Policy & Politics in Nursing

Policy & Politics in Nursing and Health Care Seventh Edition

Diana J. Mason, PhD, RN, FAAN

Rudin Professor of Nursing

Co-Director of the Center for Health, Media, and Policy

School of Nursing

Hunter College

City University of New York

New York, New York

Deborah B. Gardner, PhD, RN, FAAN, FNAP

Health Policy and Leadership Consultant, LLC

Honolulu, Hawaii

Freida Hopkins Outlaw, PhD, RN, FAAN

Adjunct Professor

Peabody College of Education

Vanderbilt University


Nashville, Tennessee

Eileen T. O’Grady, PhD, NP, RN

Nurse Practitioner and Wellness Coach

McLean, Virginia


Table of Contents

Cover image

Title page


About the Editors





What’s New in the Seventh Edition?

Using the Seventh Edition

Acknowledgments Unit 1 Introduction to Policy and Politics in


Nursing and Health Care

Chapter 1 Frameworks for Action in Policy and Politics

Upstream Factors

Nursing and Health Policy

Reforming Health Care

Nurses as Leaders in Health Care Reform

Policy and the Policy Process

Forces That Shape Health Policy

The Framework for Action

Spheres of Influence


Health and Social Policy

Health Systems and Social Determinants of Health

Nursing Essentials

Policy and Political Competence

Discussion Questions


Online Resources

Chapter 2 An Historical Perspective on Policy, Politics, and Nursing

“Not Enough to be a Messenger”

Bringing Together the Past for the Present: What We Learned From History



Discussion Questions


Online Resources

Chapter 3 Advocacy in Nursing and Health Care

The Definition of Advocacy

The Nurse as Patient Advocate

Consumerism, Feminism, and Professionalization of Nursing: the Emergence of Patients’ Rights Advocacy

Philosophical Models of Nursing Advocacy

Advocacy Outside the Clinical Setting

Barriers to Successful Advocacy


Discussion Questions


Online Resources

Chapter 4 Learning the Ropes of Policy and Politics

Political Consciousness-Raising and Awareness: the “Aha” Moment

Getting Started

The Role of Mentoring

Educational Opportunities

Applying Your Political, Policy, Advocacy, and Activism Skills

Political Competencies

Changing Policy at the Workplace Through Shared Governance


Discussion Questions


Online Resources

Chapter 5 Taking Action: How I Learned the Ropes of Policy and Politics

Mentors, Passion, and Curiosity

Chapter 6 A Primer on Political Philosophy

Political Philosophy

The State

Gender and Race in Political Philosophy

The Welfare State

Political Philosophy and the Welfare State: Implications for Nurses

Discussion Questions


Online Resources

Chapter 7 The Policy Process

Health Policy and Politics

Unique Aspects of U.S. Policymaking

Conceptual Basis for Policymaking

Bringing Nursing Competence Into the Policymaking Process


Discussion Questions



Online Resources

Chapter 8 Health Policy Brief: Improving Care Transitions

Improving Care Transitions: Better Coordination of Patient Transfers among Care Sites and the Community Could Save Money and Improve the Quality of Care1


Online Resources

Chapter 9 Political Analysis and Strategies

What is Political Analysis?

Political Strategies

Discussion Questions


Online Resources

Chapter 10 Communication and Conflict Management in Health Policy

Understanding Conflict

The Process of Conversations

Listening, Asserting, and Inquiring Skills


Discussion Questions


Online Resources

Chapter 11 Research as a Political and Policy Tool


So What is Policy?

What is Research When It Comes to Policy?

The Chemistry between Research and Policymaking

Using Research to Create, Inform, and Shape Policy

Research and Political Will

Research: Not Just for Journals

Discussion Questions


Online Resources

Chapter 12 Health Services Research: Translating Research into Policy

Defining Health Services Research

HSR Methods

Quantitative Methods and Data Sets

Qualitative Methods

Professional Training in Health Services Research


Fellowships and Training Grants

Loan Repayment Programs

Dissemination and Translation of Research Into Policy

Discussion Questions


Online Resources


Chapter 13 Using Research to Advance Health and Social Policies for Children

Research on Early Brain Development

Research on Social Determinants of Health and Health Disparities

Advancing Children’s Mental Health Using Research to Inform Policy

Research on Child Well-Being Indicators

Research on “Framing the Problem”

Gaps in Linking Research and Social Policies for Children

Nursing Advocacy

Discussion Questions


Online Resources

Chapter 14 Using the Power of Media to Influence Health Policy and Politics

Seismic Shift in Media: One-to-Many and Many-to-Many

The Power of Media

Who Controls the Media?

