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Nurses to contribute to health policy

Nursing dean calls on the profession to break its policy silence, writes Linda Belardi.

A ''virtual policy'' school to encourage the active involvement of nurses in public policy is to be established. The school will be an international collaboration between universities in Australia the UK, US and Canada.

Professor Jill White, dean of nursing at the University of Sydney, said while nurses were often involved in the implementation of health reform, they did not have a leading role in policy making.

The online postgraduate program, which would offer public policy internships to nurses, would help assist middle career nurses to operate in a political and government environment.

"It is essential to the whole of the development of health into the future that nurses are really politically skilled and are able to influence policy," she told Nursing Review.

As part of the program, the University of Sydney hopes to collaborate with the state and federal ministries of health, as well as professional organisations and unions to offer nurses public policy experience.

White has been invited to address a Canadian delegation along with experts from the US and the UK about the lessons that can be learnt from their respective health reforms. The virtual policy school is one of the priorities of the four-country consortium.

The roundtable is made up of leaders of national nursing associations, national policy decision makers, and members of the scientific community from Australia, Canada, the UK and US.

White said there was a noticeable absence of nurses from prestigious international student exchange programs, such as the Fulbright and Harkness scholarships. However, it was the nursing profession's moral responsibility to their patients to represent their interests at the level of policy and research.

"It is the moral responsibility of nurses to act on behalf of patients in the best way we can. In nursing and nursing education, we focus so much on the nurse-patient relationship; we've forgotten somehow to lift the gaze."

White said the implementation of health policy could be far improved if nurses were more involved in the formation of policy, as the profession witnessed the direct effects of policy on a daily basis.

"We understand the health consequences of social policy and the human consequences of health policy. We see what poverty does to health. We see what bad eating does to health and the effects of policies that have been poorly implemented."

While nursing practice and education hasn't traditionally fitted nurses to work in the policy and government environment, there was a need for more nurses to be involved in committees, on boards and in the development of policy documents.

However, it's not enough that nurses want to be invited to the policy table, they have to demonstrate how they can enrich it, she said.

"For too long we've cried we haven't been invited to the policy table, but I think it's time that we took some responsibility to be able to show people that we would enrich the conversation if we were at the table," White said.

She said governments would welcome an increased role for nurses in the policy arena.
In a meeting with the NSW Minister for Health, Jillian Skinner, the minister indicated that her government would welcome a far greater policy input from nurses into health reform.

"I was just in a meeting with the minister and she was saying that on a number of issues for reform in NSW, she would welcome nurses putting forward their opinions, putting forward their information, discussion documents ... but largely there is a silence.

"And where there is a vacuum, where there is a silence; well-orchestrated, well-prepared disciplines with good infrastructure will fill that space."

White said there were opportunities for nurses to learn from the strategic and policy success of well-co-ordinated health lobbies such as doctors and midwives.

"What I'm saying is not anti-medicine. Really we need to learn some lessons from medicine and in many ways from midwifery, who for a relatively, newly re-emergent profession in Australia they understand political process very well."

While many were successful at understanding the political process, it had to involve a broader-base of nurses.

There was also a broader social and political responsibility to ensure leading health systems in the West increased the input of nurses into health reform.

"When other countries seek to emulate successful health reforms they should be ones informed by a nursing understanding," White said.

While Australia has more to achieve, White said it has made some significant strides in recent years, including granting MBS and PBS access to nurse practitioners."We haven't begun to see the impact that's going to have yet. It will be quite enormous."

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