How Nurse Managers Play A Role In Policy Decision-Making

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Nurse and team having a meeting

As the largest group of medical professionals worldwide registered nurses (RNs) who work as nurse managers are positioned to inspire and influence positive changes to public health policy and political decision-making on local, state, and national levels.

In addition to continuing to provide effective clinical care, RNs have a growing role in healthcare policy development, advocacy, analysis, and implementation. RNs hold local, state, and federal elected and appointed offices, work for healthcare companies, and volunteer on boards and committees that oversee the decision-making process.

RNs who have earned a doctor of nursing practice (DNP) degree and work as nurse managers are in a position to make informed decisions to be healthcare policy influencers. As an advanced degree holder, DNP graduates have the experience, knowledge, and expertise to shape the future of health policy that could impact millions of people.

Leaders in the field say nurses as a whole have an ethical and moral responsibility to engage in policy and political decision-making for the betterment of their patients.

“Never has there been a time when the voices of nurses are more urgently needed at high levels of policy formation and decision-making than they are now,” said Judith Shamian, past president of the International Council of Nurses. “To . . . make health a reality for billions of people across the globe, we need confident, well-informed nursing leaders who understand their critical role and contribution.”

The Evolving Roles Of Nurse Managers

Nurse managers, once called head nurses, traditionally supervise nursing staff in a single unit or whole department, oversee personnel and budgeting practices, and ensure communication between the staff and middle-upper management.

Today, that role has expanded to include participating in the policy process on all levels. The Agency for Healthcare Research and Quality, an arm of the U.S. Department of Health and Human Services (HHS), described nurse managers as change agents because they work with staff and management to implement new policies and procedures on a micro (or unit) level

“Nurse managers lead their unit staff in preventing patient harm in their unit, empowering nurses to be the first line of defense against patient harm,” the agency said.

On a wide-scale, or macro, level, nurse managers are positioned to influence policy that impacts communities of all sizes and types. Cathy Catrambone, past president of the nursing honors society Sigma Theta Tau International, said engaging in policy initiatives and leading policy changes should be among the activities for nursing professionals.

She said policy-shaping is intentional work that creates performance standards for healthcare providers, governmental agencies, and others interested in patient safety and well-being.

Catrambone said vital policy issues for nurses include practicing to the fullest extent of licensure, installing nurses and nursing faculty in high-demand areas, and providing healthy work environments. On a global scale, critical policy issues include universal access to healthcare, focusing on the needs of the elderly, and the treatment of chronic diseases.

How Nurse Managers Influence Policy

Catrambone and other healthcare leaders encourage all nurses to participate in some of the following activities that can influence positive changes to policy:

  • Look for opportunities to develop, advance, improve, or change health policies within an environment (either micro or macro).
  • Assess patient needs and formulate policy messages.
  • Write white papers, position statements, newspaper editorials, and other informative correspondence that educates the public and lawmakers about the needs.
  • Foster relationships with stakeholders to advance policy agendas.
  • Volunteer in policy-related activities including development meetings.
  • Serve on committees, boards, and leadership groups that have decision-making power.
  • Seek appointments to county health department boards and local government commissions to address health needs.
  • Participate in activities that advance health-policy driven agendas.

Jennifer J. Brokaw, a wound and ostomy specialist at Tampa General Hospital in Florida, said nurses have an opportunity to create positive changes because they “are vital to the development and implementation of healthcare policy.”

“The truth is, any nurse can influence policy and politics at the local, state, and federal levels,” Brokaw said in an American Nurse Today article. “The nurses of today are younger, more educated, and more diverse. They bring more energy, more ideas, and more ingenuity to the nursing profession. Perhaps they will even bring more political activism.”

The Role Of Education In Policy Changes

Nurse leaders have said a key to advancing the role of RNs in policy decision-making is through education. Nurses who seek a DNP degree may take advanced coursework that helps them understand their roles as patient advocates and policymakers.

An Online Doctor of Nursing Practice degree prepares graduates to critically analyze proposed policies from the perspectives of patients, healthcare professionals, and other stakeholders. As highly educated medical professionals, DNP graduates are positioned to educate the public and lawmakers about the impact of policy changes.

DNP students at Duquesne University not only examine U.S. health care policy issues through the Health Care Policy and Finance coursework, but they also study the impacts of local-level policy on vulnerable populations through the Social Justice and Vulnerable Populations course.

About Duquesne University’s Online Doctor of Nursing Practice Degree Program

Duquesne University’s online DNP program prepares graduates to assume leadership roles in policy and decision-making to have an impact on healthcare needs across communities. Duquesne University’s DNP program builds on existing knowledge to provide a comprehensive education. Students who work toward a DNP at Duquesne University’s online program have the added advantage of being able to continue their career and family responsibilities while pursuing the degree.

Additional Reading:

Duquesne University Blog, “Nurses on Governing Boards”
Duquesne University Blog, “Nurses Working Abroad”
Duquesne University Blog, “Why Become A Doctor Of Nursing Practice?”


American Nurse Today, ” Move Up to the Role of Nurse Manager”
Agency for Healthcare Research and Quality, CUSP Toolkit, The Role of the Nurse Manager, Facilitator Notes
Nursing World, “Emerging Global Health Issues”
SIGMA Nursing, “Call-to-Action Global Health and Nursing”
Reflections On Nursing Leadership, “Influence through advocacy, policy, lifelong learning, and philanthropy”
American Nurse Today, “The nursing profession’s pot”