Priority setting and policy advocacy by nursing associations: a scoping review and implications using a socio-ecological whole systems lens

Through a Tainted Lens: A Qualitatve Study of Medical Learners' Thinking About Patient 'Deservingness' of Health Advocacy

Introduction

While health advocacy is a key component of many competency frameworks, mounting evidence suggests that learners do not see it as core to their learning and future practice. When learners do advocate for their patients, they characterize this work as 'going above and beyond' for a select few patients. When they think about advocacy in this way, learners choose who deserves their efforts. For educators and policymakers to support learners in making these decisions thoughtfully and ethically, we must first understand how they are currently thinking about patient deservingness.

Methods

We conducted qualitative interviews with 29 undergraduate and postgraduate medical learners, across multiple sites and disciplines, to discuss their experiences of and decision-making about health advocacy. We then carried out a thematic analysis to understand how learners decided when and for whom to advocate. Stemming from initial inductive coding, we then developed a deductive coding framework, based in existing theory conceptualizing 'deservingness.'

Results

Learners saw their patients as deserving of advocacy if they believed that the patient: was not responsible for their condition, was more in need of support than others, had a positive attitude, was working to improve their health, and shared similarities to the learner. Learners noted the tensions inherent in, and discomfort with, their own thinking about patient deservingness.

Discussion

Learners' decisions about advocacy deservingness are rooted in their preconceptions about the patient. Explicit curriculum and conversations about advocacy decisions are needed to support learners in making advocacy decisions equitably.

Maximizing the potential value of the nursing workforce

This panel paper is the fifth installment in a six-part Nursing Outlook special edition based on the 2022 Emory Business Case for Nursing Summit. The 2022 summit convened national nursing, health care, and business leaders to explore possible solutions to nursing workforce crises, including the nursing shortage. Each of the summit's four panels authored a paper in this special edition on their respective topic, and this panel paper focuses on maximizing the potential value of the nursing workforce. It addresses topics including the need to create a nursing-inclusive federal health care billing system improve nursing salaries by designing/testing nurse-informed compensation models, and strengthen nursing's national professional infrastructure.

Necessary political competences for nurses from the perception of the student body: Cross-sectional study in Spain

BACKGROUND

Nursing should have a fundamental role in the development of health policies. The current state of the educational system regarding leadership-related skills and political competence in nursing students is a field to explore.

OBJECTIVES

To explore Spanish nursing students' perceptions about their political competence.

DESIGN

Cross-sectional study that was carried out between December 2019 and June 2020.

SETTINGS AND PARTICIPANTS

Students of the Degree in Nursing at the Universitat Jaume I (Spain).

METHODS

An ad hoc scale composed of 33 items was designed. Sociodemographic variables of interest for the study were collected, such as participation in organizations. A descriptive analysis of the sample and the scale and a bivariate analysis were carried out.

RESULTS

91.8% (n = 90) of items were answered by women. The 2nd (40.8%, n = 40) and 4th (29.6%, n = 29) courses were the most represented. 29.6% (n = 29) belonged to some association or organization, with sports (31.1%, n = 9), NGOs (17.2%, n = 5), cultural (17.2%, n = 5) and student organizations (13.8%, n = 4) being the most represented. Within these associations, 48.3% (n = 14) of participants claimed to have an active role. Statistically significant differences were observed by course in the Political Knowledge category (p = 0.030). The variables "belonging to an organization" and "having an active role" in it seemed to have more influence on the scale than the rest of the sociodemographic variables.

CONCLUSIONS

Learning strategies must benefit from skills and prior experiences of students to strengthen new learning. It also seems to be important to emphasize that the theoretical basis is important, but that promoting civic participation among students can be very relevant for the acquisition of political competence.

Policy Advocacy and Nursing Organizations: A Scoping Review

Policy advocacy is a fundamental component of nursing's social mandate. While it has become a core function of nursing organizations across the globe, the discourse around advocacy has focused largely on the responsibilities and accountabilities of individual nurses, with little attention to the policy advocacy work undertaken by nursing organizations. To strengthen this critical function, an understanding of the extant literature is needed to identify areas that require further research. We conducted a scoping review to examine the nature, extent, and range of scholarly work focused on nursing organizations and policy advocacy. A systematic search of six databases produced 4,731 papers and 68 were included for analysis and synthesis. Findings suggest that the literature has been increasing over the years, is largely non-empirical, and covers a broad range of topics ranging from the role and purpose of nursing organizations in policy advocacy, the identity of nursing organizations, the development and process of policy advocacy initiatives, the policy advocacy products of nursing organizations, and the impact and evaluation of organizations’ policy advocacy work. Based on the review, we identify several research gaps and propose areas for further research to strengthen the influence and impact of this critical function undertaken by nursing organizations.

Advancing Nursing Policy Advocacy Knowledge: A Theoretical Exploration

Nursing policy advocacy continues to be recognized as a key part of a nurse's role by educators, professional associations, and regulators. Despite normative calls on nurses to engage in political action and advocacy, limited theories, models, and frameworks exist to support this practice within nursing. Using Walt and Gilson's Health Policy Triangle Framework, this article explores the theoretical underpinnings of policy advocacy to enhance nursing's contemporary role in advancing social justice. Specific consideration is placed on the type of nursing and policy knowledge and perspectives required to understand policy content, contexts, processes, and actors.

