Nurses play a critical role in shaping health policy, and faculty members at the LSU Health New Orleans School of Nursing frequently demonstrate the positive outcomes for patients and health care practitioners that can stem from their involvement.
“The right health policy is good for patients, and practitioners,” says Paula Kensler, DNP, MBA, RN, Program Director for the Clinical Nurse Leader and Executive Nurse Leader programs and Instructor of Clinical Nursing. Health policy is set at the national, state and local levels. It defines how health care is delivered, how government funding is applied, what research is undertaken and, in many ways, how health care is practiced. “Many segments of health policy directly affect patient care and access to health care,” Kensler says.
Nurses Are a Natural Fit
Nursing is typically a hands-on job during which practitioners are usually implementing or executing health policy rather than designing it. But nurses have a unique perspective on patient care that needs to be part of the conversation around any health policy issue.
“Simply put, nurses know patients and health policy directly affects patients. Nurses are the natural bridge between policy and practice. We’re right there with that patient and that family to tell the story of what they need,” Dr. Kensler says.
Patient advocacy is a big part of nursing. Extending that advocacy from the bedside to the boardroom is critical to the policy debate.
“All of our doctorally prepared nurses have a competency of advocacy. It is one of the pieces we learn when we get that education. Doctor of Nursing Practitioners (DNPs) should be able to lead the charge in developing health policies that improve patient outcomes,” says Leanne Fowler, DNP, MBA, APRN, AGACNP-BC, CNE, Program Director, Nurse Practitioner Programs; Program Coordinator, Adult Gerontology Acute Care Nurse Practitioner Concentration and Associate Professor of Clinical Nursing.
Nurses often engage in internal discussions about health care issues to reach a unified stance as a profession, Dr. Fowler says, referring to nursing organizations publishing whitepapers and holding open discussion forums.
“It is important to use data to inform these discussions. We are educating nurses at the doctoral level to collect the data and debate the issues, but we have to come to agreement as a profession at some point,” Dr. Nunn says.
Nurses also need to advocate for themselves. “Doctors have a strong lobby. If four million nurses across the U.S. were more organized, we could be a more forceful voice in the medical field,” Dr. Kensler says.
Explaining the urgency for nurses to get involved in health policy, Dr. Fowler says, “If you’re not at the table, you’re on the menu!”
The Impact of Health Policy
Most people are familiar with Medicare and Medicaid, and many health policies dictate everything from treatment protocols to fees charged for people enrolled in these programs. “When program fees are limited for certain services, fewer providers may choose to offer those services, making it harder for patients enrolled in those programs to get the care they need,” says Melissa Nunn, DNP, APRN, CPNP-PC/AC, Coordinator BSN-DNP Pediatric Nurse Practitioner-Primary Care and Acute Care Concentrations.
“Simply put, nurses know patients, and health policy directly affects patients. Nurses are the natural bridge between policy and practice. We’re right there with that patient and that family to tell the story of what they need.”
Paula Kensler, DNP, MBA, RN
Health policy also protects patients’ safety and privacy and their access to health care. The Patient Safety and Quality Improvement Act of 2005 improves patient safety by encouraging voluntary and confidential reporting of events that adversely affect patients. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. Without the legislation that created programs like Medicare and Medicaid, millions of people would have no access to the care they need.
Not all health policy is enacted at the national level. States and municipalities implement health policy that often has a more direct impact on patients, and policies enacted within individual health care systems, in which nurse have an immediate role, may be the most impactful to patients.
Nurses Setting an Example in Health Policy
School of Nursing faculty often take on important roles in health policy. Here are some examples of their involvement:
- Demetrius Porche, DNS, PhD, ANEF, FACHE, FAANP, FAAN, Professor and Dean of the School of Nursing, and Interim Vice Chancellor of Academic Affairs, is always monitoring a number of legislative bills that have a potential impact on nursing, health care or academia. Some of those recent bills focus on the establishment of a new Health Care Workforce Commission within the Louisiana Department of Health, health care worker safety issues and the articulation and transfer of academic credit among academic institutions.
- Serving as Vice Chair of the House Concurrent Resolution 121 (HCR121) Healthcare Workplace Violence Task Force, Dr. Fowler saw the task force’s recommendations for the protection of nurses and all direct patient care clinicians incorporated into House Bill 312. The bill passed the house and is in review by the senate Health and Welfare committee. She says, “As a nurse practitioner practicing in emergency department and hospital settings, which are high-risk settings for workplace violence, advocating for fellow nurses, doctors, nurse technicians, phlebotomists or any other bedside clinician demonstrates how nurses lead in health care.”
Faculty nurses also lead in health policy by preparing nursing students to participate in health policy discussions.
- The Louisiana Association of Nurse Practitioner Health Policy Conference in April 2022 included LSU Health New Orleans School of Nursing students engaged in a Louisiana Legislation Bill Review for the first time. Dr. Nunn was proud of the students who gave presentations on bills that would affect their current nursing and future advanced practice nursing careers. Drawing on the knowledge they gained in their nursing practice and the skills instilled in them by Dr. Nunn and other instructors at the School of Nursing, the students offered insights to other students and nurse practitioners from across the state about how the bills would affect their practice, the health of patients and access to health care.
- For her DNP project at the School of Nursing, Adrienne Holdridge, 2020 DNP, Acute Care Nurse Practitioner-Adult Gerontology, developed an alarm management policy for an urban teaching hospital that was accepted and implemented across the health system. The alarm management policy reduces the number of clinical false alarms in the intensive care unit by standardizing many practices including daily electrode changes, correct placement of electrodes and proper skin preparation. Fewer false alarms reduce alarm fatigue for bedside nurses and improves patient safety.
How Can Nurses Get Involved in Health Policy?
Nurses are affected by health policy at all levels every day. It seems logical that they would want to lend their voices and expertise to the discussion to advocate for patients and practitioners.
“There are so many opportunities to get involved with the health policy process through professional organizations,” Dr. Nunn says. “Becoming engaged in a professional association like the American Nurses Association or the Louisiana State Nurses Association is a good way to become familiar with the hot topics in health policy and what legislation is developing.”
Within these professional associations are task forces and work groups formed around different health policy issues. “Getting engaged in professional organizations and serving on boards can affect policy at the grassroots level. These organizations provide a unified voice for nurses,” Dr. Fowler says.
“Some of the important issues in health policy are about nurses,” Dr. Kensler says. “How do we get the funding to educate more nurses and ensure a healthy workplace, so nurses have longevity in their profession?”
These type of policy debates, especially, are incomplete without the nurse’s perspective.
“We need all nurses stepping up to the health policy table, so at LSU we work hard to prepare our nurses for that role,” Dr. Nunn says.