Interest group-people who share the same interest directly with political processes
Factions-special interests, pressure groups, or organized interests
• Development of interest groups
o James Madison’s The Federalist No. 10 (1787)
“The best wisdom is to control the effects of interest groups”
Interest group roots fall back on the constitution and the birth of the American version of democracy
o Alexis de Tocqueville, French philosopher and politician
• Functions and methods of influence
o Lobbying- “direct influence of public officials and ultimately an influence on their decisions or legislation”
o Grass Roots Mobilization- “indirectly influencing officials through constituency contract”
o Electoral Influence-“can be considered the primary prevention of policymaking because it is important activity that precedes policy work.”
o Shaping public opinion- overlaps with electoral influence and grassroots mobilization; it involves issue advocacy and public percuasion, similar to campaigning for an issue
• Landscape of contemporary health care interest groups
o American Nurses Association represented since 1974 represents as (ANA) goal- “improvement of the healthcare system in the United States”
o ANA members endorsed decisions that are formulated from ANA policy focuses and not on a candidate’s party.
• Assessing value and considering involvement
o Through involvement within interest groups nurses have capabilities of networking, engaging learning opportunities, and to improve patient care
o Advocating to the highest level for all patients
o Building on previous experiences and working as a team
• Framework for assessing Interest groups
Eight Factors to consider when looking into an interest group
o Efficiency-How does the group support, advocate and protect members?
o Effectiveness-What are the accomplishments and outcomes the interest group focuses within?
o Values- What is important to you as well as the group? Is there a connection between your passions as well beliefs within the group?
o Tactics- What methods and tools are used within the group?
o Visibility and responsiveness- How does social engagement and interaction affect members?
o Perception- What influences of other individuals affect members? What concerns do members have to be aware of?
o Costs-What are the financial contingencies members need to be aware of?
o Benefits-How can members grow, succeed and make a difference among communities?
o Interest groups provide numerous networking opportunities
o Health care policy decision topics discussions
o Benefits from interest groups discuss current topics/ issues, challenges and solutions
o I challenge each of you to get involved within a nursing organization
82 Current Issues in Nursing Associations
Associations- “groups of people who have joined together to pursue a common purpose or goal”
Registered Nurses achieve support from associations with important discussions related to compensation, hours of employment in relation to the force of labor laws, prescriptive authority, safe environments, and patient staffing ratios.
“Many of these organizations advocate for nurses and nursing in a particular area of interest. Most also advocate for patients.”
• Nursing’s professional organizations
Nursing associations bring benefits to public policy
• “Although public policy is already expensive and time consuming for organizations, much more effort is needed in helping nurses understand how this improves practice and income.”
Why do nurses not join associations?
• “Nobody asked me”
Reasons why nurses join associations
• Two primary reasons: networking & information to build upon
Membership retention issue among nursing organizations
• Economic expenses such as membership dues are not always covered by employers and then come back to nurses directly
Nursing organizations advocate for nurses by funding from nursing dues or contributions to be active in congress and state legislation decision making
• Specifically, political action at federal and state agencies
o Examples code of ethics, credentialing, working with groups with similar concerns
Leadership brings a commitment as well as purpose to an organization as opportunities provide privileges to grow and make a difference
“Volunteers are the life-blood of organizations and provide countless hours in advancing the mission”
Future in addition to present leadership numbers are a concern for many organizations due to commitments of families, personal life, work and financial constraints.
83 Professional Nursing Associations: Meeting needs of Nurses and the profession
• Evolution of Nursing Organizations
o First Nursing Organization
“late nineteenth and early twentieth centuries”
“Royal British Nursing Association”
Came about from “alumnae associations, nursing schools and alumnae groups”
• Nursing organizations and today’s nurses
o Over 120 specialty nursing associations in the United States
o Discuss current and future health concerns
An example of The Code of Ethics for Nurses (ANA)
• “The professional of nursing, as represented by associations and their members, is responsible for articulating nursing values form maintaining the integrity of the profession and its, practice and for the shaping social policy. (p.24)
• The relationship of associations and their members
“Nursing associations need members, and nurses need associations”
With health care always changing it is important to have support from an association as well as continue to support one another within the nursing profession.
o Member benefits: Gain knowledge, education, information, friendships, networking, volunteer prospects, project opportunities, professional engagement as well as advancement.
o Educational resources: Achieving new knowledge to enriching nursing skills/practice and direct patient care.
o Career advancement: Volunteering as well as joining as a member provides resume building, leadership, and mentor professional development.
o Antidote to compassion stress and fatigue: “Nurses who participate in association conference or who use association-sponsored networking tools report feeling professionally supported and invigorated as an outcome of these collegial interactions (Sadovich, 2005)”
o Professional satisfaction: Building relationships as well as friendships within a profession organization allows personal professional achievements through continually growing as an individual.
o Leadership development: Imperative for nurses to build knowledge among each other, allows for experience in communication, skills and teamwork.
• Where and When To Volunteer
o Choosing Which Organization To Join
Giving back throughout communities brings personal satisfaction and positive gratititude
o When To Join and How To Volunteer
Personal choice based on professional goals and interest
• Organizational Structure-What makes the organization what iti is? Understand the Mission. Does the organization support my values and beliefs?
• Bylaws- “rule book” Keep in mind bylaws “outline the purpose of the organization”
• Governance Policies- Provide possibly for appropriate and not appropriate changes based on organization values
o Getting Where You Want To Be In An Association
Paying it Forward
84 TAKING ACTION The Center to Campion Nursing in America: Mobilizing Consumers and
Other Stake holders
“The mission of the Center of Campion Nursing is to assure ever American has access to a highly skilled nurse when and where they need one- Center of Champion Nursing in America”
• The Center To Champion Nursing In America As A Consumer-Driven Force for Change
o The Center of Champion Nursing in America (CNNA) established in 2007.
