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Elevating The Nursing Voice: It’s Time for Us to Speak Up

Looking at nursing representation in the 118th Congress, the number of representatives identified as nurses is small – two in the House of Representatives, and a nurse has never served in the Senate

Nurses comprise the largest portion of the healthcare workforce – close to a third -and in the US, current estimates put the number of RNs at over four million. 

One of the strengths of belonging to a professional group of such size is that many people have worked with or know a nurse in some capacity. Nurses are often embedded into the systems where they provide care and have a unique first-hand perspective on their communities’ concerns. In addition to the ubiquitous nature of nurses, multiple studies point to the fact that nurses are seen as highly ethical, highly respected, and viewed positively by those on both ends of the political spectrum.

This set of circumstances places nurses in a unique position, which I would argue nurses often don’t take enough advantage of. Like the old Spiderman saying, “With great power comes great responsibility” I think that as professionals, we need to recognize our strength as advocates and use it in a way that helps to advance the profession, improve care for our patients, and strengthen our healthcare systems. 

Federal policies and decision-making happen in Washington, DC, and nurses like Lauren Underwood are making their mark on politics in that setting. However, even when we look at nursing representation in the 118th Congress, the number of representatives identified as nurses is small – two in the House of Representatives, and a nurse has never served in the Senate

When we compare that to our physician colleagues – 14 representatives and five senators – it begs the question, why? The total number of physicians with an active license in the US is around 900,000, so less than a quarter of the number of licensed RNs, and still, physicians are represented five times as frequently in Congress. 

Policy and advocacy often begin at a very local level, and this is one of the best places for nurses to be active and vocal participants. Many employed nurses are part of a healthcare organization, which provides an excellent opportunity to participate in clinical decision-making (shared governance, hospital boards, foundation boards, interprofessional organizational-wide committees) and their communities (school boards, health coalitions, local government, volunteer settings). One organization, the Nurses on Boards Coalition, helps to connect nurses with board vacancies to help facilitate more nurses at these tables. This could be a local, state, or national opportunity and aligns with the organization’s goal of increasing nursing representation to improve the health of communities and the nation. If you want to learn more, you can visit their website and sign up here.  

Nationally, it is also important for nurses to become members of their specialty or interest-affiliated groups. Many of these organizations will have a policy or legislative committee or group – an excellent opportunity to contribute to a broader dialog on issues and stay current on what is happening outside of your setting. In my career, I’ve had the opportunity to work with nursing policy and advocacy experts in both a state and national capacity, and it is both exciting and, at times, frustrating to see how our voices can create change (or not). If you are a member of a specialty group, take some time to look around their website. You will likely see an area to sign up for policy or advocacy alerts or a way to join a health policy committee. If you are unsure if you are ready for a full-time commitment, a great first step is to email the committee chair and ask if you can join as an observer or if there is a public update for members that happens regularly that you can sign up to receive.  

Additionally, studies have shown that the amount of media coverage that highlights the work and voice of nurses remains low – in the 2018 Woodhull Revisited study, authors found that merely 2% of healthcare articles quoted nurses, compared to 21% who quoted physicians.

The authors found that no nurses were quoted in those articles related to health policy, an important area for all healthcare professionals. We know many potential barriers exist to media engagement – nurses are not taught to interact with media, and few nurses actively look for such opportunities. Additionally, marketing and media teams in clinical settings may reflexively identify physicians to speak to media or provide context for stories. However, there is value and richness to varied viewpoints, and nurses are well-positioned to share data, educate, and connect with the public. 

The George Washing School of Nursing has a Health Policy and Media Fellowship available for nurses interested in learning how best to learn and grow in this area. This one-year fellowship aims to increase health policy knowledge and the visibility of nurses in the media.  

Nurses have the right and responsibility to engage in policy, advocacy, and with the media. Have you started to look at opportunities to get more involved? What has your experience been?

Danielle Altares Sarik, Ph.D., APRN, CPNP-PC, is a nurse scientist and pediatric nurse practitioner with expertise in health services and outcomes research. She is a Senior Fellow of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing and a Health Policy and Media Fellow at the George Washington University.

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