The Intersection of Media and Policy: A Case Study.

From October 2008 through 2010, journalists Charles Ornstein and Tracey Weber produced for the Los Angeles Times and ProPublica a series of investigative reports on the performance of the California Board of Registered Nursing (BRN), finding that it took an average of 3.5 years to act on complaints of professional misconduct by registered nurses, including sexual assault of patients, substance use, and repeat medication errors that resulted in patients dying. In June 2009, Governor Arnold Schwarzenegger announced that he was firing members of the BRN. Its executive officer resigned shortly thereafter. This case study analyzes interviews with nine participants, including the journalists and individuals who were public and nurse members of the BRN in 2009. Four themes emerged: (1) There is a tension between what are perceived to be the public's interests versus nursing's interests; (2) Political naiveté about government and organizational culture can lead to the personalization of actions directed at institutions; (3) A sense of fatalism may be reinforced by organizational culture; and (4) The role and use of media in a free society may be obscured when one is the focus of investigative journalism. Nurses who seek to operate in the public sector must be grounded in the political realities of complex governmental forces that may appear to be illogical or personally offensive. Media, particularly news media, is a powerful tool for influencing these forces. Nurses should employ strategic approaches to the use of media in order to advance their voices as advocates for the public's interests.

Media competencies for nurses: A Delphi study.

BACKGROUND: Media raises awareness of important health issues, provides guidance to promote health, and shapes health policies. However, nurses are poorly represented in media. PURPOSE: To propose competencies that can be used to advance nurses' knowledge and skills in using media to advance health. METHODS: A Delphi study design of three successive surveys was employed. The Round 1 survey was sent to 70 nurse media leaders, and 28 (40%) responded. Seventeen respondents (61%) participated in Round 2. The Round 3 survey was not needed. DISCUSSION: These competencies provide direction for academia, healthcare organizations, nursing associations and others who seek to develop the leadership and population health skills of nurses. Ways the competencies can be used are outlined. CONCLUSION: There is an urgent need to improve population health outcomes by reducing disparities and promoting equity in health and health care. Media engagmeent is an importnat strategy for promoting population health. Additionally, promotion of better media representation of nurses and improved media engagement by nurses and nursing organizations all speak to the importance of advancing media competence.

International Council of Nurses' Global Nursing Leadership Institute: Responding to the pandemic.

BACKGROUND: In 2020, the SARS-CoV-2 pandemic forced the redesign of the International Council of Nurses' (ICN) Global Nursing Leadership Institute (GNLI) that heretofore had included an intensive, week-long residential experience in Geneva, Switzerland. AIM: This paper describes the development, implementation, challenges and preliminary outcomes of an approach that regionalized GNLI and delivered it online, while preserving some cross-regional connections among participants. RESULTS: A virtual approach to a global policy leadership programme cannot replace the richness of an intensive, concentrated residential one, but the redesign of GNLI has given ICN, its member national nursing associations and individual nurse leaders previously unexplored opportunities for networking and collaboration aligned with the six WHO regions, and for cross-region networking and discussions of global issues. CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY: The SARS-CoV-2 pandemic has highlighted the need for nursing leadership in policy and practice. A virtual approach to leadership development can increase the reach of programmes that seek to build nursing's capacity to advance health-promoting policies in workplaces, organizations and nations.

Making health a shared value: Lessons from nurse-designed models of care.

BACKGROUND: Nurse-designed models of community-based care reflect a broad definition of health; family- and community-centricity; relationships; and group and public health approaches. PURPOSE: To examine how nurse-designed models of care have addressed "making health a shared value" based on the framework of the Culture of Health. METHOD: A mixed-methods design included an online survey completed by 37 of 41 of "Edge Runners" (American Academy of Nursing-designated nurse innovators) and telephone interviews with 13 of the 37. Data were analyzed using descriptive statistics and standard content analysis. FINDINGS: Two main areas of "making health a shared value" were increasing the perceptions that individual health is interdependent with the health of the community and community health promotion. Themes were the value of social support (interventions that engage an individual's inner circle and a group environment to reveal shared experiences); messaging (a holistic definition of health, the value of both culturally- and medically-accurate information, and the business case); and building trust (expertise sits locally and trust takes time). DISCUSSION: Refinement of the COH framework may be warranted and can provide strategies for making health a shared value within a community. Shifting the orientation of healthcare organizations must be a long-term, deliberate goal.

The Woodhull Study Revisited: Nurses' Representation in Health News Media 20 Years Later.

