A DNP’s Role in Health Policy Efforts


In Virginia, our legislative session ended two weeks ago. We have made some subtle progress in our move to full practice authority, but we still have many challenges. Our task is now to regroup and to plan a path forward in preparation for the next legislative session.

Nurses at all levels should be prepared to engage in healthcare policy and advocacy.1 However, nursing is under-represented in our political landscape. There are currently only six nurses elected to Congress,2 but 20 physicians currently serve in Congress.3 There are more than 2.7 million registered nurses working in the United States4 and 894,000 physicians.5

With the advent of the Affordable Care Act in 2010, 16 million Americans have gained healthcare coverage.6 This has created a greater need for healthcare leaders with the knowledge, skills and abilities to not only provide healthcare for additional individuals, but to ensure that healthcare policies address the population health needs and cost as well as the patient experience. DNPs are perfectly poised to be health policy leaders. But how is that achieved?

First, we must all be familiar with the basic political structure. Remember the Executive, Judicial and Legislative Branches of government you probably first learned in elementary school? We will focus on the Legislative Branch for this discussion. Recognizing your elected officials and having a basic understanding of the legislative process is the first step in understanding health policy and being an effective advocate. Each state has a website dedicated to the legislative branch where you can look up your legislators if you do not know their names or contact information. For our Congress, simply go to: House.gov and Senate.gov. Each has a link to find your Representative or Senator.

Second, the DNP needs to be able to identify opportunities to assess, design, evaluate and implement health policy based on the current healthcare and legislative landscape. Effective and politically competent advocacy efforts will result in the greatest improvement in healthcare delivery and nursing’s role in healthcare redesign. Grassroots advocacy can be a very effective way to identify and create a politically active base that has the power to inform and influence health policy.

Finally, identifying experiential learning opportunities for the nurse to actively engage in healthcare policy, politics and advocacy is essential to position the nurses as leaders in healthcare reform and improved patient outcomes. As DNPs, we can be leaders in completing Health Policy Fellowships, actively seeking opportunities to gain a seat at the table through appointments to Governor’s task forces and coalitions, and continuing to be politically aware through participation in advocacy efforts in our state and national organizations. Mentoring nurses new to advocacy can be another easy way to gather a small group of people to work together for a common goal.

Nurses are in every healthcare setting and are integral to healthcare delivery and outcomes. Empowering the nurse advocate to assess, plan, implement and evaluate healthcare policy will improve the Triple Aim7 and improve access to care to reduce health disparities. All nurses should be ready “to participate as a nursing professional in political processes and grassroots legislative efforts to influence healthcare policy.”1


1. American Association of Colleges of Nursing. The Essentials of Baccalaureate Education for Professional Nursing Practice.http://www.aacn.nche.edu/education-resources/BaccEssentials08.pdf

2. American Nurses Association. Nurses Currently Serving in Congress.http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Federal/Nurses-in-Congress

3. American Medical Association. Advocacy with Congress. http://www.ama-assn.org/ama/pub/advocacy/federal/advocacy-with-congress.page?

4. Kaiser Family Foundation. Total Number of Professionally Active Nurses. http://kff.org/other/state-indicator/total-registered-nurses/

5. Kaiser Family Foundation. Total Professionally Active Physicians. http://kff.org/other/state-indicator/total-active-physicians/

6. The White House. At a Glance. https://www.whitehouse.gov/healthreform

7. Institute for Healthcare Improvement. IHI Triple Aim Initiative.http://www.ihi.org/engage/initiatives/TripleAim/Pages/default.aspx


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About Author

Rebecca Bates, DNP

Rebecca Bates, who has been a nurse since 2000, is passionate about providing healthcare for vulnerable populations. She earned her DNP at Old Dominion University, Norfolk, Va., and has been a family nurse practitioner in primary care since 2009. Her DNP research explored NP assessment of adolescent psychosocial risk factors. During her doctoral program, she completed a health policy fellowship and remains active in state and federal health policy advocacy. She has also engaged in global health advocacy and medical missions. She recently left private practice and currently works at a Free Clinic where she continues to precept NP students. She is an assistant professor for graduate and undergraduate nursing students. Rebecca believes nurses must have a seat at the table to improve the health of individuals and communities throughout the world.

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