Political Competence & Advocacy Sarah Wickenhagen, DNP , APRN, - - PDF document

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Political Competence & Advocacy

Sarah Wickenhagen, DNP , APRN, FNP-C

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Conflict of Interest

• I have no relevant relationships with any

commercial interests related to this presentation.

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Obj ectives

• Describe political competence and identify its 3

phases as described by Bachrach

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“ ”

It’s the ability to understand what you can and cannot control, when to take action, who is going to resist your agenda, and whom you need on your

• side. It’s about knowing how to map the political

terrain and get others on your side, as well as lead coalitions. What is Political Competence? Bachrach, 2005

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Nursing & Political Competency

“ … ..in the pursuit of political competency and efficacy, the closer the profession comes to realizing nursing's historical mandate and meeting contemporary needs through activism and political

• involvement. “

Rains & Barton-Kriese, 2001

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The Politics of Nursing- Past & Present

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Political Competence 3 Phases

Bachrach, 2005

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Map your political terrain

Anticipate your stakeholders Expect resistance What are the goals of the stakeholders? How do they compare to your goals? Disagree but still see a potential path forward?

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Get others on your side

Build coalitions

• Rational
• Mimicking
• Regulation
• Expectations

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Make things happen

What’s in it for me? Network with other

• rganizations

Active leadership Communication Manage conflicts & disagreements

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Nursing Advocacy

• Nurses have first- hand knowledge that can lend expertise to

discussions that impact such issues as:

• Quality of care
• Patient safety
• Cost containment
• Chronic disease management
• Equitable access to care and a sustainable healthcare delivery system.
• Nurses continue to be ranked the highest trusted professionals

among the public which make them suitable representatives to advocate for health

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ACA- The Flop 29 million without coverage

• Adults Medicaid Eligible: 5.0

million

• Children Medicaid/CHIP Eligible:

3.0 million

• Medicaid Gap: 2.8 million
• Undocumented Immigrants: 4.8

million

• Eligible for Subsidized Exchange

policies: 6.5 million

• Ineligible for Subsidized

Exchange policies: 7.0 million

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ACA- The S uccess

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• More than 25 million obtained

insurance

• Care delivery and payment

models transforming

• Accountable Care Organizations
• Medical Homes
• Lower rates of Hospital Acquired

infections

Evaluation ACA

Mapping Terrain Build Coalitions Make Things Happen

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“ ”

Despite a long history of activism, most nurses today do not feel compelled or skilled to act politically

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Magnussen, Itano & McGuckin, 2005

Barriers to Advocacy

• Lack of understanding of the

political process

• Nurse Regulation
• Statutory
• Health S

ystem

• Frustration with the legislative

process that is both slow and tedious

• Work life balance
• Gender issues
• Fear of public speaking
• Apathy
• Fear of retaliation
• Lack of support from peers and

administration

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Facilitators of Advocacy

• Preparation to gain confidence

and knowledge on behalf of their communities

• Belief that the action would have

an impact or make or difference

• Experience with political activism
• Mentoring from a positive

political role model

• S

eeing a wrong that you want to make right

• Participation in professional
• rganizations
• Encourages nurse to vote
• Meet their policy makers
• Use communication skills
• Write letters to policy makers or

the media

• Campaign for candidates

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The Power of One Voice

“ Individually we make a difference; collectively we make a bigger difference” Rains- Warner, 2003

• # of Nurses in NPO
• # of Nurses in ONA
• # of Nurses in Oregon
• # of Nurses in ANA

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Hot Topics Nationally

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• Full Practice in the V

A S ystem

• The Medicare Access and CHIP Reauthorization Act (MACRA)
• Home Healt h Care Planning Improvement Act of 2015 would allow NPs to certify

their patients’ eligibility for home health care services

• Promot ing Access t o Diabet ic S

hoes Act (H.R. 4756), which would authorize NPs to certify their patient’s need for therapeutic shoes.

• The Rural ACO Improvement Act of 2015 (S

.2259) would allow the assignment of NPs' patients to Medicare S hared S avings ACOs.

• The CARA (Comprehensive Addiction and Recovery Act) bill expands buprenorphine

prescribing to P As and NPs.

Hot Topics Oregon

• Division 50-NP
• Under revision
• Division 56- Prescriptive Authority
• Introducing updates that include buprenorphine prescribing

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Learning from Political Leaders

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In conclusion… ..

• Nurses must “ advocate, educate and set an example for the

public” , not simply care for them. Des Jardin, 2001

• “ Political action is an expression of caring” .

Falk-Rafael, 2005

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Questions?

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References

• Avolio, Crystal D. (2014). Political Advocacy: Beliefs and Practices of Registered Nurses.

Electronic Theses and Dissertations. Paper 5064.

• Bachrach, S
• amuel. (2005). Get Them on Y
• ur S

ide: Win S upport, Convert S keptics, Get Results. Platinum Press.

• Des Jardin, K. (2001). Political involvement in nursing-Politics, ethics, and strategic action.

AORN Journal, 74(5) 613-622.

• Falk-Rafael, A. (2005). S

peaking truth to power: nursing’s legacy and moral imperative.

• Advances in Nursing S

cience, 28(3), 212-223.

• Magnussen, L., Itano, J., & McGuckin, N. (2005). Legislative advocacy skills for Baccalaureate

nursing students. Nurse Educat or, 30(3), 109-112.

• Primomo, J. (2007). Changes in political astuteness after a health systems and policy course.

Nurse Educat or, 32(6), 260-264.

• Rains, J.W. & Barton-Kriese, P

. (2001). Developing political competence: A comparative study across disciplines. Public Healt h Nursing, 18(4), 219-224.

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