NR 506 Week 1 Discussion: The Four Spheres of Political Action in Nursing
NR 506 Week 1 Discussion: The Four Spheres of Political Action in Nursing
Please discuss the four spheres of political action in nursing. In addition, please develop a brief argument sharing how these spheres are interconnected and overlapping by applying an example from your practice. What are some ethical considerations here?
Week 1- The Four Spheres of Political Action in Nursing
The four spheres of political actions in nursing are the workplace, government, community and professional organizations (Mason et al, 2012). Each one of the spheres has it’s own separate functions such as: the workplace focuses on issue, which affect jobs and patient care. Government addresses rules, laws, and manages regulations in nursing practice. Community involves issues that affect community well-being and lastly organizations which address concerns related to shaping nursing practice (Mason et al, 2012). Together the spheres can create change. Nurses are able to change policy making and improve issues in the community health systems (Mason et al, 2012).
When you start out in your new nursing career, it is vital to review the political policies and nursing policies in your organizations. Nurses don’t realize that we are already political our nursing practice is molded around governing bodies, ethical, professional, governmental standards, and healthcare itself (Bjornsdottir, 2009). 
I believe in centered family care in our organization. Especially when a trauma has occurred and the outcome doesn’t look good. It is important for family to see that you have done everything you can to help their loved one. Nursing has the greatest power in this situation (Parker, 2013). We are responsible for being the patient’s advocate. In the workplace it is vital for the patient’s family to be at their child’s bedside when something critical is taking place.
If not then the family is wondering what is being done on their child (Parker, 2013) when a family member becomes involved they know you have done your best even if the outcome is not good. We have an ethical responsibility to do everything we can to save someone’s life. Nurses have to remind surgeons and other physicians that families have a right to be with their loved ones (Parker, 2013). Physicians see families as a distraction and that they will be in the way, instead of seeing them as a positive and realizing the family needs to believe that we tried everything to save their child’s life. If not allowed in the room they decide what they think or don’t think you did for their loved one (Parker, 2013).
Some ethical problems one may face with not allowing patient centered care in your organization can be wait times in the emergency room. These extended wait times puts a patient and their families at risk for harm (CDC, 2014). The main reason for this is boarding of patient’s for lack of nurses to take care of patient’s inpatient. When boarded patient’s take up Ed resources which makes waiting times in the Ed waiting room increase to unsafe levels (CDC, 2014).
Bjornsdottir, K. (2009). The ethics and politics of home care. International journal of nursing studies, 46, 732-736. Retrieved from
http://nursingandpolitics.blogspot.com/2012/12/asyou-are-learning-this-week-about.html (Links to an external site.)
Centers for Disease Control. (2014). Emergency department visits. Retrieved from http://www.cdc.gov/nchs/fastats/emergency-department.html (Links to an external site.)
Mason, D.J., Leavitt, J.K., & Chaffee, M.W. (2012). Policy and politics in nursing and health care. Retrieved from http://nursingandpolitics.blogspot.com/2012/12/asyou-are-learning-this-week-about.html (Links to an external site.)
McClelland, M., (March 6, 2015) “Ethics: Harm in the Emergency Department – Ethical Drivers for Change”: The Online Journal of Issues in Nursing 20, (2).
doi: 10.3912/OJIN.Vol20No02EthCol0
Parler, L. (2013). Family centered care: Aiming fro excellence exploring the past, present, and future. Vancouver general hospital. Retrieved from
www.caccn.ca/en/files/Dyn14 9B Family Centered
I erased all the extra space after your post. You presented an important example that nurses impact – family centered care especially in the event of trauma. Is this hospital policy? If so, how are the four spheres connected in relation to this policy?
It actually is a standard of practice where I work. The nurses fought hard to make it a policy within our organization. Physicians were very reluctant and still need reminders at time to allow parents to be with their child when a tragedy occurs. The organization in which I work is a pediatric emergency room setting. We realized when the family was involved in an event that had a poor outcome family presence made a world of difference (ENA, 2010). The family that is involved in the decision making as much as they can be are more understanding when we can’t save their loved ones compared to ones that are outside our trauma room while their loved ones are being worked on (ENA, 2010).
It makes a considerable amount of difference if they are watching you work on their child trying to save their life. When family is outside the room they seem to imagine what is going on and sometimes have doubts if the physician and nurses did everything possible. I believe in family presence and feel as though this may help with the loss of a loved one especially if there is extenuating circumstances.
Emergency Nurses Association. (2010). Position statement: Family presence at the bedside during invasive procedures and/or resuscitation. Retrieved from www.ena.org/SiteCollectionDocuments/Position%20Statements/Archived/FamilyPresence.pdf (Links to an external site.)
You need to delete the extra space before you post as you are right, you are not able to edit once posted. There is good reasons for your hospital policy (workplace). I was wondering how this policy is connected to the other 3 spheres. It is important to think of the connection between the 4 spheres. Does a professional organization like the ANA support and advocate for this kind of policy? Is there legislation that protects parents rights during the kind of situation you described. You said it was a standard of care – is this supported by your state nurse practice act, which would make it a legislative issue. Is the community aware? These are the kinds of things you want to explore as the 4 spheres working together.
The organization has a standard of care for their organization of how patients and their families are to be treated and the fact that we now practice family centered care. We actually have a parent based counsel that meets once a month and discusses family centered care in our organization and what is working well and what we can focus on making better. Healthcare workers from each division are on that group also. I know that we take government insurance and with that we must provide great care and allow convenient access to quality and safe care (CQC, 2016).
The government expects that you will be given good care and be able to be involved in the decision making of the care every step of the way (CQC, 2016). The government tracks hospital organization trough a website at www.cqc.org.uk , this website publishes details of how the hospital services regulates and meets government standards of quality and safety (CQC, 2016). In giving this care the community is aware and through thus we get more referrals. If for some reason we do not provide the quality of care and safest care required we could lose our funding (Hughes, 2011). The four spheres relate to each other and are intwined. We need all four spheres to work together to be complete and produce change (Hughes, 2011).
Hughes, R., (May 31, 2011) “Overview and Summary: Patient-Centered Care: Challenges and Rewards” . The Online Journal of Issues in Nursing, 16 (2).
doi: 10.3912/OJIN.Vol16No02ManOS
Care Quality Commission. (2016). Retrieved from https://www.gwh.nhs.uk/media/147361/6436_cqc_hospitals.pdf (Links to an external site.)
