NURS 501 Week 8 Discussion Board Forum, From Policy Analysis to Taking Action Example

Discussion Board Forum: Taking Action in Health Policy as an Advanced Practice Nurse

NURS 501 Health Policy and Ethics, Discussion Board Forum

Thread by [Student Name]

The classmates replied to are composites written for a model discussion.

Before this course, my involvement in health policy consisted of signing one online petition about nurse staffing. Eight weeks later I have written to a member of Congress about a specific bill, analyzed a federal rule in a 12-page paper and recorded a briefing for legislative staff on the Medicare hospice election requirement. The question in this forum is whether any of that will continue after the course ends, and I want to answer it honestly.

The evidence suggests the risk of stopping is real. Ohrenschall et al. (2026) surveyed 175 advanced practice registered nurses in the Pacific Northwest using a validated measure of policy participation and found that, although the nurses valued health policy highly and believed they could be influential, their participation scores were low. Most of their policy activity happened through their employers, and participation through professional nursing organizations was minimal. Caring about policy and doing policy turned out to be two different things, even for nurses with advanced education. I recognize myself in that finding. My employer's committees are where I am most likely to be asked to help, but the decisions that shaped the problem I studied this term, the hospice election rule, are made in Congress and at CMS, far from any hospital committee.

Mason et al. (2016) describe policy work as a set of skills that grow with practice: understanding how an issue moves through government, building relationships with decision makers and working through coalitions rather than alone. This course gave me a first round of practice with each. The legislative letter taught me to make one clear request; the paper taught me to weigh options fairly; and the briefing taught me to cut an argument to what a busy staffer needs.

I am making three commitments. First, I will join the legislative committee of my state nursing association by the end of next month, because the research shows that is the route most nurses neglect. Second, I will send my hospice briefing and paper to my representative's health staffer and ask for a short meeting. Third, I will present the concurrent care evidence to our hospital's palliative care council, since local leaders can support federal change through their professional associations.

Nehemiah did not rebuild Jerusalem's walls in a day; he surveyed the damage, reported it honestly and organized each family to repair the section in front of its own house (English Standard Version Bible, 2001/2016, Nehemiah 2:17-18; 3:28). Policy work is similar. No single nurse changes Medicare, but steady effort on the section in front of each of us adds up.

Reply to Christina

Christina, I appreciated your honesty that you felt unqualified to speak to legislators before this course, and your plan to start with your hospital's nurse practice council is a sensible first step. Research suggests your hesitation is common and has more to do with skills than interest. A Croatian survey that 390 nurses and nursing students completed found broad agreement that nurses belong in policy work and that scientific evidence should guide it, alongside less confidence in the practical skills the work requires (Brešić & Car, 2025). That pattern suggests the gap can be closed with practice, which is exactly what your council role would provide. You might ask the council chair whether you could prepare a one-page evidence summary for the next meeting on the scheduling issue you described; doing that once or twice would build the same skill a legislative briefing requires. Your example of the night-shift ratio dispute also shows that local policy is real policy. I would add that the council's minutes could later become evidence for a state-level proposal, since legislators often ask whether a problem exists beyond one hospital. Keeping a record of what the council decided, and why, would give you that evidence when the time comes.

Reply to Marcus

Marcus, your policy briefing on the state's school nurse staffing bill was persuasive, and your reflection that you could not have passed it alone points to the most important skill in policy work. Mason et al. (2016) emphasize coalitions because legislators respond to groups that represent many voters and bring consistent messages, not to scattered individual requests. For your bill, the natural coalition might include the state school nurses association, parent groups concerned about children with diabetes or seizure disorders, and pediatricians, each bringing a different kind of credibility. One concrete step would be to share your recorded briefing with the school nurses association's legislative chair and offer to adapt it for their members to use when they contact their own legislators. That would multiply the effort you already invested. It would also give you feedback from nurses who have watched similar bills succeed or fail before, which is information no textbook can supply. Have you found out whether the bill has a sponsor in the Senate yet? Knowing that would tell your coalition where to aim its first letters.

References

Brešić, N., & Car, M. (2025). Political competence and evidence-informed policy engagement among nurses and nursing students in Croatia: A cross-sectional study. Nursing Reports, 15(12), Article 448. https://doi.org/10.3390/nursrep15120448

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Mason, D. J., Gardner, D. B., Outlaw, F. H., & O'Grady, E. T. (2016). Policy & politics in nursing and health care (7th ed.). Elsevier.

Ohrenschall, R., Waklatsi, A. N., & Banta-Wright, S. A. (2026). Pacific Northwest advanced practice registered nurse health policy and legislative advocacy participation. Nursing Outlook, 74(2), Article 102735. https://doi.org/10.1016/j.outlook.2026.102735