Influencing Health Care through Advocacy

Identify a problem or concern in your state, community, or organization that has the capacity to be advocated through legislation. Research the issue and complete the sections below. For each topic that requires the listing of criteria, a minimum of two criteria should be identified and discussed. Add more rows as is appropriate for the topic/proposal.

Problem   In no more than 250 words, describe the problem, who is affected, and the current ramifications. Explain the consequences if the issue continues.
    One of the major problems in the state of Texas that can be advocated through the process of legislation is the high nurse turnover rate. Texas is one of the American states that experience high rate of turnover for nurses. According to Texas Health Care Association (2021), the state’s turnover rate for practicing nurses who are registered stands at 92%. It is also reported that last year alone saw over 97% nursing assistants serving at different nursing homes within Texas quitting their jobs. Currently, the high turnover rate has disrupted the delivery of healthcare services by creating a nurse shortage (ANA, 2021). It has compromised the quality of care provided to patients due to low nurse-to-patient ratio. If the issue of nurse turnover is not addressed, it is likely to cause a serious workforce crisis in the future nursing industry. The resultant shortage of nurse practitioners can make it necessary for direct care hours to be reduced (ANA, 2021). This will help to prevent burnout of the remaining workforce. The shortage can also force the health care system to replace experienced nurses with the inexperienced ones (ANA, 2021). This is likely to lead to poor patient outcomes since inexperienced healthcare workers are in most cases prone to medical errors.
Idea for Addressing Solution   In no more than 250 words, outline your idea for addressing the issue and explain why legislation is the best course for advocacy.
Texas is already grappling with the impact of high nurse turnover and the resultant shortage. The state faces serious staffing issues. It is ranked at number 49 out of 50 in terms of worst staffing rating (Texas Health Care Association, 2021). The state pays nurses low wages. This is due to the fact that its rate of Medicaid reimbursement is 48th lowest in the country (Texas Health Care Association, 2021). It is for this reason that experienced nurses are moving out to work in other states. This has left Texas’ health care system with a less motivated workforce that is dissatisfied with its job. Under such circumstances, patients are not likely to receive quality care from nurses.   The issue of nurse turnover requires advocacy for it to be addressed. This advocacy can be effected through a legislation. There is need to endorse an appropriate bill that can help to promote nurse retention in the health care sector of Texas (Blitchok, 2018; AMSN, 2021). Such a bill will help to ensure that this state retains both experienced and highly qualified nurses. Legislative advocacy is advantageous in the sense that it brings important changes to various government policies (AMSN, 2021). For the issue at hand, there is important to introduce or sponsor bills that increase funding of nurse education, improve working conditions of nurses, and promote their general wellbeing. Such efforts can serve as incentives for attraction of many to the nursing profession.
Research the Issue   Perform research and compile information for your idea. Present substantive evidence-based findings that support your idea for addressing the problem (studies, research, and reports). Include any similar legislation introduced or passed in other states.
Evidence 1Kowalski et al (2019) sought to determine the perceptions held by nurses about what they are in need of for effective practice in various acute care hospital settings. The researchers conducted a systematic review of literature using credible databases such as CINAHL and PubMed. From the findings of the study, it was established that most nurses required sufficient resources, appropriate staffing, decision making power, autonomy, respect, and supportive leadership in order for them to do their work well. This demonstrates that such measures can help to reduce nurse turnover.    
Evidence 2Legislative advocacy can help to effectively address the problem of nurse turnover in Texas by improving retention. This strategy has given some hope to other American states that have already embraced it. For instance, the state of New York is in the process of enacting the Safe Staffing for Quality Care Act. This bill aims at establishing minimum staffing hours for registered nurses (RNS), licensed practical nurses (LPNs), and nurse aides working in nursing home residents, and setting minimum requirements for safe staffing standards within hospital environments (Barnes, 2021). This legislation is attracting more co-sponsors since it has shown that having enough nurses during the COVID-19 pandemic era is important in saving human lives. It helps to ensure that quality care services are provided to patient for better outcomes.
 
