||
| Summarizing Literature and the Politics of Guidelines and Syntheses | 332 | ||
| The Politics of Research Applied to Policy Formulation | 333 | ||
| References | 335 | ||
| 43 The Society for Women’s Health Research: | 336 | ||
| Founding of the Society for Women’s Health Research | 336 | ||
| The Birth of An Advocacy Organization | 336 | ||
| Congressional Advocacy | 337 | ||
| Continuing Sex and Gender Inequities Found | 337 | ||
| The Importance of Integrated Professional Action | 337 | ||
| Expanding the Understanding of Sex and Gender Differences in Health and Disease | 338 | ||
| Does Sex Matter? Absolutely | 338 | ||
| Public Education | 339 | ||
| Current Challenges and Opportunities | 339 | ||
| References | 339 | ||
| 44 Using Research to Advance Healthy Social Policies for Children | 340 | ||
| Research Informing Social Policies for Children | 340 | ||
| Research on Early Brain Development | 340 | ||
| Research on Social Determinants of Health and Health Disparities | 341 | ||
| Research Related to Childhood Obesity | 341 | ||
| Research on Childhood Indicators | 342 | ||
| Research on “Framing the Problem” | 342 | ||
| Research on the Nurse-Family Partnership Program | 342 | ||
| Shortcomings in Linking Research and Social Policies for Children | 343 | ||
| Who Speaks for Children? | 343 | ||
| References | 344 | ||
| 45 Taking Action: Reefer Madness: The Clash\rof Science, Politics, and\rMedical Marijuana | 345 | ||
| A Drug with An Image Problem | 345 | ||
| Once Upon A Time, Cannabis Was Legal | 345 | ||
| How and Why Did the Prohibition Begin? | 346 | ||
| The Descent into “Reefer Madness” | 346 | ||
| My Introduction to the Problem of Medical Cannabis Use | 347 | ||
| An Opportunity for Education | 347 | ||
| Barriers and Strategies | 348 | ||
| Hiding the Truth | 348 | ||
| Finding the Truth | 348 | ||
| A Powerful Mentor | 348 | ||
| Gaining Support | 349 | ||
| “Patients Out of Time” | 350 | ||
| Challenges in Disseminating Information about Cannabis | 350 | ||
| Birth of A Book and Death of A Journal | 350 | ||
| Raising Awareness at Professional Conferences | 351 | ||
| The First National Clinical Conference on Cannabis Therapeutics | 351 | ||
| The Need for Evidence | 351 | ||
| Taking on the U.S. Drug Enforcement Administration | 352 | ||
| Progress | 352 | ||
| Looking Ahead | 353 | ||
| References | 353 | ||
| 46 Taking Action: The Journey into the Hallowed Halls\rof Politics: How Nurse Practitioners\rChanged Pennsylvania Policy | 354 | ||
| The Pilot Study | 354 | ||
| The Capstone Project | 355 | ||
| The Political Arena | 356 | ||
| References | 357 | ||
| Unit 4 Policy and Politics in the Workplace and Workforce | 358 | ||
| 47 Policy and Politics in the Contemporary Work Environment | 358 | ||
| Assuring Quality, Safety, and Reliability | 358 | ||
| Agencies Leading Quality and Safety Efforts | 358 | ||
| Award Programs | 359 | ||
| Health Care Teams: Communication and Patient Safety | 359 | ||
| Teamwork and Team Training | 360 | ||
| Impact on Policy | 360 | ||
| Leveraging Technology | 361 | ||
| Opportunities for Improvement | 361 | ||
| The Role of Nursing | 362 | ||
| Balancing Financial Considerations with Quality | 362 | ||
| SUMMARY | 363 | ||
| References | 364 | ||
| 48 Quality and Safety in Health Care: | 366 | ||
| The Environmental Context | 367 | ||
| The Policy Context: Value-Driven Health Care | 367 | ||
| Performance Measurement | 368 | ||
| Public Reporting | 368 | ||
| Performance-Based Incentives | 370 | ||
| The Role of Public-Private Partnerships | 371 | ||
| Value-Driven Health Care and Nursing | 372 | ||
| References | 373 | ||
| 49 The Nursing Workforce | 375 | ||
| Characteristics of the Workforce | 375 | ||
| Expanding the Workforce | 377 | ||
| Increasing Diversity | 378 | ||
| Retaining Workers | 378 | ||
| Public and Private Efforts to Address the Nursing Shortage | 379 | ||
| Summary | 381 | ||
| References | 381 | ||
| 50 Nursing Education Policy: | 383 | ||
| The Entry into Practice Debate | 384 | ||
| Historical Perspective | 384 | ||
| Upheaval within the Profession | 385 | ||
| Current Climate: The Realities of the Workforce | 386 | ||
| The Entry into Advanced Practice Debate | 387 | ||
| Historical Perspective | 387 | ||
| Emergence of the DNP: The Early Debate | 388 | ||
| Lessons Learned from Nursing’s Journey | 389 | ||
| SUMMARY | 389 | ||
| References | 391 | ||
