The Future of Healthcare: Political Participation of Nursing and Public Health Students

Literature Review

Nursing, as one of the largest health professions with three million registered nurses across the United States, has the potential to drive policies that influence health. This large and trusted professional group accounts for one in every 44 voters (Spenceley et al., 2013; Phillips, 2012). The public expects nurses to provide compassionate and ethical care and advocate for clients and issues that are relevant. A recent Gallup poll found nurses rated highest in honesty and ethical standards compared to numerous other professional groups (Gallup, 2014). Despite the profession’s potential to influence policy, advocacy by nurses has sometimes been characterized as invisible (Spenceley et al., 2013).

Exploration of the level and types of political participation among nurses and nursing students has been addressed in recent literature. Using Verba and colleagues’ (1995) Civic Volunteerism Model (CVM), the authors identified political engagement in primarily “low cost” activities (e.g., voting, conversations about politics, contacting elected officials) among Midwestern RN to BSN students and RNs (Vandenhouten, Malakar, Kubsch, Block, & Gallagher-Lepak, 2011). Psychological engagement was found to be most predictive of political participation which was consistent with previous research by Ritter (2008) and Cramer (2002). Specific dimensions of psychological engagement most strongly associated with political participation were political interest, political efficacy and family influences. Resources (i.e., time/money, civic skills) significantly contributed to political participation as well (Vandenhouten et al., 2011). Social networking as a form of political participation was not addressed in this study (Vandenhouten et al., 2011).

Numerous barriers have been cited as reasons for low political participation by nurses and nursing students. Rains & Barton-Kriese (2001) identified in a qualitative study that nursing students had a “disconnect among personal, political, and professional expectations” and a “hesitancy in talking about themselves as political beings” (p. 222). Spenceley et al. (2006) cited the following barriers for political participation by nurses 1) lack of preparation from nursing education, 2) heavy workloads and lack of time, 3) professional silos and fragmentation, 4) risk averse personal qualities, and 5) tendency to view policy as removed from their scope of interest.