1. 1. Review the Scope and Standards of Nursing Practice. Which Standards relate to the role of the nurse as an advocate?
  2. 2. What are the four spheres of political action as identified by Mason, Leavitt, and Chaffee?
  3. a. These spheres are interconnected and overlapping. They include
    • i. Workplace
    • ii. Government
    • iii. Professional organization
    • iv. Community
  4. 3. Define the following terms:
  5. a. Power – one of the most difficult concepts to define and measure, “power is the potential capacity to influence events, cause change, intiate action, and control outcomes.”
    • b. Influence – power is the potential ability to influence action and the capacity to produce or prevent change. Influence is the use of power, but it is more subtle than power.
    • c. Authority – is based on one’s position within an organization that assigns power to the person assuming the role. Authority may be delegated for certain tasks.
    • d. Empowerment – it is associated with attempts to increase power and influence of oppressed groups.
  6. 4. Describe seven sources of power and identify guidelines for the use of each source of power.
    • a. Legitimate ( or positional) power – derives from one’s formal position or title in an organization
    • b. Reward power - derived from the perception of one’s abilities to bestow rewards or favors on others.
    • c. Coercive power – by contrast, arises from the perception of one’s ability to threaten, harm, or punish.
    • d. Information power – is associated with persons who are perceived to control key information
    • e. Referent (charismatic or personal) power – is derived from an individual’s own vision, sense of self, and ability to communicate these so that others regard the person with admiration and are motivated to follow
    • f. Connection (associative) power – derives from the perception that one has important contacts or relationships with others
    • g. Expert (or knowledge) power – is derived from one’s expertise, talents, and skills.
    • 5. Describe the six type of power that nurses can use when dealing with clients and significant others, as identified by Benner.
    • a. Transformative power – represents the ability of the nurse to assist clients to change their views of reality or their own self-image
    • b. Integrative Power – is the nurse’s ability to assist a client to return to a normal life
    • c. Advocacy power – enables the nurse to help a client and significant others deal with a health care bureaucracy.
    • d. Healing power – nurses can establish a healing relationship and a healing climate with a client.
    • e. Participative/Affirmative power – is the nurse’s ability to draw strength by investing it in others
    • f. Problem Solving – Commitment and caring enhance the nurse;s receptivity to cues and enables the nurse to recognize solutions that are not obvious.
  7. 6. Describe the five laws of power as identified by Berle.
    • i. Law 1: Power invariably fills any vacuum.
    • ii. Law 2: Power is invariably personal
    • iii. Law 3: Power is based on aa system of ideas and philosophy
    • iv. Law 4: Power is exercised through and depends on organizations
    • v. Law 5: Power is invariably confronted with, and acts in the presence of, a field of responsibility.
  8. 7. Define the following terms associated with Politics:
  9. a. Politics – can also be defined as “influencing-specifically, influencing the allocation of scarce resources”
    • b. Political Action – refers to action by a group by a group of individuals that is designed to attain a purpose through the use of political power or through the established political process
    • c. Policy – encompasses the choices that a society, segment of society, or organization make regarding its goals and priorities and how it will allocate its resources.
    • d. Negotiating – is a give-and-take process between individuals and groups to work out differences of opinion regarding the best solution to an issue. Two basic forms of negotiation are:
    • i. Problem-solving negotiation – both parties confer to resolve a complex situation together
    • ii. Trade-off negotiation – one party gives some concessions, or “points,” to the other party in exchange for other concessions, or points.
    • e. Networking – refers to a process in which people with similar interests and goals communicate, share ideas and information, and offer support and direction to each other.
    • i. Nursing networks
    • 1. Attending local, regional, and national conferences
    • 2. Taking classes for continuing education or toward an academic degree
    • 3. Joining alumni associations and attending alumni meetings
    • 4. Joining and participating in professional organizations
    • 5. Keeping in touch with former teachers and coworkers
    • 6. Socializing with professional colleagues.
    • f. Resolutions – are formal statements expressing the opinion, will or intent of an individual or group
    • g. Political Action Committees – endorse candidates for public office, such as the senate and the house of representatives. Because tax laws limit non-profit professional organizations from participating in various types of political activities, PACs provide an avenue for professional political action activities.
    • h. Coalitions – are alliances that distinct bodies, persons, or states form to achieve a common purpose. Coalitions are like networks in function but differ in that the members of the coalition represent groups with numerous of the coalition represent groups with numerous purposes and issues.
