Creating Change Through Advocacy

Creating Change Through Advocacy

Directions: Identify a problem or concern in your state, community, or organization that has the capacity to be advocated through legislation. Research the issue and complete the sections below.

Problem In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues.
A problem of concern in the State of Florida is the current nursing shortage. As of 2022, the State of Florida had a population of 22,244,823 and only 197,630 registered nurses employed in 2022 (nursejournal.org, 2023). This translates to 8.8 nurses per 1000 people in the state. This is below the national average of 9.22 registered nurses per 1000 people. Based on data projections, the availability of registered nurses and licensed practical nurses (LPNs) between 2019 and 2035 is expected to increase by 50,700 (22%) and 4,000 (9%) respectively. However, the demand for RNs and LPNs in Florida between 2019 and 2035 is projected to increase by 76,600 (31%) and 20,200 (40%) respectively (Iacobucci et al., 2021). If the current nursing shortage trends from 2019 of 11,500 RNs and 5,600 LPNs lower than demand continue, the state of Florida is expected to have a total deficit of 37,400 RNs and 21,700 LPNs totaling a shortage of over 59,000 nurses. The nursing shortage issue in Florida has significant effects on the entire healthcare system, including the people of Florida, the current patient population in outpatient and inpatient settings, hospitals, clinics, and other healthcare facilities and settings. Current nursing shortages are causing longer wait times, poor quality of care, increased nurse burnout, increased rate of intentions to leave, and a risk of compromised nursing care safety. If the shortage continues, the state of Florida risks increased strain on and collapse of its healthcare system, reduced overall population health, and high costs of care.
Idea for Addressing Solution In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy.
My idea for addressing the nursing shortage in Florida is advocacy through legislation focused on nursing education. In the proposed legislation, Florida’s government will be required to develop nursing education legislation that provides funding aimed at increasing the number of clinical training institutions for registered nurses and the supply and support for a qualified nursing faculty for these nurse training institutions. I believe that legislation is the best way for advocate for a number of reasons. First, legislation can effectively support the establishment of nurse training institutions and ensure support for the nursing faculty as it will ensure mandated funding for the institutions, including their establishment, supply of teaching and study materials, and providing adequate pay for the faculty to encourage them to work in such institutions across Florida. Legislation targeted at nursing education is also the best way to address the nursing shortage crisis in Florida as it will also provide sufficient funding for nursing students including LPNs and RNs interested in advancing their nursing education to enroll in the various nursing education without the concern over the financial burden. The legislation-backed funding can also support the acquisition of technologies that support nursing education, including support for blended learning. Therefore, legislation focused on increasing nurse training institutions and faculty will ensure that more people and nurses enroll in nursing and career development programs, ensuring continuous availability of qualified nurses in Florida’s healthcare system to meet the growing healthcare demands and needs of the state’s growing population.
Research the Issue Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (research studies, reports, etc.). Include any similar legislation introduced or passed in other states.
Evidence 1: The article by Brant et al. (2019) focused on nursing care in palliative care agrees on the shortage of nurses in palliative care settings, which is a highlight of the nursing supply shortages in global healthcare systems. The article identifies financial burden as a major barrier to nursing education focused on palliative care provision. The authors argue that increasing the necessary resources and development of multifaceted interventions that facilitate education in related settings to help improve the supply and meet global demands.
Evidence 2: Mlambo et al. (2021) in their article argue that continuing professional development (CPD) is essential to nurses’ lifelong learning. Lifelong learning supports care development and central to ensuring nurses keep their nursing knowledge and skills are up-to-date. The findings of the study define lack of funding resources as one of the major barriers to nurses’ pursuing CPD. The authors conclude that nurses value CPD as fundamental to professionalism and lifelong learning and providing financial support can help them overcome the perceived barriers to CPD.
Evidence 3: The report by Daw et al. (2018) reviews the Nurse Educator Doctoral Grants for Practice and Dissertation Research (NEDG) program in Maryland. The grant program launched in 2012 supported doctoral degree completion for full-time nurse faculty. The authors related nursing faculty shortages to the shortages in the supply of qualified nurses. The review of the program found that it reduced personal debt and increased the number of nurse educators with doctoral degrees. The grant program is expected to increase the supply of qualified nurses in Maryland.
Stakeholder Support Discuss the stakeholders who would support the proposed idea and explain why they would be in support.
Stakeholder(s) Supporting 1	Nursing students and nurses in practice: Nursing students and current nurses in practice would support the idea of legislation that aims to increase the funding for more nurse training facilities and faculty funding, as this will increase learning opportunities for new nurses and those who have career advancement intentions.  Additionally, increased funding for institutions and faculty will also mean more scholarships, grants, and loans for nursing students. Increased funding for faculty will guarantee qualified nurses graduating from these new institutions as more faculty members can be retained.
Stakeholder(s) Supporting 2	Healthcare organizations and facilities such as hospitals, clinics, and nursing homes: Healthcare organizations and facilities would support the idea of this legislation as such institutions would largely benefit from the substantial supply of qualified nurses who would improve the clinical and operational efficiency of the facilities.
Stakeholder Opposition Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations.
Stakeholder(s) Opposed 1	Anti-taxation advocacy groups: Groups that are against increased government expenditure which increases the rates of taxation to raise the funding for the new institutions and faculty. I will base my conversation with such groups by providing current statistics on shortages and how such shortages are contributing to increased costs of care, delays in care delivery, and avoidable and preventable patient harm and deaths.
Stakeholder(s) Opposed 2	Current physicians and advanced practice nurses (APNs): Physicians and APNs would oppose the idea as it would mean more qualified nurses and increase job market competition. I would prepare for my conversation with these stakeholders by reviewing current evidence on nursing shortages and the impact on the current physicians’ and APNs’ workload, work-life balance, resulting burnouts, and dissatisfaction with their work, and how the increasing availability of qualified nurses would improve the efficiency in the workplace.
Financial Incentives/Costs In no more than 250 words, summarize the financial impact of the issue and the idea (added costs, cost savings, increased revenue, etc.). Provide support (may include references from the “Research Your Issue” section).
