Notes to the Legislator

· In California, where the minimum nurse patient staffing requirements were first enacted, the lower rates of patient to nurses improved the quality of healthcare and reduced mortality. The institution of the staffing ratios also led to a higher capability to retain nurses as the workloads were substantially reduced (Aiken et al., 2010).

· The passage of the bill to the registered nurses in California mandated hospitals to recruit more staff and increase substantially the staffing of nurses in the state (Aiken et al., 2010).

· The quality of healthcare in California is higher when compared to the quality of healthcare in Pennsylvania and New Jersey. The reason for the high quality is due to the high nursing ratio to patients, when compared to the other two states (Aiken et al., 2010).

· However, researchers cannot provide specific patients to nursing ratio that can help to improve the quality of healthcare within a particular state (Aiken et al., 2010).

· The research results portray the fact that for a high quality of healthcare in hospitals, the numbers of the registered nurses delivering care to patients is important. It is also a demonstration of the aspect that the enactment of legislation can improve the numbers of registered nurses providing care in hospitals in a state (Aiken et al., 2010).

· In California, the desired ratio of the nurses to patients was set at 1:2. The implementation of the legislation implied that the ratio of registered nurse practitioners and hospital staff to patients was at 1:4. The ratio was lower than in the state of New Jersey and Pennsylvania which were given at 4:5 for the staff working in the hospitals (Aiken et al., 2010).

· It is important to have a legislation that supports the minimum number of registered nurses set in the state as a means of improving the outcome for patients (Aiken et al., 2010).

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Plan for Mandating Nurse-Patient Ratios

From the results given in the above background information, it is important that the legislature be a part of the improvement for patients. The outcome is that an enactment of a law would compel the hospital and healthcare facilities to increase the number of staffs, especially registered nurses, providing the services in medical institutions. In the following sections, I have developed a personal plan that will be used as a blue print to influence the vote of legislators in passing the bill to increase the staffing ratios.

My Strategy

The most common options available to nurses in advancing their advocacy towards the improvement of service are either through professional organizations or research. The example and precedence set by Florence Nightingale show that at a personal level the advocacy is not a forgone business. The impact of a single person is equivalent to the impact of several other persons, who desire the same course. Other nurses have also explored the single person course and had impacted the health system.

The policy proposal is a potential avenue that a nurse can explore in a personalized attempt to impact the quality healthcare system. Some nurses have also contributed in the shaping of the healthcare system through the inclusion of their thoughts and opinions in the proposal.

At the local level, the impacts of the policy proposals can also be effective albeit a small percentage to the overall population that is targeted. A registered nurse serving at any given station should be seen as an opportunity to give even better services to the population. The betterment of services includes local proposals to district health management officials on the possible strategies that legislation can take (Aiken et al., 2010). Whether the proposals for change are given from a practicing nurse in the public or private sector, the efficacy of the program introduced is the main concern.

Introducing concepts that are new to a system does not guarantee the success of the changes. Instead, the projects need the follow up of the initiator to ensure that they are natured to grow. I will not only suggest but follow through the implementation of the programs that I have proposed. Challenges that are likely to be met in the advocacy exercise include the slow process of initiating change (Lin & Lu, 2011). As a counteraction, I will take a lead role in ensuring that the programs that I have introduced are implemented and followed.

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At the state level, identification and use of the state platforms is the main strategy that will be applied in the advocacy for change in the nursing profession. According to Holfer (2006), there are several state sponsored activities for nurses that can be used as a platform for lobbying the other stakeholders in the medical sector. The study suggests becoming involved in the retreats and policy workshops organized by registered nurse unions. For such workshops and platforms, the main goal that I will follow is to share ideas with the other practitioners. The sharing of ideas could lead to finding persons with similar interest on the subject and a development of synergy in the approach taken for the same.

The higher the number of practitioners that subscribe to my ideas is proportional to the chances of the issues being addressed. In Abood (2007), the power of the number of registered nurses in the country is hailed as having the potential to deliver the needed changes. The strategy occurs as the coercive power that the number of nurses posses. Through unionization, the nurses can improve their working conditions by challenging the employer to develop legislations that change their working contract. However, the problem that most advocate nurses face is the ability to reach and marshal all the nurses. The shortcomings will be adequately dealt with by seeking any slight opportunity to air the challenges. At a personal level, the power to communicate with peers will be harnessed. The approach will involve the use of text mails as a means of sharing the ideas both at local and interstate level. The emergence of mobile phone apps such as WhatsApp makes it possible to send messages to a large number of people cheaply. I will take advantage of the app, and send messages to nurses and other stakeholder in the nursing industry.

In the workshops, I will present the findings of my personal research and results presented by other organizations and stakeholders in the healthcare industry. The aim of the presentation is to capture the audience of the policy makers in the field and improve the chances of the findings being considered. Apart from drawing the attention of the participants and followers of the workshops at the state events, I plan to influence the political leadership. This will also include the strategies to draw their attention to the subject. The application of invitations to the meetings and writing letters to the legislative bodies will motivate them to participate in the change process (Abood, 2007).

Improving my Personal Impact

In order to improve the outcome of the process, the need to employ additional strategies at a personal level is present. The strategies to improve my advocacy will majorly focus on the power of networking. Social networking has been identified as a potential tool that could improve results in any setting. In marketing, most companies have harnessed the power of social media and technology to improve their distribution channels (Lin & Lu, 2011). In lobbying case, the use of social networking will involve forming ties with strategically placed powerful individuals and influencing their thinking on the subject of improving the patient-nurse rations. The approach makes it easier to channel the complaints and any policies that affect the nursing profession to the people in charge (Abood, 2007). Most policies that pass through the congress are always pushed by well connected and powerful individuals. The people are able to lobby senior officials of the government, and influence the decision of legislators. I will communicate with them to achieve votes for the nursing ratio law.

Improving on my referent power will be a crucial factor in dealing with the advocacy in the nursing sector. I will work on some research projects that aim at documenting the need for change. Most treatises will focus on my main subject, which is improving the number of registered nurses in service. Participation in activities organized by the nursing fraternity will also be important in increasing the referent power that I will need (Abood, 2007). Through joining different organizations for nurses and healthcare providers, I will seek to improve my influence and credentials in championing for the change in the health sector. The participation in the organizations also provides the advocates with the desired platforms to air views that are related to the desired change.

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