Political Engagement to Support, Advocate, and Advance APRN Practice

That’s not my job is a phrase that I uttered over 20 years ago when I began my nursing career. I believed in speaking up for my patients; that was how I was educated. Facilitating the advancement of the nursing profession was what educators did, not frontline working nurses. I falsely believed that “politics” was a fraught abstraction and not to be discussed. Nurses are naturally drawn to helping others. Many nurses are not naturally inclined to advocate for themselves. Although this is a skill that is more easily obtained than one may think, professional advocacy and policy-making are often viewed as intimidating by nurses. It’s easy to think that expert knowledge of the workings of federal and state government are key to participating in advocacy, but in fact this knowledge contributes minimally to becoming an effective advocate and agent of change for the nursing profession.

Nurses comprise the largest proportion of health care professionals in the United States, with more than 5.2 million registered nurses (RNs) nationwide.¹  Nurses have been bargaining and fighting for recognition of their expertise since long before the pandemic. Two articles illustrate the monetary value of nursing to employers. In 1982, the Denver Post provided a table of proposed pay raises for the year for Colorado state employees—accountants topped the list at 21.5%. The lowest was bedside nurses at 0.00%, and above them was insurance analysts at 2.2%. The proposal also included a 12.8% annual raise for the position of “typist.”²  And in 1979, the Washington Post³  cited the average RN salary in Denver, Colorado, as $1064 monthly. At the time, painters in Denver were making $1191 a month.

Imagine the power of our voice if we used it. When I talk about “we,” I’m talking about all of us. The profession of nursing has the power to change history. It doesn’t take intricate knowledge of the innermost workings of our government. It takes courage, lived practice experience, and stories. This symposium is for advanced practice registered nurses (APRNs) as well as any RNs wanting to discover the world of advocacy and policy. Very few nurses serve as legislators, although I am sure they know nurses or have been touched by a nurse. Sharing with them stories about your practice are what it takes to facilitate change. And if you wish to add to add to your expertise, the following articles are meant to supplement your journey.

This symposium highlights 4 critical parts of participating in advocacy and policy, whether you are an APRN or an RN. The following 4 articles discuss licensure, accreditation, education credentialing, advocacy, policy, and regulation for nurses.

In the first article, Davis et al discuss the background and crucial importance of the APRN Consensus Model and its implications for full practice authority; they also clarify the APRN role and scope of practice.

In our second and third articles, the authors expand on the role of advocate and differentiate between advocacy and policy. In the second article, Senator Adcock discusses her personal experience as a nurse turned state senator and what it means to be an advocate. From her own experience as the only member of the North Carolina legislature to have come from nursing, Senator Adcock discusses the key pieces to her success in government and lessons nurses can draw for their own political involvement. O’Rourke and Outly explore the complex relationship between advocacy and policy, and differentiate between the 2 functions.

In the final article in the series, Fuller focuses on nursing regulation. This an essential part of nursing that is not often taught and can be critical to APRN practice. The basic understanding of state and federal regulations is discussed as well as state nurse practice acts, understanding consumer reporting, and duties of regulatory boards.

This symposium is dedicated to nurse advocacy and policy because, at this time, nothing is more important to nurses than patient care they feel good about. The problem is that nurses don’t want to give adequate care, they want to give optimal patient care. Through an increased understanding of government and regulatory efforts, and a little motivation to tell their story, nurses can make a difference. Let’s do this.