Bringing Nursing Competence Into the Policymaking Process

There are many ways to think about stakeholders and interest groups. For example, some interests may be considered public interest rather than self-interest. All people affected by health policy want to know how it will affect the people and things they care about and how they can influence those policies. To effectively influence the policymaking process, nurses must successfully analyze the process and influence it with a high degree of political competence. Policy development that is dominated by public interest generally follows a course of action that is based on data, information, and community values and addresses a solution to an actual or potential problem. It tends to be practical decision making. Policy generated by self-interest often follows a course of action with a predominantly special interest focus connected to the concerns of individuals or group interests over public interest.

Organizations that are provider-focused tend to focus on access, cost, and revenue. There is a focus on the structure of the health delivery system and points of access to their services. Stakeholder organizations that are not solely of a single provider type tend to have a broader agenda, including educational programs that develop the health workforce, insurers, pharmaceutical industry, hospitals, and medical supply companies. Although these other stakeholder organizations each have agendas of their own, it is easy to see where coalitions or policy networks can form around issues (Longest, 2010). For example, hospitals and educational programs can form coalitions around health workforce development. These stakeholder coalitions exert enormous influence in shaping health policy.

An example of a provider interest group is the National Association of Pediatric Nurse Practitioners (NAPNAP) which identified childhood obesity as a organizational priority and, as a result, created a childhood obesity special interest group which participated in a wide range of governmental committees, interviews on news media, and development of clinical practice guidelines, as well as creating culturally appropriate resources for parents. Pediatric NPs have effectively participated in a range of policy and clinical endeavors to address the alarming childhood obesity epidemic (NAPNAP, 2013) (See Box 7-2).

Box 7-2