1. Pols321
Week 5

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

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

4. Nurses as a Profession
Pre 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.

5. Nursing as a Profession
Post transfer of responsibility for nursing education out of the hospital and into university and community college settings

6. Policy determinants

7. Lomas, 2000

8. The Policy Community

10. The Policy Community: An Alternative View

11. Policy process

12. Applied Problem-Solving Model of the Policy Cycle
Agenda
Setting
Problem
Recognition
Monitoring Results
Policy
Evaluation
Policy Formulation
Proposal
Solution
Implementation
Putting Solution into Effect
Decision-making
Choice of Solution

13. Defining a Problem Causality Severity Incidence Novelty Proximity
Crisis
Problem Populations
Instrumental vs. Expressive Or.
Solutions

14. 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

15. 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

16. 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

17. Communication Start communicating with decision makers early
Make communications uncomplicated
Know the right time and places to introduce your information to the policy process 24

18. 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

19. 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

20. 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.

21. How Can Nurses Make a Difference?