Nursing & Health Policy - Putting it all together

Question 1

Policy Defined

Answer 1

a set of policies are principles, rules, and guidelines formulated or adopted by an organization (achieved through input from stakeholders) to reach its long-term goals and typically published in a booklet or other form that is widely accessible
- defines vision
- helps develop targets along the way (formative evaluation piece)
- summative (this i what we’re seeing at the end)
- have points all the way along to do formative assessments

Question 2

Nursing & Public Policy… the Dilemmas

Answer 2

What is the role of policy in your Nursing practice?
What are the issues?
Is there a difference between caring for individuals/population health vs advocating for improvements to health?
Desired Outcome Advocacy = Systematic social change to improve health & quality of life

Question 3

Current Health Policy in the News

Answer 3

• Public vs. Private Healthcare
• Indigineous health/reconciliation
• Fentanyl crisis, needle exchanges, homeless - - issues, lane housing
• Legalization of Marijuana
• Reorganization of health system in BC
• Regionalization - less or more
• Hospital Closures
• For the sickest
• Rural health closures
• Nursing Staffing – workload, issues
• Provision (or not) of services
• Pharmacare
• Long term care
• Critical care specialty surgeries contracted out of country
• Use of resources: allocation, acute v. community
• Global issues
• Environmental issues (ozone)
• Equitable resource distribution
• Infectious disease
• Pandemic Influenza, HIV,
• Global security
• Bio- and other terrorism

Question 4

Evolution of Health Policy

Answer 4

Alma Ata (1978) – Health for all (Remember this report??)
One of the first times, as a global community, we moved from acknowledging there are concerns in each country to moving and recognizing the rights to high public health standards across and above other conflicts.

Question 5

Healthy Public Policy

Answer 5

Healthy public policy intends that health be a part of all policy making; not only health systems directives
Education policies
Economic policies
Environmental policies
Socio-policies

Question 6

Since Then…

Answer 6

• Change over time = shift away from focusing on the health system
• Healthy Public Policy instead looks at how the health of Canadians is improving
• Focus on upstream thinking and prevention

Question 7

The role of Money

Answer 7

Sustainability of a National Medicare System at a Crossroads Today
1. Social, political, legal pressure to relax terms & conditions of Canada Health Act for “cash-strapped territorial/provincial governments”
2. Create two-tiered System of privately financed health care

Question 8

Ethical Influences on Community Health

Answer 8

Four ethical dilemmas related to health care

1. Curative vs. Prevention
2. Target groups
3. How to achieve public health care
4. What to cut when the economy recedes

Question 9

Constructing the “problem”: Proximal to Distal Causes of Equity

Answer 9

Proximal: Health Behaviours: drugs, addictions, sex work
Education, housing employment/income, food security
Intermediate: Trauma, historical trauma, poverty, abuse, racism
Healthcare systems, community resources, cultural continuities
Distal: Neoliberalism, colonialism, Patriarchy
Global economics, ideologies of racial superiority, capitalist priorities, social welfare systems, welfare colonialism, state policy: re resource distribution and service delivery

Question 10

Interventions: Proximal to Distal Causes of Equity

Answer 10

Biomedical: Safe Injections sites, HIV & Hep C treatment, addiction treatment, pain management, for chronic conditions
Attitudes of healthcare providers (cultural competence)
Population Health: Stable Housing, Healing Programs
Approaches of the professions (cultural safety)
Structural Policy: policy intervention, integrative solutions, challenge social discourses. advocacy - analysis of professions (critical inquiry)

Question 11

Analytic Tools: Proximal to Distal Causes of Equity

Answer 11

Proximal: Biomedical, clinical
Intermediate: equity-lens, population health
Distal: critical inquiry, intersectionality

Question 12

Significant in nursing practice

Answer 12

Social Justice issues happen through the upstream intervention of changing policy/legislation
Policy has direct impact on jobs and working conditions
As professionals in nursing we assume a certain responsibility for health of the public
Nurses are presently impacting public policy at many levels
United Nations
Ministry of Health ICN
WHO CNA
CDC
CHNC
Environmental Health

Question 13

Turning an action plan into action

Answer 13

1. Build public Awareness & Strengthen insights
2. Develop a Greater Voice for Organizations
3. Establish Supporting Strategies & examples
4. Create a forum to support the national action plan
   CNA national action plan:
5. Build public awareness and strengthen insights on Health in All policies approach in Canada.
6. Increase collaborative engagement by public, private and NGO’s to support adoption of a Health in All Policies approach.
7. Influence decision-makers to support a Health in All Policies approach through common messaging and action (CNA)

Question 14

CNAs Four recommendations for the federal budget focus on 4 areas:

Answer 14

1. Encouraging health-care innovation
2. Public health emergency preparedness
3. Improving access to palliative care and support for caregivers
4. Enhancing access to sustainable health human resources to better serve rural, remote, and Indigenous communities