Political Efficacy and Participation of Nurse Practitioners

Abstract

Twenty-eight states have laws and regulations limiting the ability of nurse practitioners (NPs) to practice to the full extent of their education and training, thereby preventing patients from fully accessing NP services. Revisions to state laws and regulations require NPs to engage in the political process. Understanding the political engagement of NPs may facilitate the efforts of nurse leaders and nursing organizations to promote change in state rules and regulations. The purpose of this study was to describe the political efficacy and political participation of U.S. NPs and gain insight into factors associated with political interest and engagement. In the fall of 2015, we mailed a survey to 2,020 NPs randomly chosen from the American Academy of Nurse Practitioners' database and 632 responded (31% response rate). Participants completed the Trust in Government (external political efficacy) and the Political Efficacy (internal political efficacy) scales, and a demographic form. Overall, NPs have low political efficacy. Older age ( p≤.001), health policy mentoring ( p≤.001), and specific education on health policy ( p≤.001) were all positively associated with internal political efficacy and political participation. External political efficacy was not significantly associated with any of the study variables. Political activities of NPs are largely limited to voting and contacting legislators. Identifying factors that engage NPs in grassroots political activities and the broader political arena is warranted, particularly with current initiatives to make changes to state laws and regulations that limit their practice.

Involvement in health policy and political efficacy among hospital nurses in Jordan: A descriptive survey

“…While internal political efficacy is defined as the confidence in one's own capabilities to understand and impact the politics, external political efficacy is defined as the confidence that the political system should be responsive to individual needs (Levy, ). Having a sense of being able to affect the political process is strongly correlated with political participation (O'Rourke, ).…”

“…Despite the size of the workforce, nurses have demonstrated less ability to influence legislative changes to health policy than other professions (Ellenbecker et al, ). Nurses do not have that much of ability to influence the legislative changes to the health policy unlike other professions (O'Rourke, ).…”

“…Several studies find a positive relationship between political efficacy and initiative political participation such as voting (Ahoya et al, ; Gil de Zúñiga et al, ; Jun et al, ; Salvador, ). More recently, O'Rourke et al () found low levels of nurses’ participation in political activities, and political efficacy among 632 U.S. nurses. The results showed that nurse practitioners who were older, having a specific education in health policy, and having a mentor in health policy had higher levels of internal political efficacy and political participation.…”

Developing a strategic model of participation in policy development for nurses

“…Nursing educational institutions can include health policy as part of the curriculum. Research has shown that policy knowledge is associated with increased political participation (O'Rourke et al ). Although many educational programmes emphasize legislative policy and its process, developing political competencies is largely absent (Benton et al ).…”

“…Nurses’ contributions to policy development include identifying policy implementation problems and solutions, rational agenda setting, policy formulation, raising public awareness of healthcare issues and suggesting possible solutions or recommendations on policy review. However, evidence indicates that nurses (Kunaviktikul et al ) and nurse practitioners (O'Rourke et al ) have little recorded participation in policy development. This is largely due to lack of awareness and skill in policy development (Brokaw ), remaining silent (Schaeffer ), having few nurses in key positions (Varghese et al ), lack of time available to get involved (AbuAlRub & Foudeh ) and nurses lack confidence in their engagement ability in policy development (Ellenbecker et al ).…”