The purpose of this chapter is to describe the influence of politics and how it affects the practice of nursing. The author works through the process by which nurses can become consumer advocates and political forces.

Politics is a process that people use to achieve their goals. It is believed that politics exist because resources are limited and there are competing interests for these resources. Resources include money, facilities, technology, property, and people. Individuals, organizations, and groups that have the ability to provide or control the distribution of resources are politically empowered. For example, the consumer movement in health care is a political movement about health care resources. Methods used in politics are typically competition, negotiation, and collaboration.

Through these methods, stockholders or vested interested groups, exert pressure for their cause. These groups range from insurance companies, consumer groups, professional organization, health care providers, and educational groups on a local, state, and federal level.

Nursing historically has had a strong influence over stakeholders, especially as it relates to coordinating health care services around patients. Political, economic, and social changes have transformed the health care system in the U.S. Health care policy is formulated, enacted, and enforced at the local, state, and federal level. Sample health care policies are reviewed, demonstrating the need for nursing involvement.

Cultural dimensions of partnerships influence health care decisions. In order to effectively impact partnerships, nurses need to understand diversity distinguished by cultural heritage, racial make-up, and ethnic background

It is important to note that not all consumers agree about health care issues. Social, cultural, economic, psychological, and demographic characteristics determine attitudes.