1. Webb, Jo Ann K. MHA, RN, FAAN

Article Content

Not a day goes by that nurses aren't involved in patient advocacy. From fulfilling a request for pain management to informing the physician that a treatment change may result in a better outcome, nurses are on the frontline advocating for their patients. Despite their advocate role, few nurses have taken this skill into the legislative arena. This may be due in part to a lack of political science exposure in college and a curriculum focused on science and clinical rotations. Another reason may be that advocacy beyond the patient care environment has never been expected. In today's era of healthcare reform, the caregiving equation is changing. As care moves from the acute care setting to the community, new advocacy models will be needed. Nurses are in the best position to identify what's needed and become such advocates.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Advocacy is defined as the act of supporting a cause in the pursuit of influencing an outcome. The most important part of being an advocate is awareness of the issues that are important. This information can be easily obtained from membership in a professional association. For example, the American Organization of Nurse Executives (AONE) has dedicated staff and resources to track issues and provide information. Through frequent communication and the online Advocacy Action Center (, AONE members are educated on various issues that impact nursing and alerted when there's a need to contact the offices of U.S. Representatives and Senators. To make it easy, sample letters are provided; members need only log in and click the appropriate button.


Consider the following tips from the AONE.


* Research pertinent elected officials by looking at their voting records and what they've sponsored or supported. The Library of Congress website ( provides all of the federal information you'll need. The Almanac of American Politics is a great resource for historical information about elected officials. For every official, it contains a photo; biography; voting record; percentage by which he or she was elected; committee memberships; and other information, including special causes or personal experiences that may have influenced the official's entry into politics.


* Votes on issues are determined by constituent input and this is where you can make a difference. Although you can't change core beliefs, your input can have an important impact on what a legislator may know about an issue.


* Every large corporation and association of any size pays professional lobbyists to make their positions known in Washington. This is also done at the state level and even at the community level. Legislators don't have to listen to lobbyists who are often characterized as "hired guns," but elected officials must be accountable to their constituents who keep them in office. By nurturing relationships, staying in contact, and educating elected officials, you can ensure that your positions are understood.


* You can choose to make a personal visit or phone call, or send a letter or e-mail. Every member of Congress has a Facebook page and Twitter account.


* If you want to make a personal visit, remember that legislators are extremely busy people and you must plan ahead. Call for an appointment, be flexible with timing, explain the purpose of the meeting, confirm the meeting time in writing, arrive early, and don't be disappointed if your Senator or Congressperson can't meet with you as planned. There are always contingencies. You'll most likely meet with a legislative assistant (LA) who handles specific issues for the official, such as the health LA, or possibly a legislative clerk or intern. This person is considered by the elected official to be the office expert; the official relies on him or her to convey the importance of the matter and often constituents' sentiments.


* Prepare and develop a one-page paper that succinctly describes why you called the meeting. Set goals for the meeting so it's clear what you want to achieve. Introduce yourself-who you are, why you're there, and what you specifically want to discuss-and provide an overview-why the problem exists, the implications, and the solutions. Know what to ask for and show that you've researched solutions. What are the strategies to mitigate the problem: more funding or a change in the law? Your strategy must be as specific as possible. Be aware of the opposition so that you can counter an argument. Skilled lobbyists often come with legislative proposals.


* Be a resource now and in the future by showing that you can be counted on to provide more data or other relevant information.



It's the Democratic process of one person, one vote that puts elected officials into office. There are cases in which an elected official won't want to meet with lobbyists, but a constituent is always accommodated and given an appointment. Members of Congress and the political party to which they belong have a significant impact on health policy, nursing, and patient safety. In the words of Florence Nightingale: "I think one's feelings waste themselves in words; they ought all to be distilled into actions, which bring results." This is the best reason to participate in the political process.