“Nurses must see policy as something they can shape rather than something that happens to them.” ~ Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health
Nursing education programs at the doctoral level recognize that advanced practice nurses are uniquely qualified to develop, implement, and evaluate health policies. Through a Doctor of Nursing Practice (DNP) program, students learn the meaning and importance of health policy and advocacy. DNP graduates are therefore armed with the skills to become leaders and political advocates who advance their own practice and protect the welfare of their patients.
Thanks to the integration of health policy curricula in DNP programs, interest has piqued among nurse practitioners and other advanced practice registered nurses interested in influencing healthcare reform, promoting global health, and contributing something of value to the nursing profession.
Thanks to their extensive clinical background and their knowledge of health policy issues, today’s DNP-prepared APRNs have an excellent working knowledge of the language of legislation and regulation and are well positioned to influence the content and quality of healthcare policy.
The Unique Contributions DNP-Prepared Nurses Bring to Healthcare Policy
There are a multitude of ways DNP nurses can engage in the process of transforming healthcare and influencing the health policy agenda. At the novice level, APRNs may start their journey by reviewing literature and analyzing health policy research. This early stage lends itself well to developing an awareness and understanding of the issues, making this the first real meaningful step towards influencing the ways in which healthcare is organized, paid for and delivered.
As they become more comfortable and knowledgeable about the process, DNP-educated APRNs may move on to make significant contributions to health policy by engaging in:
Coalition building is an effective approach to obtaining legislative and regulatory approval for an organization’s policy agenda. Nursing organizations often form coalitions, either with each other or with other healthcare organizations. DNP nurses serve as the leaders of these coalitions, organizing the work of the coalition, and motivating the group to stay on target.
DNP nurses also have the ability to address policy intervention. Through their advanced knowledge and skills, they are prepared, informed, and empowered to support a healthcare policy that aims for safe, effective, patient centered, timely, efficient, and equitable care. Through their work in health policy, DNP nurses provide expert testimony, serve as content experts, and garner support from legislators during the process.
According to The Doctor of Nursing Practice Essentials (3rd Edition, Zaccagnini and White), health policy is not just a legislative process but also a comprehensive method of identifying healthcare issues and then bringing those issues to the legislature and to the American public.
DNP nurses develop policy agendas, embrace their core values, and learn the skills involved with making and influencing policy. Together, nurses make up the largest contingent in the healthcare system. This puts the nursing workforce in the unique position of being able to influence healthcare reform by offering guidance and support to elected leaders.
DNP nurses assess the success or failure of legislation through a formative evaluation of the policy process, answering such questions as: What were the political obstacles to policy legislation and implementation? How will the outcomes be measured? Is this plan sustainable?
As the content of policy education is formalized within DNP programs, it is up to educators to demonstrate the relevance of policy in practice, including instructing APRNs on how to determine the basis for proposed policy changes.
How DNP Programs are Uniquely Well Suited for Preparing Nurses for Careers in Health Policy
According to the American Association of Colleges of Nursing (AACN), health care policy creates a framework designed to facilitate the delivery of healthcare services and enable providers to engage in practices that addresses the healthcare needs of the public. Regardless of whether healthcare policy is created through governmental actions, institution decision making, or organizational standards, nurses engaging in policy development contribute to creating a healthcare system that meets the needs of its constituents.
DNP-educated nurses in health policy are also leading the discussion around increased autonomy for advanced practice registered nurses and removing legal barriers that prevent them from practicing to the full extent of their training and education.
While master’s-level APRN programs prepare students to function as effective clinical practitioners, most do not provide them with the skills and knowledge required to develop health policy or influence the political process.
Instead, it is the DNP that has become the primary source of education for nurses as it relates to healthcare policy. For example, the National Organization of Nurse Practitioner Faculties (NONPF) identifies the following competencies for DNP graduates:
- Analyze legal, ethical, and social factors in policy development
- Evaluate the globalization on the development of healthcare policy
- Influence health policy
Program content in a DNP program focuses on the significance of healthcare policy on all levels—state, national, and international—and how it influences healthcare systems. Often times, students of DNP programs further study health policy by incorporating the topic into their scholarly project.
Field experiences in DNP programs may include visiting elected officials, spending time with an administrator, communicating with a national leader, or contacting a community-based action group. Doing so allows students to work alongside mentors who are knowledgeable about health policy. Many students also seek out faculty or healthcare leaders who are actively involved in advanced practice nursing issues.
Many times, APRNs interested in influencing legislation and serving as health policy experts complete a policy fellowship after completing their DNP. Policy fellowships provide DNP nurses with the opportunity to brief legislators on healthcare issues, develop proposals, and attend staff hearings and conferences.
DNP programs provide students with valuable exposure to the political process and opportunities to apply their newly gained knowledge as it relates to health policy.