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Learning the ropes of policy and politics Chapter 4 Political and policy skills are learnable and can be applied through lived experience and practice. Nurses can become influential policy influencers by finding politically savvy mentors who can teach, believe in, support, celebr...

Learning the ropes of policy and politics Chapter 4 Political and policy skills are learnable and can be applied through lived experience and practice. Nurses can become influential policy influencers by finding politically savvy mentors who can teach, believe in, support, celebrate successes, and help learn from failures. Both students and experienced nurses have unlimited ways to expand their knowledge and involvement in politics. Conceptual frameworks can help identify windows of opportunity to engage in policy and improve skills. Nurses can become significant participants and leaders in the nonlinear process of policymaking, as it is nonlinear with multiple entry points. The first step is to decide how much energy and time one is willing to devote.  Political consciousness raising: The "aha" moment. Political consciousness raising is a crucial first step in addressing issues of injustice, inequality, or powerlessness. It involves recognizing that problems are caused by system failures, such as decreased reimbursement rates, funding and eligibility for Medicaid and Medicare, and disparities in health outcomes due to health policies. Nurses may feel frustrated, angry, or hopeless until the "aha" moment, when they realize they can and must influence those who make the laws and regulations that create inequities. Nurses recognize the personal nature of policy issues and collectively accept that they can provide solutions to address the inadequacies of the health care system. This empowers individual nurses and the profession to act, which is essential for true advocacy. Being politically active as a nurse is grounded in the role of advocacy, as Florence Nightingale saw nursing in all its forms as a "calling" to be world citizens for the sake of human health. Sessler-Branden (2012) identified advocacy as a dynamic process through which nurses engage in actions with broadly stated goals, ultimately affecting a desired change at any level of patient care, health care systems, and/or health policy. Feeling empowered is essential for true advocacy and is a key aspect of political consciousness raising.  Getting started Nurses are a highly respected profession for honesty and ethical standards, yet they remain a dominant voice in health policy. To engage with policy or social justice issues, nurses need to develop communication skills and knowledge that can be applied to various platforms such as workplaces, schools, local, state, or federal policy. To get started, nurses can visit the American Nurses Association website and select a template from the Advocacy Toolkit to email, call, or write a letter to legislator. They can also connect with local state action coalitions through the Future of Nursing Campaign for Action. Participating in political rallies, attending community board meetings, and volunteering to join employer-sponsored committees can help build knowledge about governance or health policy. Employers like hospitals and universities offer platforms for bi-directional learning related to governance or health policy to help build knowledge. Nurses can take courses to increase political awareness within or outside of nursing, develop policy-networking skills, and attend local community events to become familiar faces to policymakers. Sharing their knowledge to educate people and influence decision-makers is essential, and nurses should not assume that policymakers or staffers fully understand the core issue.  Getting started cont.. Nurses benefit from learning the components of political skill, which include social astuteness, interpersonal influence, networking ability, and apparent sincerity. Social astute individuals are astute observers of others and keenly attuned to diverse social situations. Interpersonally skilled individuals have a subtle and convincing personal style that exerts a powerful influence to persuade those around them. Networking ability is adept at developing and building partnerships with diverse networks of people for beneficial alliances and coalitions. The Spectrum of Political Competencies demonstrates the breadth and variety of political and policy competencies ranging from novice to more sophisticated levels, including running for elective office. Initial experiences in activism and advocacy as a student are available through the National Student Nurses Association (NSNA) Health Policy and Advocacy Committee. Participating in lobby days and observing skilled lobbyists negotiate with policymakers are great ways to sharpen one's political skills. Nurse lobbyists and citizen activists serve as role models for nurses and students by exhibiting effective networking strategies and influencer behaviors while lobbying policymakers on specific legislation. This is real-life learning and a highly effective and practical way of developing political awareness and know-how.  Mentor advantage Emerging nurse leaders should secure a mentoring relationship to advance their careers and develop political skills. Mentoring is a teaching-learning process acquired through personal experience in a one-to-one, reciprocal relationship between two individuals. It provides opportunities for coaching, friendship, role modeling, challenging assignments, and sponsorship. Successful mentors should be trustworthy, active listeners, accessible, and supportive of the protégé's professional development. Mentoring functions of advocacy, career development, learning facilitation, and friendship are correlated with political skill development. Proficient mentoring relationships result in increased visibility, self- efficacy, access to new social networks, and greater career mobility. Mentors should be mindful of their time, schedule meetings, and be open to feedback. Peer-to-peer mentoring offers additional opportunities for support and expanding thinking.  Finding a mentor To find a mentor in politics and policy, start by identifying your areas of strength and improvement. Leverage your networks to identify activists in your area of interest. Establish a mentoring contract with agreed goals and timeframe to clarify expectations. The key criteria for a mentor are knowledge and interest in you. Give the relationship time to develop, be honest about expectations, and recognize that the mentor-protégé relationship is reciprocal. The mentorship contract should include goals, strategy, meeting frequency, duration, and method of meeting. The duration of the mentoring relationship can range from 6 to 12 months, with informal mentoring lasting longer. Discuss how progress and goals will be evaluated and outcomes accomplished.  