Nursing and Health Policy

Purpose: To describe ways nurses are and are not effective in the development of health policy in the United States today, and to provide useful information for those interested in making nursing a more vital part of the policy arena.
Design: Qualitative examination of the career experiences and observations of a purposive sample of 27 American nurses currently active in health policy at the national, state, local, or organizational level.
Method: Semi-structured interviews regarding career path, contributing resources improvement of resources available to nurses, and the strengths and weaknesses of currently available information for policy work.
Findings: For nurse participants, policy involvement meant speaking for patients in arenas where those need of care have limited voice. Participation occured after assessment, diagnosis, and planning revealed the need for change in the way resources were allocated. Strong belief in the capacity and importance of people caring for themselves distinguished nurses in their policy roles. Policy makers responded to the experiences and determinants of health and illness as presented by nurses.
Conclusion: Once engaged, nurses seldom turned their backs on the world of policy-making. However, they did not report significant use of nursing research or information in policy making. Further investigation and testing of systems to connect nurse policymakers with nurse scholars are recommended.     

Children in Foster Care: A Nursing Perspective on Research, Policy, and Child Health Issues

ISSUES AND PURPOSE. To examine the roles of public policy and poverty on the rising number of children in family foster care, and to examine the impact of different types of family foster care on children's well-being.
CONCLUSIONS. Recent changes in welfare legislation increase the likelihood of family poverty, with a subsequent increase in the number of children in out-of-home care. Greater emphasis needs to be placed on preventing entry into out-of-home care, improving the quality of foster care, and giving children a voice in care decisions.
PRACTICE IMPLICATIONS. Nurses have important roles to play in the prevention of family dissolution, the design of healthcare delivery systems for children in foster care, in evaluating and educating all types of foster families, and as advocates in legal and legislative proceedings.     

Transformation: A Key to Shaping Nursing

This article focuses on a time that expands the present and embraces the year 2000. The transformational world view is presented as a system of values and beliefs ever-changing and leading in different directions. Several directions are discussed in relation to the shaping of nursing.     

School Nursing in America—1902-1994: A Return to Public Health Nursing

Abstract In October 1902, Lina Lavanche Rogers began her work in the New York City schools as the first school nurse in the United States. The purpose of this research was to examine the evolution of school nursing as it exemplifies development of a public health nursing specialty. Historiographic methodology was used. Primary sources included materials written by pioneers in school nursing. Secondary sources included journals, books, newspapers, biographical materials, and unpublished materials from the archives of health care and educational institutions and agencies. Public health nurses in 1902 had a model for practice that was considerably more independent and interdependent than that characterizing the practice of hospital nurses. From its origins in public health nursing, the role of the school nurse shrunk in many school systems to that of dispenser of bandages and aspirins, only to return once more to an advanced practice model. HIV, tuberculosis, sexually transmitted diseases, addiction, and violence have returned and/or replaced the contagious diseases of 1902 and the early years of school nursing. New immigrants, poverty, homelessness, and lack of primary care offer challenges to school nurses to meet the needs of schoolchildren and their families in the 1900s.