Getting on the Public’s Agenda

Media as a Health Promotion Tool

Focus on Reporting

Effective Use of Media

Analyzing Media

Responding to the Media



Discussion Questions


Online Resources

Chapter 15 Health Policy, Politics, and Professional Ethics

The Ethics of Influencing Policy

Reflective Practice: Pants on Fire

Discussion Questions

Professional Ethics

Reflective Practice: Foundational Nursing Documents

Personal Questions

Reflective Practice: Negotiating Conflicts between Personal Integrity and Professional Responsibilities

Personal Question

U.S. Health Care Reform

Reflective Practice: Accepting the Challenge

Personal Question

Reflective Practice: the Medicaid 5% Commitment—an Appeal to Professionalism

Discussion Question

Reflective Practice: Your State Turned Down Medicaid Expansion

Personal Question

Reflective Practice: Barriers to the Treatment of Mental Illness

Personal Question

Ethics and Work Environment Policies


Mandatory Flu Vaccination: the Good of the Patient Versus Personal Choice


Discussion Questions


Online Resources

Unit 2 Health Care Delivery and Financing

Chapter 16 The Changing United States Health Care System

Overview of the U.S. Health Care System

Public Health

Transforming Health Care Through Technology

Health Status and Trends

Challenges for the U.S. Health Care System

Health Care Reform

Opportunities and Challenges for Nursing

Discussion Questions


Online Resources

Chapter 17 A Primer on Health Economics of Nursing and Health Policy

Cost-Effectiveness of Nursing Services

Impact of Health Reform on Nursing Economics

Discussion Questions



Chapter 18 Financing Health Care in the United States

Historical Perspectives on Health Care Financing

Government Programs

The Private Health Insurance and Delivery Systems

The Problem of Continually Rising Health Care Costs

The ACA and Health Care Costs

Discussion Questions


Online Resources

Chapter 19 The Affordable Care Act: Historical Context and an Introduction to the State of Health Care in the United States

Historical, Political, and Legal Context

Content of the Affordable Care Act

Impact on Nursing Profession: Direct and Indirect

Overall Cost of the Aca

Political and Implementation Challenges


Discussion Questions


Online Resources

Chapter 20 Health Insurance Exchanges: Expanding Access to Health Care


What is a Health Insurance Exchange?

Exchange Purchasers

Other Health Insurance Options

Federal or State Exchanges


Development of the Exchanges

Establishing State Exchanges

The Federal Exchange Rollout: ACA Setback

New York’s Success Story

The Oregon Story

Exchange Features

Marketplace Insurance Categories

Role of Medicaid

Nurses’ Roles with Exchanges

Consumer Education

State Requirements Include Aprns in Exchange Plans

Assessing the Impact of the Exchanges and Future Projections


Discussion Questions


Online Resources

Chapter 21 Patient Engagement and Public Policy: Emerging New Paradigms and Roles

Patient Engagement Within Nursing


Patient Engagement and Federal Initiatives

The VA System: an Exemplar of Patient-Centered Care

From Patient Engagement to Citizen Health


Discussion Questions


Online Resources

Chapter 22 The Marinated Mind: Why Overuse Is an Epidemic and How to Reduce It

Commonly Overused Interventions

Reasons for Overuse

Financial Incentives as the Major Cause of Overuse

The Marinated Mind

Physician and Nurse Acknowledgment of Overuse

Public Reporting to Reduce Overuse

Journalists Advocate for More Transparency About Overuse

Discussion Questions


Online Resources

Chapter 23 Policy Approaches to Address Health Disparities

Health Equity and Access

Policy Approaches to Address Health Disparities

Evaluating Patient-Centered Care



Discussion Questions


Online Resources

Chapter 24 Achieving Mental Health Parity

Historical Struggle to Achieve Mental Health Parity

Implications for Nursing: Mental Health Related Issues and Strategies

Discussion Questions


Online Resources

Chapter 25 Breaking the Social Security Glass Ceiling: A Proposal to Modernize Women’s Benefits1

