Dissecting an Issue

Class 1January 6, 2010

Judith Anne Shaw, Ph.D., RN

What is an issue?

Concern of widespread interest to the general public

A question in dispute and the decision of special interest

Issue as Political

Influencing others for the purpose of quality care

Why important for nurses?

Make central and visiblethe ideas of nurses’ work

Nurses need to ask:

Who benefits? What cost? Who pays cost? Who suffers? Who does not benefit? Who/what is left behind? What purpose served by no change?

Nurses asking political questions

Highlight nurses’ work –make the work visible

Nurses need to-

Clearly articulate the issue

Significance for Nursing Profession

Beyond the individual nurse Large collective: organization of

nurses Opportunity to speak in unison Organize to act: provincial/territory;

national; & international

Quality of Health Care1.

2.Nature Qualityof Nursing of Health

3. Care

4.

[1.standards of nursing education, 2. quality of care provided by practitioner, 3. number of nurses available, 4. milieu in which care offered]

Code of Ethics (Canadian Nurses Association, Patient advocacy

Issues directly affecting health status of Canadians

Lobbying for positive change

Improving the image of nursing

Political Action

Affects the health of Canadians

Nurses

Most important group of health care workers

Issue

Related to but not

trend problem

Trend

Analysis not required Signifies a direction Does not involve a solution

Problem

Benefits from analysis One dimensional Solution apparent

Usually response based Numerically measurable

Resolution-immediate

Issue

Requires analysis Multiple dimensions Multiple possibilities

Multiple barriers to resolution.Persists over time

Comparing Issues, Problems, and Trends

Issue Problem TrendRequires Benefits from Analysis NOT analysis analysis

required Multiple One dimension Signified a dimensions direction

Multiple Solution is apparent Does NOT possibilities Usually response based involve a

Numerically measurable solutionMultiple barriers to resolutionPersists over time Can be resolved immediately

Issue Framing Topic of interest

Select particular issue

Articulate issue clearly

Stipulate one’s beliefs and assumptions about the issue

Analyses: The Nature of the Issue

Historical Ethical-Legal Social and Cultural Political Critical Feminist Economic

The Nature of the Issue What makes this issue a nursing issue? Who are other participants in the issue? What are their involvement in the issue? Who first became concerned with the

subject? Who began to raise the subject as an

issue and why?

Historical

When did the issue originate? What are the conditions that led to

the development of the issue? How have these conditions

changed over time? What has contributed to the stance

taken by participants in the issue?

Ethical and Legal

What are the laws that influence the issue?

What professional codes or legislative acts mandate participant’s responses to the issue?

Social and Cultural

ALL issues develop in a social context.

What contexts shape this particular issue?

What are the prevailing attitudes in society about this issue?

Political

Who benefits from this issue being resolved?

Who benefits from things staying the same?

Relationship between knowledge and power in this situation?

Critical Feminist

Error or myths about women’s abilities or realities contained in this issue?

Is the issue influenced by power inequities---?

Economic

What ways are the forces of supply and demand at work in this issue?

Barriers to Resolution Inaccessibility of resources

Limited understanding

Irresolvable differences/ competing interests of participants

Differing assumptions/key stakeholders

Issue Resolution

Lobbying Letters to officials Letters to editors News releases Written resolution- for presentation

Strategy Success

Dependent on:

People affected by issue Interest generated Time available Human and financial resources

available

Winning Strategy

The greater the number of unified people involved- the greater the effort to

address the specific issue.