Stakeholder Support   Discuss the stakeholders who would support the proposed idea and explain why they would be in support.
Stakeholder(s) Supporting 1State government: As a major stakeholder in the health care system, Texas’ state government will support the legislation since it funds healthcare institutions. The initiative will help to enhance the government’s responsibility of providing quality care services to all citizens (ANA, n.d. a).
Stakeholder(s) Supporting 2Texas Nurses Association: will endorse the bill since its purpose is to support improvement of nursing practice (ANA, n.d. a).
Stakeholder(s) Supporting 3Texas Hospital Association: will support the law on the grounds that it aims at improving access to cost-effective and quality care to all (ANA, n.d. a).
Stakeholder Opposition   Discuss the stakeholders who would oppose the proposed idea. Explain why they would be in opposition and how you would prepare to debate or converse about these considerations.
Stakeholder(s) Opposed 1Private healthcare facilities: will oppose the bill on the grounds that working on nurse retention to lower nurse turnover in public facilities can affect their businesses. It can reduce the number of people going for their healthcare services. There is need for the facilities to understand that tackling the problem of nurse turnover can help to improve the quality of the healthcare services. Such services are crucial for the achievement of better patient outcomes (ANA, n.d. a).    
Stakeholder(s) Opposed 2Pharmaceutical firms: are also likely to make a loss if the bill pertaining to nurse retention is ratified. This effort can lower the number of customers visiting the firms. The pharmaceutical companies also need to be aware of the importance of addressing the issue of high nurse turnover (ANA, n.d. a).
  
Financial Incentives/Costs   In no more than 250 words, summarize the financial impact for the issue and the idea (added costs, cost savings, increased revenue, etc.). Provided support.
Passing a legislation that aims at enhancing nurse retention can have a significant impact in the nursing industry and the health care sector in general. Since the effort can contribute to low nurse turnover rates, it means that the healthcare system will be able to attract and retain a nursing workforce with experience and high qualifications. This approach will help to save costs since there will be no need of more financial resources for recruiting and training other nurses (National Academies of Sciences Engineering Medicine, 2021). The monetary resources can be put into another use. For instance, the can be used to improve the remuneration of the nurses.   It is also important to note that the proposed bill can enable the healthcare system to achieve its goal of providing quality and safe care services to patients. Looking for the best means of retaining nurses can lead to satisfaction of nurses and it can enhance their dedication. A satisfied and motivated workforce is likely to attract more patients to public health care facilities. This will probably help to increase the revenue of the public health care sector (Academies of Sciences Engineering Medicine, 2021). This revenue can be used to further improve the sector. For instance, it can be used to construct more facilities.
Legislature: Information Needed and Process for Proposal   Discuss the how to advocate for your proposal using legislation. Include the following:
Provide the name and complete contact information for the legislator.The proposal seeking to improve nurse retention in Texas can be advocated for through legislation. It can be presented to a legislator who can introduce it in a legislative house (Teresag_CNS, 2009). One of the legislators I would like to use in sponsoring this bill is Eddie Bernice Johnson. Johnson is a congresswoman who represents the 30th congressional district of the state of Texas (ANA, n.d. b). The choice of this legislator was informed by the fact that she is also a nurse. This means that Johnson can prioritize the interests of nurses. She can be easily reached through this physical address: Eddie Bernice Johnson 1825 Market Center Blvd. Suite 440. Dallas, TX 75207. Her phone number is (214) 922-8885.
Describe the steps for how you would present this to your legislator.In order to present the proposal to the legislator, first it is necessary make an appointment with her. During the meeting, there is need to discuss in detail with the congresswoman the reason for such a bill and how it will be important in improving nurse retention and dealing with the serious issue of high nurse turnover in Texas (Teresag_CNS, 2009). This will make her understand the importance of supporting the bill.
Outline the process if your legislator chooses to introduce your idea as a bill to congress.If Johnson agrees to sponsor the proposed legislation to the House, she will try to gain other members’ support by explaining its usefulness to the population that is targeted (Grand Canyon University, n.d). The bill can then be introduced in the House for first reading. After this, it will be subjected to the healthcare committee and subcommittee for changes to be made. From here, the bill gets to the house for consideration and amendment during the second reading. After the bill has been read for the third time, it can then be voted for or against. If voted for by many, it means it is passed. A bill that passes is taken to the president for it to be signed into a law (Grand Canyon University, n.d).
Christian Principles and Nursing Advocacy   In no more than 250 words, discuss how principles of a Christian worldview lend support to legislative advocacy in health care without bias. Be specific as to how these principles help advocate for inclusiveness and positive health outcomes for all populations, including those more vulnerable, without regard to gender, sexual orientation, culture, race, religion/belief, etc.
Christian worldview lends support to legislative advocacy in health care without bias by way of ensuring that every person is entitled to quality as well as safe healthcare services. Christian principles hold that all human beings are equal and that they must be treated with fairness (Clarke, 2018). Therefore, no person is supposed to be discriminated against when it comes to provision of basic services. This suggests that all people, including those who belong to vulnerable population groups, are supposed to access basic health care services regardless of their culture, race, ethnicity, religion, gender or sexual orientation.   One of the most important measures that can help to ensure that the above Christian principles are adhered to in the health care system is combating the high rate of nurse turnover. This initiative can play an important role in addressing nurse shortage (National Academies of Sciences Engineering Medicine, 2021). If the health care sector comes up with appropriate strategies that it can use to retain the best nursing workforce, it means that patients from all backgrounds can be able to access care service of high quality.  
   

