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The Four Spheres of Political Action in Nursing: NR 506 Week 1 Discussion
Please discuss the four spheres of political action in nursing. In addition, please develop a brief argument sharing how these spheres are interconnected and overlapping by applying an example from your practice. What are some ethical considerations here?
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The Four Spheres of Political Action in Nursing SAMPLE APPROACH
The original Action framework had four spheres of influence. Workplace, government, organizations, and the community were the four spheres (Chaffee, Leavitt, and Mason, 2014). The term “workplace” has now been expanded to include the workforce as well. Organization has also been expanded to include “associations and interest groups.”
Each of the four spheres is a component of a larger and more complex system (Chaffee, Leavitt, and Mason, 2014). Nurses can have a significant impact on their communities by identifying problems, developing strategies, and advocating for change (Chaffee, Leavitt, and Mason, 2014). Nurses can get involved in their communities to have their voices heard on nursing and healthcare issues.
In terms of the workforce and workplace, a nurse can work in a variety of settings. Nurses can work in hospitals, clinics, schools, and factories, among other places, but they must all follow certain laws and other guidelines established by their state or by their scope of practice.
In terms of the workplace and workforce, we as nurses must adhere to the same standards regardless of where we work. While our job descriptions may differ significantly depending on the type of nursing we practice, we must still only practice what is specified in our scope of practice.
At our hospital, I am in charge of all new RN orientation. One aspect of our orientation that we have begun to incorporate is having nurses familiarize themselves with the Illinois Nurse Practice Act in order to determine what is within our scope of practice as nurses. After years of nursing, I was surprised to discover that I was unaware of certain items listed within.
The government responds to and funds natural disasters. They also regulate a large portion of healthcare, so how the government views health policy is important because the government has a large influence over nursing practices.
With all of the regulations imposed by payers and CMS, it is necessary to adhere to the guidelines established by these organizations. Documentation is one example from my practice that comes to mind. There are numerous fields of documentation that must be.
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The Four Spheres of Political Action in Nursing NR 506 Week 1 Discussion
completed for each patient. VTE prophylaxis, immunization status, and sepsis screening are just a few of the issues that must be addressed on each patient upon admission. Documentation on swing bed patients is another thing that comes to mind. Certain seemingly insignificant details can be extremely important when it comes to receiving payment. For swing bed patients, the nurse or CNA must record the number of people needed to assist the patient in getting out of bed. If the proper paperwork is not completed, the entire stay may be deemed unnecessary, and payment may be refused. I teach all nursing students and new employees the importance of recording the number of people needed to transfer or ambulate a patient. As previously stated, this is a very simple step that can make a significant difference.
Nurses can also become involved in lobbying for what they believe in or in changes they think need to happen.
Organizations – There are many organizations within nursing. They work together for the good of their cause. Resources can be shared which can promote networking and can limit the amount of resources used by each organization. When organizations work together, they can be much stronger and have more opportunities. At our hospital, our CEO works with many local hospitals and organizations to build strong relationships so we can build off of one another. Working together can save time, money, and resources, and eliminate having multiple people researching the same information for potential changes.
Community- It is important for nurses to become involved in their community to help to promote change when needed, or to stand up for what is current if they feel no change is needed. Nurses can both volunteer and have paid positions where they work to influence policy and changes within policy.
I currently do not have any involvement in my community other than speaking to prospective students about nursing, but many people throughout history have voiced their concerns to promote a change.
As with anything, there can be ethical concerns. Some ethical concerns that would involve government, community, and organizations would be having an ulterior motive or any conflict of interest in what the nurse is promoting or how they are choosing to speak on certain topics. Like many things within politics, there is always a concern that someone is financially backing a person and that those people have a personal interest or have something to gain by their involvement. An example I can think of is I used to work with a physician who was the Medical Director of a local nursing home. He refused to send his patients to any nursing home other than the one he was the Medical director of. He worked with the community to promote this nursing home, but it all came back to the fact that he had personal involvement as well as financial gain from his involvement.
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There can be a lot of ethical dilemmas within the workplace. Some can be as simple as the nurses and physicians not seeing eye to eye. Other ethical dilemmas could be the nurses feel like they have an inequitable workload (Bajwa, Hamid, Kanwal, Rhalid, and Mubarak, H. (2016). This is something that is especially on my mind right now. Our hospital census has been almost double what it normally is for almost four months. Nurses are feeling overworked and as if their workload is more than they can handle. There is constant talk of this. Many good nurses have left recently due to this complaint. One argument is that even with the increased census, the nurses still take much smaller patient loads than many of the neighboring hospitals are required to take. But because our nurses have been a little “spoiled” the last several years with a lower census, they now are not satisfied with a normal full patient load. The major dilemma becomes 1) are our patients being taken care of and 2) can how do we focus on being profitable while satisfying the nurses.
The Four Spheres of Political Action in Nursing References:
Chaffee, M., Leavitt, J., & Mason, D. (2014). Policy & Politics in nursing and health care. (Sixth Edition.) St. Louis, Missouri. Elselvier.
Bajwa, M., Hamid, S., Kanwal, R., Rhalid, S., & Mubarak, H. (2016). Ethical issues faced by nursing during nursing practice in District Layyah, Pakistan. Diversity & Equality in health care. Retrieved from: http://diversityhealthcare.imedpub.com/ethical-issues-faced-by-nurses-during-nursingpractice-in-district-layyah-pakistan.php?aid=10616
