Healthcare Policy: Impact on Nurses’ Working Conditions and Scope of Practice

1. Introduction

This article explores the impact of healthcare policies on nurses’ working conditions and scope of practice. It highlights the importance of healthcare policies and nurses’ working conditions in providing quality healthcare. The influence of healthcare policies on working conditions is discussed, including staffing ratios, workload, and occupational health and safety guidelines. The impact of healthcare policies on the scope of practice for nurses is also examined, including regulatory frameworks, legal and ethical considerations, and collaborative practice. The article suggests policy initiatives to improve working conditions, such as safe staffing standards and promoting a healthy work environment. It also explores strategies to expand nurses’ scope of practice, such as policy changes to allow advanced practice roles and legislative support. Challenges and barriers in policy implementation, such as resistance to change and financial constraints, are identified. The article concludes with future directions and recommendations, including innovations in healthcare policy, strengthening advocacy efforts, and collaboration between policymakers and nursing associations. As these policies and nurses’ work situations evolve, it is still critically important to keep focus on illuminating more empirical-based knowledge, integrating research results into policy making and providing a positive trajectory that can enhance both the quality of healthcare and working lives for nurses. Interdisciplinary exchanges between nursing, health professions, sociology, psychology, public health and public policy, both in broad senses and in specific research projects, are a welcome and necessary step to realize the goals to promote a more vital and healthy nursing workforce and ultimately to contribute for improving healthcare systems. These interdisciplinary approaches especially resonate with policy research, as nursing associations and scholar researchers may work together so that innovative proposals may be generated. This article has focused on how healthcare policy has and continues to influence various aspects of nurses’ occupational life. Key issues of workload, working environments and scope of development have been addressed. However, it is not a comprehensive study of all the impacts of healthcare policy on nurses. While the majority of studies consider policy as a method of assessing nurses’ performance, this article took a broader view and used policy as an independent variable of investigating conditions of nursing work. With comparisons between United Kingdom and other parts of the world, the article has provided readers with an overall analysis of problems and directions that researchers and nurses are facing today. Also, recommendations have been made on potential future development of different aspects and implications. Future research should include more long-time studies to show how successful those changes in policy. More empirical-based evidences are needed to further validate and consolidate current findings.

1.1 Importance of healthcare policies

By pursuing a progressive healthcare policy, a more personal and comprehensive patient care system will be established. The article acknowledges that the impact of healthcare policies on healthcare providers such as doctors and nurses is an important area to concentrate on. The influence on different healthcare stakeholders needs to be researched, articulated, and communicated. Such knowledge and understanding would be much helpful for healthcare professionals to reform their practices and work dynamically and innovatively in different healthcare settings under different healthcare policies.Such a comprehensive health system will focus on holistic care and incorporate different treatment options for patient conditions. This means that nurses will be responsible for providing precise and proper care based on an individualized treatment plan. Ensuring that the patient receives the necessary care and understands their specific health needs can be vital in preventing the worsening of current healthcare conditions. And such positions will be available to nurses at different levels of experience and education. This provides many opportunities for career advancement in the field of nursing. Most importantly, it gives more chances for nurses to work in a variety of dynamic and innovative clinical settings.By forming an integrated health system under healthcare policies, patient-centered medical homes that include comprehensive physician-led healthcare and primary care case management can be established to improve the coordination and quality of care for patients. Nurses and other healthcare professionals receive payment incentives focusing on the quality of care, not the volume of patients seen. Such a system encourages the team approach to their care; each person in the group will be able to see how everyone else is working to give comprehensive patient care. This differs from a physician-centered health system where it is based primarily on one provider and leaves the patient with little to no say in their care. This will allow nurses and other healthcare professionals to have more authority and to develop innovative practices to make healthcare efficient and effective for patients.Under healthcare reform legislation passed in 2010, the entire healthcare system is shifting its focus. Emphasis will fall on prevention, increasing the availability and affordability of healthcare services, and the modernization of the United States healthcare system. Under this healthcare reform, nurses will have the opportunity to take on many new responsibilities that will change the way they give care. Nurses will be charged with being more involved in the care of individuals. This is a much more personal way of giving care to people and means that every individual will be evaluated on their own and not just diagnosed by their conditions.Healthcare policies play a critical role in the United States’ healthcare system. They serve as a framework for healthcare organizations to ensure that the clinical and business operations are in compliance with applicable laws and regulations. The United States is different from other countries because it does not have a standard health system but rather a variety of healthcare policies. Such policies range from insurance and payment policies to federal and state policies. Under different healthcare policies, a different number of cultural indicators, including effectiveness, quality, efficiency, and equity, are used to measure the respective policy and health system performance.

