▫ Politics is the exercise of power ▫ Politics is the public allocation of values ▫ Politics is the resolution of conflict ▫ Politics is the competition among individuals, groups, or states pursuing their interests

POLITICS AS COOPERATION, OR INTEGRATION – POLITICS AS CONFLICT - as the process of rule based on order and justice. Politics is driven by the considerations of the common good. More natural for the thinking of those who support the existing social order (status quo) At any given moment, in any political process or event, one can discover elements of both cooperation and conflict which interact in various ways as struggle for power. Politics is driven by selfish interests of individuals, groups, businesses, states. More natural for the thinking of those who would like to change the status quo in their favour.

The fuel of politics. The ability to make, or to influence the making of, those binding decisions which are the essence of politics Struggle for power Distribution of power: how fair? how equal? how effective? Balance of power Great power, superpower, hyperpower A powerful leader

TYPES OF POWER POLITICAL POWER : control of, or influence on, the state, ability to make, or influence, political decisions ECONOMIC POWER : control of economic assets MILITARY POWER : ability to wage war - or to compel others through intimidation or deterrence

1. AN INTERACTIVE PROCESS (you have to have someone to have power over) 2. POTENTIAL or ACTIVE 3. A PURPOSEFUL ACTIVITY 4. PROMOTIVE (Do it!) or PREVENTIVE (Don’t do it!) 5. BALANCED or UNBALANCED (“Absolute power corrupts absolutely” – Lord Acton). Democracy associated with balanced power

1. FORCE – ability to detain and harm people and damage or confiscate their property to compel them to obey your orders 2. PERSUASION – ability to convince people to do what they otherwise would not have done by invoking their own interests and common sense 3. AUTHORITY – legitimate (just and lawful) power to control and direct people’s activities 4. COERCION – controlling people by means of threatening use of force 5. MANIPULATION – controlling people without threats, by persuading them about the legitimacy of the existing power relationships, or by offering them benefits

TYPES OF LEGITIMACY (Max Weber, Politics as a Vocation) TRADITIONAL – based on tradition, established beliefs or values (example: rule of dynasties, power of the church) LEGAL-RATIONAL – based on formal arrangements (rules, laws, constitutions). The main type practiced in contemporary politics CHARISMATIC*– based on the extraordinary personal qualities of a leader, or on the influence of an idea or a cause *from ancient Greek word “charisma”, meaning “gift”

Nurses serve an essential function to society, assisting doctors in diagnosing and treating patients who are sick or injured. Significant decisions that have a dramatic impact on nurses are made at the government level. If you are a nurse or training to become a nurse, it can be helpful to understand the political issues that influence the nursing community. Funding Health insurance Education Pharmaceutical companies

Politics is a means to an end, the end consisting of public policy Political involvement leads to public policy formation If nurses wish to affect outcomes in policy formation, they must be involved in politics The term politics refers to the "exercise of influence"

Influence can be exerted on: the workplace by affecting the development of institutional policies, the community through activities on local boards professional organizations by participating on committees or serving as an officer, and government through involvement in campaigns, letter writing, and voting

Nurses hold a level of stature that is highly respected and trusted. The role of nurses in health promotion is recognized by international, national, and state organizations. This type of empowerment broadens nursing's political focus and increases respect for the profession on all political levels. Nurses, as individuals, frequently do not address political issues that affect the profession. Nurses focus on clinical care and sometimes ignore larger issues, partially due to a heavy workload, but also due to a lack of understanding of how to influence public policy. Timing is a crucial aspect in politics. Nurses need to recognize the factors that can potentiate change.

Public policy formation. There are four main steps in the process of public policy formation: setting an agenda government response policy design and program implementation

Visionary leaders can bring nursing to the next level of professionalism and involvement. If nurses can rid themselves of their traditional tunnel vision, they can participate in the promotion and election of visionary leaders.

WHO's key focus on policy development encompasses many nursing philosophies. The organizations' policies for action include: integrating health and human development into public policies ensuring equitable access to health services promoting and protecting health preventing and controlling specific health problems

Target politicians Power is not evenly distributed in Parliament, or provincial legislatures. Target only those politicians who have the authority to make the change you want and then concentrate your resources on them -- including your ads.

