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Nursing - Bloomberg > ⚖️410: Policy > Flashcards

⚖️410: Policy Flashcards

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1
Q

Define policy

A

A statement of direction resulting from a decision-making process that applies reason, evidence, and values in public or private settings.

Found at multiple levels.

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2
Q

Macro-level policies

A

National or provincial

Ex. Senators, MPs, ministry of health

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3
Q

Meso-level policies

A

Regional or institutional policies.

Ex. Hospital CEOs, nurse executives, advanced practice nurses (APNs)

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4
Q

Micro-level policies

A

Local or unit-based. Clinical programs.

Ex. Department directors, nurses, APNs, nurse managers

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5
Q

Public policy

A
  1. Often enacted at a government level.
  2. Clusters of issues

“Upstream” = addresses social, economic, political, environmental problems causing issue to intervene.

Downstream = addresses issues that are already there and trying to mitigate them.

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6
Q

What were the main reasons in the consolidation of the LHiNs into five geographical regions?

A
  1. Eliminating “hallway medicine”, reducing costs, and promoting efficiency
  2. Reduction of funding for public health
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7
Q

Neoliberal period of public policy in Canada

A

Hallstrom, 2016

  1. Reduction of public investments in social resources and structures in favour of privatization
  2. Concern about gov’t spending
  3. Reliance on private citizens to manage their own social and health endeavours
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8
Q

What are the two broad groups of health policy?

A
  1. Policies directly related to health of population

2. Policies related to the provision of healthcare

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9
Q

Healthy public policy

A
  1. Positive impact on the social, economic, and environmental determinants of health
  2. Intersection of political perspectives/values and its influence on health policy
  3. Ideally “healthy” defined by research
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10
Q

What are barriers to nurses participating in policy advocacy?

A
  1. Unaware of how to influence policy
  2. Sense that it’s not their job
  3. High work demands
  4. Political apathy
  5. Belief things “never change”
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11
Q

What’s at stake if nurses don’t participate in policy advocacy?

A
  1. Perpetuate powerlessness
  2. Demoralization and frustration
  3. Decisions made without our input that affect our practice
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12
Q

What are risks of participating in policy advocacy?

A
  1. May not lead to change you want
  2. Putting yourself out there
  3. Revealing your political or ideological orientation
  4. Political backlash of those who oppose
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13
Q

What are Malone’s (2005) ten framework questions for assessing policy environment? 🌟

A
  1. What is the problem with the current policy?
  2. Who and how many are affected by this policy?
  3. Who makes the decisions another the policy?
  4. What is the process around making policy decisions?
  5. What possible solutions could be proposed?
  6. At what level is the problem most effectively addressed?
  7. What are the ethical arguments involved?
  8. What are the obstacles to policy intervention?
  9. What resources are available to support policy intervention?
  10. How can I get involved in policy intervention/advocacy?
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14
Q

Voluntary ending of a persons life definition

A

A person makes a conscious decision to End their life and asks for help to do so

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15
Q

Non-voluntary ending of a persons life

A

A person is unable to give their consent to treatment and another person makes the decision on their behalf.

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16
Q

Passively ending a persons life

A

The act of intentionally causing someone’s death by withholding or withdrawing treatment, food, or fluids that is necessary to maintain life.

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17
Q

MAID policy adoption

A
  1. June 2012, BC Supreme Court declares laws against physician-assisted death were UNCONSTITUTIONAL because they discriminated against people with physical disabilities.
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18
Q

The MAID policy (Bill C-14)

A
  1. The administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death.
  2. The prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request, so that they may self-administer to cause their own death.
  3. Amends the criminal code
  4. Specifies eligibility criteria and safeguards
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19
Q

What are the eligibility criteria for MAID?

A
  1. At least 18 years
  2. Capable of making decisions about their health
  3. Voluntarily request medical assistance in dying
  4. Give informed consent to receive MAiD after being made aware of additional treatments to relieve suffering
  5. Eligible to receive Canadian Medicare
  6. Have a grievous and irremediable medical condition.
20
Q

What are the 4 stages in the policy cycle? (Villeneuve, 2017)

A
  1. Getting to the policy agenda
  2. Moving into action
  3. Implementation and change
  4. Policy evaluation and revision
21
Q

What are the 14 stages in the policy cycle? (Villeneuve, 2017)

A
  1. Values and beliefs
  2. Problems or issues emerge
  3. Knowledge development
  4. Public awareness
  5. Political engagement
  6. Stakeholder activation
  7. Policy deliberation
  8. Policy adoption
  9. Preparing for change
  10. Managing change
  11. Reinforcing change
  12. Evaluate content
  13. Evaluate implementation
  14. Evaluate impact
22
Q

In the policy adoption stage of the policy cycle, what is the most important factor to consider?

