3 Reasons Why Advocating for Modern Policies Isn't Just a Job for Nurse Management

In 2009 a large restaurant company was fined more than $1 million for gender-based discrimination under Title VII of the Civil rights Act of 1964. 

The company, which had created a policy in 1938 banning men from becoming food servers, hadn't updated the policy nearly four decades after Title VII.

Now, you might be thinking… 

Isn't policy development a job for risk management or compliance officers? 

Who's full-time job is it within the healthcare setting to mitigate the risk of lawsuits and fines when the implications of non-compliance can be so large?

But according to SAI Global's 2018 Healthcare Compliance Benchmark Report, only 20% of healthcare companies have one full-time staff person managing compliance, while 13% rely on one part-time worker.

Advocating for modern policies isn't just a job for nurse management for three reasons: 1) management is overloaded with hundreds of policy reviews in a year, 2) the sheer amount of different types of policies hinder their ability to become an expert on any, and 3) they are often one-step removed from the pain points staff nurses and patients feel daily.

Management Is Overloaded

Given increasing demands between financial pressures and the top priority of direct patient care, managers may find it difficult to find time to review or update policies.

Deferring policy development, however, may result in negative consequences. You may be adhering to outdated policies and those outdated policies may lead you to carry out actions that are no longer industry-recognized practices.

Christine Tarver, ANA California's Nursing Practice Director, recently recounted a time when she had to review 39 policies in a single month. And in three years, she'll be required to review these policies again.

Nurse Managers Are Not and Can Not Be Experts on Everything Policy

On top of being strapped for time, nurse managers are responsible for the development of a variety of different policies, including:

• Patient care
• Employee health and safety
• Security
• Data privacy and IT security
• Drug handling
• Administrative and HR policies
• Social media policies
• Code of ethics
• and more…

Nurse managers not only need a breadth of policy knowledge but also depth. However, the first time nurse managers are likely exposed to healthcare or public policy is during their Masters of Science in Nursing.

While MSN's learn how to research and implement policies, evaluate outcomes, allocate and manage resources, learn advocacy skills and more, much of their policy work focuses on the system of policy development rather than the knowledge and best practices of each policy type.

(I'll probably get a few people who disagree on this point with me… I'd love to hear how you stay up to date on policy best practices!)

Bedside Nurses Feel It First

Who is the first person to administer care to patients? Nurses.

Who is responsible for coordinating the care of patients? Nurses. 

Who is most likely to develop a close relationship with their patients? Nurses.

Thanks to your frontline role, you offer a unique, expert perspective on every aspect of the health care system.

Not only are you a key voice in ongoing efforts to communicate the needs of the public, but the nature of your work often allows you to notice subtle, non-verbal language critical to management.

Understanding and addressing your patient's frustrations helps your managers make proactive policy updates rather than reactive.

Conclusion

Outdated policies can have large, detrimental effects on you and your organization. Between lawsuits and fines, policies can make or break healthcare institutions and it isn't just up to your management to resolve. 

Helping nurse managers understand the scope and context of the frustrations you and your patients feel can help them make decisions about policies faster.

Nurses have a variety of specialties and each specialty factor into policies implemented in your workspace. Advising or suggesting improvements backed up with evidence and personal stories can help management navigate different types of policies. 

And finally, you are the hands-on approach that your management may be missing. 

Being a leader isn't easy, and it's even harder when you don't fully understand the complexities involved that someone like a staff or bedside nurse knows daily. While you may feel that this is common knowledge to you, your management may not be as aware. It is up to you to ensure that you and your patients' voices are heard.

Will you stand idly by or will you be a pioneer?  Your patients' and your organization's life may depend on it.

Written by: American Nurses Association \ California Staff - advancing the nursing profession by creating nurse pioneers and advocating for modern policies and legislation.