Proposed Legislation in Nursing

In Chapter 17, we learned that after a member of the Congress proposes a bill, it is gazetted and then passed through the three stages of reading before being becoming a Law. The time required for a bill to pass through these stages varies depending on whether it is controversial or complex. In the first reading, the bill is introduced to the Congress, which signals that the legislative process has started. At this stage, there nothing much is done; the bill is just read out to the members. No debate happens at this stage. Then, the bill is set for the next stage as the second reading.

Immediately after the first reading, the legislator in charge of the bill proposes a motion for the second reading of the bill. At this time, he/she gives a speech explaining the benefits of the proposed legislation. After this motion, the House adjourns the debate on the issue and refers the bill to the Congressional Committee for scrutiny. Then, if the bill is complex or controversial, the Congressional Committee will look at all the pros, cons and principles of the provisions of the bill. The Committee may consider possible amendments related to the bill. After all these considerations, the Committee reports the bill back to the Congress. After consultations, the Committee and the Legislators in charge of the bill then resume debate on the bill. Other legislators are also allowed give their views on the bill, indicating if they support it or not.

The next stage is the Committee stage. After the second reading, the members vote either for or against the bill. A negative vote means the bill may not proceed to the next stage. However, a positivated vote implies the Committee may meet again and examine the provisions of the bill clause by clause. The proposers and other Legislators may move their amendments to the bill. After passing the Committee stage, with or without amendments, the proponents of the bill move a motion that the bill is read a third time. During the third reading, members are allowed to give their views on the contents of the bill. Then, if they support it, the bill is passed and proceeds to the final stage, which is the presidential assent. However, if the majority views are negative, no further proceedings shall take place.

The final stage is the presidential stage. The presidential assent is required for any bill to become a Law. At this point, the President gives consent to the proposed bill to become a Law. In most cases, the President never rejects or refuses the proposed bill though he/she holds power to do so. From here, the bill becomes an act of parliament then a Law.

Nurses bring to the policy table different types of power. Abood (2007) has discussed the different types of power in his article. The three major types of power discussed include legitimate power, informational power and coercive power (Abood, 2007). The first power that nurses bring to the policy process is legitimate power because the nursing profession holds a higher position that controls people in other organizations (Kearney-Nunnery, 2015). However, nurses must understand that this power is given to them courtesy of their profession so they should not abuse it.

Nurses present to the policy table informational power because they possess the wanted or needed information. Having control over information that others want and need puts nurses in a powerful position at the policy table. Being aware of the pros and cons of nursing legislations, having confidential reports about the nursing field and knowing what nurses want to achieve are all examples of informational power (Kearney-Nunnery, 2015). In today's world, information is specifically a potent type of power. This power accrues not from the information itself but rather having access to the information and being in a position to withhold, share or distort it. With this form of power, nurses can use it during the policy process to help the field or a bargaining weapon.

The final power that nurses bring to the policy table is reward power. We have seen various occasions where nurses have used force or threats to achieve their policy goals. However, this type of power is normally discouraged because it does not earn them respect (Abood, 2007). Worse still, coercive power is seen as bullying in the policy process, and nurses cannot earn any credibility with this type of power.

The Congress has worked to propose various legislation since President Donald Trump took office this year. Most of them are major and likely to affect the field of nursing significantly. They include the newly proposed health-reform bill for the American Health Care Act (AHCRA n.p.). HR-114H2653 bill intends to phase out the Medicaid expansion and eliminate subsidies for low-earning Americans. It will replace the latter with a flat tax credit based on age. This system would imply that most Americans would be left without coverage. H.R.959 bill, which is currently as the subcommittee of health, was introduced to curb the problem of nursing shortage. The bill seeks to use Title VIII nursing programs and federal funding to help states like Hawaii guarantee quality health by ensuring that RNs are employed when needed (H.R.959 n.p.). Although the implementation could be costly, there is nothing precious than a healthy nation.

References

Abood, S. (2007). "Influencing Health Care in the Legislative Arena." OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 1, Manuscript 2.DOI: 10.3912/OJIN.Vol12No01Man02

AHCRA - Final Bill Text 115th. https://rsc-walker.house.gov/files/Initiatives/AHCRA%20-%20Final%20Bill%20Text%20115th.pdf

H.R.959 - Title VIII Nursing Workforce Reauthorization Act of 2017. From https://www.congress.gov/bill/115th-congress/house-bill/959?q=%7B%22search%22%3A%5B%22title+VIII+nursing+workforce%22%5D%7D&r=1

Kearney-Nunnery, R. (2015). Advancing Your Career Concepts in Professional Nursing. F.A. Davis