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  1. 1. Chapter 8 Politics and Consumer Partnerships Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company
  2. 2. Objectives <ul><li>Upon completion of this chapter, the reader should be able to: </li></ul><ul><ul><li>Describe how politics define health care services and affect nursing practice </li></ul></ul><ul><ul><li>Recognize the need for nurses to be politically involved with the consumer movement in health care </li></ul></ul><ul><ul><li>Describe the role of a nurse as a consumer advocate and political force </li></ul></ul>
  3. 3. Objectives <ul><ul><li>Propose a political strategy for strengthening nurse–consumer relationships </li></ul></ul><ul><ul><li>Articulate a service-oriented plan for providing nursing services to a selected consumer interest group </li></ul></ul><ul><ul><li>Analyze the impact of demographic changes on nursing and nursing practice </li></ul></ul>
  4. 4. Politics <ul><li>Predominantly a process by which people use a variety of methods to achieve their goals </li></ul><ul><li>Methods inherently involve some level of competition, negotiation, and/or collaboration </li></ul><ul><li>Politics exist because resources can be limited and some people control more resources than others </li></ul>
  5. 5. Stakeholders and Health Care <ul><li>Stakeholders </li></ul><ul><ul><li>Vested interest groups who control health care resources   </li></ul></ul><ul><li>All these stakeholders tend to exert political pressure on health policy makers in an effort to make the health care system work to their economic advantage </li></ul><ul><li>Nurses can garner consumer support for professional nursing positions to help patients and help the profession of nursing by tapping into strong consumer support </li></ul>
  6. 6. Stakeholder Groups <ul><li>Insurance companies </li></ul><ul><li>Consumer groups </li></ul><ul><li>Professional organizations </li></ul><ul><li>Health care groups </li></ul><ul><li>Educational groups </li></ul>
  7. 7. Why Should the Professional Nurse Be Involved in Politics? <ul><li>All nurses and patients are affected on a daily basis by public policy, as well as by the political actions of other stakeholders in the health care system   </li></ul><ul><li>By understanding the influence of both internal and outside pressures on nursing practice and patients, nurses are more able to support what is most important to them </li></ul><ul><li>To be able to advocate for health care for those who have little or no voice </li></ul>
  8. 8. The Politics and Economics of Human Services <ul><li>All health care is inextricably linked to politics and economics, as well as to the availability and services of providers </li></ul><ul><li>Health care in the United States depends heavily on a continual supply of resources from both public and private sectors </li></ul><ul><li>If nurses fail to exert political pressure on the health policy makers, nursing will lose ground to others who are more politically active </li></ul>
  9. 9. Health Policy <ul><li>Formulated, enacted, and enforced through political processes at the local, state, or federal level </li></ul><ul><li>Local level policies are established and implemented by an individual hospital board or directors of a hospital system </li></ul><ul><li>State policy governs nurses by defining nursing practice, education, and licensure </li></ul><ul><li>Federal policies include the rules and regulations governing Medicare and Medicaid funding </li></ul>
  10. 10. Cultural Dimensions of Partnerships and Consumerism <ul><li>If nurses intend to form partnerships with consumer groups distinguished by cultural heritage, racial makeup, and/or ethnic background, they must understand and value diversity </li></ul><ul><li>Nurses can work with the consumer movement to combine traditional consumer concerns with a wider sense of civic rights and responsibilities, and move culturally related health care issues to the forefront of politics </li></ul>
  11. 11. Politics and Demographic Changes <ul><li>The fastest growing consumer group is the elderly </li></ul><ul><li>Many seniors are joining consumer groups to have a greater political voice, to influence health policy decisions, and to ensure that they receive the health care services they will need for years to come </li></ul><ul><li>AARP constitutes a growing political powerhouse and an ideal consumer partner for nursing in many ways </li></ul>
  12. 12. Nurses as Political Activists <ul><li>Nurses who are politically active have a definitive voice in their work environments for patient welfare, as well as for themselves  </li></ul><ul><li>As nurses develop politically, they come to understand the need for political strategy </li></ul><ul><li>Nurses join professional organizations and actively participate to ensure a more collective, unified voice supporting health care issues </li></ul>
  13. 13. Political Roles for Nurses <ul><li>Nurse individual </li></ul><ul><ul><li>Sets goals to strengthen nursing as a profession </li></ul></ul><ul><li>Nurse citizen </li></ul><ul><ul><li>Votes and writes members of Congress and state legislators on issues of interest </li></ul></ul><ul><li>Nurse activist </li></ul><ul><ul><li>Active member of professional organization </li></ul></ul><ul><li>Nurse politician </li></ul><ul><ul><li>Runs for political office </li></ul></ul>
  14. 14. Advocacy and Consumer Partnerships <ul><li>Nurses must understand the political forces that define their relationships with consumers </li></ul><ul><li>Nurses can work with their professional organizations to promote the role of the nurses as consumer advocates in health policy arenas </li></ul><ul><li>The concept of patient advocacy is a fundamental aspect of nursing </li></ul>
