When Nancy Ridenour was a student at the bachelors, masters, and doctoral levels, she took the typical nursing courses: anatomy, physiology, biology, chemistry, pharmacology, and other science-based classes.
But it was a subject she didn’t study—political science—that fueled her lifelong passion for health policy and her drive to improve public health by reshaping public policies.
Ridenour’s passion for policy dates to her youngest days, when her parents—both of whom were family physicians in rural Colorado—struggled to increase access to care for their patients. Growing up in an agricultural area helped her to understand how national farm policy affected the well-being of rural communities.
Later, when she was a nursing student at the University of Colorado, then-Sen. John F. Kennedy visited her school to discuss a provision he wrote into a rural health law that increased payments to clinics that employed nurse practitioners (NPs) and physicians assistants. That provision, she says, played a critical role in increasing access to primary care in rural states and spurred the development of the nation’s now well-established community health clinic system.
The political became personal for Ridenour, PhD, APRN, FAAN, when she embarked on her own career as an NP in the late-1970s. She began to run into laws that prevented NPs from practicing to the top of their education and training. “I realized if I didn’t pay attention to health policy, I couldn’t practice to my fullest potential as a nurse.”
At the time, nurses in Colorado were required to get physician approval before writing prescriptions. She remembers having to stand outside of her supervising physician’s door on busy clinic nights while she waited for him to approve her prescriptions. She was frustrated, and so was the physician—“He knew I knew what I was doing,” she says—and patients had to wait longer for care. “In states where NPs don’t have independent practice, practitioners and physicians have to create all these workarounds,” she says. “Eventually we get the same outcomes, but it takes so much effort.”
Those same barriers are still in place in many states today (although no longer in Colorado), she says, and she still hears what she considers the same baseless arguments in their favor: Nurses don’t have enough education to practice independently, and giving them more responsibility would undermine patient safety and health. “It’s a bit frustrating,” she says. “There’s data from the early 1980s that show that NPs have at least as good outcomes as physicians when providing primary care. The opposition is not based on outcomes; it’s based on other things.”
A Hand in Policy
Ever since those early days, Ridenour, now a leading nurse educator, has kept a hand in health policy.
Ridenour served as professor and administrator at nursing schools including Illinois State University, Texas Tech University Health Sciences Center, and the University of Colorado. While tending to her administrative responsibilities, she also advocated for laws that would increase access and funding for primary care, enable nurses to practice to the full extent of their training and education, and better fund both health workforce education programs and data collection to determine supply and demand for the health workforce.
While at Illinois State University, she had the opportunity to work with the Illinois congressional delegation. In cooperation with Sen. Dick Durbin of Illinois and the U.S. Secretary of Labor, she helped enable displaced auto workers take advantage of federal workforce investment funds. Prior to her intervention, students who already had bachelor’s degrees in other fields were not able to access the funds, which was preventing laid-off employees at a nearby auto plant from switching careers and becoming nurses.
Ridenour has also held leadership positions with organizations including the American Nurses Association, the American Association for the Advancement of Science, the American Public Health Association, Sigma Theta Tau International, the Society of Primary Care Policy Fellows, the National Organization of Nurse Practitioner Faculties, and the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows Alumni Board.
In 2003, she was selected to become an RWJF Executive Nurse Fellow, where she focused on raising funds for nursing education from private donors. And in 2007, she returned her focus to policy when she accepted a position as an RWJF Health Policy Fellow. In that capacity, she worked for the Ways and Means Committee of the U.S. House of Representatives, focusing on Medicare and the Patient Protection & Affordable Care Act of 2010.
A recipient of the U.S. Public Health Service Primary Care Policy Fellowship, Ridenour has also: authored numerous journal articles and contributions to books; consulted extensively on primary care and public health issues in South America, Asia, India, and the Middle East; and maintained an active practice as a certified family nurse practitioner.
Ridenour is now dean and professor at the College of Nursing at the University of New Mexico, home of the RWJF Nursing and Health Policy Collaborative. The Collaborative is preparing a new generation of nurses with PhDs to meet the nation’s health policy challenges. It is building the capacity of nurse leaders who can engage as full partners in research, analysis, development, and implementation of national health policy, and it is strongly committed to increasing diversity in nurse leadership and policy.
“Our nation needs the expertise of nurses as we transform the health care system and move to a culture of health,” she says. “Policy is a tool to foster social change. Leadership and expertise in health policy ensure that nursing expertise is used to improve the health of the nation.”
Read a related story about an RWJF Nursing and Health Policy Collaborative at UNM conference focused on increasing nurse engagement with public policy issues.