Health care, as well as most public spheres, are limited by political and legal frameworks for their effective management and implementation. However, in some cases, the framework limits health care options, prohibiting controversial but effective practices, which suggests the need to relocate them. I believe that political frameworks are among the most influential in health care and my work in particular; however, they are the most flexible and adaptable.
Government and institutional policies often limit medical decision-making. While in some cases they have the advantage of making the process consistent and clean, in other situations, they can hinder the saving of lives. For example, according to US law, organ donors can be those people who signed consent during their lifetime or had a donor card (Glazier & Mone, 2019). In addition, the relatives of the deceased can also decide in favor of donation (Glazier & Mone, 2019). Nevertheless, in my nursing practice, I faced several situations when relatives of the deceased person experience severe stress and doubts when making such decisions about donation. This situation affects their ability to experience grief and mental state.
Today, as a leader, I also face the same issues because my staff tell me about it and ask for a piece of advice, since they see both sides of the donation problem. On the one hand, nurses take care of patients who die while waiting for vital organs, and on the other hand, they provide support and participate in emotionally difficult conversations with the relatives of potential donors. However, the United States passed the law on presumed consent; that is, if a person did not refuse to donate during life, they donate after death (Prabhu, 2019). This law would alleviate the stress of making a decision on relatives and saved thousands of lives of those people who need organ transplants. This situation demonstrates one of the policy frameworks affecting healthcare practice.
As a leader, I can influence this boundary by inspiring my staff to research the arguments in favor of this policy and participating in initiatives. As Wakefield (2018) noted, modern technologies allow nurses to exchange experience with professionals from other countries and improve patient care. Therefore, my followers and I could use the experience of Spain and other countries that have adopted a policy of presumed consent for donation to promote this initiative at the federal level. At the same time, I can also involve other interprofessional team members to do our independent research on the impact of donation policies on relatives and the stress levels associated with decision making and grieving. The main resources required at the initial stage are the time and participation of the professionals involved in collecting the data. However, financial resources are also needed to conduct independent research and lobby for larger-scale initiatives.
In conclusion, an example of this political boundary is one of many that is needed to improve healthcare currently and in the future. The prohibition of obtaining organs for transplant from people who have not given prior consent today is illegal and, in many cases, not ethical; however, this situation may change with political decisions. Consequently, healthcare leaders need to inspire nurses and other professionals to push this boundary. Healthcare requires continuous change, and expanding political boundaries is the primary and most possible initiative that every leader can promote.
References
Glazier, A., & Mone, T. (2019). Success of opt-in organ donation policy in the United States. JAMA, 322(8), 719–720.
Prabhu, P. K. (2019). Is presumed consent an ethically acceptable way of obtaining organs for transplant? Journal of the Intensive Care Society, 20(2), 92–97.
Wakefield, M. F. (2018). Nurse leadership in global health: New opportunities, important priorities (Links to an external site.). International Journal of Nursing Sciences, 5(1), 6-9.