Classroom Policies Per Instructor for Peer Responses

Responses to peers are a minimum of 100 words (with citations and references per APA Format). All assignments must have citations and references for credit. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. 

I expect conversation, rather than drop a quote and leave. It is best to add references and personal experiences or current events. Again, just as if you were in a ground classroom, the goal is to share and stimulate a conversation, not simply agree with everything. On that note, it is ok to agree, just support your answer and why. If I suspect copy and pasting, you will receive a zero.

Classroom Resource Materials

Chapter 4 in Trends in Health Care: A Nursing Perspective



The Future of Nursing: Leading Change, Advancing Health


Influencing Health Care in the Legislative Arena


Political Advocacy, Anyone?


How a Bill Becomes a Law


How to Write Your Legislator


Federal Issues


Proposed Federal RN Ratios – What You Can Do About It


Contact Your Legislator





Nurses Serving in Congress


Discussion Question:

Choose a legislator on the state or federal level who is also a nurse and discuss the importance of the legislator/nurse’s role as advocate for improving health care delivery. What specific bills has the legislator/nurse sponsored or supported that have influenced health care.

Peer’s Answer:

Andrea Rocha

Representative April Weaver represents House District 49, which includes portions of Bibb, Shelby and Chilton Counties. She was first elected to the Alabama House of Representatives on November 2, 2010 and is currently serving her second term. Representative Weaver spent over 23 years working in healthcare administration and currently chairs the Health Committee. When she was appointed to this position in 2014, she became the first woman in Alabama history to hold this position.

Representative Weaver graduated in 1993 from the University of Alabama with a bachelor’s degree in Business Administration. After graduation, she returned to her hometown where she worked as the Financial Director of Bibb Medical Center Home Health and the Public Relations Director of Bibb Medical Center. It didn’t take long for her to realize her desire to have a career in healthcare. She returned to college while working full time and earned a degree in nursing. After receiving her nursing degree, she held numerous clinical and operational positions at Bibb Medical Center before accepting a position at Brookwood Medical Center. At Brookwood, she quickly climbed the ranks, earning the position of Director of Public, Community & Government Relations. In this position, she had her first taste of politics by working on CON (Certificate of Need) projects for the facility and receiving an appointment to the SHCC (State Healthcare Coordinating Council). In 2002, she moved to Shelby Baptist Medical Center where she worked as the Director of Business Development & Marketing, holding responsibility for strategic planning, physician relations and other duties as a member of the administrative team for the facility for the next 13 years. In 2006, while working full time and raising a family, she earned her MBA with a concentration in Healthcare Administration.

Representative Weaver has sponsored or co-sponsored the following for the State of Alabama:

HB 44 Relating to the Board of Nursing; to amend Sections 34-21-1, 34-21-2, 34-21-21, 34-21-22, and 34-21-25, Code of Alabama 1975, and to add Section 34-21-20.01 and Article 7, commencing with Section 34-21-120, to the Code of Alabama 1975, to allow the board to enter into the Enhanced Nurse Licensure Compact as a means of providing uniformity in licensing requirements and interstate practice throughout party states; and to make technical changes relating to the multistate licensure of nurses.

HB 45 To amend Section 34-21-96, Code of Alabama 1975, relating to the loan repayment program for advanced-practice nursing administered by the Board of Nursing; to authorize the board to provide loans to currently certified nurse practitioners, certified nurse midwives, and certified registered nurse anesthetists who contract with the board to practice in medically underserved areas of the state.

HJR 37 Health care, requiring written notice that attacking a health care provider or nurse is a felony

HB 373 Relating to the Board of Nursing; to amend Sections 34-21-1, 34-21-2, 34-21-21, 34-21-22, and 34-21-25, Code of Alabama 1975, and to add Section 34-21-20.01 and Article 7, commencing with Section 34-21-120, to the Code of Alabama 1975, to allow the board to enter into the Enhanced Nurse Licensure Compact as a means of providing uniformity in licensing requirements and interstate practice throughout party states; and to make technical changes relating to the multistate licensure of nurses.


The Alabama Legislature, Representative Weaver, April. Retrieved from

Peer’s Answer:

Alexandria Witte

Congresswoman Lauren Underwood serves Illinois’ 14th Congressional District and was sworn into the 116th U.S. Congress on January 3, 2019. She is the first of many including, the first woman, the first person of color, and the first millennial to represent her community in Congress. “She is also the youngest African American woman to serve in the United States House of Representatives” (ANA, n.d.). She has heavily impacted many areas of our health care system. She has contributed to Chicago’s Medicaid plan, advised the U.S. Department of Health and Human Services in preparation for disaster response, bioterror threats, and public health emergencies. This is perhaps my draw to Congresswoman Underwood. With so much craze and chaos in the day to day at work, I find peace in knowing that a member of congress has made such an impact in an area that is in need of much focus. With a background in education and teaching, she seems to be an obvious choice for leading change based on the current health trends Americans are facing.


