护士需要参与卫生政策和政治

分享智慧共同成长

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Another election cycle has passed, and the American people have chosen their representatives. I hope everyone who reads this participated in voting and took time to review the candidates' policies on health care, access to health care, safe nurse staffing, and the myriad of other issues that nurses need to provide guidance on to our elected officials. According to the American Association of Colleges of Nursing (2022), nursing is the nation's largest healthcare profession, with nearly 4.2 million registered nurses nationwide. A large majority (84%) of licensed nurses are employed in nursing. After all, it would be extremely difficult for any type of health care to function without nursing guidance, input, services, and research. The wide variety of roles of nurses encompass acute and chronic care, inpatient and outpatient, insurance and health maintenance organizations, public and community health, home health, long-term care, school nursing, the US armed forces, nursing education, and nursing research. We need to ensure that policy on all these areas receive guidance and input from nursing. Nurses need to be involved in health policy!

又一个选举周期过去了，美国人民选出了他们的代表。我希望每一个读到这篇文章的人都参加投票，并花时间审查候选人在医疗保健、获得医疗保健、安全护士人员配备以及护士需要向我们当选的官员提供指导的无数其他问题上的政策。根据美国护理学院协会（2022）的数据，护理是美国最大的医疗保健专业，全国有近420万注册护士。绝大多数（84%）有执照的护士从事护理工作。毕竟，没有护理指导、投入、服务和研究，任何类型的卫生保健都很难发挥作用。护士的角色范围广泛，包括急性和慢性护理、住院和门诊、保险和健康维护组织、公共和社区卫生、家庭卫生、长期护理、学校护理、美国 武装部队、护理教育和护理研究。我们需要确保所有这些领域的政策都得到护理部门的指导和投入。护士需要参与卫生政策！

A well-known saying is that all politics are local, variously attributed to past Speaker of the House Thomas “Tip” O′Neill, or Associated Press Washington bureau chief Byron Price who may have said the phrase in 1932 (All Politics is Local, 2022). This is reflected in the number of nurses elected to serve in local, district, or statewide positions. Unfortunately, the number of nurses who are elected to city councils, county commissions, school boards, county boards of health, and so forth is not easily identified. On a statewide basis, in January 2022, before the November 8, 2022, election, there were 76 nurses elected to state legislatures in 36 states. In our southern region, Georgia had the most nurses elected to the state legislature with four elected to office. Unfortunately, three states in the southern region as of January 2022 had no nurses serving as legislators at the statewide level. This is concerning because a great deal of health policy is decided at the state level. In addition, nurse practice acts that determine our nursing practice are at the state level and have enormous influence on how nurses can practice as well as protect the public from fraudulent and incompetent nursing care. Nurses are the most trusted profession, at an 81% approval rating, for the 20th year (Lagasse, 2022) and are in an ideal position to influence how health policy is shaped at a state level as well as influence a nurse's scope of practice through regulations governing a state's nurse practice act. Nurses have leadership skills even if they do not recognize them, plus they understand social determinants of health and that allows them to be good candidates for office, either at local, state, or national levels (Larson, 2017). Importantly, nurses reflect an understanding of how health policy also affects people at a personal and family level.

一个众所周知的说法是，所有的政治都是地方性的，这一说法可能来自前众议院议长托马斯“Tip”O′Neill），也可能来自美联社华盛顿分社社长拜伦·普莱斯（Byron Price），后者可能在1932年说过这句话（All Politics is Local， 2022）。这反映在当选为地方、地区或全州职位的护士人数上。不幸的是，被选入市议会、县委员会、学校董事会、县卫生委员会等机构的护士人数不容易确定。在全州范围内，2022年1月，在2022年11月8日选举之前，有76名护士当选为36个州的州立法机构。在我们的南部地区，格鲁吉亚州有最多的护士当选为州议会议员，有四名当选议员。不幸的是，截至2022年1月，南部地区有三个州没有护士担任全州一级的立法者。这是令人关切的，因为许多卫生政策是在国家一级决定的。此外，护士执业法案，决定我们的护理实践是在国家一级，并有巨大的影响，护士如何可以实践以及保护公众免受欺诈和不称职的护理。护士是最值得信赖的职业，20年来的支持率为81%（Lagasse， 2022），并且处于理想的位置，可以影响州一级卫生政策的形成，并通过管理州护士执业法的法规影响护士的执业范围。护士具有领导技能，即使她们不认识这些技能，加上她们了解健康的社会决定因素，这使她们能够成为地方、州或国家一级办公室的良好候选人（Larson， 2017）。重要的是，护士反映了对卫生政策如何在个人和家庭层面影响人们的理解。

