⚖️410: Policy

Question 1

Define policy

Answer 1

A statement of direction resulting from a decision-making process that applies reason, evidence, and values in public or private settings.

Found at multiple levels.

Question 2

Macro-level policies

Answer 2

National or provincial

Ex. Senators, MPs, ministry of health

Question 3

Meso-level policies

Answer 3

Regional or institutional policies.

Ex. Hospital CEOs, nurse executives, advanced practice nurses (APNs)

Question 4

Micro-level policies

Answer 4

Local or unit-based. Clinical programs.

Ex. Department directors, nurses, APNs, nurse managers

Question 5

Public policy

Answer 5

1. Often enacted at a government level.
2. Clusters of issues

“Upstream” = addresses social, economic, political, environmental problems causing issue to intervene.

Downstream = addresses issues that are already there and trying to mitigate them.

Question 6

What were the main reasons in the consolidation of the LHiNs into five geographical regions?

Answer 6

1. Eliminating “hallway medicine”, reducing costs, and promoting efficiency
2. Reduction of funding for public health

Question 7

Neoliberal period of public policy in Canada

Answer 7

Hallstrom, 2016

1. Reduction of public investments in social resources and structures in favour of privatization
2. Concern about gov’t spending
3. Reliance on private citizens to manage their own social and health endeavours

Question 8

What are the two broad groups of health policy?

Answer 8

1. Policies directly related to health of population

2. Policies related to the provision of healthcare

Question 9

Healthy public policy

Answer 9

1. Positive impact on the social, economic, and environmental determinants of health
2. Intersection of political perspectives/values and its influence on health policy
3. Ideally “healthy” defined by research

Question 10

What are barriers to nurses participating in policy advocacy?

Answer 10

1. Unaware of how to influence policy
2. Sense that it’s not their job
3. High work demands
4. Political apathy
5. Belief things “never change”

Question 11

What’s at stake if nurses don’t participate in policy advocacy?

Answer 11

1. Perpetuate powerlessness
2. Demoralization and frustration
3. Decisions made without our input that affect our practice

Question 12

What are risks of participating in policy advocacy?

Answer 12

1. May not lead to change you want
2. Putting yourself out there
3. Revealing your political or ideological orientation
4. Political backlash of those who oppose

Question 13

What are Malone’s (2005) ten framework questions for assessing policy environment? 🌟

Answer 13

1. What is the problem with the current policy?
2. Who and how many are affected by this policy?
3. Who makes the decisions another the policy?
4. What is the process around making policy decisions?
5. What possible solutions could be proposed?
6. At what level is the problem most effectively addressed?
7. What are the ethical arguments involved?
8. What are the obstacles to policy intervention?
9. What resources are available to support policy intervention?
10. How can I get involved in policy intervention/advocacy?

Question 14

Voluntary ending of a persons life definition

Answer 14

A person makes a conscious decision to End their life and asks for help to do so

Question 15

Non-voluntary ending of a persons life

Answer 15

A person is unable to give their consent to treatment and another person makes the decision on their behalf.

Question 16

Passively ending a persons life

Answer 16

The act of intentionally causing someone’s death by withholding or withdrawing treatment, food, or fluids that is necessary to maintain life.

Question 17

MAID policy adoption

Answer 17

1. June 2012, BC Supreme Court declares laws against physician-assisted death were UNCONSTITUTIONAL because they discriminated against people with physical disabilities.

Question 18

The MAID policy (Bill C-14)

Answer 18

1. The administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death.
2. The prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request, so that they may self-administer to cause their own death.
3. Amends the criminal code
4. Specifies eligibility criteria and safeguards

Question 19

What are the eligibility criteria for MAID?

Answer 19

1. At least 18 years
2. Capable of making decisions about their health
3. Voluntarily request medical assistance in dying
4. Give informed consent to receive MAiD after being made aware of additional treatments to relieve suffering
5. Eligible to receive Canadian Medicare
6. Have a grievous and irremediable medical condition.

Question 20

What are the 4 stages in the policy cycle? (Villeneuve, 2017)

Answer 20

1. Getting to the policy agenda
2. Moving into action
3. Implementation and change
4. Policy evaluation and revision

Question 21

What are the 14 stages in the policy cycle? (Villeneuve, 2017)

Answer 21

1. Values and beliefs
2. Problems or issues emerge
3. Knowledge development
4. Public awareness
5. Political engagement
6. Stakeholder activation
7. Policy deliberation
8. Policy adoption
9. Preparing for change
10. Managing change
11. Reinforcing change
12. Evaluate content
13. Evaluate implementation
14. Evaluate impact

Question 22

In the policy adoption stage of the policy cycle, what is the most important factor to consider?

