Challenges, Extent of Involvement, and the Impact of Nurses' Involvement in Politics and Policy Making in in Last Two Decades: An Integrative Review

Purpose: To determine nurses' challenges, extent of involvement, and the impact of involvement in politics and policy making.

Organizing construct: Nurses in politics and health policy making.

Methods: Literature was searched in PubMed, Scopus, Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), OVID, and Open Grey using phrases comprising the following key words: "nurses", "policy making", "politics", "health policy", "nurses involvement in policy making/politics/health policy", "nurses challenges in policy making/politics/policy", and "impact of nursing policy making/politics/health policy"; 22 articles published from January 2000 to May 2019 were included.

Findings: The major challenges included intra- and interprofessional power dynamics, marginalization of nurses in policy making, and nursing profession-specific challenges. The extent of involvement was inadequate, and nurses mainly worked as policy implementers rather than as policy developers. Those nurses who participated in policy development focused on health promotion to build healthy communities and to empower nurses and the nursing profession.

Conclusions: Nurses' involvement in policy making has not improved over time. Nursing institutions and regulatory bodies should prepare and encourage nurses to work as policymakers rather than implementers and advocate for the rightful place of nurses at policy-making forums.

Clinical relevance: Preparation for health system policy making starts in the clinical settings. Educational institutions and nurse leaders should adequately prepare nurses for policy making, and nurses should participate in policy making at the organization, system, and national levels.