NR 506 Week 1 Discussion, The Four Spheres of Political Action in Nursing

NR 506 Week 1 Discussion, The Four Spheres of Political Action in Nursing Please discuss the four spheres of political action in nursing. In addition, please develop a brief argument sharing how these spheres are interconnected and overlapping by applying an example from your practice. What are some ethical considerations here? Dr. Tyson and Fellow Classmates Mason et. al (2016) recognize four spheres of political action in nursing that are avenues for influence, policy, action and change. There spheres include the community, the government, the workplace/workforce, and professional associations/interest groups. The spheres are not isolated entities; the proverbial boundaries are flexible and overlapping. The function of and action within one sphere is not independent of the others, the spheres interact with each other, and impact each other, so care must be taken to evaluate any potential ripple effect when implementing change. The community is the baseline for nursing practice. It was the conditions in her community that inspired Florence Nightingale’s practice, and this continues today with community issues such as obesity, chronic disease, and access to care that are driving action and legislation in the political arena. It is community members that make up our workforce, our professions, our legislative bodies, etc. Community formulates the basis for all other spheres. Associations or interest groups often have roots in the community by way of their membership or their mission. They also have ties to the workplace or the government as part of their mission, and are well situated to advocate on behalf of the community to drive action at a formal decision making level. National or international groups can also use their collective voices and resources to influence action on a wider scale. The workforce is the sphere where the decisions and action are put into practice. It is also the sphere where the need change can be identified, particularly change that protects, supports, and enhances the profession. Issues such as education and competence, licensure and certification, quality and safety, as well as the activities that make up our clinical practice are all part of the sphere of the workforce. The government is the start and end for policy and legislation that impacts action. There are many layers and levels of government with multiple functions and responsibilities. Regardless of the level of government (city, municipal, state, federal), this is where funding is regulated, policy is made, legislation is passed, and scope of practice is defined (or refined). This is also an area where nurses need to become more involved, and more adept at maneuvering. In a recent literature review, Wilson et. al (2020) found that there is a knowledge deficit about what nurses should know about the impact of government and politics on healthcare, and that nurses generally feel they are impacted by politics as opposed to actually making any impact on government policy. An example from my clinical practice that shows how the decision making spheres are interconnected is an ongoing experience with staffing furloughs. The decision was made at the board of director level for administrative employees to take 4 mandatory 1 week furloughs over a 16 week period due to the financial impact of the COVID-19 pandemic. The furloughs started in May of this year, right at the time when my hospital system was starting to talk about loosening the restrictions that were implemented at the start of the pandemic. The furloughs have made (and continue to make) it cumbersome and inefficient to collaborate with other departments, as well as move forward with any committee or group work or decisions. It has placed a burden on the staff that are not furloughed and have to do double, and sometimes triple duty to cover for the furloughed staff, as their jobs still need to be done and our work of patient care still needs to continue. The furloughs have decreased our efficiency, have increased our stress, have delayed delivery of service, and have negatively impacted the financial status of the individual employee, although it has had a positive impact on the financial status of the healthcare system. I personally have multiple projects and changes that have been “in the works” for several months that should have been completed and implemented, but have been delayed by the furloughs. Last week, my Director of Nursing was wearing three more “hats” in addition to her Director “hat” in order to cover for 3 furloughed staff: her stress was palpable and easily visible. This week, I am working in my manager role, as well as covering for 2 furloughed staff, so I will be strategically prioritizing tasks from all three roles and being very selective as to what I can work on, and what has to wait. This is an example of a decision that was made at the highest level of my hospital system (the government of the system) that has directly impacted the workforce sphere, which had a ripple effect into the community sphere. Thank You Nadine Quarshie, RN References Mason, D. J., Gardner, D. B., Outlaw, F. H., & O’Grady, E. T. (Eds). (2016). Policy & politics in nursing and healthcare (7th ed.). Wilson, D. M., Anafi, F., Kusi-Appiah, E., Karko, E. M., Keck, K., & Errasti-Ibarrondo, B. (2020). Determining if nurses are involved in political action or politics: A scoping literature review. Applied Nursing Research, 54(2020), 1-10. DOI: 10.1016/.2020.