| 51 The Politics of Advanced Practice Nursing | 393 | ||
| APRN Definition | 393 | ||
| The Political Issues | 393 | ||
| A Common Licensure: LACE | 394 | ||
| Aprn Payment Issues | 396 | ||
| Opportunities under Health Reform | 397 | ||
| Expanding the Use of APRN Skills | 398 | ||
| Overcoming Invisibility | 398 | ||
| Future Challenges and Opportunities: Making Lace Our Preferred Future | 399 | ||
| Harnessing the Power of the APRN | 399 | ||
| Expanding Media and Research beyond the Nursing Audience | 399 | ||
| Summary | 399 | ||
| References | 400 | ||
| 52 Global Nurse Migration | 401 | ||
| Migration and the Global Health Care Workforce | 401 | ||
| General Trends in Migration | 401 | ||
| The Global Nurse Workforce | 401 | ||
| Trends in U.S. Nurse Migration | 402 | ||
| Retrogression | 403 | ||
| Policy Implications for the U.S. Nursing Workforce | 403 | ||
| Determining the Relative Contribution of Foreign-Educated Nurses | 403 | ||
| Keeping Track. | 404 | ||
| Tracking by Nursing Organizations. | 404 | ||
| Monitoring Systems. | 404 | ||
| Assessing Credentials and Improving Regulatory Mechanisms for Licensure | 405 | ||
| U.S. Illegal Immigration Reform and Immigrant Responsibility Act. | 405 | ||
| VisaScreen®: Visa Credentials Assessment. | 405 | ||
| Educational Credentials. | 405 | ||
| Providing Supervised Practice, Language Training, Health System Orientation, Cultural Orientation, and Social Support | 405 | ||
| Language. | 406 | ||
| Acculturation. | 406 | ||
| Developing Ethical Policies Regarding Recruitment | 406 | ||
| Summary | 407 | ||
| References | 407 | ||
| 53 Nurse Staffing Ratios: | 409 | ||
| The Context in Which Ratios were Implemented | 409 | ||
| Regulations | 410 | ||
| What has Happened As a Result of the Ratios? | 410 | ||
| Legal Challenges | 410 | ||
| Expansion of Nursing Education | 411 | ||
| Enforcement Issues | 411 | ||
| Are Hospitals Meeting the Ratios? | 411 | ||
| Has the Mix of Staff Changed? | 412 | ||
| Have Hospitals Reduced Services? | 412 | ||
| Have Hospitals Suffered Financial Losses? | 412 | ||
| Are Nurses More Satisfied? | 412 | ||
| Other State and Federal Proposals | 413 | ||
| Issues That Need to be Addressed | 413 | ||
| Did the Ratios Improve the Quality of Care? | 413 | ||
| What was the Cost of the Ratios? | 415 | ||
| What Next? | 415 | ||
| References | 415 | ||
| 54 Taking Action: Aligning Care at the Bedside\rwith the C-Suite | 417 | ||
| Case Study | 418 | ||
| Beginning | 418 | ||
| Forming and Storming | 418 | ||
| Imagination, Innovation, Spread, and Sustainability | 419 | ||
| Spreading TCAB: The American Organization of Nurse Executives | 420 | ||
| Lessons Learned and Policy Implications | 421 | ||
| References | 421 | ||
| 55 Taking Action: When a Hurricane Strikes:\rThe Challenge of Crafting\rWorkplace Policy | 422 | ||
| Annual Preparation Activities | 422 | ||
| Before the Storm | 423 | ||
| During the Storm | 423 | ||
| After the Storm | 423 | ||
| Employee Expectations | 423 | ||
| Child Care Services | 424 | ||
| Communication Issues | 424 | ||
| Personal Impact of A Storm | 425 | ||
| Recent Experience with Disaster | 425 | ||
| The Hurricane Policies | 425 | ||
| Lessons Learned | 426 | ||
| Clear Expectations Are Critical | 426 | ||
| Safe Evacuation Plans Are Needed | 426 | ||
| Employee Needs | 426 | ||
| References | 427 | ||
| 56 Workplace Abuse in Nursing: | 428 | ||
| What Constitutes Workplace Abuse? | 428 | ||
| Incidence | 429 | ||
| Causes | 429 | ||
| Indicators of Workplace Abuse | 429 | ||
| Work Environment and Errors | 429 | ||
| Communication and Healthy Work Environments | 430 | ||
| Policy Considerations | 430 | ||
| Health Professions Education | 430 | ||
| Professional Standards | 430 | ||
| Regulatory Approaches | 431 | ||
| Institutional Approaches | 431 | ||
| Work Unit Approaches | 432 | ||
| Individual Approaches | 433 | ||
| Summary | 433 | ||
| References | 433 | ||
| 57 Taking Action: Advocating for Nurses Injured in\rthe Workplace | 435 | ||
| Becoming a Voice for Back-Injured Nurses | 436 | ||
| Establishing the Work Injured Nurses Group USA (Wing USA) | 436 | ||
| Legislative Efforts to Advance Safe Patient Handling | 437 | ||
| The Future | 438 | ||
| References | 438 | ||
| 58 Taking Action: Influencing the Workplace by Serving\ron a Hospital’s Board of Directors | 439 | ||
| Why be Concerned about Trustees? | 439 | ||
| What do Trustees do? | 440 | ||