Charting a Research Agenda for the Advancement of Nursing Organizations’ Influence on Health Systems and Policy

Nursing organizations across Canada play a significant role in influencing and shaping public policy. 2020, the Year of the Nurse and the Midwife, is an opportune time not only to support nurses in building policy leadership but also to explore opportunities to better understand and strengthen the policy advocacy work of nursing organizations. Given various social, political, and economic forces, the nature of organized nursing across Canada is changing significantly. We draw on recent key national and global events including our systematic inquiry into Canada’s 2019 federal election, the Year of the Nurse and Midwife, and the Coronavirus pandemic to examine how Canadian nursing organizations respond in highly complex and evolving contexts. We use our observations to offer a vision and chart a research agenda for the advancement of nursing organizations’ influence on health systems and policy. Specifically, we focus on three key areas including examining nursing organizations’ policy agendas and spheres of influence; nursing organizations’ decision-making around policy advocacy tactics and engagement approaches; and the impact of policy advocacy coalitions and networks on nursing organizations’ influence.

Politics, power, and predictability of nursing care

This article explores the role of politics, power, and the use of data in arenas from hospitals to governments, analyzing how multiple stakeholders, including nurses, influence policy development. As the largest health profession in the world, nurses can wield great power when they work collaboratively with others and use evidence about health care outcomes to enact important changes in health policy.

Reaching out: Organizational structures and public communication of nursing professional associations and trade unions in Portugal

AIM

To describe the organizational structure and resources for strategic mediacommunication of nursing professional associations and trade unions in Portugal.

DESIGN AND METHODS

Quantitative study, with a cross-sectional, exploratory/descriptive design. From October to November 2017, a questionnaire was sent to 21 nursing professional associations and trade unions in Portugal. Eleven (52.4%) organizations replied: nine professional associations and two trade unions.

RESULTS

The participating organizations rely on basic structures regarding strategic communication: 54.5% of them have less than 500 members; 63.6% of them have no communication budget; 54.5% of them have no formal communication structure, and only 27.3% of them hold events for the purpose of media coverage. Consequently, most of these organizations have occasional interactions with journalists, create messages about nursing problems, and directed mostly to nurses, perpetuating a circular communication.

CONCLUSION

Nursing professional organizations have limited resources and lack of formal communication structures. The restricted interaction with the media and the "echoing" voice that propagates within the profession may hinder citizens' full understanding of its contribution. Nursing organizations must develop a nation-wide strategy that promotes transversal collaboration and resources optimization, with the purpose of increasing their media visibility and strengthening their Public Health mission.

Contestations and complexities of nurses' participation in policy-making in South Africa

Background

There has been increased emphasis globally on nurses’ involvement in health policy and systems development. However, there has been limited scholarly attention on nurses’ participation in policy-making in South Africa.

Objective

This paper analyses the dynamics, strengths, and weaknesses of nurses’ participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD) remuneration policy.

Design

Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software.

Results

The study found that nurses’ participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses’ participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses’ views and inputs were considered and incorporated.

Conclusions

The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.

Forging a strong nursing future: insights from the Canadian context

Canadian nurses, with their colleagues around the globe, are experiencing waves of change in their practice and work lives, and in expectations of how they will continue to make a difference for health and health care. We describe how Canadian nurses have been called to action to lead system wide changes in nursing practice, and to influence the wider public policy arenas for health. We aim to add to the growing international awareness of the status of nursing prompted by the Francis inquiry by offering our analysis of nursing practice and nursing leadership in Canada, in the context of the dominance of a managerial culture in health care systems. A review of prior commission reports, task forces and research reports sheds light on strategies needed to support nurses to address today’s challenges in nursing practice, including staff and skill mix determinations. We share our reflection on the current situation in Canadian nursing as a basis for learning about how our issues compare and contrast with others profiled in the journal. Our goal is to join with colleagues from Canada and other countries to forge a strong future – a future in which nursing’s voices are clearly heard in practice and policy decision-making, and where our knowledge and actions actualise societal health.

2014 Future Earth Young Scientists Conference on integrated science and knowledge co-production for ecosystems and human well-being

Effective integration in science and knowledge co-production is a challenge that crosses research boundaries, climate regions, languages and cultures. Early career scientists are crucial in the identification of, and engagement with, obstacles and opportunities in the development of innovative solutions to complex and interconnected problems. On 25-31 May 2014, International Council for Science and International Social Science Council, in collaboration with the International Network of Next-Generation Ecologists and Institute for New Economic Thinking: Young Scholars Initiative, assembled a group of early career researchers with diverse backgrounds and research perspectives to reflect on and debate relevant issues around ecosystems and human wellbeing in the transition towards green economy, funded by the German Research Foundation, at Villa Vigoni, Italy. As a group of young scientists, we have come to a consensus that collaboration and communication among a diverse group of peers from different geographic regions could break down the barriers to multi-disciplinary research designed to solve complex global-scale problems. We also propose to establish a global systematic thinking to monitor global socio-ecological systems and to develop criteria for a "good" anthropocene. Finally, we aim to bridge gaps among research, the media, and education from a governance perspective linking with "sustainable development goals".