1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Nursing Leadership & Management Patricia Kelly-Heidenthal 0-7668-2508-6

2. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 7 Politics and Consumer Partnerships

3. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company3 Objectives  Upon completion of this chapter, the reader should be able to: Describe how politics define health care services and affect nursing practice. Recognize the need for nurses to be politically involved with the consumer movement in health care. Describe the role of a nurse as a consumer advocate and political force. Propose a political strategy for strengthening nurse- consumer relationships.

4. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company4 Objectives Articulate a service-oriented plan for providing nursing services to a selected consumer interest group. Describe how demographic changes are affecting nurses and nursing services. Identify ways to strengthen one's political credibility as a professional.

5. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company5  Politics is predominantly a process by which people use a variety of methods to achieve their goals. These methods inherently involve some level of competition, negotiation, and/or collaboration.  Politics exist because resources can be limited and some people control more resources than others.

6. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company6 Stakeholders and Health Care  Control of health care resources is spread among a number of vested interest groups called stakeholders.  All these stakeholders tend to exert political pressure on health policy makers in an effort to make the health care system work to their economic advantage.  Nursing has a long history of pulling together the various stakeholders and coordinating health care services to ensure that patients obtain the health services they need.

7. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company7 Why Should the Professional Nurse Be Involved in Politics?  All nurses and patients are affected on a daily basis by public policy, as well as by the political actions of other stakeholders in the health care system  By understanding the influence of both internal and outside pressures on nursing practice and patients, nurses are more able to support what is most important to them.

8. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company8 The Politics and Economics of Human Services  All health care is inextricably linked to politics and economics, as well as to the availability and services of providers.  Health care in the United States depends heavily on a continual supply of resources from both public and private sectors.  If nurses fail to exert political pressure on the health policy makers, nursing will lose ground to others who are more politically active.

9. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company9 Cultural Dimensions of Partnerships and Consumerism  If nurses intend to form partnerships with consumer groups distinguished by cultural heritage, racial makeup, and/or ethnic background, they must understand and value diversity.  Nurses can work with the consumer movement to combine traditional consumer concerns with a wider sense of civic rights and responsibilities, and move culturally related health care issues to the forefront of politics.

10. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company10 Politics and Demographic Changes  Seniors 65 and older are likely to be the most powerful consumer group through the next two decades.  Many seniors are joining consumer groups to have a greater political voice, to influence health policy decisions, and to ensure that they receive the health care services they will need for years to come.  AARP constitutes a growing political powerhouse and an ideal consumer partner for nursing in many ways.

11. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company11 Nurse as Political Activist  Nurses who are politically active have a definitive voice in their work environments for patient welfare, as well as for themselves.  As nurses develop politically, they come to understand the need for political strategy.  It is critical that nurses listen to other policy perspectives and understand as many facets of the issue as possible when making health policy proposals.

12. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company12 Nurse as Political Activist  To be most politically effective, nurses must be able to clearly articulate at least four dimensions of nursing to any audience or stakeholder: What nursing is What distinctive services nurses provide to consumers How nursing benefits consumers What nursing services cost in relation to other health care services

13. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company13 Politics and Advocacy  The nursing profession has embraced patient advocacy for several decades.  Some concern has been voiced that the restructuring of health care is eroding the advocacy role of nurses.  Interestingly, some patients have begun advocating for nurses.

14. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company14 Advocacy and Consumer Partnerships  Consumers expect the best people to be health care providers, but are confused about what the roles and responsibilities of professional nurses entail.  Nurses are responsible for ensuring that consumers understand the critical role nurses play as consumer advocates and political activists in health care politics, as well as what nurses do as direct care providers.

15. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company15 Advocacy and Consumer Partnerships  Working through their professional organizations, nurses can collaborate with consumer groups by creating formal partnerships, which serve to promote the role of nurses as consumer advocates in health policy arenas, as well as strengthen the political position of both partners.

16. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company16 Making Health Care More Service- oriented  As recipients of health care are required to pay a larger portion of the cost for health care services, consumers are demanding to be treated as something more than passive recipients of health care.  Nurses, working through professional organizations, have been strong, early supporters for patient rights, regardless of the patient’s ability to pay.  Any political vision to make health care more consumer-friendly and service-oriented must address cost, access, choice, and quality.

17. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company17 Turning a Consumer-oriented Vision into Reality  Nurses have opportunities to be more than supporters of a consumer-oriented vision for health care; they can be cocreators of it.  Nurses must have a clear image of the vision, develop a sound philosophy, demonstrate intelligent and strategic thinking, and wield more political influence.

18. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company18 Turning a Consumer-oriented Vision into Reality  Health care operates in a political context of rapid change and high financial risks. Stakeholders who are willing to take the greatest risks are afforded the most opportunities, pending good timing and appropriate political action.

19. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company19 The Consumer Demand for Accountability  People who will own the future of health care must address the growing problem of accountability.  Most people comprehend that being accountable requires being held responsible for one’s behavior, decisions, and affiliations with others.

20. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company20 The Consumer Demand for Accountability  Health care professionals, including nurses, depend upon each other to ensure the quality, consistency, and overall effectiveness of health care within their work environments.  Some consumers are demanding system-level changes, in addition to greater personal accountability by those who are a part of the health care system.

21. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company21 Credibility and Politics  To have credibility, nurses must demonstrate professional competence and a degree of professional accountability that exceeds consumer expectations.  Nurses gain credibility through more education, higher level functioning, and greater accountability.  As consumer advocates, nurses are accountable to the public and the profession beyond a particular employment setting.

22. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company22 Helping Consumers Make Better Health Care Choices  Nurses have a professional responsibility to help consumers make better health care choices and not fall victim to misleading information, quick cures, or dangerous practices.  Beyond advocacy for an individual patient, or a patient group, nurses can work to create a more supportive health care environment that encourages input and feedback among the various stakeholders or constituencies.

23. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company23 Helping Consumers Make Better Health Care Choices  If nurses believe that what they do for consumers is essential or highly valuable, nurses must manifest strategic political behaviors and take political actions for consumers of health care services.

24. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company24 New Challenges and Better Opportunities  To ensure the best use of resources for health care, it is necessary to continually work to ascertain what forms of practices in health care are most effective, which necessarily involves value judgments that should not be made by any one or two vested interests.  Effective dialogue among professionals and individuals being served by those professionals takes time and considerable effort to build. Moreover, an understanding of the perspectives of the people being served is vital for real social change to occur.

25. Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company25 New Challenges and Better Opportunities  Partnerships should openly acknowledge the potential for disparate political views and redress it by building health care models that are guided by the realities of the community and its people being served.  Nurses can and should partner with consumers to prepare them for this new level of consumer involvement and accountability.