| Course | NUR-8320 Organizational and Systems Leadership I |
|---|---|
| Module | Module 6 |
| Paper type | Leadership paper: influencing policy and transforming systems |
| Length | About 1,046 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | Doctor of Nursing Practice |
| Updated | October 2026 |
Free sample paper for NUR 8320 Module 6
Sixteen Percent per Patient: Preparing a Nurse Executive's Testimony on Staffing and Practice Authority Bills in New Jersey
Student Name
Doctor of Nursing Practice, Thomas Edison State University
NUR-8320: Organizational and Systems Leadership I
Mentor Name
Month Day, Year
Sixteen Percent per Patient: Preparing a Nurse Executive's Testimony on Staffing and Practice Authority Bills in New Jersey
The Policy Moment
The Morris County system in this sample is invented: three hospitals and a large ambulatory network. Two bills are before the New Jersey legislature in this scenario. One would set minimum nurse staffing ratios in acute care hospitals, including one nurse for every four medical-surgical patients. The other would allow nurse practitioners with a set number of years of experience to practice and prescribe without a joint protocol with a physician. The hospital association opposes the staffing bill; the nursing union supports it. Medical societies oppose the practice authority bill. The system's nursing chief, a DNP graduate who sits on the state nurse executive organization's board, has been invited to testify.
The system's own experience informs the testimony. Its three hospitals staff medical-surgical units at about five to five and a half patients per nurse, and its turnover and agency spending have risen for three years. Its ambulatory network employs 140 nurse practitioners, many of whom spend hours each month maintaining joint protocols with physicians who rarely review their charts. The chief nursing officer has data from both settings and can speak to what the bills would mean for a real system, which makes her testimony more useful to legislators than general arguments.
The Nurse Executive's Role in Policy
Nurse executives stand between bedside nurses, hospital leaders and the public. Their credibility rests on evidence and on understanding both patient safety and hospital finance. The paper argues that the chief nursing officer should neither repeat the hospital association's position nor the union's, but present evidence and a practical path.
Evidence on Staffing
Lasater et al. (2021) linked what 1,391 medical-surgical nurses reported in a 2020 survey with what happened to 210,493 Medicare patients across 87 Illinois hospitals, where a staffing bill was under debate. Medical-surgical ratios averaged 5.4 patients per nurse, with a low of 4.2 and a high of 7.6. With hospital and patient differences accounted for, every extra patient a nurse carried raised the odds of a death inside 30 days by 16 percent and of a longer stay by 5 percent. By the authors' estimate, a limit of four patients for each nurse would have averted upward of 1,595 deaths in one year and saved hospitals money through shorter stays. The study was cross-sectional, which the paper notes.
Aiken et al. (2012) surveyed 33,659 nurses and 11,318 patients in 12 European countries and 27,509 nurses and more than 120,000 patients in the United States. Nurse burnout, dissatisfaction and poor quality ratings varied widely between hospitals and countries, and hospitals with better work environments and staffing had better quality and safety ratings from nurses and higher satisfaction among patients. Nurses and patients agreed on which hospitals gave good care. The authors suggested that improving work environments could be a relatively low-cost way to improve safety and quality.
Evidence on Practice Authority
Traczynski and Udalova (2018) used state changes in nurse practitioner independence to estimate effects on health care use and outcomes. In states that let nurse practitioners work and prescribe on their own, they found more routine checkups, care that patients said was easier to get, gains on some quality measures and fewer emergency visits for certain conditions, with no evidence of harm to the outcomes they measured. Effects took several years to appear.
| Bill | Strongest evidence | Main concern raised by opponents | Proposed response |
|---|---|---|---|
| Staffing ratios | Illinois: 16 percent higher odds of death per added patient | Cost and nurse supply | Phased implementation, workforce funding |
| Practice authority | Nurse practitioner independence increased checkups without measured harm | Quality and safety | Transition-to-practice hours, outcome reporting |
Stakeholder Analysis
The chief nursing officer maps stakeholders by their interest and influence. The hospital association has high influence and opposes ratios on cost grounds. The nursing union has high influence and supports them. Rural and safety-net hospitals fear they cannot hire enough nurses. Medical societies oppose independent practice. Patient advocacy groups and the AARP state chapter support both bills. Legislators on the health committee want evidence and solutions to the workforce shortage.
The Testimony
The testimony is limited to five minutes and built on three points. First, staffing affects whether patients live or die, citing the Illinois study and the 12-country survey. Second, the staffing bill can work if phased in over three years with funding for nursing education and an exception process for safety-net hospitals facing documented shortages. Third, nurse practitioner independence has been studied in many states and has expanded access without measured harm; the bill's experience requirement and outcome reporting address safety concerns. A one-page summary with references is given to each committee member.
Preparation matters as much as content. The chief nursing officer rehearses with the system's government relations director, who plays a skeptical legislator and asks about rural hospitals, costs and nurse supply. She prepares short answers with one fact each. She also brings a staff nurse and a nurse practitioner from the system to testify briefly about their own experience, since legislators often remember stories longer than statistics, and she makes sure their accounts are accurate and do not identify patients.
Building a Coalition
The chief nursing officer works through the state nurse executive organization to bring other chief nursing officers, especially from hospitals that support safe staffing, and partners with patient groups to share stories. She meets with the hospital association to propose the phased approach and the safety-net exception, seeking to reduce opposition. After testimony, she follows up with committee staff and remains available for questions.
