We know from rigorous evidence that nurses can exert an incredible impact on the everyday lives of people and their health. Nurses can also contribute in much wider spheres of influence by applying their knowledge and skills to address broader issues affecting population health across communities, nations and globally. Despite the prevalence of so many vexing health and social issues, nurses often fail to think globally, or even regionally, when they are lobbying for change. And while much political influence is local, some issues are simply too complex to rely on local influence alone. Importantly in all this, we must acknowledge the ways these complex health issues are shaped by economic and political agendas and not necessarily by healthcare agendas. As such, the nursing community has to act globally and locally, both within and outside of the nursing arena. This paper explores early thinking about an evolving model of spheres – or "bubbles" – of policy influence in which nurses can and must operate to more effectively impact key global health and healthcare challenges.
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