Benefits for Women

Strengthening the Program

Changes We Oppose

Strengthening Financing

Discussion Questions


Online Resources

Chapter 26 The Politics of the Pharmaceutical Industry

Globalization Concerns

Values Conflict

Direct to Consumer Marketing


Conflict of Interest





Discussion Questions


Online Resources

Chapter 27 Women’s Reproductive Health Policy

When Women’s Reproductive Health Needs are Not Met

Why Do We Need Policy Specifically Directed at Women?

Women’s Health and U.S. Policy

Discussion Questions


Online Resources

Chapter 28 Public Health: Promoting the Health of Populations and Communities

The State of Public Health and the Public’s Health

Impact of Social Determinants and Disparities on Health

Major Threats to Public Health

Challenges Faced by Governmental Public Health

Charting a Bright Future for Public Health

Discussion Questions



Online Resources

Chapter 29 Taking Action: Blazing a Trail…and the Bumps Along the Way—A Public Health Nurse as a Health Officer

Getting the Job: More Difficult Than You Might Think

Creating Access to Public Health Care in West New York

On-the-Job Training

Political Challenges

Safe Kid Day Arrives

Nurses Shaping Policy in Local Government

Successes and Challenges


Chapter 30 The Politics and Policy of Disaster Response and Public Health Emergency Preparedness

Purpose Statement

Background and Significance

Presidential Declarations of Disaster and the Stafford Act

Policy Change After September 11

The Politics Underlying Disaster and Public Health Emergency Policy

The Homeland Security Act

Project Bioshield 2004

Pkemra 2006 and Disaster Case Management

National Commission on Children and Disasters 2009

Threat Level System of the U.S. Department of Homeland Security



Discussion Questions


Online Resources

Chapter 31 Chronic Care Policy: Medical Homes and Primary Care

The Experience of Chronic Care in the United States

Medical Homes

The Role of Nursing in Medical Homes

Patient-Centered Medical Homes: the Future

Discussion Questions


Online Resources

Chapter 32 Family Caregiving and Social Policy

Who are the Family Caregivers?

Unpaid Value of Family Caregiving

Caregiving as a Stressful Business

Supporting Family Caregivers

Discussion Questions


Online Resources

Chapter 33 Community Health Centers: Successful Advocacy for Expanding Health Care Access

Community Health Centers Demonstrate the Advocacy Process for



The Creation of the Neighborhood Health Center Program

Program Survival and Institutionalization

Continuing Policy Advocacy

The Expansion of Community Health Centers Under a Conservative President

Community Health Centers in the Era of Obamacare

Discussion Questions


Online Resources

Chapter 34 Filling the Gaps: Retail Health Care Clinics and Nurse- Managed Health Centers

Retail Health Clinics

Access and Quality in Retail Clinics

Retail Clinics and Cost

Challenges and Reactions to the Model

Nurse-Managed Health Clinics

Future Directions for Retail Clinics and NMHCs

Discussion Questions


Online Resources

Chapter 35 Developing Families

The Need for Improvement

Social Determinants and Life Course Model


Innovative Models of Care

Health Care Reform

Barriers to Sustaining, Spreading, and Scaling-Up Models


Discussion Questions


Online Resources

Chapter 36 Dual Eligibles: Issues and Innovations

Who are the Duals?

What are the Challenges?

