1. Miracle, Vickie A. RN, EdD CCRN, CCNS, CCRC, Editor, DCCN and Lecturer

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When I first became a nurse 30 years ago, I was not interested in politics. I was too young and naive to realize the impact of politics on healthcare decisions and their impact on patient care. With experience, I now know that politics and nursing are not mutually exclusive. Nurses make up the largest number of healthcare providers in the United States. The majority of lawmakers, at either the local or national level, do listen when we speak.


Now I know what some, if not most, of you are thinking, probably because I have thought it in the past myself. You are probably thinking that you are one person and cannot make a difference. But you can make a difference. One state legislator I know looks at the messages she has received about a particular bill(phone, letters, e-mail). Whichever view of that bill has the most comments is the way she will vote. So you see that your one call or comment can make a difference.


Imagine what could happen when organizations or larger groups become involved in legislative issues. Many large national organizations have lobbies at the state and national level, but you do not need to be part of a huge organization or have a hired lobbyist. Any group or person can contact their local, state, and national representatives and senators. The process is simple. It used to involve a letter written to your representative. While this is still an acceptable method of communication, many legislative bodies have instituted phone message systems where you can call and leave a message for your representative. Many times, these calls are toll-free. You can also contact your representative bye-mail. Of course, you can always schedule an appointment with your representative.


There are many issues currently in the political spotlight that can impact you as a nurse, you as a citizen, and your patients. Some of the current topics include:


1. Medicare/Medicaid


2. Social security


3. National insurance


4. Healthcare for low-income families


5. Healthcare costs


6. Smoking bans


7. End-of-life issues


8. Staffing


9. Insurance reimbursement


10. Education


11. Children


12. Allocation of healthcare resources


13. Pollution



This is, by no means, a comprehensive list. Your opinion does matter, as does your expertise. The majority of legislators and other lawmakers do not have a background in healthcare. They need your input in an effort to make an informed decision.


So how do you get started? First, know the names and contact information of your local council members, state representatives, and federal senators and congress persons. You would be surprised at the number of people who cannot name their representatives. I could not name all of them until I became more active in grassroots efforts to pass or reject some bills concerning issues of importance to my patients, my family, my community, and myself. Contact information can be found on the Internet, or you can call the offices of the representatives. If you still cannot find out who your representative is, you could try calling the main offices of the entire legislative body. They can usually provide you with the name and contact information of your representative once you give them your zip code. Once you have this information, you can contact your legislators either by mail, phone, ore-mail whenever a bill is introduced and is one in which you have an opinion or an interest. You can simply say please support this bill or reject this bill. If you desire, you can provide the rationale for your opinion. If you want to provide the reasons for your interest, please do so by mail or by e-mail. Most phone messages taken in phone banks usually only want you say you either support or reject a bill and do not ask you why.


As little as making a phone call or as much as actually visiting your representative can involve you. You can do as little or as much as you want. Involve others as well. If there is a bill pending concerning a topic of interest to you, it will be of interest to others. Involve professional associations, your family and friends, your colleagues, and your community. Also, I know this is a simple thing but I must say it-VOTE. It is possible to impact political decisions, but you must make the effort.


Consider becoming more involved with these and other issues in 2006. I know everyone is busy, but these decisions do impact all of us. Make a new year's resolution to become more political savvy and an active citizen. Remember, those who show up and those who work to make a difference make decisions.


On behalf of the Dimensions of Critical Care Nursing team, I hope all of you and your families have a happy, safe, and healthy holiday season and 2006.


Vickie A. Miracle, RN, EdD, CCRN, CCNS, CCRC


Editor, DCCN and Lecturer


Bellarmine University School of




Louisville, KY