American Nursing Association (n.d.). Nurses Serving in Congress. Retrieved from:

Peer’s Answer:

Wendy Wylie

Ms. Linda Upmeyer is an RN who was elected as a Representative in the state of Iowa in 2002. It was during this time of her serving as a legislator representative for the state of Iowa that the health information technologies started to manifest (Sullivan, 2012). Linda Upmeyer, an RN, received the 2012 (HIMSS) Healthcare Information and Management Systems State Policy Leadership Award for advocating and leading the way to improving the quality of health care by embracing the need for health care information management and technology (Sullivan, 2012). Advocating for the electronic medical/health records is an important and critical step in assisting health care providers in managing patients, track operational indicators; meet meaningful use, regulatory and accreditation requirements (AHRQ, 2013).

Due to Linda Upmeyer’s advocacy efforts in the building blocks of health information technology she was involved in and supported the adoption of the House Resolution bill No. 135. It was within this resolution that sought out the importance of (EMR) electronic medical records and healthcare information and management systems (Upmeyer, n.d). For example, through use of electronic medical or health records, primary care providers can improve care by entering standing orders that authorize nurses to perform medical care per practice approved protocols and also allows for provider to identify patients whose conditions are not improving and which patients who have not received the appropriate care or preventative services (AHRQ, 2013). It can further assist in identifying patient educational materials unique to each patient.

An electronic medical record system is a key component in the tracking of disease management and patient populations. It is with the use of electronic medical records that healthcare providers are able to track the progression of their patients over a lifetime and not just a single visit, thus allowing for continuity of care (AHRQ, 2013).


(AHRQ) Agency for Healthcare Research and Quality (2013). Module 17. Electronic Health Records and Meaningful Use. Retrieved from:

Sullivan, T. (2012). HIMSS State Policy Leader Award: Nurse-Legislator Rep. Linda Upmeyer. Retrieved from:

Upmeyer, L., (n.d.). House Resolution 135- Introduced. Retrieved from:

Discussion Question:

Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue?

Peer’s Answer:

Andrea Rocha

Nurses are one of the biggest growing workforce in the world. Majority of the hospital workforce consist of nurses. Role of nurses is not just limited to patient care but also involves actively advocating and lobbying for legislations that deals with public safety, community welfare, and patient care, nursing issues, wellness and preventive measures. In fact nurses have a very wide scope of interest. IOM report along with Affordable Care Act has further empowered nurses to be proactive. There are quite a few laws that we see enacted due to nursing influence.

Nurses have been against tobacco use, smoking and vaping after seeing the evidence of damage. Recent increase of vaping epidemic among youth has been a nursing concern. They have actively lobbied against it. Their fears were proved right by certain deaths caused by vaping e-cigarettes. The evidence showed that vaping cause irreversible damage to lungs. Galvanized by this new evidence, nurses advocated for ban on e-cigarettes. Their concerns were legitimatized by the elected members of office in the government. Many state governments swung into actions as they anticipated delayed congress action. Many states have banned e cigarettes totally like California (Oncology Nursing Society, 2019). Seeing the rising concern among public and health officials, many stores now refuse to sell vaping products example Walmart. Nurses are educating their patients about the ill effects of vaping whenever they visit their physician or at schools. It is not just the youth that have been affected by vaping but also the adults who took up vaping as an alternative to smoking not knowing its side effects. Since it comes in different flavors, youth are also attracted to it.

State legislation, local regulations are glimpses of bigger changes to follow at federal level. Even with federal regulation this controversy will not die down. Companies that manufacture these products will fight back or try to influence the lawmakers about the safety of the product or try to find a loop hole to bring their product back into the market. Nurses should continue to oppose vaping in any form or kind (flavored or unflavored). We need to continue to create awareness about this product and its damage to the public.


Oncology Nursing Society. (2019, September 23). Nurses impact health policy; State vaping legislation; Pelosi’s drug plan. Retrieved from

Peer’s Answer:

Cathy Wills

For years, nurses across the nation have been asking for safer staffing ratios. With tighter budgets and substantial increases in the number of patients, nurses have been working in situations that endanger both patients and themselves. Per Blitch, mandated staffing ratios are key addressing this issue.

Hospitals across the country have growing caseloads of patients and limited numbers of nurses available to treat them—the consequence of 20 years of hospital downsizing due to state budget cuts and private mergers. There are fewer nurses, all working longer hours and rushing through more patients during every shift, as a result. A survey of nurses by the American Nurses Association found 54% saying that they did not have sufficient time to spend on each patient, despite 43% of the respondents working longer hours during the prior year (Nurse-staffing ratio, 2020).

