Policies are decisions and guidelines that are determined, and acted upon, in response to a particular problem. Policies are made throughout private organizations, within the public arena, and in specific sectors, such as healthcare. Whether created to benefit a particular organization, as in allocative policies, or as a regulatory policy aimed at shaping a public objective, policies are woven together as they impact society on many levels (O’Grady, Mason, Outlaw, & Gardner, 2016).
Policies, which can take many forms and influence a variety of objectives, “are made within a dynamic environment and a complex policymaking process” (O’Grady et al., 2016, p. 8). One such policy is organizational policy, which can be described as a set of rules that describe the organization and how it operates. For example, a hospital may have organizational policies describing staff safety, fall protocols, or recruitment strategies. Organizational policies are similar to institutional policies in that they define the operation of the institution, often a university.
Organizational policies influence healthcare through their direct effects on hospitals, outpatient centers, private practices, and other organizations that employ nurses and treat patients. Likewise, institutional policies influence the processes at universities where nurses are educated. Institutional policies implemented at a school of nursing may include guidelines on academic expectations and program objectives. Not only do these policies influence nurses, but they affect the patients they care for as well.
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Public policies formed by the government aim to influence the whole population and can shape healthcare on a large scale (O’Grady et al., 2016). Public policy may be further sorted into health policy, which aims to influence health or healthcare, or social policy, which refers to guidelines focused on ensuring the well being of individuals, often through social programs. Both health policy and social policy influence healthcare, nurses, and patients.
Health policy influences nurses through federal and state regulatory policies regarding scope of practice concerns (Poghosyan, 2018). Although there is uniformity for nurse practitioner (NP) education and certification, many states vary in scope of practice regulations for NPs, thus creating restrictions in the care NPs can provide to patients (Poghosyan, 2018). Additionally, health policies that influence NPs may include limiting reimbursement; which may ultimately affect accountability and data on patient care provided by NPs (Poghosyan, 2018).
Social policy influences nurses, patients, and healthcare through social determinants of health. It is well understood that social determinants of health, such as education, environment, culture, gender, and employment status influence health. Social policies shape these aspects of society through programs aimed at meeting human needs. When policy influences education, employment, or community resources for example, it ultimately affects health. As nurses care for these populations, they too are affected by social policy.
As the “largest health care provider group,” nurses are positioned to have great influence on policymaking; however, nurses continue to demonstrate limited interest, understanding, and involvement in the political arena (Woodward, Smart, & Benavides-Vaello, 2016, p. 54). Nursing education that includes social theories, participation in civic and political activism, and quality political encounters, provides nurses an opportunity to gain a deeper understanding of health policy and define a greater role in shaping policy (Woodward, Smart, & Benavides-Vaello, 2016).
As the political development of nurses advances with formal education and relevant learning experiences, they will demonstrate greater influence over public policy, including social and health policies, organizational policy, and institutional policy. It is vital to the political role of nurses to gain an understanding that each policy is connected to the other in some way, and that all policies, not just health policy, can influence healthcare.
