APNs as Policy Healthcare Leaders

How Healthcare Policy Can Impact the APN (Advanced Practice Nurse) Profession

There has been volatile debate about policy reformation and the practice scope in all states in the United States. Nurse practitioner’s practice scope policy has arguably been stated to affect care access. Following the fact that over half of Americans have experienced the challenges of inadequate access to health care economically, societally, and personally, policy reform by the U.S. Department of Health and Human Services (HHS) has aimed to eliminate the scope of practice restrictions at the state level for nurse practitioners (Patel, Petermann, & Mark, 2019). The supporters of removing policies on the range of practice of nurse practitioners state that the policies strategically prevent the nurse professionals from practicing to their maximum capacity to enhance care access (Patel, Petermann, & Mark, 2019). Patel, Petermann, & Mark (2019) state that restrictive nurse practitioner scope of practice policies may constrain the ability of nurse practitioners to deliver all the healthcare services they are trained and built to perform. The requirements in the policy, such as physician supervision, can also restrict nurse practitioners from providing care to persons living in underserved or under-resourced places because there are low numbers of physicians in such areas to provide supervisory roles to the nurse practitioners (Goodfellow et al., 2016). Besides, physician supervisors may oblige nurse practitioners to remunerate them for supervisory work, making it even more challenging for nurse practitioners’ practices to be more financially feasible or even to provide care for uninsured patients and those insured by the government (Patel, Petermann, & Mark, 2019).

On the other hand, those who support the nurse practitioner scope of practice policies are mainly physicians who claim that removing these policies can negatively impact patient outcomes and safety (Hain & Fleck, 2014). However, no solid studies have demonstrated that advanced nurses’ care is of poor quality or unsafe. On the contrary, many studies have shown that nurse practitioner-delivered care is better or equal to that of physicians in similar care settings (Patel, Petermann, & Mark, 2019).

Why Advocacy is Considered an Essential Component of the APN’s Role

One of the procedures in advanced care emphasized by nursing organizations worldwide is nursing or patient advocacy. Davoodvand, Abbaszadeh, & Ahmadi (2016) believe that advocacy shows the expert power of nursing and assists in providing quality care. Overall, advocacy refers to defending the property and rights of other people (Davoodvand, Abbaszadeh, & Ahmadi, 2016). In nursing, it entails representing patients by defending their universal rights and patient rights, supporting the patients’ decisions, contributing to the decision-making process, and protecting the patient’s interests (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Nurses are often the first responders to the needs of the patients. More often than not, patients complain about inappropriate verbal communication with their nurses (Davoodvand, Abbaszadeh, & Ahmadi). Therefore, they choose the nurses whom they feel have a connection with them as their advocates. Since patients believe that the nurses with whom they have a connection are their advocates, they respond positively to their suggestions and advice, thus increasing quality care outcomes. For example, Davoodvand, Abbaszadeh, & Ahmadi (2016) write that advocacy enhances empathic patient-centered care and that patients constantly measure their nurses’ humanistic behavior and empathy. When a nurse responds to a patient’s needs with empathy, the nurse assists the patient and their family members in adapting to their health challenges, increasing patient protection (Bry et al., 2016).

Moreover, the essence of any nursing profession is grounded in the basic concern of the needs of the underprivileged and impoverished in society, including physical, emotional, and social needs (Williams, Phillips, & Koyama, 2018). Also, it is less likely that economically and socially underprivileged groups in society are healthy. Most of them die prematurely and cannot access quality care services than the economically and socially advantaged (Williams, Phillips, & Koyama, 2018). In the U.S., uninsured people, people who live in poverty, people of color, and the disabled endure the burden of health inequities (Williams, Phillips, & Koyama, 2018). Since nurses’ role entails promoting quality health care, advocacy is rooted in their role to defend the right social policies that promote health equity, fairness, and justice and address social determinants of health.

Four Pillars of Transformational Leadership and the Effect on Influencing Policy Change

The first pillar of transformational leadership is idealized influence. This pillar builds trust, honor, approval, and confidence, thus providing the employees with a sense of direction (Doody & Doody, 2012). This happens when nurse leaders are role models to other staff members. When a nurse is a role model to others, it becomes easier for other staff members to embrace change or any new policies and initiatives that are to be executed.