1.2 Significance of nurses’ working conditions

Nurses’ working conditions have a significant impact on the quality of nursing care and patient outcomes. Patient safety and the well-being of nurses depend on the working environment and the organizational characteristics. Therefore, when many experts and professional associations talk about quality of care, they would point out that nursing, the essential element of patient care, has a strong relationship with the quality of care. And the status of working condition has been addressed vigorously as one of the most important factors to determine the retention of nurses and patient safety. In the existing studies, it was found that 30% of hospital staff nurses received patient care assignments exceeding their level of education and clinical expertise. It is not only heightening the potential for medical error, but also has the effect of increased nursing burnout, higher turnover rate, and put the general patient safety in jeopardy. Therefore, the political motivation behind work redesign in health care, including proposals for changing skill mix, extends beyond improving technical and allocative efficiency. The importance of nurses’ working conditions has been recognized also in the political arena. The parliament debate and research topic analyzed and focused on the improvement of nursing workforce, including the issues of pay, training, career structures and flexibility around personal life, therefore, the agenda to modernize the nursing workforce appeared. Through enhancing the healthcare policies today, experts believe that a radical approach of modernizing the nursing workforce should involve the improvement of working conditions for nurses. Also the nursing professionals have to tweak the interests and the freedoms that can be designed in their everyday working practices, particularly with an eye toward improving the quality of patient care given the significance and standing of nursing work. The better working conditions not only help to improve the quality of care patients received, but also nursing workforce could be maintained as well. The general public and media commonly associate the poor working environments for nurses with many clinical turbulence and accidents in hospital, such as MRSA, overcrowdedness and long waiting list. In addition, the morale of nurses in generally are heavily influenced by the working conditions, patient care environment and the autonomy over their own practice. The deteriorated working conditions, the increasing litigation against health care providers and the temptation for nurses to strike can be seen. Ergonomists, government agencies, and equipment manufacturers alike are now paying more attention to potential reducing nursing injuries and promoting safe working environment. Creating an ergonomically working environment, which tailor the nurse working conditions and daily practice, could heighten nurses’ morale and enhance the patients’ care. It is mentioned that good work stations, comfortable design of the facilities and a supportive management can help present nursing staff to maximize their patient care time while minimize the chance to be injured at work. The significance of better working conditions towards the provision of quality care does not end on the loci of nurses and their daily practices; it makes a difference in the patients’ health and well-being as well. It also enhances and promotes the job satisfaction among nurses where these may fulfill their life seen as having significance and worthwhile.

1.3 Scope of practice for nurses

In terms of nurses, the new act has allowed nurses to become ‘independent prescribers’ and ‘supplementary prescribers’ and to prescribe almost any drug for any condition. This has greatly expanded nurses’ scope of practice in terms of drug therapies. Also, it gave nurses a chance to develop their roles and made services more accessible. On top of that, the new act is encouraging more nurses to take further training in prescribing, which can really help patients and make better use of nurses’ skills. As a result, we can see that healthcare policy can actually change nurses’ scope of practice and always impacts on it. Also, the range of activities that a nurse is permitted to undertake is based on relevant training and experiences. The nurse’s scope of practice may have different variations depending on the levels of seniority and specialisms.In a healthcare system, changes are often being made to improve it. Therefore, the scope of practice for nurses is constantly changing because the government and the NMC are always reviewing patients’ care, research evidence, the roles of the health professional, and the healthcare policy. As a matter of fact, healthcare policy has a significant impact on nurses’ scope of practice. For example, the Health and Social Care Act 2012, which was passed in the UK parliament, has changed the way that services were provided. It gave health services and professionals new responsibilities and new challenges in both providing effective patient care and protecting the safety and well-being of patients.The Nursing and Midwifery Council (NMC) is a regulatory body that maintains a register of nurses and midwives who meet set standards of training, professional skills, and behavior. Every nurse would need to follow the guidelines set by NMC. NMC also marks the nurse or midwife that has fit the practice standard. However, nurses’ scope of practice in the UK is defined by the UKCC/GCN standards for records and record-keeping, which means that if they are not under this regulation, they cannot deliver record-keeping practices. In this way, nurses are required to keep accurate records of their work.Nursing is the largest profession in the National Health Service (NHS) and nurses are also the people who use the most NHS services. Nurses and midwives make up the highest proportion of the health service workforce. The NHS could not function without them. They are valued for their care, compassion, and technical knowledge. In recent years, nurses have been given extra roles and more responsibilities. This shows their roles, for example, ‘nurse prescribers’. They have some right to prescribe some medicines just like a doctor.

2. Influence of Healthcare Policies on Working Conditions

2.1 Staffing ratios and nurse-patient ratios

2.2 Workload and job demands

2.3 Occupational health and safety guidelines

3. Impact of Healthcare Policies on Scope of Practice

3.1 Regulatory framework for nursing practice

3.2 Legal and ethical considerations

3.3 Collaborative practice and interprofessional relationships

4. Policy Initiatives to Improve Working Conditions

4.1 Implementation of safe staffing standards

4.2 Enhancing work-life balance for nurses

4.3 Promoting a healthy work environment

5. Strategies to Expand Nurses’ Scope of Practice

5.1 Policy changes to allow advanced practice roles

5.2 Legislative support for expanded responsibilities

5.3 Continuing education and professional development opportunities

6. Challenges and Barriers in Policy Implementation

6.1 Resistance to change from healthcare organizations

6.2 Financial constraints and resource allocation

6.3 Addressing cultural and societal perceptions

7. Future Directions and Recommendations

7.1 Innovations in healthcare policy for nurses

7.2 Strengthening advocacy efforts

7.3 Collaboration between policymakers and nursing associations

8. Conclusion