The American healthcare system has undergone significant changes in the last decade, and nursing practice has had to evolve with it. Today’s practitioners have to deliver patient-centered care using ever-tighter budgets. The aging baby boomer generation has placed a great strain on healthcare and the professionals who deliver it. Nurses in particular have to be highly trained and attuned to factors around them that affect healthcare delivery.

Today’s nurse needs to understand the social, cultural, political, and economic forces that affect their profession. You may encounter some of these issues in your nursing degree curriculum, but because they are always evolving, it is up to you to stay abreast of trends and news that affect your industry.

If you enrol in a Master’s of Science in Nursing, for example, you cover a curriculum that helps you understand factors that affect nursing practice. You learn quality improvement for nurses as well as leadership, systems, and policy. These courses enlighten you on how social, cultural, economic, and political factors affect healthcare delivery in the nursing profession.

MSN-AGACNP programs are designed for those who want to get into nursing management. You can fast-track your training by enrolling in an online program. All coursework is delivered online except clinical hours, which are designed to give you exposure to the everyday workings of a healthcare facility.

Students can choose part-time or full-time study where they learn how to develop tailored treatment plans for elderly patients with varying chronic conditions in different settings. To enrol, you need to have BSN from an accredited university and an active RN license. You also need two letters of recommendation and a personal statement. You can learn more about the AGACNP programs on offer at Rockhurst University here.

Before you sign up for an MSN in Nursing, it helps to have a fair idea of the various factors that affect nursing practice.

How do social factors affect advanced nursing practice? The United States spends about $3 trillion on healthcare every year, but on some of the most important indicators, it scores lower than its peers. For that amount, we should have the healthiest people in the world, but that certainly isn’t the case.

As an advanced practice nurse, one of your roles will be to reduce costs while improving the patient experience and getting better outcomes. To do this, you need to understand the contributors to a person’s health.

These are the social determinants, and they tell us why some people stay healthy for longer, have fewer visits to the hospital, and experience lower mortality rates.

Getting an insight into the social factors that affect health allows you to understand how it affects advanced nursing care.

Imagine, for example, that you work in a big urban hospital that is always stretched for resources. Seniors from a certain part of the city are frequently hospitalized, and they are taking up a significant share of hospital resources. However, because they are not properly insured, the hospital cannot recoup what it spends.

As a nurse manager, this has an impact on the quality of healthcare that you deliver. Investigating the reasons for the frequent hospitalizations and finding solutions to help seniors stay healthy will free up hospital beds and resources that can be directed to other patients. You’ll improve health outcomes for the seniors, and the quality of patient care will improve as well.

To do that, you need to understand the social factors that affect health, because they have a direct impact on nursing practice.

However, it is a complex issue. Many Americans do not understand that social factors affect their health. Throughout their lives, they are taught that their health is something that is under their control, and for which they must take personal responsibility.

Science tells us that where people are born and grow up, where they live and work, and even how much they make affects their health.

If one is born into a middle-class or upper-class family, they are a beneficiary of good prenatal and post-natal care. As they grow up, they are likely to enjoy a healthy diet with regular exercise and access to good healthcare. As a result, they tend to live longer lives with fewer hospital stays and a lower likelihood of chronic disease.

The opposite is the case for those born into low-income families.

They don’t have enough education to make sound decisions about their health. Mothers, for example, may opt to have minimum pre-natal care because they cannot afford it. They are more likely to feed their families on poor diets. They defer treatment, and illnesses are diagnosed late and are therefore expensive to treat.

These circumstances are determined by the distribution of resources. Nurses who are aware of them know what to expect not just day to day, but in the long term, throughout their careers.

A nurse who works in a relatively well-off community, for example, deals with fewer chronic and lifestyle diseases. In a typical American ER, they can expect to deal with maybe a handful of addiction-related cases every year, and injuries connected to criminal activity are few and far between. Cases of obesity and other food-related disorders are also few because the community enjoys a good diet and is in relatively good health. In some communities, nurses join the political cause, agitating for better distribution of resources to improve the health of their communities. They understand that with more money and better infrastructure, more families will have jobs and can afford healthcare. Over time, the community’s health outcomes improve, and the incidence of chronic illness declines, especially in the elderly.

This frees up resources that can be used in preventative rather than curative medicine. Within the community, people have a better awareness of factors that affect their health, and they can take steps to lead healthier lives.

How do cultural factors affect advanced nursing practice?

Cultural competence is becoming increasingly relevant in all professions, not just nursing. In healthcare, it is about providing care while taking care to respect a patient’s background, beliefs, ethics, race, and values. A good nurse must understand cultural diversity.

As an advanced nurse, you will be in charge of a team of nurses, and it is your job to instill in them the value of diversity. The best healthcare institutions take the time to train their carers on this. They are taught how to empathize with patients regardless of their background, race, or beliefs. For nurses, cultural competence focuses on four critical areas:

  • Forming relationships with patients regardless of where they are from, their race, ethics, or convictions
  • Having an awareness of different cultures from different parts of the world
  • Developing the necessary communication skills to communicate with people from different parts of the world.
  • Having a positive attitude toward all no matter how different they are

Nurses must exhibit cultural competence not just for patients but for their colleagues as well. International nurses make up a significant percentage of the workforce and this is expected to increase in coming years.

The hospital is now a diverse workplace. As an advanced practice nurse, you must train all nurses to work well with one another, respecting each other’s beliefs and cultures.