Health Care Delivery Reforms That Hold Promise

Implication for Nurses

Policy Implications

Discussion Questions


Online Resources

Chapter 37 Home Care and Hospice: Evolving Policy

Defining the Home Care Industry

Home Health


Home Medical Equipment

Home Infusion Pharmacy

Private Duty


Reimbursement and Reimbursement Reform

Hospital Use and Readmissions and the Focus on Care Transitions

Quality and Outcome Management

The Impact of Technology on Home Care

Championing Home Care and Hospice and the Role of Nurses

Discussion Questions


Online Resources

Chapter 38 Long-Term Services and Supports Policy Issues

Poor Quality of Care

Weak Enforcement

Inadequate Staffing Levels

Corporate Ownership

Financial Accountability

Other Issues

Home and Community-Based Services

Public Financing


Discussion Questions


Online Resources

Chapter 39 The United States Military and Veterans Administration Health Systems: Contemporary Overview and Policy Challenges


The MHS and VHA Budgets

Advanced Nursing Education and Career Progression

Contemporary Policy Issues Involving MHS and VHA Nurses

Post-Deployment Health-Related Needs


Seamless Transition


Discussion Questions


Online Resources

Unit 3 Policy and Politics in the Government

Chapter 40 Contemporary Issues in Government

Contemporary Issues in Government

The Central Budget Story

Fiscal Policy and Political Extremism

How Will the Nation’s Economic Health be Addressed?

The Impact of Political Dysfunction


Loss of Congressional Moderates


Congressional Gridlock: Where is the President’s Power?

Beleaguered Health Care Reform

Implementation Challenges


Increasing Access

Affordable Care Act Costs and Savings

Legal Challenges to the ACA

Immigration Reform: Will Health Care be Included?

Current Health Care Access

The Ethics and Economics of Access

Immigration Health Care Reform Options

Rising Economic Inequality

Measuring Wealth

The Great Recession Reshaped the Economy

Costs of Economic Inequality

Impact of Economic Inequality on Health Equity

Effectively Addressing Economic Inequality

Proposed Policy Strategies

Climate Change: Impacting Global Health

Climate Change: It’s Happening

Mitigation Versus Adaptation

International Progress

Adaptation is Local

Examples of Health in All Policies

Nursing Action Oriented Leadership


Discussion Questions



Chapter 41 How Government Works: What You Need to Know to Influence the Process

Federalism: Multiple Levels of Responsibility

The Federal Government

State Governments

Local Government

Target the Appropriate Level of Government

Pulling It All Together: Covering Long-Term Care

Discussion Questions


Online Resources

Chapter 42 Is There a Nurse in the House? The Nurses in the U.S. Congress

The Nurses in Congress

Evaluating the Work of the Nurses Serving in Congress

Political Perspective

Interest Group Ratings

Campaign Financing

Sources of Campaign Funds


Online Resources

Chapter 43 An Overview of Legislation and Regulation

Influencing the Legislative Process


Regulatory Process

Discussion Questions


Online Resources

Chapter 44 Lobbying Policymakers: Individual and Collective Strategies

Lobbyists, Advocates, and the Policymaking Process

Lobbyist or Advocate?

Why Lobby?

Steps in Effective Lobbying

How Should You Lobby?

Collective Strategies

Discussion Questions


Online Resources

Chapter 45 Taking Action: An Insider’s View of Lobbying

Getting Started

Winds of Change Coming in State Legislatures

Political Strategies

There Really is a Need for Lobbyists

Chapter 46 The American Voter and the Electoral Process

Voting Law: Getting the Voters to the Polls

Calls for Reform


Voting Behavior

Answering to the Constituency

Congressional Districts

Involvement in Campaigns

Campaign Finance Law

Types of Elections

The Morning After: Keeping Connected to Politicians

Discussion Questions


Online Resources

Chapter 47 Political Activity: Different Rules for Government- Employed Nurses

Why Was the Hatch Act Necessary?

Hatch Act Enforcement

Penalties for Hatch Act Violations

U.S. Department of Defense Regulations on Political Activity

Internet and Social Media Influence


Discussion Questions


Online Resources

Chapter 48 Taking Action: Anatomy of a Political Campaign

Why People Work on Campaigns


Why People Stop Working on Campaigns

The Internet and the 2012 Election Campaign

Campaign Activities

Discussion Questions


Online Resources

Chapter 49 Taking Action: Truth or Dare: One Nurse’s Political Campaign

Stepping Into Politics

Ethical Leadership

Making a Difference

Lessons Learned

Chapter 50 Political Appointments

What Does It Take to be a Political Appointee?

Getting Ready

Identify Opportunities

Making a Decision to Seek an Appointment

Plan Your Strategy

Confirmation or Interview?


