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Politics is not a dirty word. (President's Message).

Charleston, South Carolina is my home. This is where I was born and raised; this is where I developed "pluff mud" in my blood; this is where I will live, die, and be buried. This is also where I learned that politics was a subject not to be discussed in public; it was one of those taboo topics that was best left alone. Well, I am here to tell you that politics is not a dirty word.

Webster's Dictionary (1993) defines politics as the art and science of the government of a state; public affairs or public life as they relate to this; the opinions, principles or policies by which a person orders his participation in such affairs; scheming and maneuvering within a group. Mason, Leavitt, and Chaffee (2002) state politics is a neutral term. Their definition is the process of influencing the allocation of scarce resources. They further break down this definition to give us a better insight into the term:

* Influencing implies opportunities exist to alter the outcome of a process.

* Allocation means decisions are being made about how resources are divided.

* Scarce implies that there are limits to the amount of resources that are available. Keep in mind that resources mean not only money, but also time, staff, or other inputs in a process.

Nurses Should Become Involved in the Process

In nephrology the terms allocation and scarce seem to go hand and hand. Given the fact that inflationary cost adjustments are not built into the present system of reimbursement, it behooves nurses to get involved in the political arena. We work constantly with the cost restraints that affect our patients and their therapy. If we exert our influence, we could make major contributions to changing the current system; we just need to develop our skills and build our confidence in the process. Consider the facts and the possibilities.

Because as nurses we closely interact with our patients, we possess a broad appreciation of their needs. We recognize how factors in the environment affect the health of our patients and how they respond to different strategies and services. We are a pivotal part of the health care team (ICN, 2001). We value caring, collaboration, collectivity, and high-touch care. And if we want the government to develop policies that reflect our values, we must become a part of the decision-making process--the political process (Mason, Leavitt, & Chaffee, 2002).

Making a Difference

View the ESRD Briefing book. How might we make a difference? How can we be effective? The first thing to do is to download the ESRD Briefing Book for State and Federal Policymakers (American Nephrology Nurses' Association [ANNA], 2002) from the ANNA website ( It provides us with a wonderful review of facts that we should be prepared to share with those in authority. The financial information supplied may not be familiar to all of us, much less those outside of nephrology. Nancy Szymanski, Nancy Sharp, and Kathleen Smith authored this booklet.

Stay informed. Second, we must stay informed about what is happening in our own community, the state within which we live. Keep up to date with what is developing. Know who the key players are--the politicians and officials in local, regional and national government. If we hear that there are issues developing that can impact patient care, let ANNA know. There are available experts who can give us advice on what additional steps to take. We can then be better positioned to serve as expert resources, to be advocates for our patients, and to be advocates for ourselves.

Use our voices. Third, as nurses we must value our voices and learn how to use them wisely. We have an opportunity to do just that on August 15th. The ANNA Board of Directors has deemed this day our first ESRD Education Day. The purpose of the day is to invite our legislators into our units, to teach them a little about dialysis, and to let them meet their constituents. They will see and hear first hand what the ESRD program means to so many individuals. It will be an amazing opportunity to demonstrate that we can be expert resources and that we can have our voices heard. However, before our enthusiasm takes over, we must obtain permission from our employers prior to initiating our participation in this important day.

We will be provided another opportunity to influence our legislators during a preconference to be held prior to our 35th National Symposium in Washington, DC. Participants will learn how to schedule and make a visit to the Hill to see our legislators where they work. Start planning now to participate next spring!

We Must Spread Our Influence!

We are nurses. And, as the Johnson & Johnson campaign ads state so simply yet so eloquently, "we dare to care." Because we care, we must speak up and spread our influence in the political arena in order to make a difference. Nurses do make a difference in the lives of others; it is now past time to make a difference on a larger scale. And, while politics may not be a comfortable role for some of us, we all have to recognize that politics is not a dirty word, not even in Charleston, SC!

Caroline S. Counts, MSN, RN, CNN

ANNA President

Palmetto Chapter ANNA


American Nephrology Nurses' Association (ANNA). (2002). ESRD Briefing Book for State and Federal Policymakers. Pitman, NJ: Author. Available at

Mason, D.J., Leavitt, J.K., & Chaffee, M.W. (2002). Policy & politics in nursing and health care (4th ed.). St. Louis: W.B. Saunders Company.

Cayne, B.S. (Ed.). (1993). New webster's dictionary and thesaurus of the English language. Danbury, CT: Lexicon Publications.

International Council of Nurses. (2001). Guidelines on shaping effective health policy. Geneva, Switzerland: Author. Available at

ANNA's Mission

ANNA will advance nephrology nursing practice and positively influence outcomes for patients with kidney or other disease processes requiring replacement therapies through advocacy, scholarship, and excellence.
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Title Annotation:American Nephrology Nurses' Association chapter president urges nurses to get involved in practice-related issues
Author:Counts, Caroline S.
Publication:Nephrology Nursing Journal
Geographic Code:1USA
Date:Jun 1, 2003
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