Whether they are dealing with patients or colleagues, they must speak in a language that is easy for others to understand, treat them without judgment, and avoid preconceived notions. They should provide solutions that serve the patient and be empathetic. With colleagues, they should value every person’s strengths and be open to their ideas.

How do political factors affect advanced nursing practice?

Nurses make up the majority of healthcare workers, and they are in a powerful position to influence policy. Policy is often decided by politics, and nurse participation can be a driving force in the future of healthcare in America.

Healthcare policy requires participation from numerous sectors. For it to be sound and evidence-based, nurses must be willing to take on a political role and advocate for their patients and institutions.

There are three reasons why nurse participation in politics and policymaking is important:

  • Within the clinical setting, nurses spend the most time with patients and their families. It gives them a good understanding of special circumstances, such as working and living conditions, that may have a direct impact on health. This puts them in a unique position to contribute to policy about how resources are distributed within their communities. They must be active participants in the political process to do this.
  • Health policies, decided on a political platform, directly affect nurses. Imagine, for example, a state where politicians are keen to limit immigration and immigrant workers, including nurses. Many hospitals, nursing homes, and other healthcare facilities will be understaffed, and healthcare workers will need to put in long shifts with few breaks. Eventually, they will become overworked and burnt out. As an advanced nurse, you can agitate for the hiring of foreign healthcare workers to alleviate the strain on practitioners.
  • Nurses are highly trained professionals who can play a key role in educating policy wherever they work.

As a nurse, you are in a powerful position to influence policy through politics because you are on the front lines. You regularly talk to patients who can tell you what is happening within their communities, and who want to see positive change.

How do economic factors affect advanced nursing practice?

The nursing profession is affected by how healthcare is financed. In the United States, the delivery of healthcare has, for decades, been shaped by market forces.

The most basic are the principles of costs versus benefits. The healthcare institutions that survive are those that spend less than they make. They have to balance this against providing top-quality healthcare to all who need it.

In addition to that, the economics of communities impact their wealth, and therefore their health. In communities that enjoy sound economics, people have wealth and they can enjoy a good lifestyle and

better healthcare. These communities are willing to pay their nurses more and tend to attract highly-qualified professionals.

Poorer communities tend to have sicker people and fewer nurses, and the bottom line is poor outcomes for patients across the board.

Nurses need to understand the economics of nursing. As managers, they are tasked with the distribution of resources in the most efficient way. They must use whatever is at their disposal to provide adequate care to all.

Advanced nurses must also look at the broader economic factors to identify factors that have a financial effect on hospitals. They should work with the relevant government bodies and private institutions to ensure that their hospitals have the resources they need to provide healthcare to all.

To be an exceptional advanced nurse, you must know the economic realities of the healthcare landscape. You should have a working knowledge of delivery models, insurance principles, profit and loss models, and the economics of supply and demand.

You should also have an insight into the disparities between private and private healthcare delivery, and find solutions that allow for equitable distribution of resources.

Can advanced nurses learn all this in an online program?

Online nursing courses are designed to deliver the same learning and skills that one would get from attending an on-campus program. They have become a popular choice for many because they are flexible, often take a shorter time to complete and tend to be more affordable than on-campus enrollment courses.

Advanced nursing programs introduce nurses to the different social forces that continue to shape nursing practice. Those who enroll in a master’s program learn about different political, societal and cultural factors that affect healthcare delivery and how they can play an active role in advocating for better outcomes for patients.

However, it is important to understand that while you will encounter these topics during your studies, they vary depending on where you work, the kind of nursing you practice and your specific patient demographic.

It is up to you to know your particular environment. When you become a practicing nurse, take the time to know your patients and the community you serve. What you learn through patient interactions will enlighten you as to the specific problems that your community deals with as far as healthcare delivery is concerned.

Keep in mind that factors that affect healthcare delivery change all the time. What may have been a problem for a community ten or even five years ago may have changed and they could be dealing with a new set of challenges. As a nurse, you must keep your ear to the ground so that you can keep in touch with issues as they evolve.

Is online learning recommended for nurses? Online learning continues to grow for all disciplines, including nursing. An acceleration in technologies that support this type of instruction, and the fact that employers recognize online degrees has made students more confident in online education, and enrollment numbers grow every year.

It comes with obvious benefits. Online degrees are flexible and designed for the working professional. They don’t come with a strict class attendance schedule, so students can study when they have free time. These courses often take a shorter time to complete, so what may take four years to do if you attended campus classes can be completed in two or three.

However, it is important to approach it with some caution. If you are not self-motivated and self-disciplined completing an online nursing degree can be an uphill battle. No one will push you to attend classes, complete assignments or participate in class discussions. You must do all the work yourself. There are certain things you can do to increase your chances of obtaining an online degree:

  • Understand the demands of the course you plan to join. Find out how many hours of study are required each week, how many assignments, tests and exams you can expect each semester and what projects you are required to complete. Busy professionals need to restructure their lifestyle to accommodate studying. You may have to give up some things you enjoy doing until you get your degree.
  • Plan your finances and make sure you can pay for the program to the end. Check with your employer about whether you can financial support.
  • Talk to your employer about the fact that you plan to go back to school. Work with them to reorganize your schedule so that you have time to study each day.
  • Involve your family and friends in your decision and let them know that you may need some support.


Nursing practice doesn’t exist in a vacuum. It is affected by political, cultural, economic, and social factors. The good nurse understands how these things affect their work and makes an effort to deal with each accordingly.

AGACNP programs, which teach nursing for the elderly, touch on some of these issues. However, it is up to the nurse to keep up with their communities to understand how these issues affect healthcare delivery in their particular setting.