We Get It

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It is exciting to see the current wisdom focusing on the importance of being actively involved in healthcare policy as a strategy for nursing leadership. This focus is particularly critical at this time in history, since we have a unique opportunity to make inroads at a time when our administration needs and desires nurses' input and expertise.

There are nurse leaders who work directly in policy making as legislators or advisors to legislators at both the state and national level. In several states, nurse leaders have assumed critical and visible roles as healthcare policy decision-makers.

Our professional organizations have also had a strong role in influencing public policy as it affects nursing and nursing issues. Recently, the scope has expanded to include multiple healthcare issues such as the process and methods of providing universal access. We are experts at understanding the issues of the uninsured and underinsured and the impact of the lack of prevention, as well as the importance of managing chronic illness. Our expertise has expanded to include issues surrounding healthcare financing and delivery; this knowledge has been embraced by nurse leaders at all levels and in all types of setting and is being taught by many universities to aspiring nurse leaders.

The role of nursing cannot be understated in determining the direction of and access to healthcare in this country. The concerns are no longer just about what is good for nursing but rather what is the best system for all users to ensure excellent outcomes with a continuing eye on efficiency. No one disputes the indispensible role that nurses have in the design and implementation of a new and better healthcare system. Certainly, President Obama recognizes our expertise and our commitment and will ensure that nurses are deeply involved at all levels from policy making to implementation.

Success depends on nurses' involvement in the 3 areas that are the framework for healthcare reform: reducing costs, guaranteeing choice (including a public option), and ensuring quality care for all. AONE, as the major voice for nurse leaders at the management and executive level, has strategically defined its advocacy and legislative priorities in the areas of economic recovery, education, public policy and advocacy, international nurse recruitment, healthcare reform, nursing intensity, pay-for-performance, and disaster preparedness.

Being prepared as nurse leaders to carry this agenda forward requires the wisdom to understand and practice ethical politics and acquire knowledge about the legislative process, quality outcomes, and efficient delivery avenues. As we examine future needs, it will take many more nurse leaders who are committed and prepared to address and carry out healthcare reform.

Learning business and financial skills for nurses has always been my mantra, for it lays the foundation for equality at the decision-making level of the organization. Adding to this is the critical nature of knowing about and being involved in healthcare policy issues. I have always enjoyed learning and teaching healthcare policy, and when I became a CEO of a public hospital I more directly participated in and was accountable for those policies that impacted under- and uninsured populations. Learning the nuances required a crash course in the political process, but what I really needed to learn was how the informal system worked. I needed a mentor and was fortunate to have one in the chairman of the board.

Mentoring to provide this experience to our nursing management staff is essential. We need the preparation to be effective. Our nurse leaders must aspire to become politically savvy on behalf of patients, families, and our profession, and we do get it.