Political Competence & Advocacy Sarah Wickenhagen, DNP , APRN, - PDF document

9/26/2016 Political Competence & Advocacy Sarah Wickenhagen, DNP , APRN, FNP-C NPO 2016 10/ 15/ 2016 Conflict of Interest • I have no relevant relationships with any commercial interests related to this presentation. NPO 2016 10/ 15/ 2016 Obj ectives • Describe political competence and identify its 3 phases as described by Bachrach NPO 2016 10/ 15/ 2016 1

9/26/2016 “ It’s the ability to understand what you can and cannot control, when to take action, who is going to resist your agenda, and whom you need on your side. It’s about knowing how to map the political terrain and get others on your side, as well as lead coalitions. ” What is Political Competence? Bachrach, 2005 NPO 2016 10/ 15/ 2016 Nursing & Political Competency “ … ..in the pursuit of political competency and efficacy, the closer the profession comes to realizing nursing's historical mandate and meeting contemporary needs through activism and political involvement. “ Rains & Barton-Kriese, 2001 NPO 2016 10/ 15/ 2016 The Politics of Nursing- Past & Present NPO 2016 10/ 15/ 2016 2

9/26/2016 Political Competence 3 Phases Bachrach, 2005 NPO 2016 10/ 15/ 2016 Map your political terrain Anticipate your stakeholders Expect resistance What are the goals of the stakeholders? How do they compare to your goals? Disagree but still see a potential path forward? NPO 2016 10/ 15/ 2016 Get others on your side Build coalitions • Rational • Mimicking • Regulation • Expectations NPO 2016 10/ 15/ 2016 3

9/26/2016 Make things happen What’s in it for me? Network with other organizations Active leadership Communication Manage conflicts & disagreements NPO 2016 10/ 15/ 2016 Nursing Advocacy • Nurses have first- hand knowledge that can lend expertise to discussions that impact such issues as: • Quality of care • Patient safety • Cost containment • Chronic disease management • Equitable access to care and a sustainable healthcare delivery system. • Nurses continue to be ranked the highest trusted professionals among the public which make them suitable representatives to advocate for health NPO 2016 10/ 15/ 2016 NPO 2016 10/ 15/ 2016 4

9/26/2016 ACA- The Flop 29 million without coverage • Adults Medicaid Eligible: 5.0 million • Children Medicaid/CHIP Eligible: 3.0 million • Medicaid Gap: 2.8 million • Undocumented Immigrants: 4.8 million • Eligible for Subsidized Exchange policies: 6.5 million • Ineligible for Subsidized Exchange policies: 7.0 million NPO 2016 10/ 15/ 2016 ACA- The S uccess • More than 25 million obtained insurance • Care delivery and payment models transforming • Accountable Care Organizations • Medical Homes • Lower rates of Hospital Acquired infections NPO 2016 10/ 15/ 2016 Evaluation ACA Mapping Terrain Build Coalitions Make Things Happen NPO 2016 10/ 15/ 2016 5

9/26/2016 “ Despite a long history of activism, most nurses today do not feel compelled or skilled to act politically ” Magnussen, Itano & McGuckin, 2005 NPO 2016 10/ 15/ 2016 Barriers to Advocacy • Work life balance • Lack of understanding of the political process • Gender issues • Nurse Regulation • Fear of public speaking • Statutory • Apathy • Health S ystem • Fear of retaliation • Frustration with the legislative • Lack of support from peers and process that is both slow and administration tedious NPO 2016 10/ 15/ 2016 Facilitators of Advocacy • S eeing a wrong that you want to • Preparation to gain confidence make right and knowledge on behalf of their • Participation in professional communities organizations • Belief that the action would have • Encourages nurse to vote an impact or make or difference • Meet their policy makers • Use communication skills • Experience with political activism • Write letters to policy makers or the media • Mentoring from a positive • Campaign for candidates political role model NPO 2016 10/ 15/ 2016 6

9/26/2016 The Power of One Voice “ Individually we make a • # of Nurses in NPO difference; collectively we make • # of Nurses in ONA a bigger difference” • # of Nurses in Oregon Rains- Warner, 2003 • # of Nurses in ANA NPO 2016 10/ 15/ 2016 Hot Topics Nationally • Full Practice in the V A S ystem • The Medicare Access and CHIP Reauthorization Act (MACRA) • Home Healt h Care Planning Improvement Act of 2015 would allow NPs to certify their patients’ eligibility for home health care services • Promot ing Access t o Diabet ic S hoes Act (H.R. 4756), which would authorize NPs to certify their patient’s need for therapeutic shoes. • The Rural ACO Improvement Act of 2015 (S .2259) would allow the assignment of NPs' patients to Medicare S hared S avings ACOs. • The CARA (Comprehensive Addiction and Recovery Act) bill expands buprenorphine prescribing to P As and NPs. NPO 2016 10/ 15/ 2016 Hot Topics Oregon • Division 50-NP • Under revision • Division 56- Prescriptive Authority • Introducing updates that include buprenorphine prescribing NPO 2016 10/ 15/ 2016 7

9/26/2016 Learning from Political Leaders NPO 2016 10/ 15/ 2016 In conclusion… .. • Nurses must “ advocate, educate and set an example for the public” , not simply care for them. Des Jardin, 2001 • “ Political action is an expression of caring” . Falk-Rafael, 2005 NPO 2016 10/ 15/ 2016 Questions? NPO 2016 10/ 15/ 2016 8

9/26/2016 References • Avolio, Crystal D. (2014). Political Advocacy: Beliefs and Practices of Registered Nurses. Electronic Theses and Dissertations. Paper 5064. • Bachrach, S amuel. (2005). Get Them on Y our S ide: Win S upport, Convert S keptics, Get Results. Platinum Press. • Des Jardin, K. (2001). Political involvement in nursing-Politics, ethics, and strategic action. AORN Journal, 74 (5) 613-622. • Falk-Rafael, A. (2005). S peaking truth to power: nursing’s legacy and moral imperative. • Advances in Nursing S cience, 28 (3), 212-223. • Magnussen, L., Itano, J., & McGuckin, N. (2005). Legislative advocacy skills for Baccalaureate nursing students. Nurse Educat or, 30 (3), 109-112. • Primomo, J. (2007). Changes in political astuteness after a health systems and policy course. Nurse Educat or, 32 (6), 260-264. • Rains, J.W. & Barton-Kriese, P . (2001). Developing political competence: A comparative study across disciplines. Public Healt h Nursing, 18 (4), 219-224. NPO 2016 10/ 15/ 2016 9