Policies and Evaluation Term Paper

Policy Process: Evaluation, Analysis and Revision

The National Nursing Shortage Reform and Patient Advocacy Act was designed to address the public health workforce shortage that is seen, especially where nurses are concerned. It is no secret that nurses are leaving the profession in record numbers, and as they do that it is becoming more and more difficult to replace them with others who want to do the same type of work (Buerhaus & Retchin, 2013; Iglehart, 2013). Because of all the nurses retiring, and so many of them experiencing burnout, the gap between the number of needed nurses and those who are available continues to widen (Negron & Cohen, 2013). The issue here is how that Act becomes a policy, so it can provide more help to a public health workforce that is struggling. In order for the Act to become a policy, it must first be evaluated. The Act discussed here was introduced to the Senate in April of 2013, and has been read twice (S.739, 2014). It was then referred to the Committee on Health, Education, Labor, and Pensions (S.739, 2014). Since then, no further action has been taken on it.

Evaluation

The lack of action in Congress does not mean that nothing is happening to the Act. The Act must go through a process to help ensure it is ready to be passed, and to have the highest chance of getting through the Senate when it is voted on. Then it must also pass the House, and only then can it have a chance of becoming law. So many bills "die" in the House or the Senate because they are not acceptable to both sides of Congress, or because they have riders or other bills attached to them that stop them from going through. The Act will be evaluated for all of these things. It is based on legislation that required better nurse-to-patient staffing ratios, and focuses on that same type of issue (Buerhaus & Retchin, 2013). There are too many patients and not enough nurses to safely and properly care for them (Buerhaus & Retchin, 2013). While the Act is about nurses, it is actually about patients, in that it is designed to bring more nurses into the field to care for all the patients who are already there and who will be there in the future (Buerhaus & Retchin, 2013).

Analysis

After the thorough evaluation the Act receives, it will then be moved into the analysis stage, where anything that could prevent it from moving forward will be discussed and acknowledged (Iglehart, 2013). If there were serious problems that could stop the Act from advancing, they could be caught in the analysis stage and adjusted. Factors that allow the policy to meet objectives also have to be considered, in order to determine the overall strength of the policy. Currently, the policy is still with the committee to which it was assigned in April of 2013 (S.739, 2014). The government's bill tracker site shows that it has a 0% chance of being passed. However, that addresses its chances when it comes to how it was originally introduced. Work is being done on the Act in committee to provide it with a better chance of passing. An analysis of the Act shows that it would require strict patient to nurse ratios throughout all hospitals (Buerhaus & Retchin, 2013).

There would be consequences for those who did not keep these ratios, and that could cost these hospitals funding and other needs items that would be very important to them (Iglehart, 2013). With that in mind, hospitals oppose these kinds of bills, because they force the hospitals into different staffing plans than they currently have, and impose upon them something that is based only on a numbers game (Buerhaus & Retchin, 2013). This makes many hospitals uncomfortable, and is likely why similar bills introduced in 2009 and 2011 died in committee and did not advance through Congress (Buerhaus & Retchin, 2013).…