After the Appointment

Experiences of Nurse Appointees



Discussion Questions


Online Resources

Chapter 51 Taking Action: Influencing Policy Through an Appointment to the San Francisco Health Commission

Democracy and Service to the Health Commission

Checks and Balances of Health Commission Activities

Scope of Work of the Health Commission

Infrastructure of the Health Commission

Balancing Health Commission Service with Academia

Introspection: Re-Experiencing Decision Making on the Health Commission


Chapter 52 Taking Action: A Nurse in the Boardroom

My Political Career

My Campaign

Campaign Preparation

Launching the Campaign

Lessons Learned

The Future


Chapter 53 Nursing and the Courts

The Judicial System


Judicial Review


The Role of Precedent

the Constitution and Branches of Government

Impact Litigation

Expanding Legal Rights


Enforcing Legal and Regulatory Requirements

Antitrust Laws and Anticompetitive Practices

Criminal Courts

Influencing and Responding to Court Decisions

Nursing’s Policy Agenda

Discussion Questions


Online Resources

Chapter 54 Nursing Licensure and Regulation

Historical Perspective

The Purpose of Professional Regulation

Sources of Regulation

Licensure Board Responsibilities

Licensure Requirements

The Source of Licensing Board Authority

Disciplinary Offenses


Regulation’s Shortcomings


Discussion Questions


Online Resources

Chapter 55 Taking Action: Nurse, Educator, and Legislator: My Journey to the Delaware General Assembly

My Political Roots

Volunteering and Campaigning

There’s a Reason It is Called “Running” for Office

A Day in the Life of a Nurse-Legislator

What I’ve Been Able to Accomplish as a Nurse-Legislator

Tips for Influencing Elected Officials’ Health Policy Decisions

Is It Worth It?


Unit 4 Policy and Politics in the Workplace and Workforce

Chapter 56 Policy and Politics in Health Care Organizations

Financial Pressures From Changing Payment Models

The Broadening Influence of Outcome Accountability

A Door Opens—Policy to Support the Role of the Nurse Practitioner


Discussion Questions



Online Resources

Chapter 57 Taking Action: Nurse Leaders in the Boardroom

Getting Started

Are You Ready?

Discussion Questions


Online Resources

Chapter 58 Quality and Safety in Health Care: Policy Issues

The Environmental Context

The Policy Context: Value-Driven Health Care

Value-Based Payment and Delivery Models

Impact of Value-Driven Health Care on Nursing


Discussion Questions


Online Resources

Chapter 59 Politics and Evidence-Based Practice and Policy

The Players and Their Stakes

The Role of Politics in Generating Evidence

The Politics of Research Application in Clinical Practice

The Politics of Research Applied to Policy Formulation


Discussion Questions


Online Resources

Chapter 60 The Nursing Workforce

Characteristics of the Workforce

Expanding the Workforce

Increasing Diversity

Retaining Workers

Addressing the Nursing Workforce Issues


Discussion Questions


Online Resources

Chapter 61 Rural Health Care: Workforce Challenges and Opportunities

What Makes Rural Health Care Different?

Defining Rural

Rural Policy, Rural Politics

The Opportunities and Challenges of Rural Health

Discussion Questions


Online Resources

Chapter 62 Nurse Staffing Ratios: Policy Options


The Establishment of California’s Regulations

What Has Happened as a Result of the Ratios?

What Next?

Discussion Questions


Online Resources

Chapter 63 The Contemporary Work Environment of Nursing

Primary Factors

Secondary Factors

American Hospital Association (AHA) Report

Crucial Communication

Discussion Questions


Online Resources

Chapter 64 Collective Strategies for Change in the Workplace

Building a Culture of Change

Workplace Cultures Differ

Implementing the Change Decision

Examples of Change Decisions


Discussion Questions


Online Resources


Chapter 65 Taking Action: Advocating for Nurses Injured in the Workplace

Life Lessons

Becoming a Voice for Back-Injured Nurses

Establishing the Work Injured Nurses Group USA (WING USA)

