1. Dissecting an Issue Class 1 January 6, 2010 Judith Anne Shaw, Ph.D., RN

2. What is an issue? Concern of widespread interest to the general public A question in dispute and the decision of special interest

3. Issue as Political Influencing others for the purpose of quality care

4. Why important for nurses? Make central and visible the ideas of nurses’ work

5. Nurses need to ask: Who benefits? What cost? Who pays cost? Who suffers? Who does not benefit? Who/what is left behind? What purpose served by no change?

6. Nurses asking political questions Highlight nurses’ work – make the work visible

7. Nurses need to- Clearly articulate the issue

8. Significance for Nursing Profession Beyond the individual nurse Large collective: organization of nurses Opportunity to speak in unison Organize to act: provincial/territory; national; & international

9. Quality of Health Care 1. 2. NatureQuality of Nursingof Health 3.Care 4. [1.standards of nursing education, 2. quality of care provided by practitioner, 3. number of nurses available, 4. milieu in which care offered]

10. Code of Ethics (Canadian Nurses Association, Patient advocacy Issues directly affecting health status of Canadians Lobbying for positive change Improving the image of nursing

11. Political Action Affects the health of Canadians

12. Nurses Most important group of health care workers

13. Issue Related to but not trend problem

14. Trend Analysis not required Signifies a direction Does not involve a solution

15. Problem Benefits from analysis One dimensional Solution apparent Usually response based Numerically measurable Resolution-immediate

16. Issue Requires analysis Multiple dimensions Multiple possibilities Multiple barriers to resolution. Persists over time

17. Comparing Issues, Problems, and Trends Issue Problem Trend RequiresBenefits from Analysis NOT analysis analysis required Multiple One dimension Signified a dimensions direction MultipleSolution is apparent Does NOT possibilitiesUsually response based involve a Numerically measurable solution Multiple barriers to resolution Persists over timeCan be resolved immediately

18. Issue Framing Topic of interest Select particular issue Articulate issue clearly Stipulate one’s beliefs and assumptions about the issue

19. Analyses: The Nature of the Issue Historical Ethical-Legal Social and Cultural Political Critical Feminist Economic

20. The Nature of the Issue What makes this issue a nursing issue? Who are other participants in the issue? What are their involvement in the issue? Who first became concerned with the subject? Who began to raise the subject as an issue and why?

21. Historical When did the issue originate? What are the conditions that led to the development of the issue? How have these conditions changed over time? What has contributed to the stance taken by participants in the issue?

22. Ethical and Legal What are the laws that influence the issue? What professional codes or legislative acts mandate participant’s responses to the issue?

23. Social and Cultural ALL issues develop in a social context. What contexts shape this particular issue? What are the prevailing attitudes in society about this issue?

24. Political Who benefits from this issue being resolved? Who benefits from things staying the same? Relationship between knowledge and power in this situation?

25. Critical Feminist Error or myths about women’s abilities or realities contained in this issue? Is the issue influenced by power inequities---?

26. Economic What ways are the forces of supply and demand at work in this issue?

27. Barriers to Resolution Inaccessibility of resources Limited understanding Irresolvable differences/ competing interests of participants Differing assumptions/key stakeholders

28. Issue Resolution Lobbying Letters to officials Letters to editors News releases Written resolution- for presentation

29. Strategy Success Dependent on: People affected by issue Interest generated Time available Human and financial resources available

30. Winning Strategy The greater the number of unified people involved- the greater the effort to address the specific issue.