1. Goodyear, Caryl PhD, RN, NEA-BC, CCRN-K, FAAN

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Q The stress on the healthcare system from the pandemic and the recent criminal charges brought against a nurse who made a medical error have sparked my interest in becoming more active in developing public policy supporting our nursing practice. Where do I start and how do I help my staff who are also interested in advocacy?

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As nurses, we embrace our role as a patient advocate. We work tirelessly and in a collaborative way to ensure patients' care needs and wishes are met. Nurses also work locally with management, unit councils, and institutional councils to improve workplace support of nursing practice that positively impacts patient and nurse outcomes. Beyond that, we're less likely to become involved.


Advocacy, "the act or process of pleading, supporting, or recommending a cause or course of action" is foundational to our scope of practice.1,2 The last 2 years have led to myriad legislative proposals that impact nurses, and Dr. Ernest Grant, president of the American Nurses Association (ANA), urges all nurses to consider becoming involved in advocating for and developing public policy.3 Essentially, non-nurses are deciding what's best for our profession and our patients. For example, a bill currently being considered in Missouri mandates that hospitals do away with visitation restrictions, especially during a pandemic. There were no nurses nor hospital executives or employees leading this bill. Whether you'd support this bill or not, legislators need nurses' input. Our education and experience have value, and non-nurses need to be informed about what's best for patients and practicing nurses.


Recognizing our value may be a first step in stretching our advocacy muscles.4 It's as simple as communicating and educating to influence legislators by sharing our stories, expertise, and experiences.5 But where do you start?


* Get a mentor to help guide you through your growth as an active advocate.


* Contact your legislators about a piece of legislation. Helpful resources are available on the ANA website or your state association's website. Use an internet search to find the names of your representatives in state and national assemblies.


* Seek out educational events where you can learn more about the political process and public policy.


* Turn to professional associations for collective advocacy efforts, which can lead to successes that benefit our patients and our profession.6



Some important actions you can take to promote advocacy among your team members include:


* Encourage and develop every nurse into their important role of patient advocacy.


* Provide and support a place for nurses to be involved in owning their practice and workplace environment. This can include having open-dialogue staff meetings and creating or maintaining a unit council.


* Help nurses spread improvement efforts across the institution's departments and units, which may include active involvement in shared governance.


* Encourage nurses to attend educational offerings on advocacy.


* Know, acknowledge, and educate staff about your institution's policies for individual advocacy efforts outside employment. There are important requirements prohibiting nonprofits from engaging in political campaigns, and your institution may have other policies about individual advocacy.



The pandemic certainly has stressed the healthcare system and the nursing profession, creating challenges to the way we've operated in the past. Now more than ever, nurses need to advocate for our patients as we always have and to increase these advocacy efforts by supporting public policies that align with improving health for all.




1. Hegge M, Fowler M, Bjarnason D, et al Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD: American Nurses Association; 2015. [Context Link]


2. American Nurses Association. Nursing: Scope and Standards of Practice. 3rd ed. Silver Spring, MD:; 2015. [Context Link]


3. Grant E. Advocacy agenda: collective action reaps rewards in public policy. Am Nurse. 2022;17:13. [Context Link]


4. Wilson DM, Underwood L, Kim S, Olukotun M, Errasti-Ibarrondo B. How and why nurses became involved in politics or political action, and the outcomes or impacts of this involvement. Nurs Outlook. 2022;70(1):55-63. [Context Link]


5. Houskova M. Nurse leaders and advocacy. Safeguarding nurses' scope of practice and the profession. Am Nurse. 2022;17:42. [Context Link]


6. Mahlin M. Individual patient advocacy, collective responsibility and activism within professional nursing associations. Nurs Ethics. 2010;17(2):247-254. [Context Link]