Legislative Efforts to Advance Safe Patient Handling

The Future


Chapter 66 The Politics of Advanced Practice Nursing

Political Context of Advanced Practice Nursing

The Political Issues

Toward New APN Politics: Overcoming Appeasement and Apathy

Discussion Questions


Chapter 67 Taking Action: Reimbursement Issues for Nurse Anesthetists: A Continuing Challenge

Nurse Anesthesia Practice

Nurse Anesthesia Reimbursement

Advocacy Issues in Anesthesia Reimbursement

TEFRA: Defining Medical Direction

Physician Supervision of CRNAs: Medicare Conditions of Participation

Medicare Coverage of Chronic Pain Management Services




Chapter 68 Taking Action: Overcoming Barriers to Full APRN Practice: The Idaho Story


Nurturing the Passion to Achieve Statutory Change

Building Broad Coalitions and Relationships

Sustaining the Effort and the Vision

Removing Barriers to Autonomous APRN Practice

The Stars Align

The 2012 NPA Revision


Chapter 69 Taking Action: A Nurse Practitioner’s Activist Efforts in Nevada

Being a Leader

Activism Means Leaving Your Comfort Zone

Honing Your Verbal and Nonverbal Messages

Activism Requires Funding Knowledge

Developing Activist Skills Through Experience


Chapter 70 Nursing Education Policy: The Unending Debate over Entry into Practice and the Continuing Debate over Doctoral Degrees

The Entry Into Practice Debate

The Entry Into Advanced Practice Debate



Discussion Questions


Online Resources

Chapter 71 The Intersection of Technology and Health Care: Policy and Practice Implications

Public Policy Support for HIT


Discussion Questions


Online Resources

Unit 5 Policy and Politics in Associations and Interest Groups

Chapter 72 Interest Groups in Health Care Policy and Politics

Development of Interest Groups

Functions and Methods of Influence

Landscape of Contemporary Health Care Interest Groups

Assessing Value and Considering Involvement


Discussion Questions


Online Resources


Chapter 73 Current Issues in Nursing Associations

Nursing’s Professional Organizations

Organizational Life Cycle

Current Issues for Nursing Organizations


Discussion Questions


Online Resources

Chapter 74 Professional Nursing Associations: Operationalizing Nursing Values

The Significance of Nursing Organizations

Evolution of Organizations

Today’s Nurse

Organizational Purpose

Associations and Their Members

Leadership Development

Opportunities to Shape Policy

Influencing the Organization


Discussion Questions


Online Resources

Chapter 75 Coalitions: A Powerful Political Strategy


Birth and Life Cycle of Coalitions

Building and Maintaining a Coalition: the Primer

Pitfalls and Challenges

Political Work of Coalitions

Evaluating Coalition Effectiveness

Discussion Question


Online Resources

Chapter 76 Taking Action: The Nursing Community Builds a Unified Voice

The Necessity of Coalitions

Coalition Formation

Defining a Coalition’s Success: the Importance of Leadership and Goal Setting

A Perspective on Nursing’s Unified Voice

Nursing Unites: the Nursing Community



Chapter 77 Taking Action: The Nursing Kitchen Cabinet: Policy and Politics in Action

The Context

Discussion Questions



Chapter 78 Taking Action: Improving LGBTQ Health: Nursing Policy Can Make a Difference

LGBTQ Rights in the United States

Nursing and LGBTQ Advocacy

Taking Action



Online Resources

Chapter 79 Taking Action: Campaign for Action

The Future of Nursing Report

A Vision for Implementing the Future of Nursing Report

Success at the National Level

Success at the State Level



Online Resources

Chapter 80 Taking Action: The Nightingales Take on Big Tobacco

Tobacco Kills

Ruth’s Story

The Personal Becomes Political

Compelling Voices

Strategic Planning

Kelly’s Story


Policy Advocacy

Shareholder Advocacy: “the NURSES are Coming…”

Extending the Message

What NURSES Can Do

Nursing is Political

Lessons Learned: Nursing Activism

Discussion Questions


Online Resources

Unit 6 Policy and Politics in the Community

Chapter 81 Where Policy Hits the Pavement: Contemporary Issues in Communities

What is a Community?

