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Current bill proposes the adoption of the nurse-patient ratios to improve the quality of health care in our state. The reasons of necessity of the given bill are the following:

– Each additional patient added to the nurse’s load is associated with the increase of mortality by seven percent during general surgical operations. In addition, nurse dissatisfaction and combustion at work are linked with increased workload (Aiken, Sloane, Cimiotti, Clarke, Flynn, Seago, Spetz, & Smith, 2010).

– Lesser workloads for nurses lead to the improvement of their operating environment. As a result of the increase in the number of hospital nurses in other states, such as California, their workload has remained reasonable. At the same time, they received considerable support in their everyday work. It was enough nurses to perform the necessary work and provide high-quality patient care (Aiken et al., 2010).

– When the number of hospital nurses in California was less, their workload led to occurrences when they missed a change in the patient’s condition. This could cause the death of the patient (Aiken et al., 2010).

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Proceeding from the positive results of the implementation of California Nurse Staffing Mandate (Aiken et al., 2010), the adoption of such legislation in our state will be a reasonable step. As this precedent had positive results, the implementation of the bill on mandated nurse-patient ratios will prove the nurses’ and patients’ support to the party which will adopt this legislation and the legislator who will lobby and enact it.

My Strategies to Influence Votes

To pass the legislation on nurse-patient ratios, I should use the strategy of entering the legislative arena for a start. According to this strategy, I will have to meet with legislators and their staff to build good relations with them and find points of contact. It is also necessary to establish contacts with people from committees having jurisdiction over the issues of the legislation on nurse-patient ratios. Besides, I will need to increase my political education by participating in hearings and briefings (Abood, 2007). This strategy is suitable for the local level when the advocacy activity is in the first stage – getting acquainted with the local players of the legislative process. It is important to show my best side at the stage of entrance into the legislative arena.

During the legislative learning it is important to grasp all the features of the steps of the legislative process. The process adopts laws, creates and finances health care programs, and adjusts health policy to the other policy areas. Once the problem is submitted for agenda of the NA, the bill is transmitted to the appropriate committee for review and hearings. After reviewing the bill, the committee makes a decision about the unsuitability of the project, the need for its revision, or transfers it to the legislator to vote (Abood, 2007). The strategy of understanding the steps of the legislative process is the base for successful promotion of the bill on nurse-patient ratios in the future. In general, these steps are similar at the local and the state levels. There are local laws that rule at the local level and state laws that apply at the state level, where the advocate also gets acquainted with the procedures of the House of Representatives and the Senate. The difference lies mainly in the key players. Thus, I should grasp this strategy while working at the local level and use it further at the state level. First, I would have to create a detailed bill that would help increase the number of nurses in my state in accordance with nurse-patient standards by cooperating with consultants. Once the bill is drafted, I would have to determine the willingness of the legislators to support the bill. I would prepare a detailed, but brief presentation of the legislation with slides, graphs, and charts in the most simple and understandable format. Additionally, it would be wise to take care of the legislators’ interests. This can be done by determining their needs and trying to satisfy them. For example, I could ensure the nurses’ political support of these legislators, like voting for them in the elections.

For adopting the bill it is important to know the key players of the legislative field who can influence the process. This strategy will work well both on local (establishing a contact with local committees) and state levels (reaching out to the members of the House of Representatives and Congressmen). The legislator’s attitude towards the legislation on nurse-patient ratios can depend on many factors. They comprise personal preferences, politics of the party, regional electorate’s preferences, and the pressure of different organized groups such as trade unions. The outcome of the proposed legislature depends on the identifying of the maintainers and non-maintainers of the legislation on nurse-patient ratios among the legislators and their staff, reaching an understanding with the chairperson and the members of the appropriate committees. Establishing a contact with my legislator is crucial for the legislature’s outcome. (Abood, 2007). When the main players in this process are determined, I will introduce my team as one of them. The united nursing community will have an enormous influence on the process and will achieve more than any separate person would be able to achieve on his or her own. (Abood, 2007). During the lobby day, I will visit numerous Congressional offices to find as many legislators as possible to sign on to support the legislation on nurse-patient ratios.

The strategy of understanding the committees is indivisible from the legislative process and occurs at the local and state levels. The committee serves as a purgatory for all legislations. All proposed bills are subjected to a detailed study at the committee stage. To promote the legislation on nurse-patient ratios through the committee gates, I would testify at the hearing as a representative of the nursing community and monitor the process of consideration of the bill in the committee. In addition, if some committee workers would happen to be the representatives of the health care field, I will try to win their support based on professional solidarity.

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The strategy of communicating with the legislators is used on both local and state levels. At the local level the advocate meets with the local legislators in his office or other stipulated places, writes letters and e-mails. At the state level, the process is similar but the advocacy meets with the members of the Senate and the House of Representatives on specially appointed days. It is important to build a trusting relationship with the legislator and his or her staff before I ask for their support. It is also important to find the worker among the legislator’s personnel, who advises him or her on health care issues, and establish cooperation with this worker at first (Abood, 2007). To enlist the support of legislators in the bill on nurse-patient ratios, I will introduce it for review in the short form using bullet points. To achieve the goal I will communicate with the legislator by writing letters, sending e-mails and thank-you notes, and inviting him or her to visit my workplace. To make the legislators vote for the adoption of the legislation on nurse-patient ratios I have to convince them that it affects their district positively, and people will definitely support this legislator after the adoption of the bill. Another argument will be the support of the bill by the legislator’s party, if that is the case; if not, I will provide all the positive comments about the bill that the people of that district have. During the negotiations with the legislator, I will present him or her with major benefits from my bill adoption, mainly the nurses’ and patients’ support in further elections or other issues. I will convince the legislator that the main supporters of the legislation on nurse-patient ratios are numerous and powerful communities, and cooperating with them will ensure a reliable platform for his or her political career.

Increasing My Power to Influence Votes

The main source of power that will help influence the votes in this process will be the support of the health care workers. In order to engage them, however, I will have to bring them together in a team, stand by them and their interests, and motivate them to work on our goal cohesively. Other sources that will be useful for me are the legitimate power and the expert power. The license granted to me by the State Board of Nursing imparts legitimate power to me. According to this license, I can stand in the health care community and authoritatively defend my position concerning health issues on behalf of the community. My expert power is represented by my skills and experience in the medical field. Nurses deal with patients’ issues every day, so they have the most knowledge when it comes to health care questions. (Abood, 2007). Using my expert power, I will meet with the powerful players such as legislators or the members of the committees, educate them, push them to action and bring them to justice if their actions do not correspond with their promises. To push the legislators and other powerful players to adopt the bills I need, I will use the reward power. The main reward for the legislators’ successful cooperating will be the support of the nurses’ community on further elections or other issues.

Apart from that, there are two more sources of power – the referent power and the coercive power. The first one represents the nurses’ high social standing and the people’s trust to them because of their honorable profession. The second one is based on the punishment of unacceptable behavior, but it is not used often in the legislative world.

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