Learning+Activity+10

1. Review the scenario below and identify information from this scenario that applies to the stages of Milstead’s policy cycle as identified in McIntyre and McDonald (2012, p.99).

Moving from Issue to Policy:

a. Values and Cultural Beliefs- grounded in supportable set of values and cultural beliefs

Different cultures within the community, each with unique set of values and beliefs. Generational value gap is also present between the elders and youth. A general disconnect is present.

b. Emergence of problem or issue(s)- needs to have urgency; be visible and important to others

Extreme urgency is required. With rapid increase in suicide, STI rate, high school drop out rates, violence and petty crimes and family violence within the community. It is visible to the RCMP, community elders, community health nurse and principles of the schools. Community health is suffering on multiple levels.

c. Knowledge and development of research - is there research and/or evident to support the perceptions?

Qualitative data from community members are present from and quantitative data from RCMP, school district and the health care system. A wide base of research and information based on the aboriginal community and the issues identified.

d. Public awareness- create broad based awareness; who will support you, how will you communicate the issue?

Public forums to bring the community together and discuss issues openly and will be the best option for a small community. Having the forum with the undertone of openness, acceptance and a less formal tone will increase the likelihood of participation. A suggestion would be a community BBQ or dinner. Getting Aboriginal leaders involved to support the identified causes as well as community health leaders (such as Drs/nurses/councilors).

e. Political Engagement- need to have support and acceptance for the proposed solution/strategies


 * Support of MP’s and MLA’s
 * Support of Aboriginal leaders within the community

f. Interest group activation- engage other interest groups; keep repeating the message anywhere and everywhere; build relationships

Interest groups include the Aboriginal community, RCMP, health care providers, local politicians, youth, media and community members (essentially the whole community is our interest group!). In order to keep the groups activated and interested, keep the message in constant public eye and in the media.

g. Public policy deliberation and adoption- move the issue to the public and government agenda

The cost of dealing with community needs is minimal in comparison to the anticipated costs of untreated community needs.

Public is in agreement that there are significant issues arising rapidly regarding violence, education and sexual health

With Aboriginal leaders and political leaders in collaboration, there is a high chance of receptiveness for the elected officials to fight for the causes.

h. Regulation, experience and revision- proposed action becomes a formal policy, law or regulation- new cultural norms.

The values and beliefs of individuals need to be changed in order for new cultural norms to form. Formal policy and laws will provide members such as the RCMP and health care providers with guidelines to improve community health.

2. Identify how the social determinants of health impact the scenario.

All of the social determinants of health are affected in this scenario. Determinants of particular importance include income, socioeconomic status, education, access to heath care and culture/context.

3. Describe how you as an individual nurse can influence each stage of the policy cycle.

Step one: Meet with community members promoting cultural safety Step two: Discuss needs with all stakeholders and identify themes Step three: Preform literature searches, be a consumer of research, translate and disseminate the research, present the research to the community members in a language they can understand (be a knowledge broker) Step four: Participate in community forum Step five: Personally engage MP, work with nursing union and stakeholders Step six: Promote community forums, advocate for message through media, build relationships Step seven: Collaborate with politicians, act as expert on community health Step eight: Evaluate effectiveness of change in the community through surveys and observations

4. Think back to the presentation from week 8; describe how the Manager of the ER at RCH contributes to the profession of nursing.

Jackie, the manager, contributes to the profession of nursing by advocating for rapid, efficient and competent care. Patient streaming includes rapid triage, reduced delays, reduced time and improved patient satisfaction. Increase in quality care from the nurses then comes from increased job satisfaction and less stagnation.