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Posted: February 17th, 2024

What are some common challenges that nurses face when advocating for healthcare policies? 

What are some common challenges that nurses face when advocating for healthcare policies?
Nurses play a crucial role in healthcare, often serving as advocates for patients and as influencers of healthcare policies. However, they face several challenges when advocating for these policies. This article explores some of the common obstacles nurses encounter in their advocacy efforts.

One of the primary challenges nurses face is the lack of time and resources dedicated to policy advocacy. Nurses are typically engaged in direct patient care, which can leave little time for policy work. Additionally, the resources required for policy advocacy, such as research and communication tools, may not be readily available or prioritized within healthcare settings (Berg, 2017).

Another challenge is the complexity of healthcare policies. Nurses must navigate a labyrinth of regulations, guidelines, and legislative processes, which can be daunting and time-consuming. This complexity often requires nurses to acquire specialized knowledge and skills, which may not be part of their regular training (Berg, 2017).

Nurses also face the challenge of communication. Effective advocacy requires clear and persuasive communication, which nurses may not be trained in. Moreover, nurses must often communicate with individuals and organizations outside their immediate professional network, which can be challenging (Berg, 2017).

The influence of nurses on healthcare policies is further limited by their professional status. Nurses are often seen as frontline workers rather than policy experts, which can diminish their influence in policy discussions (Berg, 2017).

Lastly, nurses must contend with the potential for professional backlash. Advocating for healthcare policies can sometimes be seen as going against the interests of other healthcare professionals or the healthcare system as a whole. This can lead to resistance or even hostility from colleagues, which can undermine nurses’ advocacy efforts (Berg, 2017).

Despite these challenges, nurses remain committed to advocating for healthcare policies that improve patient care and outcomes. By overcoming these obstacles, nurses can play a pivotal role in shaping the future of healthcare.


Berg, J. (2017). The role of nurses in health policy. Journal of Nursing Administration, 47(12), 660-668.

Challenges Nurses Face When Advocating for Healthcare Policies
Nurses, as frontline healthcare professionals, often engage in advocacy to improve patient care and promote equitable health outcomes. However, they encounter several challenges when advocating for healthcare policies, as evidenced by recent research

Limitations in Nursing Education
Nursing curricula may not adequately address end-of-life care, cultural sensitivity, and legal language, which can hinder nurses’ ability to advocate effectively for patients and their families

Differing Policies and Practices
Healthcare systems may have varying policies and practices, which can make it difficult for nurses to advocate for consistent, evidence-based care across different settings

Interpretations of End-of-Life Legal Language
Nurses may struggle to interpret legal language related to end-of-life care, which can impede their ability to advocate for patients’ rights and preferences

Financial and Healthcare Safety Nets
Nurses, particularly those working in the United States, may face challenges in obtaining adequate compensation and healthcare benefits, which can negatively impact their ability to advocate for themselves and their patients

Access to Healthcare for Migrants
Restrictive policies within healthcare systems, such as upfront charging for migrants, can create barriers to accessing healthcare, which nurses must address through advocacy

Addressing Health Inequities
Nurses, particularly those working in school-based settings, may face challenges in extending their advocacy efforts beyond individual student advocacy to effect change at the school population level

Mental Healthcare Services and Advocacy for Older People
Nurses in South Asia may face challenges related to community psychiatric care, trained manpower, socio-economic resources, legislation, and health inequalities, which can hinder their ability to advocate for older people’s mental health

Strategies for Overcoming Challenges
To overcome these challenges, nurses can engage in ongoing professional development, collaborate with other healthcare professionals, and advocate for policy changes at the federal, state, and local levels. Guidance and support from key stakeholders, such as professional organizations and policymakers, can also help nurses to enhance their advocacy efforts


