Guided Reflection
The course has offered critical background on how political factors influence the state of health and why nurse leaders should be empowered to participate in policy advocacy. Health Equity and Access under the Law (HEAL) for Immigrant Families of 2023 (H.R. 519) provided further credence to the reality that access to healthcare is not merely a clinical concern but a politically influenced one. Intensive fighting over legislatures that favor undocumented immigrants reveals how health equity is intertwined with lawmaking and political will: Guided Reflection.
The Political Determinants of Health by Dawes (2020) narrowed down how systemic inequities result from policy disadvantaging marginalized groups. Non-eligibility access via a five-year wait for Medicaid and non-enrollment in ACA marketplaces are bureaucratic and legislative decisions maintaining inequities (Buchmueller et al., 2024).
Health disparities should be acknowledged as regrettable shortages instead of policy effects that can be amended. Nurses can be care providers as well as instruments in structural transformation (Oldland et al., 2020). In addition, California’s policy model shows that local and state-level reforms may result in immediate and measurable improvements, and they require federal alignment and sustained efforts.
Moreover, nurse leaders play a part in traversing through this complexity through the use of community trust and clinical expertise to promote caring and inclusive policies. For the future, strategic advocacy should be evidence-based, equitable, and sustainable. According to Han and Kim (2024), the barrier to legislation, in the case of H.R. 519, demonstrates the importance of nurses sharing their appeal in bipartisan structures, economic reasons, and coalition formation.
Nursing voices are necessary when creating cost-effective policies and addressing the ethical urgency of increased access to care. The course reaffirmed that health equity is not the outcome of medical progress without active participation in politics. Prolonged advocacy by caregivers is necessary to achieve structural change, given the actual policy examples and political realities brought up by Dawes (2020), as the DNP disciplinary role should also involve fearless and data-informed political participation to promote just and inclusive systems of healthcare.
References
Buchmueller, T., Whitman, A., Peters, C., & Lew, N. D. (2024, June 7). Improving access to affordable and equitable health coverage: A review from 2010 to 2024. Nih.gov; Office of the Assistant Secretary for Planning and Evaluation (ASPE). https://www.ncbi.nlm.nih.gov/books/NBK611354/
Dawes, D. E. (2020). The political determinants of health. Johns Hopkins University Press.
Han, N. K., & Kim, G. S. (2024). The barriers and facilitators influencing nurses’ political participation or healthcare policy intervention: A systematic review and qualitative meta‐synthesis. Journal of Nursing Management, 2024(1). https://doi.org/10.1155/2024/2606855
Oldland, E., Botti, M., Hutchinson, A. M., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare: Exploration of content validity. Collegian, 27(2), 150–163. https://doi.org/10.1016/j.colegn.2019.07.007
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Question 
WK11 8100 Guided Reflection
Study without reflection is a waste of time, Reflection without study is dangerous.
—Confucius (Clark, 2011).
Reflection of an experience, lesson learned, and/or importance of a role, demonstrates a clear understanding of process, comprehension, and expertise. To reflect requires an ability to consider lessons learned, personal connections, and next steps. As we come to the end of the course, it is important for you to consider what you learned and how to connect these lessons beyond this course.
For this Discussion, you will reflect on what you learned throughout this course. What is the impact of what you learned? How might you approach engaging in policy advocacy moving forward?
Guided Reflection
Reference:
- Clark, J. (2011). Let’s reflect: What is the point? British Journal of General Practice, 61 (593), 747. https://doi.org/10.3399/bjgp11X613232Links to an external site.
To Prepare:
- Consider what you learned throughout this course and reflect on the impact.
- Consider how you might use what you have learned beyond this course experience.
By Day 3 of Week 11
Post a response detailing the following:
- How has this course impacted your knowledge, attitude, beliefs, perceptions about nurse engagement in policy advocacy and politics?
- What are the takeaways as you move forward as a DNP, in your role as a policy advocate? What resonates with you and how will you use it?
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