It seems a nurses work is never done. And neither is the work of those who lobby on behalf of nurses.
Every two years when a fresh U.S. Congress convenes in Washington, D.C., advocacy begins anew. Bills from the previous Congress are dead. Some sponsors of that legislation may have been voted out of office, or have retired. Bills need to be reintroduced and often need new sponsors.
The life of a bill is about two years, and if that bill doesnt meet success, isnt voted on and signed into law, then you start at square one with the new Congress, hoping youve maintained your sponsors and trying to re-energize those sponsors, says Rose Gonzalez, RN, MPS, director of government affairs for the American Nurses Association.
As hard as navigating the labyrinth of Congress can be, Gonzalez and other lobbyists say this isnt a job to leave to the professionals. They need help especially when it comes to energizing lawmakers.
Members of Congress love to hear from their constituents, says Jerome Mayer, senior political action specialist for the ANA. Lawmakers and their staffs regularly discuss what constituents are fired up about, so contacting their offices is one of the best ways to get an issue in front of a member of Congress, Mayer says.
Activism by constituents may prompt a lawmaker to co-sponsor a bill. The more cosponsorships, the more support a bill has and the more pressure there is to bring it up for action, Mayer says.
Because politics can be messy, many nurses prefer not to get involved, says Laurie Nagelsmith, RN, PhD, associate dean at Excelsior College School of Nursing. You can sit on the sidelines and say, Ugh, or you can get involved and try to make a positive impact, she says, noting that nurses should be comfortable with advocacy because they are constantly advocating for their patients.
Last spring, Nagelsmith participated in the Nurse in Washington Internship sponsored by the Nursing Organizations Alliance. Her mission was to advance the National League for Nursings public policy agenda: quality healthcare for all; diversity in the nursing work force; work force development; and easing of the nurse faculty shortage.
On behalf of her nursing school, Nagelsmith already had been deeply involved with legislative issues in multiple states, in part to promote educational innovation and help decrease barriers to licensure. All this is about advocacy and making an impact on healthcare education and policy, she says.
Levels of Involvement
Statehouses are hotbeds for important nursing issues, such as scope of practice, reimbursement, staffing requirements and workplace safety, says Sue Clark, RN, a contract lobbyist with Consulting4Biz, which works on issues before the Illinois General Assembly with groups including the Illinois Nurses Association, the Illinois Society for Advanced Practice Nursing and the Illinois Association of Colleges of Nursing.
Oftentimes, the states are the drivers of the bigger pieces of legislation that affect nursing, Clark says. Once the states adopt it, the federal government follows suit. Conversely, she says, major federal legislation can trickle down to the states, where narrower issues are hashed out, as is becoming the case with healthcare reform.
At both the state and federal levels, RNs can get involved politically just a little or a lot. Legislation can be read, and its progress tracked, on websites. The Library of Congress site at thomas.gov, allows the public to search and track federal legislation. Often keyword searches (try nursing) can help locate relevant legislation.
Nurses also can visit websites of their state and federal lawmakers and sign up for e-mail news alerts. I wasnt aware of how well informed I could be by just getting on these … and going onto my representatives websites and finding out about their positions on certain bills, Nagelsmith says.
Gonzalez urges nurses to be ready for debate with facts and not just rhetoric. Do some research on your own, she says. Go the extra mile to make sure we are the most informed consumers and most informed voters.
Clark says she ends speeches on political activism by telling nurses, If youre not at the table, youre on the menu. That means if nurses dont speak up then hospitals, physicians and others will advance their own agendas, she says.
Joining a professional organization can open doors to a wealth of information about issues affecting nursing. By researching legislation for members, these organizations make it easier to learn about the issues. When the Illinois legislature is in session, Clark reviews all the bills that are introduced often more than 6,000 and identifies those that affect her nursing clients. Government relations committees for the organizations review the legislation, establish positions on pieces they consider important, and marshal members in support or opposition.
Even simple monetary donations to political action committees for nursing interests can make a difference, Clark says. Imagine if in the state of Illinois there are 160,000 nurses and each of them gave $10 a year to a nursing PAC. Think of how powerful wed be.
Nurses also can advocate directly on an issue with their legislators, or even make themselves available as experts on specific topics. For example, Nagelsmith acts as an expert on education and community health. They embrace that, she says of lawmakers and their staffs. Theyre glad to have people to call upon.
A Contact Sport
Some methods of contacting lawmakers are more effective than others, Clark says. An in-person visit is best, she says. After that, she recommends a personally written letter (for non-time-sensitive matters); then a fax; then a telephone call.
Regarding e-mail, she has found legislators have different preferences. For example, they dont always know if the e-mails author is a constituent. Legislators like to know theyre dealing with a constituent, someone who can connect with an issue locally, she says. If youre advocating for prescriptive authority for advanced practice nurses, legislators want to know how that will improve healthcare in their district.
A form e-mail, such as from an advocacy website, is quick, easy and better than nothing, Mayer says. And sometimes those form letters can be customized.
No matter how nurses choose to get politically involved, its important that they focus on concerns they share, rather than their differences, Gonzalez says. If we could get 3.1 million nurses to agree on one major issue, it would get done very quickly.
Nagelsmith agrees. Just the sheer numbers of nurses and the publics perception of the work that we do are huge drivers of how politically powerful we could be.
Karen Patterson is a freelance writer.