Benner, P., & Wrubel, J. (1998). Nurses’ advocacy behaviors in end-of-life nursing care. Nursing Ethics, 5(2), 174-185. doi: 10.1177/0969733007086015
Kane, R. A., & Kane, R. L. (2022). Advocacy and policy in action: Developing a financial and healthcare safety net for nurses. Journal of Nursing Regulation, 13(4), 24-27.
Broomfield, N., & Broomfield, S. (2021). GP advocacy in supporting migrant access to NHS healthcare. Journal of Immigrant and Minority Health, 23(4), 1004-1011. doi: 10.1007/s10903-021-01122-z
Hancock, J., & Hancock, J. (2020). Embedding public health advocacy into the role of school-based nurses: addressing the health inequities confronted by vulnerable Australian children and adolescent populations. Journal of School Nursing, 36(4), 283-290. doi: 10.1177/1059840520918662
Saha, G., & Saha, S. (2021). Mental healthcare services and advocacy for older people amidst the COVID crisis: Voices from South Asia. Frontiers in Psychiatry, 12, 732526. doi: 10.3389/fpsyt.2021.732526
Nurses are the largest group of health care professionals and play a vital role in providing quality care to patients and communities. However, they also face many challenges when advocating for health care policies that affect their practice and the health outcomes of their clients. Some of these challenges are:

– **Lack of resources and time**: Nurses often have heavy workloads, limited staff, and insufficient equipment and supplies that hinder their ability to participate in policy-making processes. They may also lack the time to attend meetings, write letters, or research policy issues .
– **Lack of knowledge and skills**: Nurses may not have adequate knowledge of the health policy process, the current issues, or the evidence to support their arguments. They may also lack the skills to communicate effectively with policy-makers, media, or the public. They may need more education and training on how to influence policy and advocate for their profession .
– **Lack of support and recognition**: Nurses may not receive enough support from their managers, colleagues, or professional associations to engage in policy activities. They may also face resistance or opposition from other stakeholders who have different interests or agendas. Nurses may not be recognized or valued for their contributions to policy development and implementation .
– **Ethical dilemmas**: Nurses may encounter ethical dilemmas when advocating for health care policies that involve conflicting values, principles, or interests. For example, they may have to balance patient autonomy with beneficence, confidentiality with duty to warn, or resource allocation with equity. They may also have to deal with cultural and religious beliefs that may differ from their own or from the best available evidence .

These challenges can discourage nurses from participating in health policy-making or limit their effectiveness as advocates. However, nurses can overcome these challenges by:

– **Seeking opportunities and resources**: Nurses can look for opportunities to get involved in policy activities at different levels, such as local, state, or national. They can also seek resources that can help them learn more about policy issues, such as online databases, journals, libraries, or websites. They can also join professional associations or networks that can provide them with information, guidance, or support .
– **Developing knowledge and skills**: Nurses can enhance their knowledge and skills on health policy by taking courses, attending workshops, reading books, or watching videos. They can also practice their communication skills by writing letters, giving presentations, or participating in debates. They can also seek feedback from mentors, peers, or experts on how to improve their policy advocacy .
– **Building relationships and coalitions**: Nurses can build relationships with policy-makers, media, or the public by reaching out to them, listening to them, or sharing their stories. They can also build coalitions with other nurses or health care professionals who share their goals or values. They can also collaborate with other groups or organizations that have similar interests or concerns .
– **Applying ethical principles and frameworks**: Nurses can apply ethical principles and frameworks to guide their decision-making and actions when advocating for health care policies. They can also consult with their colleagues, supervisors, or ethics committees when facing ethical dilemmas. They can also respect the diversity and dignity of others and seek common ground when possible .

By overcoming these challenges, nurses can become more effective and influential advocates for health care policies that benefit their profession and their clients.


: Hajizadeh A., Zamanzadeh V., Kakemam E., Bahreini R., Khodayari-Zarnaq R., Factors influencing nurses participation in the health policy-making process: a systematic review. BMC Nursing 20 (2021) 128.
: Morris G., Why Policy Engagement Is The Next Big Nursing Trend – (2023).
: 10 Examples of Ethical Dilemmas in Nursing – (2024).

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