The nursing shortage has a negative financial impact due to a number of factors. With a high demand for nursing care services and a reduced supply of nurses, there is reduced access to healthcare services including preventive care services and interventions. It has also led to reduced work satisfaction among nurses and reduced efficiency (Brant et al., 2019). This definitely leads to poor health outcomes and increases expenditure and added costs. The legislation idea proposed although will require a substantial initial investment, has the potential to improve savings in the long term on healthcare access, quality, costs, safety, and revenue.  Evidence from a review of the Nurse Educator Doctoral Grants for Practice and Dissertation Research (NEDG) program in Maryland showed that the total funding for a total of 98 recipients between 2013 and 2018 cost a total of $2,350,000 (Daw et al., 2018). Considering the infrastructure and other costs related to an entire nursing school, the initial investment is expected to add costs to the state’s expenditure. However, the institutions are expected to lead to a sustainable supply of competent nurses, both RNs and APNs, who will help meet the healthcare demands of the state and the country. The sustained supply of nurses is expected to improve access to quality and timely care. This is expected to improve patient and population health outcomes which would reduce the burden of disease and related costs in the long-term.
Legislature: Information Needed and Process for Proposal Discuss how to advocate for your proposal using legislation. Include the following:
Provide the name and complete contact information for the legislator.		The legislator to contact for the legislation is Congresswoman Frederica Wilson. She is the representative of the 24th District in Florida. Her contacts include: 1.      Washington DC office 2080 Rayburn House Office Building Washington, D.C. 20515 (202) 225-4506 2.      Miami Gardens Office 18425 NW 2nd Avenue Miami Gardens, FL 33169 (305) 690-5905 3.      West Part Office West Park City Hall 1965 South State Road 7 West Park, FL 33023 (954) 989-2688
Describe the steps needed to present this to your legislator.		Presenting the legislation idea to the legislator will require proper preparations to ensure the proposal is accepted and presented to the House for debate. To start with, I will carry out sufficient research and review of current statistics to substantiate my argument in the presented idea. I will then prepare a comprehensive paper on the idea and then schedule a meeting with Congresswoman Frederica Wilson at her office. After gaining an audience with the congresswoman, I would then clearly present the issue of nursing shortage in Florida, present data and available evidence, clearly articulate my proposed solution, and present evidence to back the potential benefits of the solution that involved increasing the number of nurse training institutions. I will also provide time for the Congresswoman to ask questions related to the issue and the proposed solution. I will then provide the Congresswoman with a copy of the developed paper on the issue, solution, and supporting documents for reference.
Interprofessional Collaboration in the Legislative Arena In no more than 250 words, discuss the role interprofessional collaboration plays in advocacy through legislation.
Interprofessional collaboration plays an essential role in advocacy through legislation. First, since the healthcare system has multiple players in diverse fields, such as healthcare professionals, nurse educators, healthcare administrators, policymakers, insurance providers, and investors in healthcare learning institutions, interprofessional collaboration allows for the development of stronger advocacy alliances that can help handle the opposition to the proposed legislation. Interprofessional collaboration leverages on multidisciplinary expertise and perspectives in healthcare settings to improve the power and outcomes of advocacy (Domínguez et al., 2020). This further makes it possible to develop multifaceted perspectives to inform the legislation and achieve desirable outcomes. Interprofessional collaboration is also essential in the legislative arena as it further utilizes the power of numbers and multiple perspectives to present the legislative idea to legislators. Presenting a legislation proposal backed by a large number of professionals with diverse perspectives gives the proposal more credibility. This can push policymakers and legislators to appreciate the seriousness and urgency of the issue and push toward debating and passing the piece of legislation. Most importantly, interprofessional collaboration in the legislative advocacy process ensures that the stakeholders can pool resources required to support research to provide evidence and support the proposal as well as for successful lobbying for the idea. At the same time, collaboration for advocacy through legislation further helps grow trust and collaborative skills among healthcare professionals and providers, which can improve collaborations in practice and healthcare service delivery.
Leadership Competencies and Styles The American Organization of Nurse Executives (AONE) has identified leadership competencies relevant for nurse leaders to guide practice within the health care system. Describe two leadership competencies identified by the AONE that would also be necessary for a nurse to advocate for the legislative solution you have proposed. Discuss how the theory of servant leadership supports these competencies. This section should be addressed in no more than 250 words.
Two AONE leadership competencies relevant for nurse leaders to guide practice within the health care system and that would also be necessary for a nurse to advocate for the legislative solution proposed are communication and relationship-building and business skills and principles. The communication and relationship-building competence is applicable in advocating for my proposed legislative solution as it would require a lot of effective communication and building and management of interprofessional relationships in order to push for the legislation. Effective communication will ensure that I can effectively present the idea to the various stakeholders in the healthcare environment as well as the chosen legislator. Additionally, pushing for the legislation through lobbying will require creating the right and strong relationships that can persuade the legislators to pass the piece of legislation. On the other hand, competence in knowledge of business skills and principles is important as starting and financing a nursing school requires knowledge of financial matters and managing a business. This competence will help me provide financial estimations and projections that promise better outcomes that can persuade the passing of the legislation. The theory of servant leadership requires placing the needs of others first. By prioritizing the needs of others, it is possible to create an environment that promotes engagement of stakeholders and the development of trustful relationships that can promote advocacy for the legislation. It can also promote better collaboration among various professionals, including healthcare and financial professionals, to provide evidence to support the proposal.
Christian Principles and Nursing Advocacy In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc.
The Christian worldview argues that all humans were created in the image and likeness of God. This means that all people are equal. The principles of the Christian worldview promote empathy, compassion, justice, and inclusiveness. This means that we all need to work together towards achieving a world of equity and justice in which all people have access to the best care. These principles can be applied and provide support to the legislative advocacy in healthcare without bias as the main argument in the legislation idea is to improve the number of nurses so that care can be available to all people. This proposal therefore aligns with the principles of equity, justice, and inclusiveness in the delivery and access to healthcare service regardless of an individual’s social and economic status, gender, race, or other cultural beliefs.

