Pols321

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Pols321

• Week 5

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Outline

• Professionalism and Nurses
• Historical context
• Recent context
• Public Policy
• Policy determinants
• Policy process
• How nurses might impact on the policy process?

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Professionalism

• Exclusive claim to control over a core body of
  knowledge
• Occupational monopoly
• Control over entry into the marketplace
• Service orientation
• Professional autonomy

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Nurses as a Profession

• Pre-1980- hospital-based nursing heavily skewed
  to on-site as opposed to classroom learning,
  physician involvement in education, highly
  regimented supervisory structure, values of
  obedient commitment, supply of physicians
  moderate supply of nurses.
• Oriented to produce a cheap, subservient, readily
  available work force armed with basic knowledge
  of hospital and sanitary procedures.

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Nursing as a Profession

• Post-1980- transfer of responsibility for nursing
  education out of the hospital and into university
  and community college settings

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Policy determinants
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Lomas, 2000
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The Policy Community
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(No Transcript)
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The Policy Community An Alternative View
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Policy process
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Applied Problem-Solving Model of the Policy Cycle
Agenda Setting
Problem Recognition
Monitoring Results
Policy Evaluation
PolicyFormulation
Proposal Solution
Implementation
Putting Solution into Effect
Decision-making
Choice of Solution
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Defining a Problem

• Causality
• Severity
• Incidence
• Novelty
• Proximity
• Crisis
• Problem Populations
• Instrumental vs. Expressive Or.
• Solutions

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Agenda Setting(Problem Recognition)

• How a problem is defined has a major impact on
  how issues are addressed and what solutions are
  devised by decision makers
• gun control personal freedom vs. public safety
• health care freedom of choice vs.
  accessibility
• poverty self-reliance vs. entitlement

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Policy Formulation Decision-Making

• Once a problem has been defined, policy makers
  can then turn to developing solutions

• Steps
• establish goals relating to the defined problem
• assess what the potential solutions might be
• what resources and instruments are available to
  make potential solutions operational
• assess the impacts (costs/benefits,
  positive/negative) on the problem
• rank alternative according to established
  criteria (impacts, costs, goals)
• construct a predictive model

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Perfect Implementation(Hoggwood and Gunn)

• No insurmountable external constraints
• Adequate time sufficient resources
• Required combination of resources are available
• Policy is based on a valid theory
• Cause and effect relationships are direct and
  uncluttered
• Dependency relationships are minimal
• Objectives are agreed upon and understood
• Tasks are specified in correct sequence
• Perfect communication and coordination
• Power and compliance

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Communication

• Start communicating with decision makers early
• Make communications uncomplicated
• Know the right time and places to introduce your
  information to the policy process

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SCAM

• Source local opinion leaders
• Channel trade journals, newspapers, web pages,
  television, conferences, one-on-one
• Audience who is/are your audience/s
• Message needs to be tailored to the audience

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Concepts of Policy Impact

• Direct Impact the impact on the identified
  target group

• Political Impact

the extent to which a policy affects the
popularity, re- election chances and partisan
support of the government

• Economic Impact

the net impact on the economy

• Social Impact

extent to which a policy affects social
structures, mores, and self-esteem
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Modified Garbage Can Model

• Policy process consists of three separate
  streams
• - streams of problems
• - streams of solutions
• - streams of political opportunity
• When the three streams meet, they create a policy
  window that can be exploited by policy
  entrepreneurs.
• Timing is everything.

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How Can Nurses Make a Difference?

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