Nurse leaders and health-care experts agree that nurses have a responsibility to address the health problems facing the nation by participating in health policy development. However, nurses have not fully realized their potential when it comes to engaging in health policy advocacy and leadership. Nurse leaders, professional nursing organizations, accrediting bodies, and the Institute of Medicine have all identified the need to educate nurses in heath policy. Valuable recommendations for content and learning activities in health policy have been made. We argue that nursing education in health policy and the many recommendations offered have been broad and overly ambitious. This article presents a proposal for a staged approach to educating nurses. This approach would tailor content to the role of the nurse at each level of nursing education. The focus of health policy content would progress from the organizational level to local, state, and finally national level health policies. The goal of this approach is to better prepare all levels of nursing students to participate in shaping effective health policies.

The Legislative Action Interest Group (LAIG) is a hospital-based health policy forum that engages nurses in exploring clinical implications of existing and pending health policies and regulations, while also creating a feedback loop to inform policy makers about the realities nursing practice and patient care. The LAIG is a collaborative effort between the hospital's Department of Nursing and Patient Care Services and the Office of Government Relations at an academic children's hospital. Nurses participating in the LAIG forums build a working knowledge of health policy and can articulate the practice realities for policy decision makers. Participants explore the political context of nursing and pediatric policies while learning about the state legislative process. Beyond the monthly meetings, members build policy advocacy skills and have testified at public hearings, met with state and federal legislators, and led tours for policy makers through the hospital. The LAIG model also benefits the government relations staff by providing time for them to discuss clinical implications of pending policies with nurses from practice settings in the hospital. Forum discussions enhance the ability of the hospital's lobbyists to articulate practice implications of health policy to lawmakers. This case study, describing the origin, structure, operations, and outcomes of the LAIG model, and has implications for nurses in hospitals and academic settings who are interested in engaging in policy work. Opportunities to research the sustainability, replicability, and patient-centered outcomes of LAIG forums represent future work needed to advance nursing's participation in policy.

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This study was designed to describe and quantify the experiences of nurse leaders working to influence policy and to build consensus for priority skills and knowledge useful in policy efforts within the context of a nursing conceptual framework. The conceptual model for nursing and health policy and the Adams influence model were combined into a conceptual framework used to guide this two-round modified Delphi study. Twenty-two nurse leaders who were members of a state action coalition participated in the Round 1 focus group; 15 of these leaders completed the Round 2 electronic survey. Round 1 themes indicated the value of a passion for policy, the importance of clear communication, and an understanding the who and when of policy work. Round 2 data reinforced the importance of clear communication regarding policy engagement; knowing the who and when of policy closely followed, and having a passion for policy work was identified as least important. These themes inform learning objectives for nursing education and preparation for interactions with public officials because influencing policy requires knowledge, skills, and persistence. Study findings begin to describe how nurse leaders influence policy within the context of a nursing conceptual framework and generate implications for research, education, and professional practice.