PURPOSE: To determine if nurses are represented in health news stories more frequently today than 20 years ago when Sigma Theta Tau International Nursing Honorary Society published The Woodhull Study on Nursing and the Media, which found that nurses were cited as sources in only 4% of the stories. DESIGN: Content analysis of health news stories for the month of September 2017 in the same publications used in the original Woodhull study. METHODS: Searches with Nexis and Webhose identified 2,243 articles related to health care published by the news outlets in September 2017. A random sample of 537 of these articles was obtained: 258 from seven newspapers, 127 from three weekly newsmagazines, and 152 from three health industry publications. After removing irrelevant articles or those with only passing references to health, 365 articles were reviewed and coded, using the original study's coding schema. FINDINGS: Nurses were identified as the source of only 2% of quotes in the articles and were never sourced in stories on health policy. When quoted, nurses mainly commented on the profession itself. Nurses or the nursing profession were mentioned in 13% of the articles. Nurses were identified in 4% of photographs or other images that accompanied the articles. CONCLUSIONS: Nurses remain invisible in health news media, despite their increasing levels of education, unique roles, and expertise. CLINICAL RELEVANCE: Nurses' clinical expertise is accompanied by unique perspectives on health, illness, and health care; but the public is not benefiting from the wisdom and insight that nurses can provide in health news stories.

The growth and development of gerontological nurse leaders in policy.

BACKGROUND: The National Hartford Center of Gerontological Nursing Excellence (NHCGNE) Scholars/Fellows Award Program was designed to promote the growth and development of nurse scientists, educators, and leaders in aging. PURPOSE: McBride's conceptual framework of the growth and development of nurse leaders was used to examine the NHCGNE impact on health and aging policy work among scholars/fellows, including barriers, facilitators, and resources. METHODS: A multimethod two-phased approach included an online survey (phase I) focused on research and policy impact at local, state, or national level. Telephone interviews (phase II) were conducted to further understand the nature, depth, and focus of respondents' policy work. DISCUSSION: Based on our findings, we propose multilevel recommendations for advancing nurse scientists' capacity to be leaders in shaping policy. Keen research skills are influential in policy advancement but not sufficient to advance policy. Preparing nurse scientists with competencies in translating research into policy can ultimately transform health and health care for older adults.

Commonalities of nurse-designed models of health care.

The American Academy of Nursing has identified examples of care redesign developed by nurses who address the health needs of diverse populations. These models show important clinical and financial outcomes as summarized in the Select Edge Runner Models of Care table included in this article. A study team appointed by the Academy explored the commonalities across these models. Four commonalities emerged: health holistically defined; individual-, family-, and community-centric approaches to care; relationship-based care that enables partnerships and builds patient engagement and activation; and a shift from episodic individual care to continuous group and public health approaches. The policy implications include examining measures of an expanded definition of health, paying for visionary care, and transparency and rewards for community-level engagement.

The representation of health professionals on governing boards of health care organizations in New York City.

The Representation of Health Professionals on Governing Boards of Health Care Organizations in New York City. The heightened importance of processes and outcomes of care-including their impact on health care organizations' (HCOs) financial health-translate into greater accountability for clinical performance on the part of HCO leaders, including their boards, during an era of health care reform. Quality and safety of care are now fiduciary responsibilities of HCO board members. The participation of health professionals on HCO governing bodies may be an asset to HCO governing boards because of their deep knowledge of clinical problems, best practices, quality indicators, and other issues related to the safety and quality of care. And yet, the sparse data that exist indicate that physicians comprise more than 20 % of the governing board members of hospitals while less than 5 % are nurses and no data exist on other health professionals. The purpose of this two-phased study is to examine health professionals' representations on HCOs-specifically hospitals, home care agencies, nursing homes, and federally qualified health centers-in New York City. Through a survey of these organizations, phase 1 of the study found that 93 % of hospitals had physicians on their governing boards, compared with 26 % with nurses, 7 % with dentists, and 4 % with social workers or psychologists. The overrepresentation of physicians declined with the other HCOs. Only 38 % of home care agencies had physicians on their governing boards, 29 % had nurses, and 24 % had social workers. Phase 2 focused on the barriers to the appointment of health professionals to governing boards of HCOs and the strategies to address these barriers. Sixteen health care leaders in the region were interviewed in this qualitative study. Barriers included invisibility of health professionals other than physicians; concerns about "special interests"; lack of financial resources for donations to the organization; and lack of knowledge and skills with regard to board governance, especially financial matters. Strategies included developing an infrastructure for preparing and getting appointed various health professionals, mentoring, and developing a personal plan of action for appointments.