The following are the benefits our state can get from implementing the same legislation that mandates the nurse-patient ratio in our hospitals:
- Mandating nurse-patient ratios reasonably decreases the workload of licensed nurses, affording them more time to devote close attention to the conditions of their patients (Aiken, Sloane, Cimiotti, Clarke, Flynn, Seago, Spetz, and Smith, 2010; Bolton, Aydin, Donaldson, Brown, Sandhu, Fridman, and Aronow, 2007).
- A decreased workload also results in decreased reports of burnouts and job dissatisfaction among nurses which keep them more encouraged to remain in their jobs (Aiken et al., 2010).
- A decreased workload among nurses also results in higher output and lower mortality rates (Aiken et al., 2010).
- A decreased workload among nurses resulting to higher work output is also proportional to more patients being satisfied with the care being offered to them which in turn also results to decreased incidences of patient-to-nurse verbal abuse (Aiken et al., 2010).
- Mandating the nurse-patient ratio in hospitals also results in decreased employment of other ancillary workers, therefore producing more licensed nurses who are good at managing various tasks in relation to the healthcare of their patients and reducing the employment of less-experienced workers (Aiken et al., 2010; McHugh, Kelly, Sloane, and Aiken, 2011).
- A decrease in workload among nurses, with reference to the California’s mandate as benchmark, generally results to improved nurse recruitment and retention, and overall improved patient care and service delivery (Aiken et al., 2010).
My Strategies to Influence Votes
A well-mandated nurse-patient ratio is the best solution to the problems brought about by overstaffing of nurses and other ancillary personnel in hospitals. In order for a nurse-patient ratio mandate to be implemented and followed, a legislator needs to pass a law that will prompt its enactment in hospitals all over the state. However, a legislator must be persuaded to get him/her interested with following the proposition and shepherding it up to its legislation—an act called lobbying.
Lobbying requires knowledge of the issue being discussed, knowledge of its oppositions, and the background of the legislator being approached (League of Women Voters of Washington, 2004). In order for me to influence legislators and persuade them into putting my campaign to materialization, faithful and persistent lobbying is the key. According to League of Women Voters of Washington (2004), direct communication with a legislator is the most powerful way to influence his/her decision to support the bill being proposed. There are three ways by which an advocate can demonstrate faithful and persistent lobbying: (1) personal visits, (2) telephone calls, and (3) well-crafted letters—all this topped by a strategic timing (League of Women Voters of Washington, 2004).
Personal visits to the legislators are highly beneficial as these could give me the advantage of personally discussing the bill with them. By personally talking to the legislators, I also get the chance of establishing a lively discussion with them where they get to ask questions and express their concerns which may be answered and addressed immediately. Personal visits are also helpful in establishing a firm impression of the advocates being highly concerned with the issue (League of Women Voters of Washington, 2004), resulting to a better chance of getting a vote in favor of their advocacy. Personal visits can also give me the opportunity of knowing all the staffs of my chosen legislator, which is always helpful as they play significant roles in the legislator’s office. According to Abood (2007), an active interaction with the staffs of a legislator is one way of making sure that all the necessary information is conveyed and heard, thus increasing the advocate’s influence and the likelihood of the proposition to be processed and shepherd into legislation. Personal visits can also pave a good friendship between an advocate and a legislator. Making telephone calls are also proven to be an effective way to follow-up the progress of the proposed mandate. Telephone calls are useful in reminding or supplying information that the legislator might need but would not have time to set a meeting for. And just like personal visits, telephone calls also help in firming the legislator’s impression of the advocate about his/her eagerness to have the bill processed into materialization. Letters are also one of the best ways to influence a legislator to vote for and support an advocate’s proposed bill. A well-written letter is oftentimes better and given more weight than a lengthy formal petition carrying multiple signatures (League of Women Voters of Washington, 2004). For this reason, a letter addressed to a legislator can best serve the purpose of an individual advocate who aims to have his/her opinions heard by a lawmaker (League of Women Voters of Washington, 2004). Furthermore, Abood (2007) states that well-crafted letters and other forms of mails that show gratitude and supply information to the legislator are forms of effective communication with the lawmaking body, increasing the chance of the mandate being actually legislated.
