Doctor of Nursing Practice Students Advocating for Healthcare Access, Quality and Reform

Doctor of Nursing Practice (DNP) graduates must be politically astute and strategically engaged in health care policy development, analysis, implementation, and evaluation. These activities by DNP graduates are critical to ensure that their advanced practice experience and requisite knowledge are recognized and used to advance policies that promote health care access, quality, and cost effectiveness. The AACN in the Essentials of Doctoral Education for Advanced Nursing Practice devotes Essential V to Health Care Policy for Advocacy in Health Care.  The DNP students enrolled in an online Health and Social Policy course at our school of nursing had the unique opportunity to experience health care policy for advocacy from multiple vantage points, culminating in a trip to Capitol Hill to meet with congressional representatives and their legislative aides. A major focus of the course was comparative effectiveness (CE). This approach was especially timely because President Obama's stimulus plan earmarked $1.1 billion for research that compares the effectiveness of different medical options, and $300 million was appropriated in the American Recovery and Reinvestment Act of 2009 for AHRQ to fund CE research for 2 years.  Issues related to CE, the interplay between nursing autonomy and conditional reimbursement for advanced practice nurses, and the need to increase funding for Nurse Managed Health Centers (NMHC) to address shortfalls in access to quality, wellness-based health care were distilled into a health policy paper and an abbreviated executive summary by each DNP student. The visit to Capitol Hill provided students with experiential learning that helped them move beyond conceptual knowledge to acquisition of working knowledge. Students found that the legislative aides possessed an admirable working knowledge of the proposed health care legislation moving through their division of Congress, but lacked familiarity with health care policy as it pertained to nursing as well as the role that NMHC could play in alleviating problems with access to health care for patients. The students learned first hand the need for nurses in the practice arena to develop policy partnerships, as well as value that policymakers place on nursings' voice to inform health policy conversations.