1. Section Editor(s): Raso, Rosanne MS, RN, NEA-BC

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At this time last year, we started the New Year pledging to lead with confidence, exuding positivity and courage, and ridding ourselves of self-doubt. How did that work out for you? I hope you successfully practiced confident leadership throughout 2017. What's striking me about the year ahead is my hope for us to find our voices, and use them well.

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There seems to be some disparity when it comes to being heard. On one hand, at the recent American Academy of Nursing meeting, nursing workforce researcher Dr. Jack Needleman commented about the Quadruple Aim. He made the point that it took the voices of our physician colleagues to have work environment added to the Triple Aim. We're the largest healthcare workforce, with years of study and effort on healthy practice environments; however, it wasn't nursing's voice that brought this foundational need to national attention. Are we that invisible?


On the other hand, there are healthcare organizations for which there's deep-seated tension that nursing is heard above all other disciplines, while, at the same time, several studies and even meta-analyses reveal that nurses experience fear and anxiety about speaking up. As leaders, we must create open environments where our staff members' voices are heard and acted on, influencing for the right reasons. It always surprises me that when nurses ask for what's needed to take care of patients, sometimes we're perceived as greedy and whining. In actuality, we're proxies for patients and families, whether in the organization or outside of it, with a responsibility to use our voices to effect change for them, individually and collectively.


And speaking of outside, what about your voice in the community? We're experts on so many health issues that we can easily touch people's lives. If you offer to speak at a community or school event, or even write for a PTA newsletter, your offer will be readily accepted. Diabetes education, immunizations, preparing for healthcare provider visits, infection prevention, nursing careers, and medications come immediately to mind. When you see issues of social or health interest, think about sending a letter to the editor of your local paper and sign it with your RN credential. Partner with a colleague to make it easier. Think of all who read it and how that may shape their thoughts or actions.


The public barely knows what we do-giving medications and following physician orders continues to be the prevailing image to this day. That must change. If we get out there, all 3.3 million of us, we can advance the Robert Wood Johnson Foundation vision of a Culture of Health, as well as every state's Future of Nursing action coalition.


Our professional organizations have voices on Capitol Hill and there are many local/regional associations that have an impact on state legislatures. I know from my state that the influence can be palpable, and from national reports we see the same. Pamela Cipriano, president of the American Nurses Association, shows no fear when using multimodal communication, including social media, loud and clear. This is influence in action.


From the bedside to the community, our voices are important and influential. Let's use them and help our staff members use theirs. It's a professional and even moral obligation. Use the "why" to make sure your focus is understood; this goes a long way in molding reaction, attitude, and follow-up. Invisible no more!


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