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Nurse leaders and advocacy

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By: Marketa Houskova, DNP, MAIA, BS, RN

Safeguarding nurses’ scope of practice and the profession.  

Nursing leadership means different things to different nurses. As executive director of the American Nurses Association\California (ANA\C), my leadership is focused on statewide policy, legislation, and regulation advocacy via coalition, partnership, and consensus building. ANA\C participates in educational campaigns aimed at elected state leaders, regulators, interested key stakeholders, all California RNs, and the public. Professional nursing voices within state legislative and policy arenas are fundamental to the nurse representation and ownership necessary to safeguard the current regulatory framework and support the next generation’s changing needs.

You wouldn’t believe how many times I’ve heard that nurses shouldn’t be part of the legislative process. But nothing could be further from the truth. Asking simple questions leads us to the crux of this issue. Who’s advocating for the nursing profession or deciding APRNs’ scope of practice? It’s not hospitals, departments of public health, The Joint Commission, or boards of nursing. It’s your state elected officials who are making decisions about your nursing practice.

For example, realizing that not one nurse was elected to the California state legislature should change our view of nursing roles and responsibilities in advocacy and policy. Recognizing that state lawmakers vote on a plethora of issues ranging from agriculture, banking, public safety, healthcare, and technology—to name a few—we see they have enormous responsibilities, and they can’t be experts in all areas. That’s where our opportunity exists—communicating, educating, and leading on nursing issues. We should play a fundamental role in explaining and communicating our stories, expertise, and experiences as part of our professional recommendations to state officials.

ANA\C is taking its advocacy and policy responsibilities seriously. We established the ANA\C Advocacy Institute in 2020 and welcomed an inaugural cohort in May 2021. Our Advocacy Fellows are working on four important policy projects: racism in healthcare and nursing, air pollution and environment, Future of Nursing 2030 (FON2030) Report recommendations, and mental health in nursing.

In 2021, the ANA\C Racism in Nursing work group created the Racism in Healthcare and Nursing Assessment tool for individual staff nurses and nurse managers. In addition, ANA\C designed follow-up action plans to offer education on various aspects of racism, such as microaggressions. We also developed discussion points to start crucial conversations. Other Fellow-led policy projects included hosting a mental health discussion panel with national nursing experts, finalizing the Air Pollution in Central Valley webinar, and actively advancing the FON2030 statewide recommendations.

Throughout 2021, in addition to our policy work, we actively participated in legislative and regulatory advocacy. We monitored approximately 300 state bills, attended virtual meetings at the California Board of Registered Nursing, created new coalitions, and supported our existing coalition partners and projects.

The work of a statewide professional nursing association is never done, but ANA\C can be proud of the work we accomplished in 2021 to shape the healthcare landscape. Here’s to 2022 and hope for a return to in-person meetings with legislators and committees, and hosting summits and symposia to educate, influence, and shape nursing legislation and policy.

Marketa Houskova is ANA\California executive director.

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