Importance of Advocacy

Importance of Advocacy

Healthcare policy provides nurses with the context in which to practice, defines their roles as well as integrating appropriate standards for the delivery of care and addressing conditions necessary for that care to occur (citation policies 2). The primary concern for nurses is patient care; however, healthcare policies influence decisions made by nurses as they strive to offer services that comply with payer guidelines. Medical policies often describe these requirements and define the conditions that nurse practitioners must meet to receive payment (Xue et al., 2016). Healthcare policies the items and services covered and the steps nurse practitioners must take to receive payment. Healthcare policies represent society’s health goals and priorities at micro and macro levels. It is policies at the micro level-policies within the narrow scope of a practitioner’s work responsibilities- that directly influence nursing practice. Nurses, on their part, can also impact healthcare policy by joining professionals and advocacy (Burke, 2016). Nurses need to understand that they have the capacity and responsibility to influence current and future healthcare delivery systems.

Importance of Advocacy

Advocacy is an essential component of the advanced practice nurse’s role. Restrictions in practice are one of the significant challenges nurse practitioners face, with only 19 states and the District of Columbia, allowing full practice authority. Despite this and other limitations, nurse practitioners can influence policies aiming at breaking down these barriers. New and experienced nurses need to advocate for better state and federal policies (Estes, 2017). Nurse practitioners need to get involved, write, and talk with their legislators regularly since they are at an advantage as most legislators do not have a background in healthcare. The need for advocacy arises due to the disconnect between the high level of care that advanced practice is well prepared to offer and the limited degree of care that outdated state practice laws allow them to deliver. Nurse practitioners should collaborate with other stakeholders in introducing bills that help expand their roles in clinical settings. Furthermore, the American Nurses Association believes that advocacy is the pillar of nursing (ANA, 2020).

Impact of Healthcare on Population Health

Healthcare policy has a significant influence on population health. For example, the passing of the Affordable Care Act (ACA) increased insurance access for Americans. However, uniform implementation of the ACA across states based on political affiliation creates a growing divide in healthcare coverage and access associated with documentation status, income level, and state of residence (Obama, 2016). Another healthcare policy that influences population health is the Medicare Access and Children’s Health Insurance Program Reauthorization Act (MACRA) (Hussey, Liu & White, 2017). The policy introduced changes that aim at rewarding healthcare providers that offer value-based quality care at low costs as opposed to the volume of care provided. The potential of ACA and MACRA to transform the healthcare industry translates to better access and care delivery, which could improve population health.

Smoking in the United States

In the United States, tobacco use leads in the causes of preventable disease, disability, and death. As of 2017, the number of adult smokers in the U.S. was 34 million, the number of non-smokers exposed to secondhand smoke was 58 million, and about 2,000 minors smoked their first cigarette, with more than 300 of the minors becoming daily smokers (CDC, 2017). Moreover, 3.6 million U.S. middle and high school students used tobacco products as of November 2018, compared to 2 million in 2017. More than 16million people had a medical condition caused by smoking. Americans spend more than $300 billion each year on smoking-related illnesses, with $170 billion in direct medical costs. Effecting appropriate smoking bans will prevent young people from starting to smoke as well as help smokers to quit.

Smoking Ban in Higher Education Institutions

As of 2017, Virginia laws prohibited smoking in public schools only. In 2019, a ban on smoking and e-cigarettes at Virginia schools was put in place. The law prohibits smoking on school property or any school function in Virginia. Based on this ban, the students proposed the extension of the prohibition to universities and colleges in Virginia. The rationale of the smoking ban is protecting young students from exposure to smoking in schools will reduce the number of new smokers. The proposed ban aims to promote healthy lifestyles for students both physically and mentally.

Benefits of Quitting Smoking

Irrespective of age, quitting smoking has benefits. They include the body initiating the healing process immediately, the risk of heart attack significantly drops, the chances of stroke reduces, the possibility of cancer of the mouth, throat, esophagus, and bladders decreases by half within five years of quitting, the risk for other conditions such as peripheral artery disease, cardiovascular diseases, and other forms of cancer also reduces (Kuehnle & Wunder, 2017). Also, people with diabetes have better control of sugar levels when they quit smoking. Additionally, when a person quits smoking, they protect their family, friends, and coworkers from the health risks linked to breathing secondhand smoke. The benefits quitting smoking to the individual and those close to them improve community health. Also, the economic benefits of tobacco in the community are replaceable and are meager when compared to the extent of human life lost.

Presentation to John Bell

John Bell is a senator in Virginia State, representing the 13th District. Bell champions policies to address the opioid addiction crisis, which he had a personal encounter with (Bell, 2019). Similar to opioids, smoking is also substance use, and some of the policies targeting the prevention of opioid addiction also address smoking, such as educating students on the danger of drug addiction. Therefore, Bell is a perfect choice as the elected official as his support is vital in implementing the proposed ban. The slides Presented to Bell Included Smoking in the United States, Smoking Ban in Higher Education Institutions, and Benefits of Quitting Smoking.

Bell’s Response

Bell acknowledged that the selection of the health concern was convinient, and the proposed ban was appropriate and that the presentation was good. However, he added that for such a proposal to be considered for legislation, a lot more needs to be done. He recommended the following: justification why the proposed ban would be more effective than other interventions, whether the ban interferes with students’ and other people’s rights, resistance to the proposed barriers would face, and the efficacy of the intervention in other states.

Self-Reflection

Before the presentation, I had little information on the prevalence of smoking in Virginia and nationally, the adverse effects of smoking, and the benefits of quitting smoking both to the individual and community. Researching on these issues enable me to go through many articles on the same, deepening my understanding of the process.

Also, the type of intervention selected depends on various factors such as preference, culture, and geographic area. No intervention fits all settings and that the appropriate intervention must address these factors, among others. In Virginia, extending a smoking ban seems to take priority over other interventions.

The revisions I would make to the proposed intervention, as suggested by the elected official is to make the research more extensive to include advantages and disadvantages of implementing the smoking ban and how it impacts all stakeholders.

I have learned that healthcare policy significantly impacts the nursing profession. Policies not only descried the nurse’s scope of practice but also determine the type of services for reimbursement. Similarly, nurses can influence healthcare policy by gaining a good understanding of their effect on the profession and advocating for better policies that improve the quality of care and ensure better outcomes for patients.

Future Plans

Possible future opportunities for advocating for a smoking ban in tertiary institutions include joining media campaigns on drug and substance abuse, collaborating with community groups raising awareness on the effects of tobacco and other drugs, and presenting the revised proposal to Bell.

As mentioned above, the potential revision includes adding more information on the potential impact of the intervention on all concerned parties, its advantages and disadvantages, potential barriers, and its efficacy in other states.

The American Nurses Association (ANA) could help support a smoking ban in schools at all levels. The association recognizes that tobacco is the leading cause of preventable diseases and that individuals need to take of their health. The ANA recommends pharmacies to stop selling tobacco products (ANA, 2020). Also, it urges healthcare providers to educate pharmacies and drug stores education on tobacco cessation and training to support customers.

Conclusion

In the United States, tobacco use leads in the causes of preventable disease, disability, and death. It affects both smokers and non-smokers. In recent years there has been a significant increase in the number of minor and young adults starting to smoke. Effecting appropriate smoking bans will prevent young people from starting to smoke as well as help smokers to quit. A presentation to John Bell, a member of the Virginia senate, included information on the prevalence of smoking in the U.S. the adverse effects of smoking, a proposed smoking ban in all levels of schools, and the benefits of quitting smoking.