Historical perspective on policy, politics, and nursing

Historical perspective on policy, politics, and nursing

Historical perspective on policy, politics, and nursing

It is described that in the year 1893, Lillian Wald and Mary Brewster believed that only living the experience of living in very poor communities such as those shown in immigrant communities could really impact the policies of habitability, hygiene, health, nutrition and education in the city.

These families would learn from visiting nurse how to keep themselves healthy in the face of the infectious diseases rampant at the time. In addition, these visiting nurse would respond to calls from the families in the community just as she would respond to the calls from de physicians.

During these home visits by nurses, families could learn  and worry about staying as healthy as possible and coping with the large number of infections that plagued them in those days.

Likewise, this group of nurses could respond in the same way to the call of the community and the physicians for whom they work.

Transforming their vision of how to solve health problems into a tangible reality involved hard work and an integration strategy with insurance companies, schools, donors, and of course, the New York City Department of Health.

However, she persisted and managed to change the structure of the health system; which was called Public Health. The precarious nursing staff continued to develop programs to promote health and prevent disease

With the idea that the strength of coalitions and agreements could bring about major changes, Wald and his colleagues in their workplaces and with the help of other nursing leaders were able to establish the National Nursing Public Health Organization in 1912, creating an organization to control and establish the guidelines of nursing practice as protagonists of Public Health.

On the other hand, She had developed the expertise to get Private Foundations and Donors to seek financial support for the initiatives she proposed. Their success in creating these coalitions was that they had a work strategy, in the first place they identified the problem, found the necessary resources and used them in such a way that the objectives that the community deserved were achieved.

Efforts were focused on the care sites and in the pursuit of the well-being of the community, they did not manage to extend their effect on public policies until the late 1970s. On the other hand, they had a powerful competitor that was the medical union that was better organized and had the support of important contacts in the upper echelons of the government. In addition, they preached a strong message for many decades. The message said: “Physician were the only safe providers because of their longer and more intensive education”; although this position cannot currently be endorsed with sufficient data.

Another lesson learned in Public Health was the importance of creating solid bridges between the community and the health system.

These historical references are important to keep in mind, but they need to continue to progress and push the politics of these changes. However, the most important step has been achieved in this 21st century, especially in the change of expression that is beginning to permeate more and more, driven by insurance companies and the community itself. Federal legislation began to include the expression provider instead of physician or, even better, the phrase “physicians and nurses”.

Medicare and others recognized nurse practitioner as primary care provider, although some states still maintain their regulatory authority to allow or not full scope of practice. Importance to advocate the role this profession holds as part of a larger solution to improve health care in United States.

 

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