Politics in health care, as elsewhere, consists in exercising power, consolidating power, or effecting a change in power relationships - or put more crudely, working the system to advance one's interests.

According to the Socialization Paradigm, the traditional division of masculine and feminine roles has deprived women of an adequate political education, undermined their motivation to become politically active, and encouraged them to devalue both themselves and other women. the difficulties faced by women around issues of power and leadership are built into the dramatically different division of labour between men and women in most organizations.

Kanter (1977) has identified three factors as critical in limiting the influence of women in decision-making and policy spheres: blocked opportunities for advancement; limited power to mobilize resources; and the problem of tokenism whereby women are kept "in their place" in situations where men vastly outnumber them.

Her analyses underscore the importance of structural approaches to helping nurses gain greater political influence. Specifically, there is a need for strategies which take account of the structural forces that support stereotyping: blocked opportunity, powerlessness, and tokenism.

 Control of health care resources is spread among a number of vested interest groups called stakeholders.  All these stakeholders tend to exert political pressure on health policy makers in an effort to make the health care system work to their economic advantage.  Nursing has a long history of pulling together the various stakeholders and coordinating health care services to ensure that patients obtain the health services they need. 21

 All nurses and patients are affected on a daily basis by public policy, as well as by the political actions of other stakeholders in the health care system  By understanding the influence of both internal and outside pressures on nursing practice and patients, nurses are more able to support what is most important to them. 22

 Nurses who are politically active have a definitive voice in their work environments for patient welfare, as well as for themselves.  As nurses develop politically, they come to understand the need for political strategy.  It is critical that nurses listen to other policy perspectives and understand as many facets of the issue as possible when making health policy proposals. 23

 To be most politically effective, nurses must be able to clearly articulate at least four dimensions of nursing to any audience or stakeholder: ◦ What nursing is ◦ What distinctive services nurses provide to consumers ◦ How nursing benefits consumers ◦ What nursing services cost in relation to other health care services 24

 As recipients of health care are required to pay a larger portion of the cost for health care services, consumers are demanding to be treated as something more than passive recipients of health care.  Nurses, working through professional organizations, have been strong, early supporters for patient rights, regardless of the patient’s ability to pay.  Any political vision to make health care more consumer-friendly and service-oriented must address cost, access, choice, and quality. 25

 Nurses have opportunities to be more than supporters of a consumer-oriented vision for health care; they can be cocreators of it.  Nurses must have a clear image of the vision, develop a sound philosophy, demonstrate intelligent and strategic thinking, and wield more political influence.  Health care operates in a political context of rapid change and high financial risks. Stakeholders who are willing to take the greatest risks are afforded the most opportunities, pending good timing and appropriate political action. 26

 Health care professionals, including nurses, depend upon each other to ensure the quality, consistency, and overall effectiveness of health care within their work environments.  Some consumers are demanding system- level changes, in addition to greater personal accountability by those who are a part of the health care system. 27

 To have credibility, nurses must demonstrate professional competence and a degree of professional accountability that exceeds consumer expectations.  Nurses gain credibility through more education, higher level functioning, and greater accountability.  As consumer advocates, nurses are accountable to the public and the profession beyond a particular employment setting. 28

 Nurses have a professional responsibility to help consumers make better health care choices and not fall victim to misleading information, quick cures, or dangerous practices.  Beyond advocacy for an individual patient, or a patient group, nurses can work to create a more supportive health care environment that encourages input and feedback among the various stakeholders or constituencies.  If nurses believe that what they do for consumers is essential or highly valuable, nurses must manifest strategic political behaviors and take political actions for consumers of health care services. 29

 To ensure the best use of resources for health care, it is necessary to continually work to ascertain what forms of practices in health care are most effective, which necessarily involves value judgments that should not be made by any one or two vested interests.  Effective dialogue among professionals and individuals being served by those professionals takes time and considerable effort to build. Moreover, an understanding of the perspectives of the people being served is vital for real social change to occur. 30

 Partnerships should openly acknowledge the potential for disparate political views and redress it by building health care models that are guided by the realities of the community and its people being served.  Nurses can and should partner with consumers to prepare them for this new level of consumer involvement and accountability. 31