Nurses as Advocates (Nursing)

by Heide Cygan, DNP, RN

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    00:01 The number and types of laws that influence public health and patient outcomes are increasing.

    00:06 Because of this, nurses need to be involved in the policy process.

    00:09 As nurses, we need to understand the importance of the influence that we have on the health of communities through policy work.

    00:18 Nurses working in the community know all too well about the specific issues that influence the health of a community and contribute to health disparities.

    00:26 It's through advocacy and policy that solutions are developed.

    00:30 Nurses can and should be involved in policy activities.

    00:34 And there are a number of ways to do that.

    00:36 We can vote, we can understand how policies are made, we can advocate for policy issues that impact our patients and our own profession.

    00:46 Advocacy is a specific effort to support the adoption of a policy.

    00:50 Or on the other hand, we can also advocate against policies that we believe could be harmful to the communities that we serve.

    00:58 As experts in health care, and as experts on the communities in which we work, nurses can engage in a variety of advocacy activities that influence policy.

    01:07 Common methods of advocating for health policy include: face to face interactions, personnel letters and emails, telephone calls, written or spoken testimony, signing of petitions, writing of position papers, letters to the editor.

    01:35 And finally, participation in demonstrations and lawsuits.

    01:41 Depending on the issue, and the nurses comfort level with advocacy efforts, all of these advocacy methods can be effective.

    01:49 The first step in advocacy is to understand who you need to contact to advocate for your cause.

    01:54 This requires that you understand who the decision makers are.

    01:58 So for example, if George here really thinks he deserves a raise at work, he complete his case his co-workers over and over again.

    02:05 But if his boss is the decision-maker, then will need to plead his case to his boss in order to see that money in his paycheck.

    02:12 The same is true for advocacy.

    02:14 If you want to see change at the state level, advocating to the federal government will not impact change.

    02:20 Instead, you'll need to figure out who your state level decision-maker is, and plead your case to them, advocate to them.

    02:28 While nurses can be engaged in the legislative process at any point in time, today, we're going to focus mostly on how nurses can be involved in advocating for policies as they're formulated and passed into law.

    02:39 This type of advocacy begins with relationship building.

    02:43 Relationships are essential for effective advocacy, and relationships can be built in several ways.

    02:49 We can build relationships by contributing money, time, or expertise.

    02:55 So while you may not feel comfortable or have the ability to contribute money to a political campaign, you could spend time canvassing your community to advocate on behalf of a policymaker who supports causes that are important to you.

    03:07 This is just one way that you can build relationships.

    03:11 Advocacy often involves communicating with legislative staff.

    03:14 Now legislative staff are just individuals who do the legwork for policymakers, they work for policymakers, they conduct research, they follow up on phone calls or email communication.

    03:24 They conduct a variety of other activities that move policy ideas into bills, This includes working closely with individuals and This includes working closely with individuals and groups who are advocating.

    03:34 Developing a strong working relationship with key legislative staffers is essential in the advocacy process.

    03:41 Now face to face visits are viewed as the most effective way to advocate.

    03:45 But there are a few important considerations.

    03:47 First of all, it's important to know how much time you'll have.

    03:51 Call ahead and ask how much time you'll have with the staff or the policymaker.

    03:55 From there, you can develop a short speech.

    03:59 You should start your speech by introducing yourself.

    04:05 Make sure you explain your expertise, tell them that you're a nurse, tell them why they should listen to you.

    04:11 Next, explain the problem and why it's important to you and other people that they represent.

    04:16 Numbers count.

    04:17 If the views you express are shared by local nursing organizations, or by other nurses employed at your health care system, then let the legislator know there's power in numbers.

    04:28 Finally, be sure to explain how the proposed policy will address the issue you just described to them.

    04:35 Your speech should end with an ask.

    04:37 This is where you very specifically asked the policy maker to take action.

    04:43 Be more specific than just saying, "Do I have your support on this?" You could ask them something as simple as, "Would you sign on as a co-sponsor to this bill?" Or "Can I count on you to vote against passing this bill?" Whatever your ask is, make sure you're specific.

    04:59 Make sure you allow in enough time at the end to answer questions.

    05:03 Offered to provide additional information or find answers to questions they ask.

    05:07 Do not assume that the legislator or the legislative staff is well informed on your issue.

    05:13 They may be experts at policymaking, but that does not make them experts on your issue.

