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From apathy to political activism


When someone mentions the words politics and nursing in the same sentence, do you roll your eyes? Do you think to yourself or ask aloud, “What does this have to do with being a nurse?”
For many nurses, public policy and political activism seem far removed from day-to-day practice. Yet public policy and politics shape nursing everywhere nurses practice—at the bedside, in the classroom, and in the administrative suite.
We must become political activists to protect our profession from internal and external threats that can be leveled through political processes and changes in public policy. The nursing profession exists because public policy recognizes nursing care as a way to meet the public’s healthcare needs. Politics is the force that revises nurse practice acts—the laws that legalize the practice of our profession. Politics and public policy also drive healthcare reimbursement, which plays a major role in shaping nurses’ work environment.

The path to political activism
Political activism is a critical skill nurses must learn to protect their practice and the nursing profession. On an individual level, the path to political activism proceeds gradually in stages. Cohen, Mason, Kovner, Leavitt, Pulcini, and Solchalski developed a four-stage model that serves as a framework for the nurse’s political development. This model starts with buy-in and progresses to leadership. To these four stages, I’ve added a fifth—apathy—as the starting point.
1.  Apathy. The apathetic nurse doesn’t belong to professional organizations, takes little or no interest in legislative politics as they relate to nursing and health care, and may not be a registered voter.
2. Buy-in. The nurse starts to recognize the importance of activism within professional nursing organizations but hasn’t
taken an active role in these organizations. He or she starts to become interested in legislative politics related to critical nursing issues, but takes little or no political action. Nurses at this stage are likely to be registered voters.
3.  Self-interest. The nurse seeks involvement in professional organizations to further his or her career and seeks to develop and use political expertise to promote professional self-interest.
4.  Political sophistication. The nurse is active at the professional organizational level and may hold an organizational office at the local or state level. He or she has moved beyond self-interest and recognizes the need for activism on behalf of the public.
5.  Leading the way. The nurse serves in an elected or appointed position at the state or national level of a professional organization. To provide true leadership on broad healthcare interests within legislative politics, he or she may seek appointment to policymaking bodies. Some nurse-leaders seek election to political office.Where to start
First, shake off your apathy. Recognize the importance of political activism for nurses. Take an interest in politics—especially on issues related to nursing.
Political activism skills are learned and exercised most effectively through the organized efforts of nurses working together through professional organizations. So the critical next step is to become a member of a professional organization, such as the American Nurses Association and its constituent state nurses association. Being a member gives you ready access to information on health policy issues and political action in nursing. Without membership, you’d need to routinely review a wide range of journals, newsletters, and websites to educate yourself on health policy issues; also, you might not be able to access information critical to developing policy expertise and becoming a political activist.

Gain political savvy
Move beyond mere membership and take an active role in a professional nursing organization at the local or state level. Attend local or state meetings, nurse lobby days, and workshops on policy issues and political activism. For an excellent learning opportunity that will help you move to the next stage, enroll in a for-credit course in health policy at the undergraduate or graduate level.
Get involved in the leadership of your professional organization, such as by seeking office at the local or state level. Or seek appointment within the organization to a committee or other body that addresses political and policy issues—for instance, a political action committee, government relations committee, or health policy committee.
Educate yourself by reading relevant nursing publications, newspapers, and newsmagazines. Attend local and state meetings of legislative bodies that address health policy issues. This will prepare you to be a productive member of the organization’s committee or its board of directors.

Lobby legislators
Lobbying has an important role in political activism. Lobby your state and federal legislators. Write letters or e-mails, visit legislators in local or state capital offices, or leave telephone messages for them on important nursing and healthcare issues. Always identify yourself as a nurse during meetings and in written or telephone messages.
Cultivate a professional relationship with your legislators. Get to know them, and help them get to know you. Volunteer to work on their election campaigns; if you have the resources, donate money to their campaigns. Provide them with information on critical healthcare issues or volunteer to serve as an expert resource in your nursing specialty. Continue to serve as a citizen lobbyist.

Take a leadership role
Becoming a leader takes a high level of commitment to both political activism and the nursing profession. Nurses at this level have developed their political skills at the local and state levels and expanded their efforts to national leadership of nursing organizations.
If you want to become a leader, run for office or seek appointment to national committees and commissions at the national level of your professional organization. Also consider seeking appointment to government boards and commissions that shape health policy.
Some nurses take their activism to the limit by running for political office. Three nurses now serve in Congress—Lois Capps, RN (D-CA), Eddie Bernice Johnson, RN (D-TX), and Carolyn McCarthy, LPN (D-NY). Other politically active nurses serve in state legislatures and on county boards, city councils, county health department boards, and school boards.

Benefits for all involved
Not every nurse can—or needs to—be a leader. But all of us benefit by becoming politically savvy and active. Start by assessing your level of political development according to the model I’ve presented. Then identify which actions you need to take to move to the next level and begin your pursuit of political activism. Your efforts not only will serve your own professional development but will benefit the profession and the public as well.

Selected references
Cohen S, Mason D, Kovner C, Leavitt J, Pulcini J, Sochalski J. Stages of nursing political development: where we’ve been and where we ought to go. Nurs Outlook. 1996;44:259-266.
Kelly K. Power, politics, and influence. In: Yoder-Wise P, ed. Leading and Managing in Nursing. 4th ed. St. Louis, Mo: Mosby/Elsevier; 2007:169-187.
Leavitt J, Chaffee M, Vance C. Learning the ropes of policy, politics, and advocacy. In: Mason D, Leavitt J, Chaffee M, eds. Policy & Politics in Nursing and Health Care. 5th ed. St. Louis, Mo: Saunders/Elsevier; 2007:34-46.

Karen Kelly, EdD, RN, CNAA, BC, is an Associate Professor and Coordinator for Continuing Education in the School of Nursing at Southern Illinois University in Edwardsville.

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