Modern health systems present health professionals as equal participants in the public health system. Nurses can overcome inequalities in access to health care and the provision of knowledge about health and medical education, using professional expertise and competencies in the largest group of medical professionals. It is the professional and moral duty of nurses to participate in legislation that affects their patients and enhances their healthcare-related experiences. However, their participation in health policy formulation remains low in both developed and developing countries. When nurses influence policies that improve health care delivery, they protect their patients. In this way, nurses can have a profound impact on politics on a global scale. The issue discussed in this paper is the poor distribution of health expenditures, which leads to a decrease in the quality and a heavier hospitalization indication.
Healthcare Issue: Health Expenditures and Their Distribution
Even in those countries whose governments reaffirm their commitment to universal health care principles, providing health services requires high and ever-increasing budgetary costs. The increase in the population, its aging, and the costs associated with new technologies, constantly increase these costs. Distribution is one of the cost management mechanisms in the health sector. In some cases, restrictions on access to certain types of services are used depending on medical indications. In others, the public sector provides services only to those who cannot afford to pay for them.
It is possible to exclude certain procedures from public funding as redundant or ineffective (for example, cosmetic surgery). Since such decisions may raise allegations of discrimination, they must be made after extensive public consultation. The mechanisms of hidden distribution and redistribution of resources are common. Strategies aimed at reducing costs have led to a heavier indication for hospitalization, a reduction in the length of stay in a hospital, and a limitation in the number of employees, which directly affects the quality of medical care and treatment.
To meet the needs of society in quality healthcare and improve the level of individual and public health, it is necessary to use financial resources effectively, increase responsibility for personal health, and provide equal access to medical services. Recently, the public health sector has faced severe financial cuts and difficulties. The Nurse Manager (NM) is tasked with managing and reducing costs in the nursing sector without compromising the quality of care (Naranjee et al., 2019). It is necessary to master and develop the skills of financial management.
Staff and supplies, as well as equipment, are part of individual nursing departments, each with its budget. The staff budget, which is the most significant part of the operating budget, comprises the average daily census, patient acuity, staffing requirements according to full-time equivalents (FTE), and productive and non-productive hours (The nursing profession’s potential, 2021). Although managers or heads of nursing may not be involved in developing the revenue budget, knowing this is important for making effective decisions (Naranjee et al., 2019). The capital budget is of a different type; this includes all costs that are necessary to acquire capital items.
The hospital’s finances have traditionally been out of the control of the professional nurse. The modern nurse understands or should understand the basic funding needs of hospitals and medical centers. Although this is not considered the central issue in hiring, it is necessary knowledge for the smooth functioning of any department. However, the NM is expected to understand and manage the financial side of the nursing sector by taking on this role (Rundio, 2020). Health care spending provides insight into the institution’s problems and its leaders. Intelligent management, with an understanding of the financial issue, can largely positively affect the process of patient care. That and many other reasons are essential for nurses to understand their role in managing the healthcare budget.
Ways to Solve the Problem
Professional nursing organizations should evaluate the benefits that can be gained by collaborating with each other and with non-nursing organizations to advance the profession. One of the most exciting potential collaborations has begun between the National Advisory Council for Nursing Education and Practice (Rundio, 2020). It recommends the Secretary of Health and Human Services, and the Council for Graduate Medical Education, which advises Congress on health policy issues pertaining to medical education (Rundio, 2020). The collaboration of groups now working on both medical and nursing education has been explored for primary health care. These two bodies determine the national health personnel financing policy and serve as models for cooperation between the two professions in all areas of policy development. As an equal partner in this effort, nursing can demonstrate its reliability and expertise in all aspects of health care delivery, including health workforce issues.
Application of the Policy Process and Possible Nursing Contributions
It is hard to disagree that state and local authorities’ actions play a primary role in addressing various healthcare issues, including the abovementioned problem. Poor allocation of resources and inadequate strategies to plan healthcare budgets can significantly affect social determinants of health (Sullivan, 2019). Therefore, precisely the focus on correct and quality health programs and policies can contribute to the process of health expenditures distribution and improve access to healthcare services. All the following phases of the policy process can be applied to this issue, and it is noticeable that there are potential nursing contributions across each stage.
