The policy priority issue is a needed change in the school health system, specifically the need to stock epinephrine (EpiPen) in schools to treat anaphylactic reactions in students and faculty staff. This policy puts an emphasis on sudden severe allergic reactions and students whose death could be prevented with an emergency treatment of epinephrine. There is a need for a campaign to ensure this law passes as it did not pass the last session and will be reviewed during the next session. Hence, the need for mass campaigns by parents, teachers, students and health professionals. The planned legislature visit targets to inform the legislator on the issues surrounding the bill and to find out his stand on that issue and get a commitment from the legislator that he will take action. At the end of the meeting, the legislator and the group should agree on a follow up strategy.
In the planning process, a meeting is to be scheduled with the legislator; this includes determining the venue of the meeting. In addition, a group of people will be selected to participate in the planning process. The proposed group includes; a school nurse, a parent of a child with allergic reactions or asthma and a parent of a child who was a victim of lack of epinephrine in school to give their experiences and recommendations. The group will have a meeting to discuss the goals of the legislative visit and the message to be discussed.
Understanding the steps in a policy making process is important in ensuring that the bill becomes a policy. It will also guide the proposed legislative visit as it will make members aware of what they want and therefore, schedule a meeting according to the step the bill has reached. This issue concerning the stocking of epinephrine in school was first discussed in the public agenda, a bill was then introduced which was then assigned to a committee. The committee held hearings but it did not pass, although it will be reviewed again by the committee and if it is successful it will be presented on the floor for voting. Patti Moss and Iva Hall learned that for them to use the legislative process effectively to make a difference in the health profession and to the patient, they had to understand the legislative process (Hall & Moss, 2000).
Another strategy is to know the key people involved in the policy making process as they influence the decisions. The final decision that will be made by the legislators voting may be affected by other factors other than the importance of the bill at hand. These factors include; party politics, pressure from interest groups, preference of voters and personal preference of the legislators (Abood, 2007). Apart from visiting the legislator, it may be necessary to seek support from other interest groups in the state to support the matter. Every legislator has a staff member who gives them advice concerning health matters. It may be necessary to contact such a staff and deliberate with them the importance of this bill.
This bill did not pass the committee and thus, it is important for the group conducting the legislative visit to understand the role of committees in the policy making process since committees are the center of the policy making process. It is also here that the pros and cons of the proposed bill are discussed. The committee chairperson usually provides an agenda for the discussion of a bill. The committee provides a venue for educating the members and the public on the bill (Abood, 2007).Part of the plan of the legislative visit is to seek an audience with the committee to articulate issues surrounding the matter. The committee also decides what to take to the floor and what to ignore, which is the final step in ensuring a bill becomes policy.
The most important part of the legislative visit is the message. In order to ensure that the objectives of the visit are achieved, it is important to set goals for the meeting. Some of the goals of the planned legislative visit are in the table below.
Goals of the legislative visit
- To educate legislators and their staff about needed changes in the school health care system especially the need to stock epinephrine in the school clinics.
- To determine the opinion of the legislator on the bill; stocking of epinephrine in Schools.
- To obtain a commitment from the legislator to take action on the matter
- To obtain information on any future visits and contact persons
The message to be put across is the reasons for the bill to be made policy. The parents of affected children will be involved in the conversation in order that the legislators get first hand information from victims of lack of epinephrine in schools. One strategy to ensure that the message is delivered is to be precise and to the point. Short messages usually ensure that the recipient gets the important facts only and remembers them when pushing for a Bill to remove barriers in a Comprehensive plan for disaster management, nurse advocates Patti Moss and Iva Hall learned how to deliver their message in a short two minute speech (Hall & Moss, 2000).
The group will also print out some papers with the message that is to be delivered and a copy will be given to all group members conducting the legislative visit, the legislators and their staff. This will ensure each person remembers the message to be put across and in the case they do not, they will have the handouts to refer.
Needed changes in School Health Care
- Asthma and allergies are a leading cause of absenteeism among school going children.
- Accidental ingestion of substances that result in anaphylactic reactions most commonly occurs at school.
- 10% of all school going children have allergies; about 50% 0f those with allergies have a high risk of developing an anaphylactic reaction.
- 1 out of every four children who is diagnosed with anaphylaxis has never had allergies before.
- 1-2 minutes- time taken for a mild allergic reaction to become anaphylactic
- Epinephrine- standard treatment for anaphylaxis and has no contraindications.
- Illinois- state that has passed a law to allow stocking of epinephrine in schools.
In delivering the message, the group will also be keen to listen to what the legislators have to say, to ensure a mutually beneficial relationship. The group will listen and help the legislators achieve their objectives as the legislators help to actualize the bill requiring stocking of epinephrine in Schools. Still referring to the case of Patrick Moss and Iva Hall, they made a point to ensure that they helped the legislators achieve their causes as the legislators helped them achieve theirs (Hall & Moss, 2000). After delivering the message, the group should seek a commitment from the legislator that he will take action. This will be through finding out the legislators stand on the issue and telling them the recommendations on what should be done. In addition the group should arrange for a follow up meeting to assess progress of the issue (California School Health Centers Association, 2009).
In the case that this policy making visit is successful, the nursing profession will benefit a lot. There will be a direct impact on School health care as the visit will increase the chances of the bill being made a policy. This will improve the services provided by the nurses at that level. In order to be able to successfully achieve the nurses’ objectives of caring for the patient, the nurse needs to be able to influence people; this can be done through advocacy. According to Kalisch and Kalisch (1982) physicians used advocacy to dominate the policy making process. Through advocacy and legislative visits the nurses are able to define their role in the policy making process and it leads to the development of the profession as a whole. In addition, nurses will develop a mutually beneficial relationship with legislators, and when there is an issue affecting the nurses that needs to be addressed with urgency, the nurses will have an easier way through the process as they already are involved in the policy making process.
In conclusion, the issue of stocking epinephrine in schools directly affects nurses. The making of policies is done by people who are not necessarily nurses. Nurses have an understanding of health problems as they are always in contact with the patient. They are also the ones who are actively involved in implementing policies. It is therefore important that nurses are involved in making policies affecting health. Through advocacy and legislative visits nurses influence the policy making process.
References
Abood, S.A. (2009). Influencing Health Care in the Legislative Arena. The Online Journal of Issues in Nursing: A scholarly Journal of the American Nurses Association. Retrieved from: www.nursing world.org.
California School Health Centers Association. (2009). Educating policy makers: A guide to legislative visits and hosting sites. Web.
Haass, R. (2005). The politics of power; new forces and new challenges. Defining Power27(2). Web.
Hall, I. & Moss, P. (2000). Nursing and the legislative process: a successful outcome. Texas Nursing 74(10), 4-6.
Kalisch, B.J. & Kalisch, P.A. (1982). Politics of nursing. Philadelphia: J.B.Lippincott Company.