Nursing Lobbying and EU Health Workforce Policy: A Qualitative Policy Analysis

AIM: 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-setting process addressing the health workforce crisis. DESIGN: Qualitative policy analysis using a descriptive single-case study approach. METHODS: The case examined was the development of a joint own-initiative 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-tracing approach to identify lobbying strategies and trace their plausible influence on policy language across successive stages of the pre-legislative process. RESULTS: 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-led terminology, the reframing of professional recognition through common European training mechanisms, the protection of profession-specific terminology and the consolidation of advanced practice nursing within the final parliamentary report. CONCLUSION: Findings from this single-case 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-informed and strategically timed practice, lobbying can enable nurses and their representative organisations to shape pre-legislative policy frameworks with implications for future health workforce legislation. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: 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. IMPACT: What problem did the study address? Limited understanding of how nursing organisations influence health workforce policy within complex multilevel governance systems such as the European Union. What were the main findings? Strategically coordinated lobbying, coalition-building and sustained engagement during amendment and compromise negotiations enabled nursing priorities to be embedded in policy language within a major parliamentary policy process. Where and on whom will the research have an impact? 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. REPORTING METHOD: Qualitative policy analysis using document analysis and process tracing. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct or reporting.