Focus on consumer representation to support challenges among nurses (“eg., the nurse and nurse faculty shortage, and health care delivery).”
o Goals: Increase nursing enrollment as well as education demands to meet the patient needs of “twenty first century”
• Evolving Strategic Priorities
o Prepare more RN’s within the nations education system
o Diversity within RN workforces
o Improve access to for consumers to healthcare
o Leadership growth to increase nursing advancement
• Lessons Learned
o Trust is imperative for all patients
o Nursing communities earn respect and trust among patient support
o Health care is always changing
85 TAKING ACTION The Raise the Voice Campaign: Nurse Led Innovations Changing Public Policy
“Innovation distinguishes between a leader and a follower –Steve Jobs”
Focus: Patients getting the health care the deserve and nurses making a drive to improve patient care.
• Innovations and policy
o Addressing Social Determinants Of Health: Chicago Parent Program
Deborah Gross, PhD, RN, FAAN
• Target: Child abuse reflecting on parents uneducated by positive approaches to child behaviors, turning to personal cultural beliefs and norms.
• What did she do: 12 week program using videotaped scenarios focused on parenting challenges and how to effectively deal with situations.
• Conclusion: Those who completed the program had improved positive tactics to handling their child’s behavior challenges.
o Keeping People In Their Communities: Living Independently For Elders
Pennsylvania Nursing School aims improvement targeted to keep elderly patients within their homes rather than institutionalized care environments due to lower costs.
Living Independently for Elders (LIFE) formed by Medicare and Medicaid
Benefits: decrease in declining elderly adults related to “falls, unnecessary medications, emergency room use, hospitalizations, and nursing home placement”
Expense: less than institutionalized care as a result of success from LIFE program
o Raise the Voice
Nurses are constantly pushing for groundbreaking improvements within health care. To bring positive change throughout communities presently and continue to move forward into the future!
86 Coalitions: A Powerful Political Strategy
• Birth And Life Cycle Of Coalitions
o Coalition: group of people who have a mutual interest that work toward a goal together.
• Building And Maintaining A Coalition: The Primer
o Essential four Ingredients:
o Coalition Structure
• Group process
o “Norming and Storming creating group behavioral norms and settling disagreements”
Among a coalition is difficult with members having different perspectives and community targets
Trust is not always present during this phase.
o Coalition Meetings
• Complete work-exchange knowledge/information
• Social engagement
• Decision making
• Problem solve
o Promoting The Coalition
Communication is essential
• Catchy title to the audience for engagement
How to people hear about coalitions?
• Social media, advertisement and target audiences
o Funding a Coalition
Members choose how they will come up with expenses
Assign people to make contacts informing the groups mission requesting for support
• Pitfalls and Challenges
o Failure to Get Right People To Participate
o Culture And Language Differences Among Coalition Members
o Persistent Distrust Among Coalition Members
o Control Freaks And Protecting Turf
o Poor Handling Of Different Perspectives
o Failure To Act
o Losing Balance
• Political Work Of Coalitions
o Reasons Not to Advocate
Coalitions lose finical support due to loss of representation
o Reasons To Advocate
Change in laws
Goals met in addition to accomplishments
o How To Advocate With Grace
“proceed with care”
Members should understand appropriate methods that won’t endanger members or funders
• Evaluating Coalition Effectiveness
o Table 86-1 PG 631 ADD!
87 TAKING ACTION A Rough Road in Texas: Advanced Practice Nurses Build a Strong Coalition
• Coalition for nurses in Advanced Practice (CNAP)
Increase perspective authority
Ensure clinical privileging with due process
Expand third-party reimbursent
o Vision: improve the future for advanced practice nurses as well as patients
o Today: CNAP provides government expertise and focusses power for all APN groups
88 TAKING ACTION The National Coalition for Lesbian, Gay, Bisexual, and Transgender Health
• Lesbian, Gay, Bisexual, and Transgender Health (LGBT)
o Equal healthcare access among all people regardless of sexual orientation, gender, gender identity, gender expression, or character of sex differentiation/intersex
o Healthcare service access and payment coverage must include full reproductive services (including family planning and pregnancy termination). No matter if a patient is able to pay for services or not.
o Every patient is treated equally maintaining dignity, confidentiality and hipaa standards
o Military personal with any sexuality background are also included within equal health care as well as medical treatment and “not fear risking discharge from the military services”
89 Taking Action The Virginia Nursing Kitchen Cabinet
o Kitchen Cabinet Mission
Founded by: Legislative Coalition of Virginia Nurses Association
Promote awareness to candidates regarding nursing profession shortage, advise resolutions, effect political campaigns and transform public policy
90 The Politics of Pharmaceutical Industry
• Medications Demands on patients
o Values Conflict
• New medications
• Demands for current medications
o Detailing-“combines education-like activity with traditional advertising”
It was estimated in 2005, “6.8 billion dollars or 22% of promotion spending” departed toward detailing
• Along with, “18.4 billion or 58% of promotion spending went to free drug samples”
• Public concerns
o “The public wants treatment to be based solely on a clinical assessment of the patient’s best interests, not on personal or monetary considerations tied to specific medications, but industry promotion is designed to sell particular drugs in service of the company’s primary goal of profitability”
What is one of your biggest concerns as you further your education in regards to advanced practice roles as an educator or as a nurse practitioner in relation to policy and politics?
How has or will a nursing organization you have joined or are considering to join influenced your current nursing practice? What do you hope to get out of the nursing organization experience?
Where do you see Pharmaceutical Industry in 5, 10 and 20 years from today? What do you hope comes in the future? How will the patient experience be influenced?