Collective mentoring Nurses should actively mentor others to refine their skills and deepen their involvement in politics. Reciprocal collective mentoring is effective in expanding the political power of the profession and its members. Nurses should develop strategies for mentoring political neophytes and identify nurses in nontraditional careers. Networking opportunities exist among political leaders in professional associations, such as the NSNA, Graduate Nursing Student Academy, American Nurses Association, American Organization for Nursing Leadership, minority nursing associations, specialty and state nursing associations, and volunteer health-related organizations. In the workplace, health professionals can learn from influential committee leaders.  Educational opportunities Educational opportunities in health policy and politics are diverse and include continuing education programs, graduate programs in political science and policy, workshops run by campaign organizations, fellowships, and conferences. Schools of nursing offer health policy courses as core requirements or electives, while public health, public administration, and political science departments offer policy tracks, programs, and courses at baccalaureate, master's, and doctoral levels. Annual conferences on health policy are offered by academic institutions, professional associations, and health policy organizations. Other conferences may also have a health policy track or session. Workshops in politics, campaigning, or policy can provide a quick, intensive, and participatory approach. Political parties and nonpartisan groups host campaign workshops at the state and national level. The Nurse in Washington Internship (NIWI) is a 2.5-day experience sponsored by The Nursing Organizations Alliance. Learning by doing is another way to obtain valuable practical experience in health policy and politics, including volunteerism, internships, and self-study programs.  Learning by doing Internships and fellowships are valuable learning experiences that provide practical placements, mentoring, and networking opportunities to refine skills with knowledgeable leaders. These can be arranged for credit in academic programs or through local, state, and federal legislative bodies and government agencies. Professional associations like the American Nurses Advocacy Institute (ANA) offer year-long mentored experience, while organizations like the Robert Wood Johnson Foundation, the American Academy of Nursing (AAN), and state policy centers offer internships or fellowships in policy. Volunteer service is another way to learn the ropes of politics, as it helps build relationships and educate policymakers on nursing's expertise. Candidates for elective office at all levels of government welcome volunteers who donate time and energy. Professional associations like the Academy Health, American Public Health Association, the American Cancer Society, and the American Heart Association have strong advocacy and legislative programs. Check their websites for volunteer opportunities.  Learning by doing cont.. Internet discussion boards and other resources offer pathways for engagement across various policy topics to expand learning and social networking opportunities. Joining professional networking sites like LinkedIn to identify and join relevant discussion groups is essential for learning and educating policymakers. The value of reading and self-directed learning helps improve one's understanding of policy and politics. The Politics & Ideas website offers webinars and frameworks to help improve the use of knowledge for policymaking. Many types of literature, such as eBooks, podcasts, and university websites, cover diverse interests related to policy. Professional journals include updates on current political issues, while organizational newsletters feature health policy-related columns. Books can also provide valuable information on politics, policy, or health policy. Newspapers, such as the Washington Post, New York Times, Los Angeles Times, and Wall Street Journal, offer political analysis of national, regional, and local politics. Television and social media platforms like C-SPAN offer a wealth of information about the democratic process without editing, commentary, or analysis. Social media platforms like Twitter allow interest groups to interact directly and participate in televised stories and discussions. Radio continues to be a rich source of political information and debate on AM, FM, and satellite radio stations. In conclusion, nurses must learn to be savvy and use trustworthy platforms to promote their presence and expert knowledge in the field of nursing.  Fellowship experience A policy fellowship is a short-term professional development opportunity that provides structured lived experience with mentoring in a safe learning environment. The Jonas Health Policy Scholars program of the AAN provided Teresa Hagan Thomas, PhD, RN, and Emerson Ea, PhD, RN, FAAN, with an opportunity to "learn the ropes" through a robust mentored fellowship. They had access to a cadre of experienced nurse leaders who guided their policy skill development via participation on expert panels, coauthored briefs, white papers, policy networking, and mentoring. Thomas participated on AAN's Women's Health Expert Panel to promote evidence- based policies related to sexual and reproductive health care. During her fellowship, she learned strategies on how to respond swiftly to disruptive policies using a "rapid response" protocol and how to use social media and write op-eds for public online and print publications. Mentors provided expert guidance and supported her in participating in these policy processes and products.  Fellowship experience cont.. Dr. Emerson Ea began his AAN fellowship with the AAN Cultural Competence and Health Equity Expert Panel, whose mission is to advance cultural competency that leads to a measurable impact on health disparities. He assisted in the development of policy products aligned with the strategic priorities of the Academy and provided him with invaluable knowledge and experience. Ea worked as a community leader, advocating for health equity for the Filipino population in New York City. In 2017, he assumed the position of Chair-elect of Kalusugan Coalition, a multidisciplinary community-based organization representing the New York and New Jersey area to promote cardiovascular health among Filipinos. Leveraging the skills gained during his policy fellowship, he worked with Filipino restaurants in the New York City area to adopt nutrition-related policies to improve cardiovascular health among Filipinos. As a Policy Scholar at the AAN, Ea made significant contributions to a position statement on the health of migrants, refugees, and displaced persons adopted by the International Council of Nurses in 2018.