I wanted to post this paper that I wrote for my Nursing Leadership course because few people had asked if they could read it after I was finished. If it reads a bit choppy at parts, its because the paper had specific requirements, and I just had to shove some sentences in there to make sure everything was covered.
Here it is:
Those of us getting ready to graduate and begin our careers as nurses are entering the health care arena in a time of chaos and uncertainty in the field. The Patient Protection and Affordable Care Act (PPACA), a 974 page healthcare reform bill signed into law by President Obama in March of 2010, contains several new provisions and regulations that will affect our job in a variety of ways (Healthcare.gov). The policies, or laws and regulations surrounding healthcare are closely governed by politics, or the interactions and competitive influence among government officials. As Americans, it is our responsibility to be as informed as we can be about the political process, our leaders, and the legislation that governs us. As nurses, healthcare reform will affect who we can legally treat, the quality and quantity of the care we are able to give our patients, and even our wages. Therefore, it is even more important for us to not only stay knowledgeable of healthcare reform, but also to involve ourselves in the political process in order to give those of us in the healthcare field a stronger voice in how our work is governed.
One issue that I have noticed on a discussion board of the nursing website, allnurses.com, is the topic of having a national versus a state licensure program. We currently receive our nursing licenses at the state level. Although the NCLEX exam is consistent throughout the United States, individual states are allowed to have their own guidelines and requirements for nursing students to meet before they sit for boards. One benefit of our current licensure system is that each state can tailor its requirements to meet the needs of its specific population. It may be argued, however, that this system contributes to the national shortage of nurses that we face; it is costly and time consuming for nurses to travel and change locations when they have to adjust to each states requirements for licensure. If there were a national licensure program, nurses could change locations without having to worry about such a big adjustment. Perhaps if the scope and career of nursing were a closed system, a national licensure program would be more efficient and effective, but as it is, nursing is highly integrated with other aspects of a larger health care system within each state. Although there are national regulations on health care, states do have, to some degree, the ability to regulate their specific health care system, which may mean that nurses may or may not need special training, or a specialized subset of knowledge to meet their state’s needs.
Another issue that has been widely debated is whether graduation with a Bachelor of Science in Nursing (BSN) degree should be mandated in order to receive licensure as a nurse, as opposed to simply an Associate’s Degree in Nursing (ADN). One argument in supporting this mandate is that nurses would have a wider base of knowledge before diving into their practice, and would potentially be more prepared to competently care for their patients. An argument against this mandate is that it would drastically worsen the current nursing shortage in the United States; current registered nurses with an associate’s degree would be forced to return to school and temporarily be unavailable to work as many hours, or be fired. Furthermore, several potential nurses may be discouraged from entering the field due to either extended education period or cost of the program. If there is enough clinical evidence to support the fact that ADN graduates are providing significantly less skilled, competent, and safe nursing care to their patients on a national or state scale, there should be a policy to require a BSN in order to be licensed as a nurse; if not, however, this should be a policy that individual hospitals and health care facilities are able to choose to implement based on their own clinical experiences.
The third issue that is not directly involved in nursing, but affects it none-the-less is the health insurance mandate and the individual mandate which has been passed into law with PPACA (healthcarereform.kff.org). This aspect of the law states that all individuals must purchase some form of insurance by the year 2014, or pay a penalty (effectively, a tax) for noncompliance (healthcarereform.kff.org). I have debated the justifiability of this provision with several people who claim that this is a good way to ensure that people pay for the health care services that they receive; those who have, in the past, gone without health insurance, and then were unable to pay for their emergency ride to the hospital will now be forced to either purchase insurance, or pay tax dollars into the system to support the safety net for the uninsured. However, the concept of forcing U.S. citizens to purchase a product, or pay a penalty is a serious threat to our freedom. As radical as that may sound to some, consider the fact that many people currently choose to pay for their health care out of pocket as it arises. Under these provisions, these people are not allowed to do so.
I believe policies and politics affect almost every aspect of our lives; we are governed daily by organizational, state, and federal regulations, and should we choose not to follow them, we face penalties. We have several federal government departments that do things such as set standards for water companies; the Food and Drug Administration sets requirements and limitations on how our food is processed, among others. We have laws that regulate traffic safety, and ones that regulate the safety of products we buy—for example, car seats for children.
Politics and policies certainly affect the air we breathe – our government regulates how and where companies dispose of waste products in attempt to prevent air and water pollution. They also affect the quality of our parks by penalizing littering.
Politics most certainly affect the quality and cost of health care, as evidenced by PPACA and the many debates that have ensued because of it. The policies put upon those of us in the health care field will influence who we care for, how we care for them, who pays for our services, and the cost of our services; depending upon how much revenue hospitals and clinics can make will affect our wages and retirement income, therefore eventually affecting our choices and possibilities to retire at an age we are comfortable with.
Television and radio are often regulated on what type of language is allowable or prohibited, as well as nudity. Beyond that, almost every show out there at some point either touches on some politically charged theme, or blatantly praises or belittles past or present politicians. It is practically impossible to watch a news program or read a piece of journalism that isn’t motivated by the author’s political agenda. Politics are everywhere.
It is extremely important for nurses, as well as anyone, to take an interest in politics and policies because of the affect they have on our lives. Going to the voting booth once every four years to get an “I voted!” pin to wear around for the day does not constitute adequate political activity. Without becoming educated on current and past political issues by direct sources (i.e. not Jon Stewart), the politicians, and their records, a person’s vote is nothing more than a tool to the “hippest” politician.
It often times seems that American youth avoid discussing and becoming involved in politics due to feeling intimidated by the complexity of the political world we live in; taxes, economics, ethics, media, and the political process may take time to learn, and controversy and differences of opinion often times lead to anger and hurt feelings. As someone who is highly engaged in social media such as Twitter and Youtube on a daily basis to discuss politics with a variety of individuals across the political spectrum, I can identify with these feelings. However, having experienced the joy of learning about a policy, tweeting or making a video about what I’ve learned, and then watch my 5,000+ twitter followers (which includes a fair few legislators) take in my opinion and engage in civil discourse, I rest assured that it is well worth it.
We live in a world where we can access information with the touch of a button, and we can make ourselves heard with the same. Not only does this process create a shortcut to influencing the environment in which we live in, but it is also surprisingly fun. Different political organizations offer conferences that allow us to network with like-minded individuals, to speak with political leaders face to face, to learn from knowledgeable speakers, and to socialize and meet knew people. For those who lack the time and resources to attend such conferences, even just reading about issues that compel us and writing to legislators to influence their vote on policies that affect us is a great way to be politically active. Our civic duties extend beyond and before the voting booth; after all, politics are not meant to be left to the politicians, but to the constituents they represent.
