nurses influencing healthcare policyIn this three-part series, we will discuss the importance of nursing role, both individually and as a profession, in politics and policy development.This first installment will focus on a basic review of the lawmaking process. This may vary slightly at the state level due to differing procedures; however the general tenets are the same.Subsequent installments will focus on current legislation which is important to nursing, and how we as nurses can make a difference to our profession by influencing public health policy.

We should know who our elected representatives are on the state and national level. This may sound simplistic, but many people do not know this information.Names, contact information, etc. for elected officials at national and state levels is readily available on government websites.


On the national level and in most states, there are three separate branches of government: executive, legislative, and judicial. Each branch of the governemtn have various roles. The executive branch consists of the president or governor and those agencies under their jurisdiction. Their role is to recommend legislation, propose related policy initiatives, and implement lanurses influencing healthcare policyws that have been passed. The Legislative branch (Congress or Legislature), has the sole power to pass legislation, or laws and accompanying regulations.  The Judicial branch (Supreme Court) interprets laws, and can invalidate laws passed if they are deemed unconstitutional. This branch is unable to recommend or promote legislative initiatives on its own.


We may remember from high school civics class “how a bill becomes a law”.  For those of us who do not, let’s quickly review:

  1. An idea for a law or rule comes from an individual or group. The idea becomes a bill introduced in either the House or Senate by a legislator in that body. 
  2. Each bill is referred to and reviewed by at least one legislative committee, and passed out if acceptable to the membership.
  3. The bill is read on the House or Senate floor and approved by a majority of the membership.
  4. The process repeats itself on the alternate side of the Legislative body. A bill must be approved in both the House and Senate in order to become law. 
  5. The approved bill is sent to the Executive branch for signature, at which time it becomes law.  

The President or Governor can veto (nullify) legislation that is passed with which they disagree.If this happens, the Legislative branch can override the veto with a two-thirds vote and the bill becomes a law without Executive approval.


nurses influencing healthcare policy




The political process may be intimidating. We must remember, however, that politics is an essential part of health care policy development. Competition among special interest groups, corporate entities, and elected officials may complicate the picture, as each group wishes to achieve its own goal.Effective political action by nurses can help to promote policy which has a positive impact on nursing.


See below for parts 2 and 3 of this article.