    05:17 You are the expert.

    05:20 When you leave, leave something behind, one page document or a fact sheet that reminds them of the issue and the policy and your ask.

    05:30 Before you leave, repeat your ask.

    05:33 And in a nice way, of course demand and answer.

    05:36 You could say something along the lines of, "now I've asked you if you would sign on as a co-sponsor for this bill.

    05:41 Do I have your word that you'll do it?" After your visit, make sure you follow up.

    05:46 Follow up with a letter of thanks to both the legislator and the staffer.

    05:50 You can always make a phone call as well to ask for the result of your visit.

    05:54 Did they follow up on your ask? Now let's take some time to practice.

    06:00 Imagine that you have just a few minutes with a policymaker.

    06:03 How could you ask them to support a policy that you know it'd be beneficial to you and the communities that you serve? I'm going to show you a very, very quick example.

    06:13 Hi, my name is Heide.

    06:15 I'm here today to talk to you about Bill S-123.

    06:19 This bill will provide funding for nursing education.

    06:23 I've been a nurse for over 20 years and I'm an expert nurse educator with over 15 years of nursing education and administrative experience.

    06:32 Further I live in your district and I work as a public health nurse in the communities in your district.

    06:37 This bill is important to the people in our district because we are currently experiencing a great deal of health disparities.

    06:43 This includes a dramatic increase in cardiovascular disease and death, as well as increases in teen pregnancy.

    06:50 This is all due to a lack of access to care.

    06:53 By passing this bill into law, more nurses will be available to serve your constituents and therefore health outcomes will improve health disparities will decrease.

    07:03 I'm asking that you sign on as a co-sponsor to this bill.

    07:07 Do you have any questions for me? Great. I'd love to leave this document for you that recaps everything that we talked about today.

    07:15 And as a reminder, my ask today is that you sign on as a co sponsor.

    07:19 Can I have your word that you'll do this? I'll follow up with you later this week. Thank you.

    07:26 And that is a short example of how you can concisely advocate for a policy.

    07:31 Nurses can have increased impact in the policy arena if they work with and through professional organizations.

    07:37 These organizations have policy committees made up of volunteer members who are dedicated to understanding policy.

    07:44 They monitor, analyze and shape health policy in a way that will benefit their members and the populations their members serve.

    07:51 Some organizations even hire nurses to be professional lobbyist and to sit on as political action committee members.

    08:00 Here are a few influential public health nursing organizations.

    08:04 When you become a member of one, you have access to all of their advocacy tools.

    08:08 This could include pre-written letters or specific policy analysis documents.

    08:13 You also gain power and numbers, by advocating with others, you have the ability to impact change faster than when you abdicate as a voice of just one.

    08:24 Nurses can learn more about organizational public policy activities and learn ways to get involved by visiting organizational websites.

    08:33 Nursing as a whole has an advantage in advocating for issues and influencing policymakers just based on our numbers.

    08:40 Nurses are the largest health care professional group in the country.

    08:44 On top of that, we're also the most trusted profession in the country.

    08:48 However, to harness this advantage, nurses must speak with one voice.

    08:52 The greatest effect can be had when all nurses make the same demands for policy outcomes.

    08:57 This is one reason that advocating through professional organizations where all members can have a unified voice is so impactful.

    About the Lecture

    The lecture Nurses as Advocates (Nursing) by Heide Cygan, DNP, RN is from the course Public Health and Policy (Nursing).

    Included Quiz Questions

    1. Call local politicians to tell them about the policy.
    2. Meet with local school officials to spread awareness of the policy.
    3. Tell the employer they will quit if the policy is not approved.
    4. Initiate a lawsuit against those opposing the policy.
    5. Circulate a petition to get those not supporting the policy to resign.
    1. Relationship building
    2. Protesting
    3. Fundraising
    4. Drafting a policy
    1. Face-to-face meetings
    2. Writing position papers
    3. Creating petitions
    4. Telephone calls
    1. Take a short document highlighting the cause for which they are advocating.
    2. Allow time at the end of their speech for questions.
    3. Follow up with a thank you letter following the meeting.
    4. Avoid directly asking the legislator to support the cause.
    5. Develop a short speech summarizing the cause, ensuring it is no longer than one minute.

    Author of lecture Nurses as Advocates (Nursing)

     Heide Cygan, DNP, RN

    Heide Cygan, DNP, RN

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