Aside from the legislator, the local public also holds an important position in shepherding the mandate through its enactment. The local public is the one that deems if the bill being proposed is something that is really necessary and worth pushing through legislation. The local body also needs to be persuaded as they will stand as the most important supporters of a bill being proposed.
The best way to influence the vote of the local public is to hold seminars or conferences that will mostly target the attention of the officials and of the people within the workforce. Conferences and seminars will serve the best purpose of disseminating information about the campaign being held among the local leaders. Aside from conferences and seminars, the social media can also serve as an information post. Dissemination of information through the social media also has the advantage of targeting more citizens—regardless of their occupational or educational background—that will be concerned about the topic within a shorter period of time than would other forms of local public campaign.
Above all, a clear platform on how the mandate on nurse-patient ratio could help the hospitals and patients will serve the best purpose of raising awareness among the local public and the legislative body.
Increasing My Power to Influence Votes
As advocates for a better healthcare system through proper nurse staffing, nurses are at an advantage in talking the public and legislators over to support a bill on mandated nurse-patient ratio. We are the ones who are at the frontline, together with patients and other medical practitioners, in experiencing the impacts of a disproportioned workload, thus making us the best candidates to campaign for the legislation of the mandate being tackled on hand. As Abood (2007) enumerated, nurses advocating for a better healthcare through proper nurse staffing can utilize any, a combination, or all of these powers: potential, expert, legitimate, referent, reward, and coercive power. Power in this sense is the “potential to exert influence” (Abood, 2007). As nurses serving as legislative advocates for a mandate on nurse-patient ratio, we have the advantages of (1) knowing more about the issue as we get to experience it first hand, (2) knowing the best possible solutions as we have already analyzed possible setbacks, disadvantages, and advantages due to repeated exposure to the problem, and (3) having already formulated a proper way to approach the problem. But aside from these seemingly naturally available advantages, we, advocate-nurses, can have better potential to exert influence by (1) joining larger advocate groups that campaign for the same outcome regarding the issue at hand, (2) increasing credentials for better recognition as a credible advocate, and (3) by holding programs that will target other nurses and get them interested into campaigning for the same cause.
Larger advocate groups are undeniably better heard. Although this does not nullify the effectiveness of individual advocacy, joining a larger advocate group increases the chance of the campaign actually getting noticed by the legislators. Also, larger advocate groups can help in increasing an individual advocate’s credibility.
Increasing credentials as a nurse is also a way to establish a recognizable character in the eyes of the legislator. A nurse advocate that has achieved so much in his/her field of profession makes a very notable person in the legislative arena.
Lastly, holding programs that will raise awareness of the issue among other unfamiliar or less-concerned nurses can be a good way to educate them with the importance of the advocacy therefore, leading them to be more aware, concerned, and engaged with the campaign and thus strengthening more the workforce of nurses that actively promote the advocacy to the legislators and the public.
References
Abood, S. (2007, 31 January). Influencing Health Care in the Legislative Arena. OJIN: The Online Journal of Issues in Nursing, 12(1). DOI: 10.3912/OJIN.Vol12No01Man02
Aiken, L.H., Sloane, D.M., Cimiotti, J.P., Clarke, S.P., Flynn, L., Seago, J.A., Spetz, J., and Smith, H.L. (2010). Implications of the California Nurse Staffing Mandate for Other States. Health Research and Educational Trust, xx(xx), 1-18. DOI: 10.1111/j.1475-6773.2010.01114.x
Bolton, L.B., Aydin, C.E., Donaldson, N., Brown, D.S., Sandhu, M., Fridman, M., and Aronow, H.U. (2007, November). Mandated Nurse Staffing Ratios in California: A Comparison of Staffing and Nursing-Sensitive Outcomes Pre- and Postregulation. Policy, Politics, and Nursing Practice, 8(4), 238-250. DOI: 10.1177/1527154407312737
League of Women Voters of Washington. (2004). How to Lobby Your Legislator. Retrieved from http://www.lwvwa.org/pdfs/lobby_your_legislator.pdf
McHugh, M.D., Kelly, L.A., Sloane, D.M., Aiken, L.H. (2011, July). Contradicting Fears, California’s Nurse-To-Patient Mandate Did Not Reduce The Skill Level Of The Nursing Workforce In Hospitals. National Institute of Health, 30(7), 1299-1306. DOI: 10.1377/hlthaff.2010.1118.