  15. 15. The Nurse as Political Activist <ul><li>To be most effective politically, nurses must be able to clearly articulate at least four dimensions of nursing to any audience or stakeholder: </li></ul><ul><ul><li>What nursing is </li></ul></ul><ul><ul><li>What distinctive services nurses provide to consumers </li></ul></ul><ul><ul><li>How nursing benefits consumers </li></ul></ul><ul><ul><li>What nursing services cost in relation to other health care services </li></ul></ul>
  16. 16. Essential Dimensions of Nursing <ul><li>Establishing a caring relationship that enhances healing and health </li></ul><ul><li>Focusing on the full range of experiences and human responses to illness and health within both the physical and social environment </li></ul><ul><li>Appreciating the subjective experience and the integration of such experience with objective data </li></ul>
  17. 17. Essential Dimensions of Nursing <ul><li>Diagnosing and intervening in care by using scientific knowledge, judgment, and critical thinking </li></ul><ul><li>Advancing nursing knowledge through scholarly inquiry </li></ul><ul><li>Influencing social and public policy to promote social justice </li></ul>
  18. 18. Advocacy and Consumer Partnerships <ul><li>Consumers expect the best people to be health care providers, but are confused about what the roles and responsibilities of professional nurses entail  </li></ul><ul><li>Nurses are responsible for ensuring that consumers understand the critical role nurses play as consumer advocates and political activists in health care politics, as well as what nurses do as direct care providers </li></ul>
  19. 19. Advocacy and Consumer Partnerships <ul><li>Working through their professional organizations, nurses can collaborate with consumer groups by creating formal partnerships, which serve to promote the role of nurses as consumer advocates in health policy arenas, as well as strengthen the political position of both partners </li></ul>
  20. 20. Making Health Care More Service-Oriented <ul><li>As recipients of health care are required to pay a larger portion of the cost for health care services, consumers are demanding to be treated as something more than passive recipients of health care </li></ul><ul><li>Nurses, working through professional organizations, have been strong, early supporters for patient rights, regardless of the patient’s ability to pay </li></ul>
  21. 21. Making Health Care More Service-Oriented <ul><li>Any political vision to make health care more consumer-friendly and service-oriented must address cost, access, choice, and quality </li></ul>
  22. 22. Turning a Consumer-Oriented Vision into Reality <ul><li>Nurses have opportunities to be more than supporters of a consumer-oriented vision for health care; they can be co-creators of it </li></ul><ul><li>Nurses must have a clear image of the vision, develop a sound philosophy, demonstrate intelligent and strategic thinking, and wield more political influence </li></ul>
  23. 23. Turning a Consumer-Oriented Vision into Reality <ul><li>Health care operates in a political context of rapid change and high financial risks </li></ul><ul><li>Stakeholders who are willing to take the greatest risks are afforded the most opportunities, pending good timing and appropriate political action </li></ul>
  24. 24. The Consumer Demand for Accountability <ul><li>People who will own the future of health care must address the growing problem of accountability  </li></ul><ul><li>Most people comprehend that being accountable requires being held responsible for one’s behavior, decisions, and affiliations with others </li></ul>
  25. 25. The Consumer Demand for Accountability <ul><li>Health care professionals, including nurses, depend upon each other to ensure the quality, consistency, and overall effectiveness of health care within their work environments </li></ul><ul><li>The practice of nursing is based on a social contract with society that gives nurses certain rights and responsibilities and requires that nursing is accountable to the public </li></ul>
  26. 26. Credibility and Politics <ul><li>To have credibility, nurses must demonstrate professional competence and a degree of professional accountability that exceeds consumer expectations </li></ul><ul><li>Nurses gain credibility through more education, higher level functioning, and greater accountability </li></ul><ul><li>As consumer advocates, nurses are accountable to the public and the profession beyond a particular employment setting </li></ul>
  27. 27. Helping Consumers Make Better Health Care Choices <ul><li>Nurses have a professional responsibility to help consumers make better health care choices and not fall victim to misleading information, quick cures, or dangerous practices  </li></ul><ul><li>Beyond advocacy for an individual patient or a patient group, nurses can work to create a more supportive health care environment that encourages input and feedback among the various stakeholders or constituencies </li></ul>
  28. 28. Helping Consumers Make Better Health Care Choices <ul><li>If nurses believe that what they do for consumers is essential or highly valuable, nurses must manifest strategic political behaviors and take political actions for consumers of health care services </li></ul>
  29. 29. New Challenges and Better Opportunities <ul><li>Nurses strengthen their political position by sharing accountability for health care problems with other health care providers </li></ul><ul><li>Effective dialogue among professionals and individuals being served by those professionals takes time and considerable effort to build </li></ul><ul><li>An understanding of the perspectives of the people being served is vital for real social change to occur </li></ul>
  30. 30. New Challenges and Better Opportunities <ul><li>When a consumer group forms a political coalition with other groups such as nurses in a given community, the political influence of both is strengthened </li></ul><ul><li>Consumer partnerships will become more critical for all stakeholders in health care </li></ul>