Nearly a decade later, California is still the only state to have enacted a nurse-staff ratio law. But nurse unions in other states are pressing their lawmakers to follow suit. Six more states—Florida, Iowa, Minnesota, New Jersey, New York, and Texas—and the District of Columbia are now considering enacting nurse ratio laws of their own. They have several allies in the U.S. Congress, too. The National Nursing Shortage Reform and Patient Advocacy Act, which Sen. Barbara Boxer (D-California) introduced in April 2013, would require hospitals to maintain minimum ratios of nurses to patients and would impose audits and fines on the hospitals whose ratios fall too low. Rep. Jan Schankowsky (D-Illinois) introduced a related bill, the Safe Nurse Staffing for Patient Safety and Quality Care Act, to the House of Representatives in May 2013.

Other states have passed legislation relating to nurse-staff ratios, too, but not by prescribing set ratios like California has, he also noted. For example, seven states—Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington—now require hospitals to have formal written policies on staffing and patient caseloads. This can potentially avoid nurse overloading, since hospitals that plan ahead for busy days and staff absences will be less overwhelmed when the congestion happens. Illinois also requires hospitals to publicly disclose their nurse-staff ratios, as do New Jersey, Rhode Island, New York, and Vermont. This can reduce overcrowding by letting patients and nurses know which hospitals are the most crowded, the result of which will be some of the less-crowded hospitals getting more new patients and more nursing job applicants.

“If the nurses are able to identify the hospitals with the better nurse staffing levels, those are the hospitals they will be more likely to work in. This could provide an impetus for those hospitals with worse nurse to patient ratios to improve their work settings and staff ratios,” McHugh said. California being the only state to have implemented a nurse-staff ratio law, we can’t really tell whether such a law would be beneficial if implemented across the country, McHugh cautioned. But he strongly supports the goal of maximizing the numbers of well-trained nurses relative to patients. Through a number of reforms, including not only laws but also new clinics, better workplace management, and expanded education, healthcare systems everywhere can achieve better results for both nurses and patients.


Blitch, A. (2018). Proposed Federal RN Ratios-What you can do about it. Retrieved from

Health Experts Debate the Merits of Nurse-Staffing Ratio Law. (2020). Retreived from


Peer’s Answer:

Stacey Walker

HR 647, also know as the Palliative Care and Hospice Education and Training Act (PCHETA) is meant to amend the Public Health Service Act to increase the number of permanent faculty in palliative care at accredited allopathic, osteopathic, medical, nursing, and social work schools, as well as other programs for medical professionals, to promote education and research into palliative and hospice care, as well as support the development of faculty careers in academic palliative medicine.

Until recently, I worked as a hospice nurse in a hospice inpatient unit, within a hospital. Our clientele consisted of people who needed high-level 24/7 medical management due to intractable symptomology; similar to a “hospice ICU”. Because we were located inside a hospital, we frequently got referrals from other units. There were several things I learned from this perspective, but 2 particularly stand out-

  1. The vast majority of people are uncomfortable dealing with death. Even medical professionals. The dying on the floors and units get moved the farthest away from the station, and almost always get substandard care comparatively to those who are expected to leave walking and talking with their families. I think about this a lot, and I’m not sure if it is a conscious/subconscious fear of mortality, an exercise in time management (they will die anyway, and there is an overwhelming amount of work already for those who are expected to live, so better to apply resources in that direction), or maybe a sense of failure, as our system is designed to heal people, not let them go….. Maybe its all those things? I don’t know.
  2. We as a health care community are not properly educated on death.We don’t know how to talk about it, how to interpret what we see, even just how to accept it and move past the point of the terminal ending to make it the most positive experience it can be. I have seen doctors stumble, and nurses, and every other discipline in “regular” (health-focused) medicine when trying to work with dying patients. I was never taught about hospice and palliative care, and it doesn’t seem much like most others were, either.

The thing is, with the aging of America, more and more patients will have to face their own mortality. As people become more educated to what medicine can do, it is important to consider what medicine can’t do. It cannot overcome inevitable death, and it cannot promise you quality of life. Very few people want to live on into eternity with no quality of life. There is a point where continued existence is an affront to personal dignity. We’ve all seen it; we should learn how to talk to our people about it. The ability to give a dying patient a dignified death, in whatever way that resonates with them, is to me, the most human thing one can do to honor another’s existence in this life. We as health care professionals are uniquely qualified to do this, if only we are exposed to it, and educated on how to do it well. Removing stigma and fear should begin in school. It just makes sense.

PCHETA is bipartisan passed the house in Oct 2019, and is now goes to the Senate, where it also has several supporters on both sides of the aisle. It is my sincere hope that this is signed into law sooner rather than later, because I really can’t see any drawbacks for anyone. Our patients deserve the right to live, and die, on their own terms. This is important not only for them, but for the families and communities they leave in their wake when they go. We need to be leading the charge on this, creating awareness of the situation and showing our support as health care professionals.


Reference: (2020). H.R.647-116thCongress: Palliative Care and Hospice Education and Training Act. Retrieved from:

Stone, A. (2018). Key federal health policy legislation updates for 2018. Retrieved from:

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