 References

 Brant, J. M., Fink, R. M., Thompson, C., Li, Y. H., Rassouli, M., Majima, T., Osuka, T., Gafer, N., Ayden, A., Khader, K., Lascar, E., Tang, L., Nestoros, S., Abdullah, M., Michael, N., Cerruti, J., Ngaho, E., Kadig, Y., Hablas, M., … Silbermann, M. (2019). Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care. Journal of Palliative Medicine, 22(8), 945–960. https://doi.org/10.1089/JPM.2018.0566

Daw, P., Seldomridge, L. A., Battistoni, S., & Belcher, A. E. (2018). Increasing the number of nurse faculty with doctoral degrees: Outcomes of the Maryland nurse educator doctoral grant program 2013-2018. In Nursing Economics (Vol. 36, Issue 5).

Domínguez, D. G., García, D., Martínez, D. A., & Hernandez-Arriaga, B. (2020). Leveraging the power of mutual aid, coalitions, leadership, and advocacy during COVID-19. American Psychologist, 75(7), 909–918. https://doi.org/https://doi.org/10.1037/amp0000693

Iacobucci, W., Dall, T., Chakrabarti, R., Reynolds, R., & Jones, K. (2021). Florida Nurse Workforce Projections:  2019 to 2035. In IHS Markit.

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a metasynthesis of the literature. BMC Nursing, 20(1), 1–13. https://doi.org/10.1186/S12912-021-00579-2/TABLES/4

nursejournal.org. (2023, November 10). The U.S. Nursing Shortage: A State-by-State Breakdown. NurseJournal. https://nursejournal.org/articles/the-us-nursing-shortage-state-by-state-breakdown/

 

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The purpose of this assignment is to identify a problem or concern in your organization, local community, or state in which change can occur through advocacy and legislation.

Nurses often become motivated to change aspects within the larger healthcare system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger healthcare system.

Identify a problem or concern in your organization, local community, or state. Examples of problems relevant to nursing include but are not limited to, title “nurse” protection, sharps injury prevention, nursing shortage, nurse well-being, valuation of nursing services, etc. Research the issue you selected and use the attached “Creating Change Through Advocacy” template to complete this assignment.
Nursing shortage in the state of Florida

You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.