Guest Editorial: Nurses and policy: What more is there to say?

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In 1975, Political Dynamics: impact on nurses and nursing¹ was published, in large part because the authors were teaching community mental health graduate students about community development and change and found little available for use by students. In the intervening years, the number and quality of these policy-related publications have expanded, in peer-reviewed journals, textbooks, and web-based materials. There is even a specialized journal in the field, Policy, Politics and Nursing Practice. So why this special focus in Nursing Outlook (NO)? And why now? The stated purpose of NO is to serve “nursing educators, policy makers, administrators, and practitioners with practical advice, new teaching methods and recruiting techniques, curriculum and heath policy developments, and information on proposals that will affect the profession.” Most readers of NO do not routinely read a journal devoted exclusively to policy, no matter how important policy might be to their daily work. You are busy, and your reading will be focused within a specific clinical area or practice setting, while you rely on a general journal for information on broader issues. For that reason, an issue devoted to consideration of policy and politics provides an overview and update and will, we hope, stimulate exploration beyond the superficial in some area of interest.

The timing is auspicious, as the country begins a new policy cycle under the leadership of a newly elected president who is expected to bring sweeping proposals for change to the political table. Nurses have been active in his campaign, engaged in the pre-inauguration policy development process, and may (by the time of printing) be serving in key roles within the Obama administration. Naïve observers might expect that all of their dreams of a nurse-perfect world will come true overnight. More experienced observers will at least have the patience to wait a year or so. Realists know that no single group of policy participants will achieve all that might be desired and that much active negotiating will be necessary to make any measurable progress.

The articles included in this issue cover the field of policy and politics from a variety of perspectives. Judy Leavitt discusses opportunities and examples of ways in which expert nurses can use their knowledge, their perspective, their experiences, and their skills as communicators to change public policy at all levels of government. Bethany Hall-Long reflects on the value of the nursing profession's public policy involvement and provides a case example of the author's experiences as a nurse-legislator at the state level. Kristine Gebbie provides a review of reports on nursing and nursing education issued during the 20th century to glean evidence of both progress and failure to resolve persistent questions. Connie Mullinix and Dawn Bucholtz reviewed studies of nurse practitioner quality of care from 1966 through the present and found evidence that nurse practitioners provide high-quality health care within their areas of competence. Jeanne M. Sears and Sheilah Hogg-Johnson document an example of policy-relevant research that facilitated direct policy impact and describe environmental facilitators/barriers and best practices for enhancing the effective impact of evaluation research on policy. Peter Buerhaus argues in his commentary that staffing ratios will lead to negative consequences for nurses involving the equity, efficiency, and costs of producing nursing care in hospitals.

Policy (what we are going to do) and politics (who gets to say so) are critical to the continuing development of nursing in the 21st century. The articles in this issue are not a cookbook for policy success or even a comprehensive review of the policy issues of concern to the profession. They provide, however, a window into current thinking and current issues. You are invited to let them stimulate thinking, inspire action, and support further study.

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Reference 

1. Deloughery GW, Gebbie KM. Political dynamics: Impact on nurses and nursing. St Louis, MO: CV Mosby Company; 1975;
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