Ethics and Role Conflict
The chief nursing officer's employer is a member of the hospital association. The paper addresses this conflict: she informs her chief executive in advance, testifies in her role with the state nurse executive organization and presents evidence rather than her employer's position.
Conclusion
Evidence from Illinois ties heavier nurse workloads to more deaths, a 12-country survey links work environments to quality, and studies of nurse practitioner independence find expanded access without measured harm. The chief nursing officer's testimony presents that evidence in five minutes, offers practical answers to opponents' concerns and is supported by a coalition and careful handling of role conflict, the skills nurse executives need to transform health systems through policy.
References
Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344, Article e1717. https://doi.org/10.1136/bmj.e1717
Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: An observational study. BMJ Open, 11(12), Article e052899. https://doi.org/10.1136/bmjopen-2021-052899
Traczynski, J., & Udalova, V. (2018). Nurse practitioner independence, health care utilization, and health outcomes. Journal of Health Economics, 58, 90-109. https://doi.org/10.1016/j.jhealeco.2018.01.001
NUR 8320 Module 6 instructions, in plain terms
Developing strategies to influence and transform healthcare systems, including through policy, is part of TESU's NUR-8320 course description, and since the syllabus is not shown outside the course, module six was written as a policy leadership paper. Expect a DNP leadership analysis that describes the policy issue and the bills or regulations involved, explains the nurse executive's role and credibility, reviews evidence for and against with attention to design, analyzes stakeholders by interest and influence, plans testimony or other advocacy with clear messages and practical responses to opponents, builds a coalition and addresses ethical conflicts. Some sections assign a federal policy, a regulatory comment or an organizational policy instead. Look closely at whether the directions require a policy brief format, a stakeholder map or a letter to a legislator, and use current bill numbers if the course requires real legislation.
Inside the NUR 8320 Module 6 example
An invented Morristown chief nursing officer invited to testify on staffing and practice authority bills opens the paper. The nurse executive's role in policy is described. The Illinois staffing study and the 12-country survey supply staffing evidence, and the study of nurse practitioner independence supplies practice authority evidence. A table pairs each bill's evidence with opponents' concerns and responses. Stakeholders are mapped, a five-minute testimony with three points is built, and a coalition plan follows. Role conflict with the employer is addressed, and then the conclusion. Notes in the margin show how the testimony meets its opponents and offers solutions. Rehearsal with a skeptic and brief testimony from two of the system's own nurses strengthen the case.
Where the marks sit in the NUR 8320 Module 6 rubric
Policy leadership papers earn credit for describing the issue and bills clearly, explaining the nurse executive's role, reviewing evidence with attention to design, analyzing stakeholders by interest and influence, planning advocacy with clear messages and practical responses to opponents, building a coalition and addressing ethical conflicts. Mentors credit testimony that is short, evidence-based and solution-oriented. Handling a conflict between the employer's position and the nurse executive's evidence is often noted as mature leadership. Offering phased implementation and exceptions shows understanding of how bills pass. Evidence figures should be stated precisely as in the studies, with APA citations and references. Bringing front-line nurses to testify, with accurate and private accounts, is often noted.
NUR 8320 Module 6 help: mistakes that cost marks
Students often write advocacy that only argues their side; address opponents' concerns with practical solutions. Another frequent weakness is long testimony; limit it to a few clear points and a one-page summary. Name the study designs and their limits. Map stakeholders by interest and influence. Address conflicts between your employer's position and your own. Plan follow-up after testimony. If you are preparing a policy brief or testimony, the Morristown example can guide it, and a first draft built on your brief is free. Rehearse with someone who will ask the hardest questions, and prepare one fact for each answer.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More NUR 8320 and Doctor of Nursing Practice sample papers
- NUR 8320 Module 1: Leadership Styles Paper: Relational Leadership, Burnout and a Nurse Executive's Development Plan
- NUR 8320 Module 2: Culture and Psychological Safety Paper: Culture-Outcome Evidence, Team Learning and Inclusive Leadership
- NUR 8320 Module 3: Work Environment Paper: The Practice Environment Scale, Magnet Outcomes and an Improvement Plan
- NUR 8320 Module 4: Systems Thinking Paper: Complexity Science, Feedback Loops and a Rapid Response System
- NUR 8320 Module 5: Leading Quality Change Paper: The Keystone ICU Project, Context Factors and a Collaborative Plan
- NUR 8420 Module 4: Complexity Paper: Emergency Boarding, Safety-II and Simple Rules for Patient Flow
- NUR 8050 Module 3: Guideline Appraisal: The 2022 SHEA Compendium Read With AGREE II
- NUR 8200 Module 3: Prevention Program Paper: Diabetes Prevention Program, Fifteen-Year Results and the National DPP
- NUR 8250 Module 3: Cost-Effectiveness Paper: Universal Decolonization, QALY Thresholds and the Second Panel's Rules
NUR 8320 Module 6 questions, answered
Where can I find a free NUR 8320 Module 6 sample paper?
The policy leadership paper on staffing and practice authority testimony in New Jersey can be read in full above, with references.
How does nurse staffing affect patient deaths?
An Illinois study of 210,493 Medicare patients linked each additional patient per medical-surgical nurse with 16 percent higher odds of 30-day death.
What did the 12-country nurse survey find?
Hospitals with better work environments and staffing had better quality and safety ratings from nurses and higher patient satisfaction.
Does nurse practitioner independence affect care?
States allowing independent practice saw more routine checkups and easier access to care without measured harm.
How should a nurse executive prepare testimony?
With a few clear evidence-based points, practical answers to opponents' concerns, a one-page summary and a coalition behind it.