Nurse Practitioners (NPs) and Health Policies and Advocacies

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Healthcare policy is created to strive for society's shared healthcare goals on the state and national levels, with various interest groups influencing associated laws and regulations (American Association of Nurse Practitioners, n.d.-b). Interest groups include professional healthcare organizations such as the American Medical Association (AMA), insurance companies, and individual patients seeking healthcare services. Regardless of the agendas of interest groups, there is a consensus on the national level to promote health, reduce healthcare costs, and increase access to care (US Department of Health and Human Services, n.d.). Numerous studies have demonstrated that NP-led care is equivalent to the care provided by physicians in the primary care setting, with higher satisfaction rates and positive patient outcomes. As such, NPs are in a position to influence current and future implementation of health policy to improve health outcomes for all patients. According to the American Association of Nurse Practitioners (AANP), current policies affecting nurse practitioners (NPs) include promoting full practice authority (FPA) nationwide and allowing direct reimbursement from insurance companies for medical services provided (n.d.-b).
Since NPs are one of the fastest-growing professions in the healthcare setting, there is the potential to significantly drive health policy change (American Association of Nurse Practitioners, n.d.-b). For example, partnering with local and nationally based NP organizations to promote legislation for FPA will increase the number of healthcare providers accessible to the general population. Increased access to care is beneficial for underserved communities to promote health and prevent the incidence of chronic disease. Current practice barriers include policies restricting FPA in the remaining 18 states, with 32 allowing for FPA (American Association of Nurse Practitioners, n.d.-a). Another barrier involves insurance companies billing NP services indirectly or through a supervising physician. According to a recent study, if insurance companies allowed NPs to bill directly for their services, Medicare would have saved about $194 billion in 2018 (Patel et al., 2022). As consumer demand for low-cost quality healthcare increases, the NP must advocate for ethical policies to promote health equity for every community member.
Nurses are taught to advocate for patients by sharing their concerns and communicating patient needs to healthcare providers. Before this course, I did not see NPs as a political force and thought it best to stay out of politics. It is now clear that to begin to make a shift in the current system, nurses must be entrenched in the process of health policy and advocacy. Understanding the communities we are part of and the resources available to the general public is a starting point in determining advocacy concerns. We learned that social determinants of health affect how an individual works, eats, uses transportation, and uses social networks that influence health outcomes. Becoming aware of every aspect involving a patient and their health status will make NPs more effective primary care providers. According to the Code of Ethics for Nurses, NPs must continue advancing health as a human right and advocate for reducing health disparities (Russell, 2020). As one of the most trusted professions, our perspectives are valuable in addressing health equity and social justice issues. In addition, as front-line workers, nurses contribute unique perspectives on the functionality of current policies and certainly have ideas for improvement. As a result, NPs must continue to advocate for the profession and patients while believing we have a right to be part of the policy-development process.
The implementation of policies consists of a dynamic process between organizational leadership, middle management, and staff. The success or failure of policy implementation is based on the trust level staff feel toward those appointed leaders and whether there is a shared vision. As future NPs, promoting positive policy change begins with developing a foundational relationship based on trust with other staff members. Leaders empower others to follow a shared vision by engaging in open, honest communication where ideas, comments, and concerns are heard in a non-threatening environment (Dolansky et al., 2023). A recent article on nursing leadership presented pillars of transformational leadership, including leading by example, engagement, encouragement, inspiring a shared vision, and challenging the process (Dolansky et al., 2023). Celebrating staff accomplishments, involving them in the policy implementation process, and allowing the flow of new ideas from staff members are all examples of encouraging positive policy adoption within any clinical environment. Valued staff will more likely adopt a shared vision with an organization that respects their values and opinions. To accomplish this, organizations must invest in their employee's well-being and take a whole-person approach to building professional and relatable relationships with staff members.