{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:55:13Z","timestamp":1790780113209,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To examine lobbying as a form of nursing political leadership and to explore how coordinated lobbying efforts plausibly influenced policy framing, compromise amendment negotiations and policy language during a European Union parliamentary agenda\u2010setting process addressing the health workforce crisis.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Qualitative policy analysis using a descriptive single\u2010case study approach.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The case examined was the development of a joint own\u2010initiative report of the European Parliament committees responsible for employment, social affairs and public health addressing the European Union health workforce crisis. Data sources included draft reports, political amendments, compromise amendments, final parliamentary texts, policy position papers and documentary records of institutional engagement. Analysis followed a chronological, thematic and process\u2010tracing approach to identify lobbying strategies and trace their plausible influence on policy language across successive stages of the pre\u2010legislative process.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The analysis provides traceable qualitative evidence that coordinated nursing lobbying contributed to agenda setting, policy framing and compromise negotiations within the parliamentary process. Influence was evidenced through identifiable changes in policy language across drafting stages, including the removal of hierarchical doctor\u2010led terminology, the reframing of professional recognition through common European training mechanisms, the protection of profession\u2010specific terminology and the consolidation of advanced practice nursing within the final parliamentary report.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Findings from this single\u2010case study suggest that lobbying can be understood as a legitimate dimension of nursing political leadership within European health policymaking processes in this context. When approached as a sustained, evidence\u2010informed and strategically timed practice, lobbying can enable nurses and their representative organisations to shape pre\u2010legislative policy frameworks with implications for future health workforce legislation.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n Strengthening political competence and policy engagement among nurses and nursing organisations is essential for addressing workforce shortages, safeguarding professional autonomy and supporting sustainable health systems.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n \n What problem did the study address?<\/jats:italic>\n Limited understanding of how nursing organisations influence health workforce policy within complex multilevel governance systems such as the European Union.\n What were the main findings?<\/jats:italic>\n Strategically coordinated lobbying, coalition\u2010building and sustained engagement during amendment and compromise negotiations enabled nursing priorities to be embedded in policy language within a major parliamentary policy process.\n Where and on whom will the research have an impact?<\/jats:italic>\n The findings inform nurse leaders, professional organisations and policymakers by illustrating how nursing engagement can influence health workforce policy development in the European Union and other multilevel policy environments.\n <\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n Qualitative policy analysis using document analysis and process tracing.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n This study did not include patient or public involvement in its design, conduct or reporting.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70763","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:00:58Z","timestamp":1790776858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nursing Lobbying and\n EU<\/scp>\n Health Workforce Policy: A Qualitative Policy Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8255-061X","authenticated-orcid":false,"given":"Paul","family":"De Raeve","sequence":"first","affiliation":[{"name":"European Federation of Nurses Associations Bruxelles Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3992-984X","authenticated-orcid":false,"given":"Manuel","family":"Ballotta","sequence":"additional","affiliation":[{"name":"European Federation of Nurses Associations Bruxelles Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1010-6581","authenticated-orcid":false,"given":"Anne Marie","family":"Rafferty","sequence":"additional","affiliation":[{"name":"Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3560-3811","authenticated-orcid":false,"given":"Ivana","family":"\u017dili\u0107","sequence":"additional","affiliation":[{"name":"Nursing Home Senior Garden Zagreb Croatia"},{"name":"School of Medicine University of Zagreb Zagreb Croatia"},{"name":"University of Maribor Maribor Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.7208\/chicago\/9780226039466.001.0001"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1057\/978-1-137-51781-4"},{"key":"e_1_2_13_4_1","volume-title":"Building & Sustaining a Resilient EU Nursing Workforce & Healthcare","author":"De Raeve P.","year":"2021"},{"key":"e_1_2_13_5_1","first-page":"66","article-title":"Nurses Silent Resignation \u2010 Stop the \u2018Ticking Bomb\u2019","volume":"24","author":"De Raeve P.","year":"2023","journal-title":"Health Europa Quarterly"},{"issue":"5","key":"e_1_2_13_6_1","first-page":"1","article-title":"The Ticking Time Bomb in the European Union Has Exploded: The Importance of European Council Recommendations on the Healthcare Workforce","volume":"4","author":"De Raeve P.","year":"2024","journal-title":"Iris Journal of Nursing & Care"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15775"},{"key":"e_1_2_13_8_1","volume-title":"EU Accession Policy Window Opportunity","author":"De Raeve P.","year":"2016"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15271544231182586"},{"key":"e_1_2_13_10_1","unstructured":"Directive 2013\/55\/EU.2013.\u201cDirective 2013\/55\/EU of the European Parliament and of the Council of 20 November 2013 Amending Directive 2005\/36\/EC on the Recognition of Professional Qualifications and Regulation (EU) No 1024\/2012 on Administrative Cooperation Through the Internal Market Information System (\u2018the IMI Regulation\u2019) EUR\u2010Lex \u2010 32013L0055 \u2010 EN \u2010 EUR\u2010Lex (europa.eu).\u201d"},{"key":"e_1_2_13_11_1","unstructured":"EFN Tour de Table Report.2023.\u201cSafe Staffing Levels (Nursing Ratios).\u201dEFN: Belgium."},{"key":"e_1_2_13_12_1","unstructured":"European Commission.2008.\u201cGreen Paper on the EU Workforce for Health.\u201dhttps:\/\/ec.europa.eu\/health\/ph_systems\/docs\/workforce_gp_en.pdf."},{"key":"e_1_2_13_13_1","unstructured":"European Commission.2012.\u201cAction Plan for the EU Health Workforce.\u201dhttp:\/\/ec.europa.eu\/social\/BlobServlet?docId=7622&langId=en."},{"key":"e_1_2_13_14_1","volume-title":"Addressing Health Workforce Challenges in the European Union","author":"European Commission","year":"2023"},{"key":"e_1_2_13_15_1","volume-title":"EFN Workforce Matrix 3+11","author":"European Federation of Nurses Associations","year":"2017"},{"key":"e_1_2_13_16_1","volume-title":"Rules of Procedure of the European Parliament","author":"European Parliament","year":"2022"},{"key":"e_1_2_13_17_1","volume-title":"Transparency Register: Interinstitutional Agreement on a Mandatory Transparency Register","author":"European Parliament","year":"2023"},{"key":"e_1_2_13_18_1","volume-title":"Everything You Always Wanted to Know About European Union Health Policies but Were Afraid to Ask","author":"Greer S. L.","year":"2021"},{"key":"e_1_2_13_19_1","volume-title":"ICN Policy Brief: Nurses and Health Policy Engagement","author":"International Council of Nurses","year":"2021"},{"key":"e_1_2_13_20_1","unstructured":"International Council of Nurses.2023a.\u201cICN Report Says Shortage of Nurses is a Global Health Emergency.\u201dhttps:\/\/www.icn.ch\/news\/icn\u2010report\u2010says\u2010shortage\u2010nurses\u2010global\u2010health\u2010emergency."},{"key":"e_1_2_13_21_1","volume-title":"Featuring ICN's New Charter for Change: Value, Protect, Respect and Invest in Our Nurses for a Sustainable Future for Nursing and Health Care","author":"International Council of Nurses","year":"2023"},{"issue":"21","key":"e_1_2_13_22_1","first-page":"6231","article-title":"The Paradox of Progress: Why the Nursing Workforce Remains a Political Challenge","volume":"32","author":"Jackson D.","year":"2023","journal-title":"Journal of Clinical Nursing"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.70458"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/nin.70082"},{"key":"e_1_2_13_25_1","volume-title":"Agendas, Alternatives, and Public Policies","author":"Kingdon J. 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