ADVOCACY AND NURSE-PATIENT RATIO

Nurse-patient ratio.

Today’s healthcare system is a major concern, in need of change and practicing nurses
are well versed in it. For two decades, nurses have reported that there are not enough nurses in
hospitals to provide high-quality care (Aiken et al, 2010). The regulations that govern the health
sector and restrictions imposed by private insurers’ challenges nurses and patients who are torn
between cost limitations and access to proper quality health care. Nurses are the first to realize
when and how the health care system does not meet patients’ needs effectively thus seeing the
need for the universal amendments in the policies that address many health-related issues. They
are motivated by their experiences in the world of health care to take on advocacy roles to
influence changes in regulations and laws that govern the larger health care system.
The role of policy advocacy requires nurses to have the power, the will, the time, and the
energy, along with the political skills needed to ‘play the game’ in the legislative arena (Abood,
2007). According to a report by the Commonwealth Fund, a highly variable quality of care is
delivered by a system that is too often poorly coordinated, thus driving up costs, and putting
patients at risk (Abood, 2007). In essence, this makes the role of boosting health care
performance a matter of national urgency. Accepting the responsibility of policy advocacy offers
nurses the special opportunity to make a difference and to have the satisfaction of being part of
conveying a better health care system into reality for themselves and their patients.
Nurses advocate for change through instigating policy proposals, altering others’
recommendations and significantly influencing the implementation of health policy. Intricate
health care policies require the mastery and efforts of organized groups and the help of
professional lobbyists, thus the need for nurses to join professional nursing organizations so as to
enhance their advocacy efforts. Professional nursing organizations monitor public policy, offer

ADVOCACY AND NURSE-PATIENT RATIO
ways for their members to learn about health policy and serve as a resource for reliable
information related to policy issues and decision makers. They also provide information and
tools to ensure that candidates who are supportive of nursing are elected to, or remain in, office.
The ability to successfully exert influence in the various arena where future health care policy
decisions are made and to take advantage of opportunities to present nursing’s perspective on the
medical issues depends on having a power base and knowing where and when to exert that
influence (Abood, 2007).
The sources of power available for nurses involved in policy advocacy roles include
expert, legitimate, referent, reward and coercive powers. Physicians exercise a coercive,
legitimate, and expert power to influence the health care policy process in both the private and
public sectors thus implying that the combined use of power bases is more active in advocating
for changes in policies. The aptness to successfully advocate for safe, quality, patient care
depends on the ability to translate potential power into influence and accomplishments.
The positive impact of policy advocacy in the health sector is beneficial to both the nurses and
patients. For instance, after the implementation of the mandated nurse staffing ratios, nurses in
California care for an average of one fewer patient each, and these lower ratios have substantial
effects on surgical patient mortality (Aiken et al, 2010). The nursing skill mix in hospitals
appeared to improve, and research suggests that more registered nurses are associated with better
patient outcomes compared to others. (Aiken et al, 2010).

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References

Abood, S. (2007). Influencing health care in the legislative arena. Online Journal of Issues in
Nursing, 12(1).
Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A., … & Smith, H.
L. (2010). Implications of the California nurse staffing mandate for other states. Health
services research, 45(4), 904-921.