References:

Academy of Medical-Surgical Nurses (AMSN). (2021). Advocacy: Take Action. Retrieved from https://www.amsn.org/advocacy/take-action/#/

American Nurses Association. (ANA). (2021). Federal Issues. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/federal/

American Nurses Association. (ANA). (n.d.)a. Nurses Serving in Congress. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/federal/nurses-serving-in-congress/

American Nurses Association. (ANA). (n.d.)b. State. Retrieved from https://www.nursingworld.org/practice-policy/advocacy/state/

Barnes, K. (2021). Safe Staffing for Quality Care Act passes out of Health Committee. New York State Nurses Association. Retrieved from https://www.nysna.org/press/2021/safe-staffing-quality-care-act-passes-out-health-committee#.YOVfen5RXhk

Blitchok, A. (2018). Proposed Federal RN Ratios – What You Can Do About It. Retrieved from https://nurse.org/articles/federal-staffing-ratios/

Clarke, J. (2018). Spiritual care in everyday nursing practice: A new approach. Basingstoke : Palgrave Macmillan

Grand Canyon University. (n.d.). How a Bill Becomes a Law. Retrieved from https://lc.gcumedia.com/nrs440v/how-a-bill-becomes-a-law/v3.1/#/

Kowalski, M. O., Basile, C., Bersick, E., Cole, ad. a., McClure, D. E., & Weaver, S. H. (2019). What Do Nurses Need to Practice Effectively in the Hospital Environment? An Integrative Review with Implications for Nurse Leaders. Worldviews on Evidence-Based Nursing, 17 (1): 60-70. https://doi.org/10.1111/wvn.12401

National Academies of Sciences Engineering Medicine (2021). The Future of Nursing: Leading Change, Advancing Health. Retrieved from https://www.nap.edu/read/12956/chapter/2

Teresag_CNS. (2009). How to Write to Your Legislator. Retrieved from https://allnurses.com/how-write-your-legislator-t284873/

Texas Health Care Association. (2021). Workforce crisis endangers long term care in Texas. Retrieved from https://txhca.org/texas-health-care-briefing-feb-2018/

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