| Notes on Board Service | 441 | ||
| Getting on a Board | 442 | ||
| 59 The Intersection of Technology and Health Care: | 444 | ||
| The Demand for Value-Based Health Care | 444 | ||
| Technology Enhanced Nursing Practice | 445 | ||
| The Effect of Technology on Nursing Practice: The TD2 Study | 445 | ||
| The “Technology Drill Down” | 446 | ||
| Conclusions from the TD2 Study | 447 | ||
| Recommendations from the Research | 447 | ||
| Priority Setting for Technology Acquisition | 447 | ||
| Choosing the Products | 448 | ||
| Synergy with Emerging Health Information Policy | 448 | ||
| References | 450 | ||
| 60 The Influence of Magnet Recognition® on Organization and Workplace Policy | 451 | ||
| Uncovering the “Forces of Magnetism” | 451 | ||
| Establishment of the Magnet Program | 451 | ||
| The Magnet Application Process | 452 | ||
| Eligibility Requirements | 453 | ||
| References | 453 | ||
| 61 Collective Bargaining in Nursing | 455 | ||
| A Brief History of Collective Bargaining in Nursing | 455 | ||
| Collective Bargaining and Legislative Initiatives Since 2000 | 457 | ||
| References | 459 | ||
| 62 Workplace Advocacy | 461 | ||
| Workplace Policy | 461 | ||
| The Center for American Nurses | 461 | ||
| Current Workplace Advocacy Policy Issues | 462 | ||
| Mandatory Overtime | 462 | ||
| Nurse Fatigue | 462 | ||
| Musculoskeletal Injuries | 462 | ||
| Mature Nurses | 462 | ||
| Workplace Design | 462 | ||
| Lateral Violence and Bullying in the Workplace | 463 | ||
| Initiating Workplace Policy | 463 | ||
| References | 463 | ||
| Unit 5 Policy and Politics in the Government | 464 | ||
| 63 Contemporary Issues in Government | 464 | ||
| Historical Perspective | 465 | ||
| The Rocky Road to Health Insurance Reform: States Rebel | 466 | ||
| Congressional Reform | 467 | ||
| The Battle over Public Opinion | 468 | ||
| Federal Implementation of Health Insurance Reform | 468 | ||
| Health care Workforce Shortages and Reform Resolutions | 469 | ||
| State-Level Health Reform | 470 | ||
| Health Care Quality and Patient Safety | 471 | ||
| Medical Technologies | 472 | ||
| Preventive Health and Obesity | 474 | ||
| Obesity-Prevention Care will be Critical | 475 | ||
| Bioterrorism: Threats and Preparedness | 476 | ||
| Summary | 477 | ||
| References | 478 | ||
| 64 How Government Works: | 480 | ||
| Federalism: Multiple Levels of Responsibility | 480 | ||
| The Federal Government | 481 | ||
| The Executive Branch | 481 | ||
| Executive Office of the President (EOP). | 481 | ||
| The Cabinet. | 482 | ||
| The Department of Health and Human Services (HHS). | 482 | ||
| The Social Security Administration (SSA). | 482 | ||
| The Department of Defense (DOD). | 483 | ||
| The Department of Veterans Affairs. | 483 | ||
| The U.S. Department of Education. | 483 | ||
| Regulatory Functions of the Executive Branch of Government. | 483 | ||
| The Legislative Branch | 483 | ||
| The Federal Budget | 486 | ||
| The Senate and House Committees on Appropriations. | 488 | ||
| State Governments | 489 | ||
| Executive Branch | 489 | ||
| Regulatory Function of State Governments | 489 | ||
| Translating Laws into Regulations. | 489 | ||
| Regulation of Health Professionals. | 489 | ||
| Legislative Branch | 490 | ||
| Local Government | 490 | ||
| Target the Appropriate Level of Government | 490 | ||
| Pulling it all Together: Covering Long-Term Care | 491 | ||
| Summary | 492 | ||
| References | 492 | ||
| 65 An Overview of Legislation and Regulation | 494 | ||
| Influencing the Legislative Process | 494 | ||
| Introduction of a Bill | 494 | ||
| Influencing the Introduction of a Bill | 494 | ||
| Committee Action | 495 | ||
| Authorization and Appropriation Process | 496 | ||
| Committee Procedures | 497 | ||
| Hearings. | 497 | ||
| Markups. | 499 | ||
| Reports. | 499 | ||
| Floor Action in the House and Senate | 499 | ||
| Conference Action | 501 | ||
| Senate Role in the Confirmation Process | 501 | ||
| Executive Action | 502 | ||
| Regulatory Process | 502 | ||
| A Regulatory Example: The American Association Of Colleges Of Nursing And Education Requirements For Nurse Practitioners and Clinical Nurse Specialists | 503 | ||
| References | 505 | ||
| 66 Nursing Licensure and Regulation | 506 | ||
| Historical Perspective | 506 | ||
| The Purpose of Professional Regulation | 506 | ||
| Sources of Regulation | 507 | ||
| Nursing Boards | 507 | ||
| Health and Human Services | 507 | ||