Healthy Communities

Partnership for Improving Community Health

Determinants of Health

Discussion Questions


Online Resources

Chapter 82 An Introduction to Community Activism

Key Concepts

Taking Action to Effect Change: Characteristics of Community Activists and Activism


Challenges and Opportunities in Community Activism

Nurses as Community Activists

Discussion Questions


Online Resources

Chapter 83 Taking Action: The Canary Coalition for Clean Air in North Carolina’s Smoky Mountains and Beyond

Lessons in Communicating

Persuasion: the Integrated Resource Plan Example

Speaking to Power

Clean Air: a Mixed Blessing

The Crucible of Financial Challenge

Efficient and Affordable Energy Rates Bill

Nurses’ Role in Environmental Stewardship


Chapter 84 How Community-Based Organizations Are Addressing Nursing’s Role in Transforming Health Care

Community as Partner and the Community Anchor

Accountable Care Community

Superstorm Sandy

the Population Care Coordinator

Hospital Partnerships and Transitional Care

Vulnerable Patient Study



Discussion Questions


Online Resources

Chapter 85 Taking Action: From Sewage Problems to the Statehouse: Serving Communities

Sewage Changed My Life

My Campaigns

The Value of Political Activity in Your Community

Leadership in the International Community

Mentoring Other Nurses for Political Advocacy

Recommendations for Becoming Involved in Politics

Chapter 86 Family and Sexual Violence: Nursing and U.S. Policy

Intimate Partner and Sexual Violence Against Women

State Laws Regarding Intimate Partner and Sexual Violence

Federal Laws Related to Intimate Partner and Sexual Violence

Health Policies Related to Intimate Partner and Sexual Violence

Child Maltreatment

State and Federal Policies Related to Child Maltreatment

Health Policies Related to Child Maltreatment

Older Adult Maltreatment

State and Federal Legislation Related to Older Adult Maltreatment

Health Care Policies Related to Older Adult Maltreatment

Opportunity for Nursing


Discussion Questions


Online Resources

Chapter 87 Human Trafficking: The Need for Nursing Advocacy

Encountering the Victims of Human Trafficking

Advancing Policy in the Workplace

Role of Professional Nursing Associations

Advocating for State Legislation and Policy on Human Trafficking

Advancing Policy Through Media and Technology

Trafficking as a Global Public Health Issue

The World of the Victims

International Policy

U.S. Response to Human Trafficking


Discussion Questions


Online Resources

Chapter 88 Taking Action: A Champion of Change: For Want of a Hug

What Happened?

The Struggle to Find Help

We Got Help, but What About Others?

Commitment in My Community


Meeting Basic Needs

Gang Violence Prevention

It Takes a Village


Chapter 89 Lactivism: Breastfeeding Advocacy in the United States

Why Advocate for Breastfeeding?

The Historic Decline in Breastfeeding in the United States

Culture of Breastfeeding

Action to Support Breastfeeding

The Need for Breastfeeding Advocacy Education

Discussion Questions


Online Resources

Chapter 90 Taking Action: Reefer Madness: The Clash of Science, Politics, and Medical Marijuana

A Plant with an Image Problem

Once upon a Time, Cannabis Was Legal

How and Why Did the Marijuana Prohibition Begin?

My Introduction to the Problem of Medical Cannabis Use

An Opportunity for Education

Barriers and Strategies

Patients Out of Time

The Tide is Shifting


Looking Ahead at a Paradigm Shift


Chapter 91 International Health and Nursing Policy and Politics Today: A Snapshot



Global Health

The Policy Role of the World Health Organization

The Millennium Development Goals

Beyond the Millennium Development Goals

Human Resources for Health

Advanced Nursing Practice

The World Health Organization and Nursing

Nursing’s Policy Voice

Getting Involved

Discussion Questions


Chapter 92 Infectious Disease: A Global Perspective


Determinants of Infectious Disease Introduction and Transmission

Ebola Virus Disease Outbreak: West Africa, 2014

Surveillance and Reporting



Discussion Questions


Online Resources




3251 Riverport Lane St. Louis, Missouri 63043 POLICY & POLITICS IN NURSING AND HEALTH CARE ISBN: 978-0-323-24144-1

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Library of Congress Cataloging-in-Publication Data Policy & politics in nursing and health care / [edited by] Diana J. Mason, Deborah B. Gardner, Freida Hopkins Outlaw, Eileen T. O’Grady.—Seventh edition. p.; cm. Policy and politics in nursing and health care Includes bibliographical references and index. ISBN 978-0-323-24144-1 (pbk. : alk. paper) I. Mason, Diana J., 1948-, editor. II. Gardner, Deborah B., editor. III. Outlaw, Freida Hopkins, editor. IV. O’Grady, Eileen T.,


