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A Year of Nursing Advocacy: A Personal Journey.

I will always remember 2016 as the year I learned about what it meant and what it took to advocate for nursing practice at the state level and at the national level. My journey started with a humbling experience as a doctoral nursing student going over a checklist to assess how much about health policy I already knew and have participated in doing. What I learned was that I knew very little about how laws are made and this process was far more complicated than Schoolhouse Rock's little ditty about how a bill becomes a law. First of all, I had never been to Indiana's statehouse even though I live less than 30 minutes away. I didn't know who my senators were and the house representative for my district, much less know the difference between the two. On closer reflection, I learned my problem did not necessarily revolve around my not knowing but in my attitude. I learned I was indifferent to the processes that affected my chosen profession and my livelihood. I believed membership and paying my annual dues to ANA and ISNA were enough and left the "fighting" for others to do.

Advocacy is "any action that speaks in favor of, recommends, argues for a cause, supports or defends, or pleads on behalf of others." (1) In 2012, Karen Tomajan, wrote on Advocating for Nurses and Nursing, that nurses in today's healthcare environment are experiencing unprecedented changes and challenging times...but it has also created emerging opportunities for nurses to positively impact care in many practice settings. (2) Advancing the nursing profession is not to be left to who we think are the called few but rather a call-out to individuals to understand it takes a united many to move the proverbial mountain that impacts changes which affect our profession.

This summer, I had the wonderful privilege of attending the American Nurses Association's 2016 Membership Assembly in Washington, D.C. with the current and previous Indiana State Nurses Association presidents. The 4-day assembly started bright and early at 7:30 in the morning through 9:00 in the evening and even later for those who held office. The Membership Assembly was a formal process that began with a call to order, introductions, establishing a quorum, adoption of standing rules for conduct of business, and adoption of meeting agendas. Microphones were set up in various locations in the meeting room so members would be able to voice their opinions and/or concerns on each agenda item before it was voted on by eligible members using clickers. Each ANA entity (ANCC, ANF, and AAN) also provided a report on their activities and financial status.

Lobby Day was perhaps one of the many highlights of my experience. It began with an early morning briefing of the healthcare bills we would bring to the forefront during our discussions with the office aides from Indiana's Senators and Representatives. Lobby Day 2016 focused on the following bills: The RN Safe Staffing Act (H.R. 2083/S.1132); Title VII Nursing Workforce Reauthorization Act (H.R. 2713); and The Home Health Care planning Improvement Act (H.R. 2713/S.578). One of the more specific requests for support were changes to the IHSAA bylaws to permit Nurse Practitioners and Physician's Assistants to be able to continue performing sports physicals which in July, 2016, was amended to reflect the requested changes. Nothing opens one's eyes more, I think, than experiential learning. Walking up and down Capitol Hill in DC's summer weather wearing business attire is an experience in itself. The purpose, of course, is to go from office to office and have a brief moment of a senator/representative aide's time to communicate as succinctly as possible what you want them to act on and why. It takes the nurse's presence and the sum of his/her experiences and knowledge to tell stories that frames the importance of a bill in such a way and gives perspective to what it is we are advocating for.

This September, ISNA packed the room with members, students, and guests at the annual state convention held at IU Kokomo. The purpose of the annual convention is to increase awareness of health policy needs at the state level and to further communicate activities being done at the national level. The theme that was impressed upon me this year after attending both gatherings is there is power in numbers. Did you know there are 4,011,911 professionally active nurses to 926,119 physicians in the U.S. (3,4) Imagine what could be accomplished!

There are three things I learned as I reflected on my own journey of becoming a more active advocate of the nursing profession. The first is nurses need to be mentored on how to become advocates. It isn't enough to invite someone to a meeting nor to join. Someone needs to invest a little time to show you the ropes and demystify this process. The second requires an action plan. It isn't enough to feel warm all over after an uplifting experience because eventually, the feeling goes away. That plan of action should, at the very least, include membership to ANA/ISNA. Membership has its perks along with getting information that keeps you up-to-date on healthcare issues and agendas like ISNAbler or ANA's Nursing Insider. The third, is to establish and/or maintain relationships with elected politicians/officials--whether you voted for them or not. One site you may find helpful as you explore advocacy is Election 2016 is over but the nurses' work of advocating for patients, population health, and the profession is ongoing. What about you? Will 2017 be the year you embark on your own personal journey of nursing advocacy?


(1) Alliance for Justice. (n.d.). What is advocacy? Definitions and examples. Retrieved from what-is-advocacy.pdf

(2) Tomajan, K. (2012). Advocating for nurses and nursing. The Online Journal of issues in Nursing, 17(1). Retrieved from

(3) Kaiser Family Foundation. (2016, September). Total number of professionally active nurses. Retrieved from,%22sort%22:%22asc%22%7D

(4) Kaiser Family Foundation. (2016, September). Total professionally active physicians. Retrieved from,%22sort%22:%22asc%22%7D

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Author:Griffith, Cheryl
Publication:ISNA Bulletin
Date:Feb 1, 2017
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