| Centers for Medicare & Medicaid Services | 507 | ||
| The Joint Commission | 507 | ||
| Federal, State, and Local Law | 507 | ||
| Organizational Policy | 507 | ||
| Licensure Board Responsibilities | 508 | ||
| Protect the Public | 508 | ||
| Issue and Renew Licenses | 508 | ||
| Investigation and Prosecution of Complaints | 508 | ||
| Licensure Requirements | 508 | ||
| Examination | 508 | ||
| Endorsement | 508 | ||
| Nursing Licensure Compact | 508 | ||
| Nurse Practice Acts | 509 | ||
| Scope of Practice | 509 | ||
| Advisory Opinions and Practice Alerts | 509 | ||
| The Source of Licensing Board Authority | 509 | ||
| Disciplinary Offenses | 510 | ||
| Complaint Resolution | 510 | ||
| Disciplinary Actions | 510 | ||
| Collateral Impact | 511 | ||
| Regulation’s Shortcomings | 511 | ||
| Summary | 512 | ||
| References | 513 | ||
| 67 Regulating Industrial Chemicals to Protect the Environment and Human Health | 514 | ||
| History of Chemicals Causing Disease and the Lack of Regulation | 514 | ||
| Emerging Field of Environmental Health | 515 | ||
| Size Matters | 516 | ||
| Sensitivity Matters | 516 | ||
| Interactions Matter | 516 | ||
| Regulating Chemicals Like We’re Supposed to Regulate Drugs | 516 | ||
| Absence of Information is not the Same as Absence of Harm | 517 | ||
| Number and Quality of the Stressors on the Patient Matter | 517 | ||
| Any Stressors You Can Remove Matter | 517 | ||
| Changing Policies | 517 | ||
| References | 518 | ||
| 68 Lobbying Policymakers: | 519 | ||
| Lobbyists, Advocates, and the Policymaking Process | 519 | ||
| Lobbyist or Advocate? | 519 | ||
| Why Lobby? | 520 | ||
| Steps in Effective Lobbying | 520 | ||
| Research | 520 | ||
| Identifying Supporters | 520 | ||
| Contacting Policymakers | 521 | ||
| Types of Congressional Staff. | 521 | ||
| Building Relationships. | 521 | ||
| How Should You Lobby? | 522 | ||
| Personal Visits | 522 | ||
| Telephone Calls | 522 | ||
| Letter-Writing | 523 | ||
| 523 | |||
| Providing Hearing Testimony | 524 | ||
| Collective Strategies | 525 | ||
| References | 526 | ||
| 69 Taking Action: An Insider’s View of Lobbying | 527 | ||
| Getting Started | 528 | ||
| Political Strategies | 528 | ||
| Getting Nurses on Every Health-Related State Agency | 528 | ||
| Numbers Connote Strength | 529 | ||
| Long-Term Strategies for Long-Term Solutions: Tackling the Nursing Shortage | 529 | ||
| Call in the Nurses | 529 | ||
| Be in the Right Place at The Right Time | 530 | ||
| Putting Frogs in A Wheelbarrow: Use Humor As A Tool | 530 | ||
| Use Your Best Assets | 530 | ||
| Use Proven Strategies | 531 | ||
| Be Patient; Do Not Give Up | 531 | ||
| There Really Is a Need for Lobbyists | 532 | ||
| 70 Political Appointments | 533 | ||
| What Does It Take to Be A Political Appointee? | 533 | ||
| Getting Ready | 533 | ||
| Identify Opportunities | 534 | ||
| Making a Decision to Seek an Appointment | 535 | ||
| Plan Your Strategy | 535 | ||
| The Vetting Process | 535 | ||
| Political Party Affiliation | 536 | ||
| Getting Support | 536 | ||
| Using the Power of Networks | 537 | ||
| Confirmation or Interview? | 537 | ||
| Compensation | 537 | ||
| After the Appointment | 537 | ||
| Relationships with Supporters | 537 | ||
| Experiences of Nurse Appointees | 538 | ||
| Dr. Shirley Chater | 538 | ||
| Marilyn Tavenner | 538 | ||
| Rita Wray | 539 | ||
| Summary | 539 | ||
| References | 539 | ||
| 71 Taking Action: Influencing Policy as a Member of\rthe San Francisco Health Commission | 540 | ||
| Applying My Nursing Background in Commission Activities | 540 | ||
| Overview of the San Francisco Health Commission | 541 | ||
| The Commission’s Scope of Work | 541 | ||
| Infrastructure | 542 | ||
| Difficult Decisions | 542 | ||
| The Balance of Power | 542 | ||
| The Public’s Trust in Nurses and What It Means | 543 | ||
| Summary | 543 | ||
| References | 543 | ||
| 72 Nursing and the Courts | 544 | ||
| The Judicial System: A Brief Overview | 544 | ||
| Judicial Review | 544 | ||
| The Context for Court Decisions: The Constitution and the Branches of Government | 545 | ||
| Impact Litigation: Establishing Rights | 546 | ||
| Interpreting and Enforcing Existing Legislation | 547 | ||
| Expanding Legal Rights through Litigation | 547 | ||
| Enforcing Legal and Regulatory Requirements | 547 | ||
| Antitrust Laws | 548 | ||
| Criminal Courts | 548 | ||
| Influencing and Responding to Court Decisions | 549 | ||
