Broadly speaking, health policy is a course of action that influences health care decisions (www.aacn.org). Public policy refers to policy that is generated by governmental agencies and enacted through legislation. Public policy is made on behalf of the public and is influenced by factors such as economics, social issues, research, and technology. Health policy influences decisions about the health of a society. Similar to public policy, health policy is also influenced by factors such as health status of the citizenry, research, and economics. Health policy can be developed and implemented:

• on an institutional level to address workplace issues, such in hospitals to establish limitations on the number of patients an RN can care for;
• or to shape nursing practice through professional organization policies by established standard of care or a code of ethics;
• or to promote healthy communities through community, regional, or national policies, e.g., improving air quality or implementing health screening processes.

As the single largest group of health care providers, nurses are in a powerful position to influence public and health policy on all levels. Efforts devoted to strengthening the voice and presence of nursing within the policy arena can shape the health care delivery system, as well as highlight the value and contributions of the nursing profession to the health and well being of society.

Getting Involved in the Public and Health Policy Arena

Once you have decided to get involved in the policy arena, you must first familiarize yourself with policy and politics. Cohen, Mason, Kovner, Leavitt, Pulcini, and Solchalski (1996) developed a model that provides a framework for professional nurses and political development. The model describes the process of political development in terms of stages/phases.

Stage One: Buy-In
This stage occurs when individual nurses decide to take a position on a particular issue. The interested parties are reacting to an issue that may affect the profession or the health of the public. Individuals decide to become actively involved.

Stage Two: Self-Interest
During this stage, the individuals begin to establish their identity as a political voice. Individuals organize and develop strategies to resolve the particular issue.

Stage Three: Political Sophistication
At this stage, the politically interested nurses seek to influence policymakers and other health care stakeholders to make them aware of the value and contributions of nursing to particular public and health policy. Nurses are testifying before legislative committees on various health issues and are appointed to advisory boards and policy-making bodies.

Stage Four: Leading the Way
This stage marks the highest level of political involvement. Nurses are very involved in setting the agenda and initiating policy development, which is often enacted through the legislative process.

Several nursing and health care organizations in New Jersey have lobbyists, who monitor bills and regularly testify in Trenton. For example, The New Jersey State Nurses represents RNs by monitoring bills and regularly testifying. The New Jersey Hospital Association, the Home Health Assembly, and the Health Care Association of New Jersey each represent their constituencies in a similar manner. Check out their web sites on our Home Page, Members, for more specific information about this organizations.

Cohen, S., Mason, D., Kovner, C., Leavitt, J., Pulcini, J., & Solchalski, J. (1996). Stages of nursing’s political development: Where we’ve been and where we ought to go. Nursing Outlook, 44(1), 20-23.

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