At the national level of course, we are proud of our national nurse congresswomen, Cori Bush (D-MO-1), Bernice Johnson (D-TX-30), and Lauren Underwood (D-IL-14). They have varied backgrounds in nursing, from community nursing and health activist (Bush), psychiatric nursing and public administration (Johnson), and public policy and nursing education (Underwood). They contribute to the national debate about health policy as well as the myriad of other significant issues affecting our lives as nurses as well as the health of the nation. There are Congressional Nursing Caucuses, one each in the House and Senate. The caucuses have the responsibility of educating legislators on issues important to nurses, as well as providing education on the impact nurses have on the health of the population. Along with a list of primary staff contacts, the members of the caucuses can be located at https://www.legistorm.com/organization/summary/122077/Congressional_Nursing_Caucus.html Congresswoman Bernice Johnson is a member of the House Nursing Caucus.

当然，在国家一级，我们为我们的国家护士国会女议员科里布什（D-MO-1）、 伯尼采·约翰逊（D-TX-30）和 劳伦·安德伍德（D-IL-14）感到自豪。nbsp;他们在护理方面有着不同的背景，包括社区护理和健康活动家（布什）、精神病护理和公共管理（约翰逊）以及公共政策和护理教育（安德伍德）。他们促进了全国关于卫生政策的辩论，以及影响我们作为护士的生活以及国家健康的无数其他重大问题。有国会护理核心小组，众议院和参议院各一个。核心小组有责任就对护士重要的问题对立法者进行教育，并就护士对人口健康的影响提供教育。除了主要工作人员联系人名单外，核心小组成员还可以在https：//www.legistorm.com/organization/summary/122077/Congressional_Nursing_Caucus.html上找到。国会女议员伯尼采·约翰逊是众议院护理核心小组的成员。

What are the policies affecting nurses that can be addressed through legislation either at the state or national level? Many states' legislatures have formed committees or task forces to address the nursing shortage or have appointed state agencies to propose solutions to increasing the number of nurses in the affected states. Supporting nurses to remain in acute positions requires institutional provision of tangible resources, such as personal protective equipment, and intangible actions, such as including nurses on boards and committees deciding staffing levels and nurse input on patient and nurse safety. Policies to increase the number of new nurses entering the profession require increasing the number of nurse faculty. Increasing faculty and facilities for clinical education can be dealt with through state and national legislature targeted investment in nursing education to help address the nursing shortage.

有哪些影响护士的政策可以通过州或国家一级的立法来解决？许多州的立法机构已经成立了委员会或工作队来解决护士短缺问题，或者已经任命了州机构来提出增加受影响州护士数量的解决方案。支持护士留在急诊岗位需要机构提供有形资源，如个人防护设备，以及无形行动，如将护士纳入决定人员配置水平的董事会和委员会，以及护士对患者和护士安全的投入。增加新护士数量的政策要求增加护士队伍的数量。增加临床教育的师资和设施可以通过州和国家立法机构对护理教育的定向投资来解决，以帮助解决护理短缺问题。

In summary, it is vital for all nurses and all citizens who currently need nursing care, or will need it in the future, to be politically active in promoting nursing and health policy. At a minimum, be sure to vote in every election and learn about the candidates' positions on health policy. But that is only the minimum. Maybe you will be the next nurse legislator, at the state or national level!

总之，对于所有护士和所有目前需要护理或将来需要护理的公民来说，在政治上积极推动护理和卫生政策至关重要。至少，一定要在每次选举中投票，了解候选人在卫生政策上的立场。但这只是最低限度。也许你会成为下一个护士立法者，在国家或国家一级！

原文链接：

https://onlinelibrary.wiley.com/doi/10.1002/nur.22300

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