| Influencing the Courts: Amicus Curiae Briefs | 549 | ||
| Responding to Court Decisions | 550 | ||
| Appealing an Unfavorable Decision. | 550 | ||
| “Repudiating” the Court. | 550 | ||
| Revising the Law. | 550 | ||
| Pursuing Multiple Strategies. | 550 | ||
| Amending the Constitution. | 551 | ||
| Promoting Nursing’s Policy Agenda | 551 | ||
| References | 552 | ||
| 73 The American Voter and the Electoral Process | 553 | ||
| Voting Law: Getting the Voters to the Polls | 553 | ||
| A Call for Reform | 554 | ||
| Voting Behavior | 554 | ||
| Voter Turnout | 555 | ||
| Patterns in Voter Choice | 555 | ||
| Political Party. | 556 | ||
| Religion. | 556 | ||
| Race and Ethnicity. | 556 | ||
| Gender. | 556 | ||
| Age. | 557 | ||
| Answering to the Constituency | 557 | ||
| Voting Districts | 557 | ||
| Involvement in Campaigns | 558 | ||
| Choosing “Your” Candidate | 558 | ||
| Campaigning | 558 | ||
| Getting the “Best” Candidate | 559 | ||
| Campaign Finance Law | 559 | ||
| Types of Elections | 559 | ||
| Primary Elections | 559 | ||
| General Elections | 560 | ||
| Presidential Elections: a Special Case | 560 | ||
| The Morning After: Keeping Connected to Politicians | 560 | ||
| References | 560 | ||
| 74 Taking Action: Anatomy of a Political Campaign | 561 | ||
| Why People Work on Campaigns | 561 | ||
| Belief in an Issue or Candidate | 561 | ||
| Network Building | 561 | ||
| Party Loyalty | 561 | ||
| Payback | 561 | ||
| Why People Stop Working on Campaigns | 562 | ||
| The Internet and the 2008 Election Campaign | 562 | ||
| Social Networking Websites | 563 | ||
| Campaign Activities | 563 | ||
| Basic-Level Campaign Activities | 563 | ||
| Types of Campaign Activities | 564 | ||
| Phone Banks. | 564 | ||
| Literature Drops. | 564 | ||
| Door-to-Door Canvassing. | 564 | ||
| House Parties. | 564 | ||
| Created Events. | 564 | ||
| Political Action Committees. | 565 | ||
| Get-out-the-Vote Activities. | 565 | ||
| Advanced-Level Campaign Activities | 565 | ||
| References | 567 | ||
| 75 Taking Action: Nurses for Obama: My Advocacy and\rExperience on the Campaign Trail | 568 | ||
| Meeting State Senator Barack Obama | 568 | ||
| My Work on Mr. Obama’s Campaign for U.S. Senate | 569 | ||
| Fundraising for the Senate Campaign | 569 | ||
| Candidate’s Forums | 570 | ||
| Volunteering for the Campaign | 570 | ||
| Mr. Obama’s Democratic National Convention Speech—a Turning Point | 570 | ||
| “Yes We Can” | 570 | ||
| A Challenge for Nurses—Yes We Can | 570 | ||
| 76 Is There a Nurse in the House? The Nurses in the United States Congress | 572 | ||
| The Nurses in Congress | 572 | ||
| The Honorable Eddie Bernice Johnson | 572 | ||
| The Honorable Carolyn Mccarthy | 574 | ||
| The Honorable Lois Capps | 574 | ||
| Evaluating the Work of the Nurses Serving in Congress | 575 | ||
| Power Rankings | 575 | ||
| Political Perspective | 575 | ||
| Interest Group Ratings | 575 | ||
| Campaign Financing | 575 | ||
| Sources of Campaign Funds | 576 | ||
| Earmarks | 577 | ||
| References | 578 | ||
| 77 Taking Action: Nurse, Educator, and Legislator:\rMy Journey to the Delaware\rGeneral Assembly | 579 | ||
| My Political Roots | 579 | ||
| Volunteering and Campaigning | 579 | ||
| There’s a Reason It’s Called “Running” for Office | 580 | ||
| A Day in the Life of a Nurse-Legislator | 580 | ||
| What I’ve Been Able to Accomplish as a Nurse-Legislator | 581 | ||
| Tips for Influencing Elected Officials’ Health Policy Decisions | 582 | ||
| Is It Worth It? | 582 | ||
| References | 582 | ||
| 78 Taking Action: Into the Rabbit Hole: My Journey to\rService on a City Council | 583 | ||
| Working as a Novice | 583 | ||
| A Lesson about the Power of Policy | 583 | ||
| Twin Miracles | 584 | ||
| Shifting Direction | 584 | ||
| The Campaign Goes Forward | 585 | ||
| On to the Election | 585 | ||
| Service on the City Council | 586 | ||
| References | 586 | ||
| 79 Taking Action: Truth or Dare: One Nurse’s\rPolitical Campaign | 587 | ||
| 80 Political Activity: | 590 | ||
| The Hatch Act | 590 | ||
| Why was the Hatch Act Passed? | 591 | ||
| What is Political Activity? | 591 | ||
| Hatch Act Enforcement | 592 | ||
| Penalties for Hatch Act Violations | 592 | ||
| Department of Defense Regulations on Political Activity | 592 | ||
| References | 593 | ||
| Unit 6 Policy and Politics in Associations and Interest Groups | 594 | ||
| 81 Interest Groups in Health Care Policy and Politics | 594 | ||