To begin with, it is essential to clearly and in detail identify the concern and frame it. In order to do that, it is required to collect and interpret the relevant data and information that will explain the budgeting issue (Centers for Disease Control and Prevention, 2022). For instance, it can be related to the past and present correlations between reductions in health budget and access to some advanced services. Potential causes, the main characteristics like scope and frequency, and possible solutions are also examined during this phase. To provide help during this phase, nurses can take part in the collection and analysis of information and share their own experiences to get a complete picture.
This step is focused on identifying and evaluating potential solutions. In other words, this phase includes listing several possible policies that would address the issue of health expenditures distribution (Centers for Disease Control and Prevention, 2022). What is required is to describe each option and assess the costs and benefits of each policy. Additionally, one will need to define how precisely the options are expected to affect the problem and other health aspects like patient satisfaction, access to the necessary services, and medical workers’ abilities to perform their duties. The potential role of nurses is to share their ideas regarding each option’s impact on their work to assist in identifying the best solution.
Strategy and Policy Development
When one option is prioritized based on its potential costs, benefits, and effects, this phase begins, focusing on the further definition and detailing of the selected policy. Researchers and developers will need to clearly understand the capacity needs and contexts of the policy. For instance, how it will operate, what are some obstacles or difficulties, are there ways to overcome them, and what is required for the implementation of the policy. What is more, this phase also includes creating involvement strategies for policy actors and stakeholders, as well as preparing a policy draft. Again, since nurses will be the ones to comply with the new regulations, they can help define the policy’s context by sharing their experiences and also thinking of all potential threats.
This is one of the most challenging phases because its success depends on the authorities’ decision. All external and internal procedures have to be followed in order to get the health policy passed or enacted (Centers for Disease Control and Prevention, 2022). Depending on the final selection of the policy, this phase’s result is unpredictable, but if the option’s benefits outweigh costs, it is likely that the law, procedure, or regulation will finally get enacted. While the role of nurses during this phase is not very significant, they can help verify the final version of the policy.
Finally, when the policy is passed, it should be put into action to foster the process of addressing the identified problem. Implementation standards, guidelines, and recommendations need to be defined and realized, resources have to be coordinated, and some aspects of the evaluation process should be considered (Centers for Disease Control and Prevention, 2022). What is more, personnel capacity should be built and secured to ensure that the policy is implemented promptly and correctly. Referring to the identified issue with budgeting and health expenditures distribution, medical workers should be informed of the new changes and asked to comply with them. The role of nurses is to strictly follow the new policy, inform their colleagues and patients, and provide timely feedback to regulate the process.
Stakeholder Engagement and Education and Following Evaluation
The stakeholder engagement phase involves connecting with both supporting and opposing parties, informing them about the problem and selected policy, and assessing whether they have any gaps in knowledge. These are some tasks for nurses: they can implement proper communication strategies to inform the stakeholders, especially patients, and then gather feedback. As for the evaluation phase, it refers to assessing the policy’s steps, impact, and outcomes (Centers for Disease Control and Prevention, 2022). Nurses can participate in creating relevant questions and then conducting questionaries to receive and assess results.
Contrary to the belief of many nurses that financial management belongs to the finance department, the Nursing and Midwifery Council have been clear about what they do in terms of their financial management roles. The main role of NM in health system financing is to participate in budget planning for such stages as premeditated, budgetary, operational, purchasing, and personnel. They defined their overall managerial planning function and agreed on their roles and contribution in each of the previous activities in the context of economic planning. Thus, many results show that both managers and nurses at all levels influence financial planning at the health policy level, and the issue of health expenditures and their distribution should be solved through the policy process.
Centers for Disease Control and Prevention. (2022). CDC policy process. CDC. Web.
Naranjee, N., Ngxongo, T. S. P., & Sibiya, M. N. (2019). Financial management roles of Nurse Managers in selected public hospitals in KwaZulu-Natal Province, South Africa. African Journal of Primary Health Care & Family Medicine, 11(1). Web.
The nursing profession’s potential impact on policy and politics. American Nurse. (2021). Web.
Rundio, A. (2020). Budget development for nurse managers. Sigma. Web.
Sullivan, J. (2019). Better state budget, policy decisions can improve health. Center on Budget and Policy Priorities. Web.