The second pillar is inspirational motivation. Inspirational motivation entails posing encouragement to others to attain the aspirations and goals of the organization while at the same time achieving one’s own aim (Doody & Doody, 2012). Motivation influences client care and performance as nurse leaders may communicate high expectations to other staff members and encourage them to share the same vision in the organization (Doody & Doody, 2012). This happens when nurse leaders involve frontline employees in the policy change committees, which would encourage empowerment to employ the policy change.

The third pillar is intellectual stimulation, which refers to challenging staff beliefs and encouraging staff innovation (Hall et al., 2002). According to Doody & Doody (2012), transformational leaders encourage new ideas and proposals, thus empowering the staff members to have new approaches to problems using evidence-based practices. Since the nursing profession is constantly changing due to the changing dynamics in the market, challenging nurses who are always in close contact with patients would facilitate proper policy changes. Besides, nurses understand the needs of patients more than other professionals because of their proximity and familiarity with the patients and their needs.

The last pillar is individualized consideration, which entails leaders encouraging and supporting others to strive for excellence (Hall et al., 2002). When a nurse leader acts as a coach to others, the others look up to and learn from them, making it easier to employ suggested policy changes.

Conclusion

In summary, advocacy should be central in the advanced nursing profession as nurses are key responders to the needs of patients. This means that policy changes that affect the health of society must include the participation of nursing professionals, particularly transformational leaders.

References

Bry, K., Bry, M., Hentz, E., Karlsson, H. L., Kyllönen, H., Lundkvist, M., & Wigert, H. (2016). Communication skills training enhances nurses’ ability to respond with empathy to parents’ emotions in a neonatal intensive care unit. Acta Paediatrica, 105(4), 397-406.

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: a qualitative study. Journal of medical ethics and history of medicine, 9.

Doody, O., & Doody, C. M. (2012). Transformational leadership in nursing practice. British journal of nursing, 21(20), 1212-1218.

Goodfellow, A., Ulloa, J. G., Dowling, P. T., Talamantes, E., Chheda, S., Bone, C., & Moreno, G. (2016). Predictors of primary care physician practice location in underserved urban and rural areas in the United States: a systematic literature review. Academic medicine: journal of the Association of American Medical Colleges, 91(9), 1313.

Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. The Online Journal of Issues in Nursing, 19(2).

Hall, J., Johnson, S., Wysocki, A., & Kepner, K. (2002). Transformational Leadership: The Transformation of Managers and Associates: HR020/HR020, 7/2002. EDIS, 2002(2).

Patel, E. Y., Petermann, V., & Mark, B. A. (2019). Does state-level nurse practitioner scope-of-practice policy affect access to care? Western journal of nursing research, 41(4), 488-518.

Williams, S. D., Phillips, J. M., & Koyama, K. (2018). Nurse Advocacy: Adopting a health in all policies approach. Online Journal of Issues in Nursing, 23(3).

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Question

Week 7: APNs as Healthcare Policy Leaders (Orig Post due Wednesday, Responses due Sunday)
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Purpose
The purpose of this assignment is to discuss the healthcare policy of the APN profession and how transformational leadership can help influence policy changes. This week’s assignment focuses on the APN as a Health Policy Leader, one of the nine NONPF NP competencies. Students will analyze how health policy may affect NP practice and how transformational leadership can help influence policy changes.

APNs as Policy Healthcare Leaders

Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:

Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic, and political factors (CO2)
Demonstrate professional and personal growth concerning the advocacy role of advanced practice nursing in fostering policy within diverse healthcare settings (CO3)
Advocate for institutional, local, national, and international policies that foster person-centered healthcare and nursing practice (CO4)
Due Date: Wednesday of week 7 by 11:59 PM MST
Initial responses to the discussion topic must be posted by Wednesday 11:59 pm MT. Two additional posts to peers and/or faculty are due by Sunday at 11:59 pm MT. Students are expected to submit assignments by the time they are due.

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 7, regardless of the number of days late. NOTHING will be accepted after 11:59 pm MT on Sunday (i.e., the student will receive an automatic 0).

Total Points Possible: 100
Requirements:
Criteria for Content

Explanation of how healthcare policy can impact the advanced practice nurse profession
Explanation of why advocacy is considered an essential component of the advanced practice nurse’s role
Discuss the four pillars of Transformational leadership and the effect it may have on influencing policy change.
A scholarly resource must be used for each week’s discussion question.
DISCUSSION CONTENT

APNs as Policy Healthcare Leaders