| Development of Interest Groups | 594 | ||
| Functions and Methods of Influence | 596 | ||
| Lobbying | 596 | ||
| Grassroots Mobilization | 596 | ||
| Electoral Influence | 596 | ||
| Shaping Public Opinion | 597 | ||
| Litigation | 597 | ||
| Landscape of Contemporary Health Care Interest Groups | 598 | ||
| Assessing Value and Considering Involvement | 599 | ||
| Summary | 599 | ||
| References | 600 | ||
| 82 Current Issues in Nursing Associations | 602 | ||
| Nursing’s Professional Organizations | 602 | ||
| Membership | 604 | ||
| Advocacy | 605 | ||
| Leadership | 606 | ||
| Summary | 607 | ||
| References | 607 | ||
| 83 Professional Nursing Associations: | 609 | ||
| Evolution of Nursing Organizations | 609 | ||
| Nursing Organizations and Today’s Nurses | 610 | ||
| The Relationship of Associations and Their Members | 611 | ||
| Member Benefits | 611 | ||
| Educational Resources | 611 | ||
| Career Advancement | 611 | ||
| Antidote to Compassion Stress and Fatigue | 612 | ||
| Professional Satisfaction | 612 | ||
| Leadership Development | 612 | ||
| Where and When to Volunteer | 612 | ||
| Choosing Which Organization to Join | 612 | ||
| When to Join and How to Volunteer | 613 | ||
| Organizational Structure. | 613 | ||
| Bylaws. | 613 | ||
| Governance Policies. | 613 | ||
| Processes and Procedures. | 613 | ||
| Volunteering | 614 | ||
| Committee, Task Force, and Other Volunteer Roles. | 615 | ||
| Political Action Committees. | 615 | ||
| Governance Roles. | 615 | ||
| Getting Where You Want to be in An Association | 615 | ||
| Summary | 616 | ||
| References | 616 | ||
| 84 Taking Action: The Center to Champion Nursing in\rAmerica: Mobilizing Consumers and\rOther Stakeholders | 618 | ||
| The Center to Champion Nursing in America as A Consumer-Driven Force for Change | 618 | ||
| Evolving Strategic Priorities | 620 | ||
| Lessons Learned | 620 | ||
| Reference | 620 | ||
| 85 Taking Action: The Raise the Voice Campaign:\rNurse-Led Innovations Changing\rPublic Policy | 621 | ||
| Innovations and Policy | 621 | ||
| Addressing Social Determinants of Health: Chicago Parent Program | 621 | ||
| Keeping People in their Communities: Living Independently for Elders | 622 | ||
| The Importance of Outcome Data: the Nurse-Family Partnership | 622 | ||
| Removing Barriers to Diffusing Innovations: the Eleventh Street Family Health Services | 623 | ||
| Defining the “Policy Ask”: the Transitional Care Model | 623 | ||
| Making the Invisible Visible | 624 | ||
| References | 625 | ||
| 86 Coalitions: | 626 | ||
| Birth and Life Cycle of Coalitions | 626 | ||
| Building and Maintaining a Coalition: the Primer | 627 | ||
| Essential Ingredients | 627 | ||
| Coalition Structure | 628 | ||
| Decision-Making | 628 | ||
| Meetings | 629 | ||
| Promoting the Coalition | 629 | ||
| Funding | 629 | ||
| Pitfalls and Challenges | 629 | ||
| Failure to Get the Right People to Participate | 629 | ||
| Cultural and Language Differences among Coalition Members | 630 | ||
| Persistent Distrust among Coalition Members | 630 | ||
| Control Freaks and Protecting Turf | 630 | ||
| Poor Handling of Different Perspectives | 630 | ||
| Failure to Act | 630 | ||
| Losing Balance | 631 | ||
| Political Work of Coalitions | 631 | ||
| Reasons Not to Advocate | 631 | ||
| Reasons to Advocate | 631 | ||
| How to Advocate with Grace | 631 | ||
| Evaluating Coalition Effectiveness | 631 | ||
| References | 632 | ||
| 87 Taking Action: A Rough Road in Texas:\rAdvanced Practice Nurses\rBuild a Strong Coalition | 633 | ||
| All is Not Rosy in Texas | 633 | ||
| The Coalition for Nurses in Advanced Practice is Born | 633 | ||
| The Coalition’s Operating Procedures | 633 | ||
| The Coalition’s Objectives | 634 | ||
| Action Leads to Accomplishment | 634 | ||
| The Coalition’s Challenges | 634 | ||
| Funding | 634 | ||
| Negotiating Boundaries with Established Organizations | 634 | ||
| The Opposition | 635 | ||
| Building Influence with Limited Resources | 635 | ||
| Define What is Wanted | 635 | ||
| Use Grassroots Strategies for Statewide Success | 635 | ||
| Hire the Right Lobbyist | 635 | ||
| Find an Affordable Way to Be a Visible Part of a Political Action Committee | 635 | ||
| Focus on Regulation as Much as Legislation | 635 | ||
| Summary | 636 | ||
| References | 636 | ||
| 88 Taking Action: The National Coalition for\rLesbian, Gay, Bisexual, and\rTransgender Health | 637 | ||
