Nursing in health policy: a specialty with a view

Nurses have been influencing health policy a minimum of since Florence Nightingale lobbied the British Parliament to coach and train nurses to work in public workplaces. Dorothea Dix, Lavinia Dock, Lillian Wald, and Margaret Sanger are a part of a convention of nurses using evidence and their very own field experiences to assist shape policy to enhance health conditions in large populations. More recently, reports reminiscent of the Institute of Medicine 2010 have emerged “The Future of Nursing: Leading Changes, Advances in Health” highlighted the advantages of getting more nurses in political positions. Nurses served as heads of presidency agencies, including the Centers for Medicare and Medicaid Services, in addition to influential consumer groups reminiscent of AARP. They hold leadership positions as health policy advocates, researchers, developers, administrators, and evaluators. Today’s nurses have different paths to a profession in health policy, said Susan A. Chapman, PhD, RN, FAAN, professor on the University of California, San Francisco School of Nursing and director of the Master of Science in Nursing in Health Policy program. Beginning in 2002, UCSF began offering degrees and certificates in health policy nursing. According to the American Nurses Association, these programs represent considered one of many educational opportunities for nurses fascinated with becoming health policy specialists. Chapman said some students within the UCSF program planned to turn out to be health policy nurses from the moment they entered nursing school. Others are there because they realize that lots of the clinical problems they encounter are the results of a broken health care system. “They want to fix the system,” said Ruth E. Malone, MD, RN, FAAN, professor and chair of the department of social and behavioral sciences on the UCSF School of Nursing and co-director of the nursing health policy program. “Nurses who are best at dealing with politics have broad interests. These are big-picture people.” For Leslie Dubbin, PhD, MS, RN, exposure to the larger picture got here while working as a nurse in an intensive care unit. On the identical day, she admitted two patients – a white man and a black woman – who got here to the hospital after suffering the identical heart attack. The man was successfully treated with an aggressive procedure, but the girl was treated more conservatively, Dubbin was told, because “black women didn’t do as well” with the treatment the person received. On the day the person recovered enough to be transferred from the ICU, the girl died. “I still think about it to this day,” said Dubbin, now director of ambulatory care program integration on the San Francisco Department of Public Health. Why were some patients offered treatment and never others? Why did African-American patients have worse outcomes than whites? She wanted answers and saw two paths – conducting clinical trials to analyze the disparities or taking a look at the environmental and social aspects that cause people to find yourself in hospital in the primary place, the opposite path and a level in health policy nurse “seemed like a natural solution,” she said .

Different directions

Students in health policy programs take courses in theory, research, communication, and leadership. They learn in regards to the economics of health care, caring for populations, and global health. They need writing and important pondering skills to have the option to articulate and justify their ideas, Malone said. Dubbin had 20 years of experience in critical care and was working as an administrator at San Francisco General Hospital when she began her master’s degree in nursing in health policy on the University of California, San Francisco in 2007. She eventually obtained her Ph.D. The program requires students to finish an internship in a health policy setting, reminiscent of a legislative office, an advocacy group, or the office of an expert organization. Dubbin accomplished her residency in Washington, D.C. on the National Association of Hospitals and Health Systems. The organization lobbied to take care of disproportionate share payments to covered hospitals that were caring for big numbers of uninsured patients on the time. As a nurse and administrator at a safety-net hospital, Dubbin was welcomed and her expertise was recognized by legislative aides and policymakers. “There was a sense that nursing was trusted and respected,” she said. “She has a voice that should be heard much more often.” Malone said finding a health policy nurse position is not so simple as scanning a job website. “You won’t see an ad for a nurse in charge of health policy,” she said. Nurses who wish to work in health policy need to consider carefully about where their skills shall be appropriate, she added. “Our graduates have gone in many different directions.” One of them got a position on the CDC in Rwanda, where she focused on maternal kid’s health and HIV prevention, she said. Another became regent of the California university system. Malone said health policy nursing graduates at UCSF have gone on to institutions working in high-tech, biotechnology and advocacy. Some have returned or stayed within the facilities where they worked, but in positions where they will use their political skills to enhance patient care. After Dubbin accomplished her doctorate while continuing to work at SF General, she was approached about working on the San Francisco Department of Public Health. As an ambulatory care integration specialist, her role is to make sure a seamless transition between town’s various health care groups, reminiscent of primary care, correctional care and mental health. A serious project he’s currently overseeing is the creation of nursing wellness centers that shall be part of latest mixed-income housing complexes which can be intended to exchange among the poorest public housing projects in San Francisco. The goal of the centers, which include behavioral health and social connections, is to enhance access and reduce health disparities for patients long before they reach the hospital, she said. “Now I’m looking at health care from 5,000 feet.” Cathryn Domrose is a author. To comment, please write an email [email protected].