Several factors limit the involvement of nurses in the formulation of healthcare policies at state, national, or organizational levels in the United States. One of them is inadequate policy content in the nursing curricula, which leads to poor understanding and practice in policy development. Furthermore, due to the heavy workload that is associated with clinical practice, there is limited time for advocacy among the nurses (Barr, 2023). This makes them have a perception that policy development is not within their professional domain since they are not involved in decision-making processes due to the nature of institutional hierarchies and bureaucracies. Additionally, nurses are not well connected with policymakers because they lack enough mentors and have few connections in influential circles. Another factor that limits involvement is the financial aspect, such as the cost of membership in professional bodies and the cost of attending policy-related events (Barr, 2023). Other challenges that further hinder nurses’ engagement in policy initiatives include a lack of well-defined steps through which nurses can engage in policy solutions at different levels, poor advocacy on aspects related to systemic changes, and a lack of capacity to influence evidence-based policies.

The rationale for the barriers above stems from a lack of structural and systemic changes within the health care and political systems. The absence of policy education in the standard nursing curriculum limits the knowledge that can be imparted to the nurses. Thus, they lack adequate preparation to undertake advocacy roles fully (Nickitas et al., 2024). On the other hand, due to the hierarchy of healthcare organizations, nurses’ input is not highly regarded, and their role in policymaking is minimal. Research shows that nurses are not often involved in policy-making bodies such as committees, meaning that they do not effectively participate in the formulation of laws (Nickitas et al., 2024). Also, due to the pressure of time and workload, the implementation of policies is limited, as patient care is given a higher priority. The other factor that prevents participation includes the cost of membership to professional organizations, which is a burden as nurses are usually underpaid. Finally, nurses are still sidelined in the formulation of health care policies due to a lack of mentorship and clear career progression to engage in policy-making processes.

References
Barr, D. A. (2023). Introduction to US health policy: The organization, financing, and delivery of health care in America. JHU Press.

Nickitas, D. M., Middaugh, D. J., & Feeg, V. (2024). Policy and politics for nurses and other health professionals: Advocacy and action. Jones & Bartlett Learning.