| The Coalition’s History | 637 | ||
| Members, Affiliates, and Staff Members | 638 | ||
| The Coalition’s Accomplishments | 638 | ||
| The Coalition’s Objectives in Healthy People 2010 | 638 | ||
| Healthy People 2020 | 638 | ||
| Work with the Presidential Transition Team | 639 | ||
| Lesbian, Gay, Bisexual, and Transgender Cultural Competency Curriculum | 639 | ||
| Raising Awareness | 640 | ||
| References | 640 | ||
| 89 Taking Action: The Virginia Nursing Kitchen Cabinet | 641 | ||
| The Context | 641 | ||
| The Policy Development | 641 | ||
| The Politics in Action | 642 | ||
| The Impact | 642 | ||
| 90 The Politics of the Pharmaceutical Industry | 644 | ||
| Values Conflict | 644 | ||
| Direct to Consumer Marketing | 646 | ||
| Conflict of Interest | 647 | ||
| Education | 647 | ||
| Gifts | 648 | ||
| Samples | 648 | ||
| Summary | 648 | ||
| References | 649 | ||
| Unit 7 Policy and Politics in the Community | 651 | ||
| 91 Where Policy Hits the Pavement: | 651 | ||
| What is a Community? | 651 | ||
| Healthy Communities | 652 | ||
| Partnership and Participation for Improving Community Health | 653 | ||
| Determinants of Health in Communities | 653 | ||
| Public Policy | 654 | ||
| Socioeconomic Status, Health Disparities, and Inequities | 655 | ||
| Environmental Health | 656 | ||
| Summary | 657 | ||
| References | 657 | ||
| 92 An Introduction to Community Activism | 659 | ||
| Key Concepts | 659 | ||
| Social Justice | 659 | ||
| Community | 660 | ||
| Consciousness Raising, Critical Reflection, and Praxis | 661 | ||
| Consciousness Raising | 661 | ||
| Critical Reflection | 661 | ||
| Empowerment | 661 | ||
| Taking Action to Effect Change: Characteristics of Community Activists and Activism | 662 | ||
| Envisioning Change and Possibilities for Different Realities | 662 | ||
| Taking Action | 663 | ||
| Creating and Sustaining Collaborations | 663 | ||
| Challenges and Opportunities in Community Activism | 664 | ||
| Nurses as Community Activists | 665 | ||
| References | 665 | ||
| 93 Taking Action: From Sewage Problems to\rthe Statehouse: My Life as\ran Elected Official | 667 | ||
| Sewage Changed My Life | 667 | ||
| Seeing is Believing | 667 | ||
| My Campaigns | 667 | ||
| The Value of Political Activity in Your Community | 668 | ||
| An Opportunity to Learn the Ropes | 668 | ||
| Networking | 668 | ||
| Leadership in the International Community | 668 | ||
| Recommendations for Becoming Involved in Politics | 669 | ||
| Join a Political Party | 669 | ||
| Connect with Other Nurses | 669 | ||
| Learn from Others in Your Community | 669 | ||
| Develop Cost-Effective Campaign Strategies | 669 | ||
| Get the Message Out | 669 | ||
| 94 Taking Action: Community Advocacy in\rPennsylvania: How I Worked to Make\rmy Community Healthier | 671 | ||
| My Path to Becoming a Community Advocate | 671 | ||
| The Hopwood Village Project—An Example of Community Collaboration | 672 | ||
| Another Opportunity Presents Itself | 673 | ||
| Walking Toward Better Health | 673 | ||
| A Spiritual Aspect of Community Service | 674 | ||
| An Unexpected Recognition | 674 | ||
| Community Advocacy and “Giving Back” | 675 | ||
| 95 Taking Action: A Nurse Practitioner’s Advocacy\rEfforts in Nevada | 676 | ||
| Wanting to Be A Nurse | 676 | ||
| My First Nursing Job | 676 | ||
| Back to School | 677 | ||
| The Value of Volunteering | 677 | ||
| Challenges in Advocacy and Service | 677 | ||
| Working in the Media | 678 | ||
| The Value of Recognition | 679 | ||
| 96 Taking Action: One Nurse’s Fight Against Gang\rViolence in California | 680 | ||
| My Childhood in the Philippines | 680 | ||
| Becoming A Nurse, Wife, Mother—and U.S. Citizen | 680 | ||
| What Happened? | 681 | ||
| The Struggle to Find Help | 681 | ||
| We Got Help—But What About Others? | 681 | ||
| Opportunities for Advocacy | 682 | ||
| Reference | 685 | ||
| 97 Taking Action: The Canary Coalition for Clean\rAir in North Carolina’s\rSmoky Mountains | 686 | ||
| The Canary Coalition at Work | 686 | ||
| The Connections Between Environmental Activism and Nursing | 688 | ||
| Political Strategies | 689 | ||
| Together We Stand | 689 | ||
| Walking the Talk | 689 | ||
| Is Environmental Stewardship A Luxury? | 689 | ||
| Stepping Up | 690 | ||
| References | 690 | ||
| 98 Taking Action: The Nightingales Take on\rBig Tobacco | 691 | ||
| Ruth’s Story | 691 | ||
| The Personal Becomes Political | 691 | ||