Answer 22

The process of a bill becoming legislation

Question 23

In the policy deliberation stage of the policy cycle, what is the most important factor(s) to consider?

Answer 23

1. Feasibility

2. Wording and structure

Question 24

In the political engagement stage of the policy cycle, what is the most important factor(s) to consider?

Answer 24

Understanding decision making structures

Question 25

In the Preparing for change stage of the policy cycle, what is the most important factor(s) to consider?

Answer 25

Identify potential points of resistance

Question 26

Direct lobbying

Answer 26

Directly engaging with decision maker. Ex. Letters, meetings, petitions, etc

Question 27

Indirect lobbying

Answer 27

Efforts to influence public opinion, which may influence policy makers later. Ex. Social media, ads, etc

Question 28

Grassroots lobbying

Answer 28

Mobilizing a committed group of people to influence the opinion of policy makers. Often have champion/advocate. Includes both direct and indirect.

Question 29

_______ involves experiential and reflexive learning so practitioners adopt good standards.

Answer 29

Practice

Question 30

Managerialism

Answer 30

The standardization of everyday nursing practice

Question 31

Moral ecology

Answer 31

Connection b/w an organization (structure/culture) and the ability of nursing to be a moral practice or the ability of nurses to practice in a moral way. Can support or restrict. Organizations informally shape people’s moral action by providing background, area and field for moral practice. Ex. Workload for nurse engagement Ex. Educational and ethical supports

Question 32

What are the major characteristics of clinical leadership?

Answer 32

1. Clinical experts 2. Challenge the status quo 3. Reflect positive attitudes toward their profession 4. Engages in reflective practice 5. Supportive and approachable 6. Acts as role model 7. Collaborative learning 8. A Knowledge source 9. Interprets/critiques managerial agenda 10. Translates vision fo institution into care delivery 11. Strategic vision for frontline practice

Question 33

Leadership is:

Answer 33

A process (involves interaction) whereby an individual influences a group (followers) to achieve a common goal (movement towards an end).

Question 34

Why is leadership important for nursing?

Answer 34

1. Coordination needed | 2. Associates with better patient outcomes

Question 35

Autocratic leadership

Answer 35

1. Decisions are made for staff/followers 2. Followers are not able to participate in decision making 3. Staff are often unmotivated

Question 36

Laissez-faire Leadership

Answer 36

1. Leader takes a step back 2. Important decisions left to staff with little to no direction 3. Organization lacks direction 4. Work may not be held accountable to operational processes

Question 37

Transactional Leadership

Answer 37

1. Providing rewards for meeting/exceeding expectations 2. May offer negative feedback if standards not met 3. Considered a “lower order” of leadership 4. Bureaucratic leadership: - maintains formal role - follows organizational structures - clarifies work tasks

Question 38

Transformation al Leadership Theory (Finkelman and Kenner, 2016)

Answer 38

1. Dominant leadership theory 2. Create vision and mission statements 3. “Human-capital-enhancing resource management style” 4. Emphasizes positive environment 5. Leader characteristics include confidence, self-directed, energetic, flexible, and committed

Question 39

What are critiques of Transformation al Leadership Theory?

Answer 39

1. Focused on heroic and distant leaders 2. Idealize leader - follow without challenge 3. Less attention to leader personal integrity 4. Fails to address immoral leader behaviours 5. Sexist stereotypes - often misses feminist perspective

Question 40

What are the 6 types of power used in leadership?

Answer 40

1. Coercive - based on punishment 2. Reward 3. Persuasive 4. Referent - leader admired 5. Expert - respected for expertise 6. Informational - access and share info

Question 41

Management

Answer 41

1. Accomplishment of tasks/goals. 2. Formal authority to direct work of employees. 3. Takes responsibility for quality and cost of work

Question 42

What are the 4 main functions of management?

Answer 42

1. Planning 2. Organizing 3. Directing 4. Controlling

Question 43

What are the 3 types of Leaders in Nursing?

Answer 43

1. Frontline Management 2. Middle Management 3. Nurse Executives

Question 44

Shared Governance in nursing

Answer 44

Management approach and professional practice model 1. Nursing staff are directly involved in decision making, particularly when affects their practice 2. Decentralized leadership and autonomous decisions 3. May include council structure

Question 45

What are barriers to clinical leadership?

Answer 45

1. Lack of confidence 2. Resistance to change 3. Clinician cynicism 4. Perceptions of leadership as “other” 5. Poor interdisciplinary relationships

Question 46

What are the types of councils found in shared governance?

Answer 46

1. Quality Council 2. Education Council 3. Research Council (apply best practice) 4. Management Council 5. Coordinating Council - facilitate and integrate activities of other councils