Incorporating political socialization theory into baccalaureate nursing education

The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

Background

The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.

Methods

The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services.

Results

Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes.

Conclusion

There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06272-z.

An integrative review of pursing policy and political competence

INTRODUCTION

For several decades, there have been repeated calls for nurses to become more involved in policy and political processes.

AIMS

The purpose of this article is to conduct an integrative review to identify and assess the current state of the science relating to supporting the pursuit of greater involvement by the nursing profession in policy and political processes.

DESIGN

Standard integrative review procedures were used to identify studies that examined how policy competence could be achieved. A comparative thematic approach to synthesis was used. Both published and grey literature written in English between January 1965 and January 2015 were identified via a structured search of CINAHL, SCOPUS, Science Direct and Google Scholar.

RESULTS

Forty-five primary studies were identified with literature from North America dominating, but contributions from low- and middle-income countries have recently started to feature. Studies tended to focus on the immediate impact of didactic and action learning-based approaches. The majority of articles were descriptive survey designs utilizing small convenience samples.

CONCLUSIONS AND POLICY IMPLICATION

Many programmes of education have focused on developing an understanding of legislative policy and political processes, but the development of policy and political competencies at team and institutional levels has been ignored. Existing research have looked at the short-term effects of educational programmes. At this time, there are conflicting reports on the impact of variables such as gender and educational preparation on policy and political competence. There is an urgent need to address these major gaps if nurses at all levels are to play a full role in shaping policy and political process.

A service-learning experience to teach baccalaureate nursing students about health policy

Incorporating health promotion strategies in practice, and in particular within healthy public policy based on the Ottawa Charter, is widely recognized as within the mandate of nursing, although evidence suggests that nurses are reluctant to take on this role. An innovative strategy was developed to facilitate baccalaureate nursing students' learning about healthy public policy by immersing them in a real-world service-learning experience. Students partnered with a population, assessed the determinants of health, and implemented a population health promotion strategy that included attention to a health policy issue. Students identified strengths and weaknesses of the existing policy and were required to propose recommendations for change that addressed the social justice issues. Students presented their work to faculty, students, and community partners and developed a written position paper on the topic. Students evaluated the service-learning experience as an excellent experiential learning opportunity.

Public health nurses perception of clinical leadership in Ireland: narrative descriptions

AIM

The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery.

BACKGROUND

Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles.

METHOD

Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery.

RESULTS

Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective.

CONCLUSIONS

Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. RELEVANCE TO NURSE MANAGERS: Public health nurses are well placed to shape and influence health service culture through effective clinical leadership.

Spiritual intelligence of nurses in two Chinese social systems: a cross-sectional comparison study

BACKGROUND

The spirituality of healthcare providers and their clients is becoming a crucial issue in a world increasingly preoccupied with material issues. In light of such, how do nurses enhance their spiritual intelligence against such materialist pressures? After a 60-year separation of Chinese on both sides of the Taiwan Strait and the rancor between their two governments, what are the similarities and the differences in nurse spirituality profiles between these two different societies? With increasing contact between the two, this issue should be examined and explored, as it has the potential to become an essential unspoken element underpinning holistic care quality.

PURPOSE

The purpose of this study was to compare spiritual intelligence between nurses in two different Chinese societies.

METHODS

A cross-sectional descriptive and inferential study was conducted at five medical centers in China and Taiwan. A total of 524 registered hospital nurses were recruited as participants. We used R. N. Wolman's (2001) self-reported PsychoMatrix Spirituality Inventory to measure participant levels of spiritual intelligence. The PsychoMatrix Spirituality Inventory incorporated seven factors, including divinity, mindfulness, extrasensory perception, community, intellectuality, trauma, and childhood spirituality.

RESULTS

Results showed that social systems did have an impact on nurses' spiritual intelligence. Childhood spirituality and religious beliefs and activities greatly affected and effectively predicted nurses' spiritual intelligence. Nurses on either side of the Taiwan Strait all reported a need to deal with their daily lives pragmatically, objectively, and rationally and relied on empirical evidence in work settings.

CONCLUSIONS

As social and economic contacts increase across the Taiwan Strait, it is imperative that nurses adopt cultural awareness and sensitivity as they provide holistic care to clients. This study opens doors to dialogue about and a better understanding of nurses' spiritual intelligence in Taiwan and China.

The road less traveled: nursing advocacy at the policy level

A frequent observation made about nursing advocacy at the policy level is its absence-or at least its invisibility. Yet there is a persistent belief that nurses will participate in advocacy at the societal level in matters of health. Although gaps exist in our knowledge about how to advocate at the policy level, the authors suggest that a number of other factors contribute to the disconnect between what nurses are expected to do in terms of policy advocacy and what they actually do. There are two main purposes in this article: to review the epistemological foundations of advocacy in nursing, and to present a discussion of other factors that limit our participation in policy advocacy. The authors discuss challenges within the discipline, in the practice context, and at the interface of the worlds of policy and nursing practice. The article concludes with a discussion of possible strategies for moving forward.

Strategies for Teaching Public Policy in Nursing

Professional discourse and facilitation of student-student and student-faculty interaction is at the heart of learning, especially with value-laden subjects such as politics and public policy. The authors discuss an online public policy course in nursing, specifically focusing on examples of successful strategies that inspired learning through communal expression.

The health-promoting nurse as a health policy career expert and entrepreneur

A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.

Nursing and politics: a South African perspective

The purpose of this paper is to provide a general introduction to politics, and to describe some political changes which have affected the rendering of multidisciplinary health care services in the Republic of South Africa since 1994. Political issues which will be addressed include: changed provincial borders; opening up of the Republic of South Africa's international borders; increased emphasis on primary health care services; enhanced international involvement of the Republic of South Africa; changes in the statutory bodies governing the nursing profession; and changed legislation affecting health care workers. Political know-how is essential for professional survival. Unless nurses in the Republic of South Africa collaborate proactively as a united group representing the largest proportion of health care professionals in the country, the nursing profession and nursing education might become irrelevant to the political realities of the country and its people. Unless nurses can succeed in engaging in successful political debates and in negotiating their rights, they might become an increasingly voiceless, faceless and powerless female profession in the Republic of South Africa. However, politically knowledgeable nurses may help to ensure that the people will get the nurses and the nursing care they deserve, whilst the nurses will enjoy the benefits to which they are entitled, including market-related salaries.