A

The process of a bill becoming legislation

23
Q

In the policy deliberation stage of the policy cycle, what is the most important factor(s) to consider?

A
  1. Feasibility

2. Wording and structure

24
Q

In the political engagement stage of the policy cycle, what is the most important factor(s) to consider?

A

Understanding decision making structures

25
Q

In the Preparing for change stage of the policy cycle, what is the most important factor(s) to consider?

A

Identify potential points of resistance

26
Q

Direct lobbying

A

Directly engaging with decision maker.

Ex. Letters, meetings, petitions, etc

27
Q

Indirect lobbying

A

Efforts to influence public opinion, which may influence policy makers later.

Ex. Social media, ads, etc

28
Q

Grassroots lobbying

A

Mobilizing a committed group of people to influence the opinion of policy makers. Often have champion/advocate.

Includes both direct and indirect.

29
Q

_______ involves experiential and reflexive learning so practitioners adopt good standards.

A

Practice

30
Q

Managerialism

A

The standardization of everyday nursing practice

31
Q

Moral ecology

A

Connection b/w an organization (structure/culture) and the ability of nursing to be a moral practice or the ability of nurses to practice in a moral way.

Can support or restrict. Organizations informally shape people’s moral action by providing background, area and field for moral practice.

Ex. Workload for nurse engagement
Ex. Educational and ethical supports

32
Q

What are the major characteristics of clinical leadership?

A
  1. Clinical experts
  2. Challenge the status quo
  3. Reflect positive attitudes toward their profession
  4. Engages in reflective practice
  5. Supportive and approachable
  6. Acts as role model
  7. Collaborative learning
  8. A Knowledge source
  9. Interprets/critiques managerial agenda
  10. Translates vision fo institution into care delivery
  11. Strategic vision for frontline practice
33
Q

Leadership is:

A

A process (involves interaction) whereby an individual influences a group (followers) to achieve a common goal (movement towards an end).

34
Q

Why is leadership important for nursing?

A
  1. Coordination needed

2. Associates with better patient outcomes

35
Q

Autocratic leadership

A
  1. Decisions are made for staff/followers
  2. Followers are not able to participate in decision making
  3. Staff are often unmotivated
36
Q

Laissez-faire Leadership

A
  1. Leader takes a step back
  2. Important decisions left to staff with little to no direction
  3. Organization lacks direction
  4. Work may not be held accountable to operational processes
37
Q

Transactional Leadership

A
  1. Providing rewards for meeting/exceeding expectations
  2. May offer negative feedback if standards not met
  3. Considered a “lower order” of leadership
  4. Bureaucratic leadership:
    - maintains formal role
    - follows organizational structures
    - clarifies work tasks
38
Q

Transformation al Leadership Theory (Finkelman and Kenner, 2016)

A
  1. Dominant leadership theory
  2. Create vision and mission statements
  3. “Human-capital-enhancing resource management style”
  4. Emphasizes positive environment
  5. Leader characteristics include confidence, self-directed, energetic, flexible, and committed
39
Q

What are critiques of Transformation al Leadership Theory?

A
  1. Focused on heroic and distant leaders
  2. Idealize leader - follow without challenge
  3. Less attention to leader personal integrity
  4. Fails to address immoral leader behaviours
  5. Sexist stereotypes - often misses feminist perspective
40
Q

What are the 6 types of power used in leadership?

A
  1. Coercive - based on punishment
  2. Reward
  3. Persuasive
  4. Referent - leader admired
  5. Expert - respected for expertise
  6. Informational - access and share info
41
Q

Management

A
  1. Accomplishment of tasks/goals.
  2. Formal authority to direct work of employees.
  3. Takes responsibility for quality and cost of work
42
Q

What are the 4 main functions of management?

A
  1. Planning
  2. Organizing
  3. Directing
  4. Controlling
43
Q

What are the 3 types of Leaders in Nursing?

A
  1. Frontline Management
  2. Middle Management
  3. Nurse Executives
44
Q

Shared Governance in nursing

A

Management approach and professional practice model

  1. Nursing staff are directly involved in decision making, particularly when affects their practice
  2. Decentralized leadership and autonomous decisions
  3. May include council structure
45
Q

What are barriers to clinical leadership?

A
  1. Lack of confidence
  2. Resistance to change
  3. Clinician cynicism
  4. Perceptions of leadership as “other”
  5. Poor interdisciplinary relationships
46
Q

What are the types of councils found in shared governance?

A
  1. Quality Council
  2. Education Council
  3. Research Council (apply best practice)
  4. Management Council
  5. Coordinating Council - facilitate and integrate activities of other councils

Nursing - Bloomberg (52 decks)

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