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The Division of Nursing of the U.S. Health Resources and Services Administration projects that baring aggressive intervention the supply of nurses in America will fall 29% below requirements by the year 2020.


The Nurse Reinvestment Act (P.L. 107-205) holds the promise of attracting more people into the nursing profession, increasing nurse education, and encouraging practicing nurses to remain in the profession. However, this legislation will not become a reality until Congress appropriates the money to fulfill its mission.


Home health nurses can build political pressure so that Washington inaction results in consequences no politician wants to experience. Former Speaker of the House Tip O'Neill said, "All politics are local." When a politician is not viewed as having "done good things for the people back home" he or she is not reelected.


Building political pressure means being "politely and respectfully relentless " in your advocacy. The first step is to communicate that alleviating the nursing shortage is important to you and many other individuals "back home." Essential "nuts and bolts" of legislative advocacy are:


* Send letters to your legislator briefly defining the problem and how it affects you, your agency, and your patients.


* Be specific about what you would like your legislator to do. For the nursing shortage, ask "support funding for the Nurse Reinvestment Act (P.L. 107-205) by including a $20 million appropriation in the FY 2004 Labor/Education/HHS Appropriations Bill."


* Ask your Senators and Representative to meet with you in their local office when they are back home.


* Take a legislator on home visits with you.


* Know what committees your legislators serve on and follow their votes on issues.


* Call the legislators through their health legislative assistants in their Washington, DC offices prior to each vote on the issue. Be specific about what issue you're calling about and what bill number the issue is included in.


* Give your legislators every chance to help, but if they don't, try to create tactful publicity about the lack of help through your local media. Write a "Dear Editor" letter in your local newspaper. Politicians hate to receive negative publicity in the newspaper.


* Increase political pressure during the months, weeks, and days prior to primary and general elections. Representatives and Senators up for reelection are always on alert for hot issues.


* Find out the legislator's key contacts-individuals who have the legislator's ear. Educate them about your issues and ask them to speak to the legislator about the action needed.



Nurses should feel confident that their views are important. Legislators are more motivated to act if the individuals who are providing the direct care to patients are contacting them-especially if many nurses are contacting them about the same issue at the same time.


Nurses need to take action on their own behalf. Even though we no longer wear "white hats," our opinions and guidance are highly valued.


For more information on the association, publications, meetings, and any other questions, contact:




99 Summer Street, Suite 1700


Boston, MA 02110


(617) 737-3200 voice


(617) 737-1144 fax