| Compelling Voices | 692 | ||
| Strategic Planning | 693 | ||
| Kelly’s Story: “the Nurses are Coming…” | 693 | ||
| Extending the Message | 696 | ||
| What Nurses Can Do | 697 | ||
| Nursing is Political | 698 | ||
| Lessons Learned | 698 | ||
| References | 698 | ||
| 99 Lactivism: | 700 | ||
| Why Advocate for Breastfeeding? | 700 | ||
| The Historic Decline in Breastfeeding in The U.S. | 700 | ||
| Action to Support Breastfeeding | 701 | ||
| Federal Efforts | 701 | ||
| State Efforts | 704 | ||
| Breastfeeding Advocacy Organizations | 704 | ||
| Hospital Policies | 704 | ||
| The Need for Breastfeeding Advocacy Education | 704 | ||
| Summary | 705 | ||
| References | 705 | ||
| 100 Taking Action: Postpartum Depression: The\rConvergence of Media Coverage\rand Community Activism to\rInfluence Health Policy | 706 | ||
| Introduction | 706 | ||
| One Media Portrayal of Postpartum Depression | 706 | ||
| Background on Postpartum Depression | 707 | ||
| Baby Blues | 707 | ||
| Postpartum Depression | 707 | ||
| Postpartum Psychosis | 707 | ||
| Magnitude of the Problem | 707 | ||
| Melanie Stokes’ Story | 708 | ||
| The Media’s Role in Changing Policy | 708 | ||
| Action in Response to Media Attention to Melanie’s Death | 709 | ||
| U.S. House Action | 709 | ||
| U.S. Senate Action and Legislative Success | 709 | ||
| Analyzing the Media’s Influence | 710 | ||
| Summary | 710 | ||
| References | 710 | ||
| 101 Nursing in the International Community: | 711 | ||
| Globalization | 711 | ||
| Migration: a Case in Point | 712 | ||
| The Global Workforce Crisis and Millennium Development Goals | 715 | ||
| Poverty | 716 | ||
| HIV/AIDS | 717 | ||
| Nursing, Governments, and the World Health Organization | 718 | ||
| The World Health Organization | 718 | ||
| National Governments | 719 | ||
| Nursing’s Policy Voice | 719 | ||
| Partnerships and Strategic Alliances: a Way Forward | 719 | ||
| Getting Involved | 720 | ||
| References | 721 | ||
| 102 Taking Action: Ugandan Nurses Leading Health\rPolicy Change | 722 | ||
| The Challenge in Uganda | 722 | ||
| The Strategy | 724 | ||
| Lessons Learned | 725 | ||
| References | 726 | ||
| 103 Emerging and Reemerging Infectious Disease: | 727 | ||
| Background | 727 | ||
| Defining Emerging and Reemerging Infections | 727 | ||
| A Global Concern | 728 | ||
| Avian Influenza A (H5n1) | 728 | ||
| West Nile Virus | 728 | ||
| Sars Coronavirus | 729 | ||
| Monkey Pox | 729 | ||
| 2009 Pandemic H1N1 Influenza | 730 | ||
| Global Surveillance and Reporting | 730 | ||
| Surveillance and Reporting Systems | 731 | ||
| Immunization Policy | 731 | ||
| Quarantine Policy | 731 | ||
| Travel and Immigration Policy | 732 | ||
| Restrictions Related to the Importation of Food and Animals | 732 | ||
| Summary | 733 | ||
| References | 733 | ||
| 104 Human Trafficking: | 735 | ||
| The Myths | 736 | ||
| Trafficking as a Global Public Health Issue | 736 | ||
| International Policy | 737 | ||
| U.S. Response to Human Trafficking | 738 | ||
| State Legislation and Policy on Human Trafficking | 738 | ||
| Professional Nursing Associations | 739 | ||
| Summary | 739 | ||
| References | 739 | ||
| APPENDIX A The Affordable Care Act: Historical Context and an Introduction to the State of Health Care in the United States | 741 | ||
| Direct Impacts on Nursing as a Health Workforce | 744 | ||
| Funding | 744 | ||
| Patients | 745 | ||
| Nursing | 745 | ||
| Education and Loan Repayment. | 745 | ||
| Nursing Services. | 745 | ||
| Regulation of Practice | 745 | ||
| Indirect Impacts on Nursing | 745 | ||
| Regulations | 746 | ||
| Federal Oversight | 746 | ||
| State Exchanges | 749 | ||
| Third-Party Payers | 749 | ||
| Employers | 749 | ||
| Health Care Delivery Models: Affordable Care Organizations | 750 | ||
| Individual Mandate | 750 | ||
| Overall Cost of the ACA | 750 | ||
| Cost for Individuals and Households | 750 | ||
| Political and Implementation Challenges | 751 | ||
| Conclusion | 751 | ||
| References | 751 | ||
| Appendix B Health Policy Internships and Fellowships | 753 | ||
| Index | 763 | ||
| A | 763 | ||
| B | 765 | ||
| C | 766 | ||
| D | 770 | ||
| E | 771 | ||
| F | 772 | ||
| G | 773 | ||
| H | 774 | ||
| I | 776 | ||
| J | 777 | ||
| K | 778 | ||
| L | 778 | ||
| M | 779 | ||
| N | 781 | ||
| O | 783 | ||
| P | 784 | ||
| Q | 787 | ||
| R | 787 | ||
| S | 788 | ||
| T | 790 | ||
| U | 791 | ||
| V | 792 | ||
| W | 792 | ||
| Y | 793 |