    • i. Lobbying – is a process in which individuals or groups attempt to influence legislators to support or oppose particular legislation
    • j. Testifying – refers to the presentation of information at a committee hearing, usually about controversial aspects of a proposed bill.
  10. 8. Describe six guidelines for negotiation.
    • a. Obtain all of the essential facts of the issue beforehand
    • b. Explore the other party’s viewpoint.
    • c. Consider the consequences of the issue and how you can deflect those consequence to support your viewpoint
    • d. Verify the strength of your own viewpoint and ways to strengthen it further; then consider ways to counteract or weaken the other party’s viewpoint
    • e. Determine any limitations surrounding your viewpoint, such as time constraints or other resources.
    • f. Consider other groups that support your viewpoint or that of the other party.
  11. 9. Identify five ways in which nurses can communicate with legislators.
    • a. A statement of the request in the first sentence and a brief summary of the issue
    • b. A brief rationale for the request
    • c. Factual data that support your viewpoint
    • d. A closing statement thanking the legislator for his or her concern and continuing support or attention
    • e. Appropriate closing.
  12. 10. Discuss nine guidelines for testifying.
    • a. Confirm the time to register
    • b. Prepare your testimony concisely and clearly in advance. Avoid the use of professional terminology that may not be understood by the legislators
    • c. Dress appropriate to convey your professional status, and introduce yourself
    • d. Maintain a courteous, professional composure throughout the hearing
    • e. Verify any time limits to your presentation so that you can present essential facts and arguments first.
    • f. Provide copies of your written testimony, including any graphs or other illustration, to each committee member
    • g. Present your material without reading it to make the presentation more interesting for the listeners
    • h. Answer any question completely
    • i. Thank the committee for allowing your testimony.
  13. 11. What legal limitations may restrict a nurse’s ability to contribute to political activities?
    a. The Hatch Act – initiated in the 1930s was to prevent government workers from being forced to support political activities. Nurses who are employed by stated governmental agencies are advised to investigate specific limitations in their state of employment.
  14. 12. What three key assumptions must precede a discussion of when and where to engage in political action?
    • a. Individuals who are deeply concerned about a particular issue or cause are most likely to identify ways to take action.
    • b. Political action in any sphere is best carried out by a group
    • c. Successful political action requires the thoughtful application of change theory.
  15. 13. What knowledge and skills do nurses need to increase their political astuteness and activity?
    • a. Keeping informed about health care issue
    • i. Obtain information from source such as newspaper, television and radio news report
    • b. Ability to analyze an issue
    • i. Identify all the relevant facts about the issue
    • c. Ability to speak out and voice an opinion
    • d. Ability to participate constructively
    • e. Ability to use power bases
  16. 14. Discuss how nurses can be politically involved in their organizations, community and government.
    • a. Professional organization – including the ANA, CAN, NLN, and NSNA – publish articles on legislative matters and encourage nurses to take action on behalf of health care consumers and the nursing profession.
    • b. The community In which the nurse lives and works can include the local neighborhood, the corporate world, the nation, and the international community. The community encompasses the workplace, professional organization and government.
    • c. The laws and regulations or local state, and federal governments greatly influence nursing practice and health care.
  17. 15. Describe eleven ways in which nurses can influence legislative and regulatory processes.
    • a. Become informed about the public policy and health policy issues that are currently used consideration at the local, state, and federal levels of government
    • b. Become acquainted with the public officials and elected officials that represent you in the legislative arena at the local, state, and federal levels of government
    • c. Call, write, or send a fax or email message to your legislator, stating briefly the position you wish him/her to take on a particular issue
    • d. Request that legislation be introduced or a regulatory change made
    • e. Become active in your professional association and work to active a strong grassroots network of members who are prepared to contact their elected representatives on key health care issues
    • f. Attend a public hearing on a bill or regulation to show support for an issue, or actually testify yourself
    • g. Build your own political resume
    • h. Volunteer to work on the campaigns of candidates who are knowledgeable and supportive of nursing’s perspective on health care issues
    • i. Seek appointment to a government task force or commission and have the opportunity to make legislative, regulatory, and public policy changes.
    • j. Seek election to public office or employment in an administrative or executive agency.
    • k. Explore opportunities to be involved with the policy and legislative process through internships, fellowships, and volunteer experienced at the local, state, and federal levels.
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