1963-, editor. V. Title: Policy and politics in nursing and health care. [DNLM: 1. Nursing–United States. 2. Delivery of Health Care– United States. 3. Politics–United States. 4. Public Policy–United States. WY 16 AA1] RT86.5 362.17′3–dc23 2015008880 Senior Content Strategist: Sandra Clark Content Development Manager: Laurie Gower Senior Content Development Specialist: Karen Turner Content Development Specialist: Jennifer Wade Publishing Services Manager: Jeff Patterson Senior Project Manager: Clay S. Broeker Design Direction: Ashley Miner Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1


About the Editors

DIANA J. MASON, PhD, RN, FAAN, is the Rudin Professor of Nursing and Co-Founder and Co-Director of the Center for Health, Media, and Policy (CHMP) at Hunter College and Professor at the City University of New York. She served as President of the American Academy of Nursing (2013-2015) and as Strategic Adviser for the Campaign for Action, an initiative to implement the recommendations from the Institute of Medicine’s Future of Nursing report, to which she contributed. From 2012 to 2015 she served as Co-President of the Hermann Biggs Society, an interdisciplinary health policy salon in New York City.

Dr. Mason was editor-in-chief of the American Journal of Nursing for over a decade. Under her leadership, the journal received numerous awards for editorial excellence and dissemination, culminating in the journal being selected by the Specialized Libraries Association in 2009 as one of the 100 most influential Journals of the Century in Biology and Medicine—the only nursing journal to be selected for this distinction.

As a journalist, she has produced and moderated a weekly radio program on health and health policy (Healthstyles) for 30 years. She blogs for HealthCetera (www.centerforhealthmediapolicy.com) and for the JAMA News Forum. In 2009, she was appointed to the National Advisory Committee for Kaiser Health News—the only nurse and health professional on the Committee.

She is the lead co-editor of The Nursing Profession: Development, Challenges, and Opportunities, part of the Robert Wood Johnson Foundation Health Policy Book Series. She has been the lead co-


editor of all seven editions of Policy & Politics in Nursing and Health Care.

She is the recipient of numerous honors, including Honorary Doctorates from Long Island University and West Virginia University; fellowship in the New York Academy of Medicine; and the Pioneering Spirit Award from the American Association of Critical Care Nurses.

DEBORAH B. GARDNER, PhD, RN, FAAN, FNAP, is a health policy and leadership consultant. She has more than 35 years of health care experience as a clinician, manager, trainer, and consultant delivering care across diverse institutional and community settings. Dr. Gardner practiced as a psychiatric mental health clinical nurse specialist for 15 years. She received a PhD in Nursing Administration and Health Policy from George Mason University.

At the National Institutes of Health (NIH) Clinical Center she established and held the position as the Director of Organizational Planning and Workforce Development for 10 years. She served at the Bureau of Health Professionals, Health Resources and Services Administration (HRSA) as a senior consultant collaborating on the implementation of the Affordable Care Act (ACA) (2010-2012). As the Director of the Hawaii State Center for Nursing, she led the State’s Campaign for Action Coalition, a Robert Wood Johnson Foundation Initiative to support the Institute of Medicine’s Future of Nursing report.

In 2012 she served as a member of the Hawaii Governor’s Healthcare Transformation Steering Committee to assess and refocus Hawaii’s health care delivery system for alignment to the ACA goals.

A Fellow in the American Academy of Nursing and in the National Academy of Practice, she was instrumental in establishing the National Center for Interprofessional Practice and Education in Minneapolis, Minnesota. She has received numerous awards, including the HRSA Administrator’s Special Citation for National Leadership in Interprofessional Education and Collaborative Practice, an International Coaching Federation Award for

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