Imagine, for a moment, that you’re part of a group that’s casually and informally invited to a dinner party. You like dinner, and you like parties, so it sounds like an event that you should attend. You didn’t get much information about the party, and since the invitation was informal, you don’t have any details in writing. You’re pretty sure you heard that the party is at a mansion, and you have a vague idea about which neighborhood it might be in, but you don’t have the exact address.

As the day of the party approaches, you realize you’re not sure if you have an appropriate outfit to wear. After digging around in your closet for a while, you find something that you feel comfortable in, and hope that you’re not dressed too differently than the other guests. The night of the party, you head toward the area of town where you think it’s being hosted and hope that you’re able to find the right house. You don’t want to be late! Fortunately, you have a good sense of direction, so you’re able to figure out where the event is.

No one is at the door to greet you, but there are lots of cars outside, so you’re pretty sure you’re at the right place. You head inside, looking for the dining room. It dawns on you that you have no idea who else will be at the party, or even how many people were invited. You hear voices down the hall and walk toward them. Sweat slicks your palms as you reach for the doorknob. Perhaps your heart is racing at this point. Who else will be around the table? Do you have enough to offer to the conversation during dinner?

This is how it often feels to be the nurse who wants to care for patients and communities by influencing policy. Several nursing organizations (and this author) have made statements about nurses needing to “be at the policy-making table.” But what if you don’t know anything about the table? Or who else is around it? It’s intimidating to offer your perspective to an unknown group.

There are ways to ameliorate this discomfort, but they’re not easily accessible, especially to entry-level nurses. Professional and specialty nursing organizations are happy to distribute what’s essentially a written invitation, personal styling advice, conversation tips, and information about the other guests in my drawn-out dinner party metaphor. They’ll even send you to the party with friends. However, most nurses don’t belong to a professional nursing organization.

Nursing schools certainly have a full plate as it is, but they need to make room next to other priorities to support policy education and, with that, professional organization membership. Without some foundation in what the policy-making table is, we can’t expect to fill many seats around it. We find ourselves most often hovering at the edges of the room, and this is not where America’s most trusted professionals belong. To serve as comprehensive advocates for our patients and our communities, we must feel comfortable with advocating outside of the hospital. One of the greatest lessons we all learn in nursing school is how much growth and knowledge comes from moments of discomfort. Policy is no different.

The American Association of Colleges of Nursing (AACN) uses the word “policy” 37 times in the most recently released version of the Essentials document, which describes “necessary curriculum content and expected competencies of graduates” across all levels of nursing education. Policy is explicitly called out as a needed piece of entry-level professional nursing education in Domains 3 (Population Health), 6 (Interprofessional Partnerships), 7 (Systems-Based Practice), and 10 (Personal, Professional, and Leadership Development). These categories represent 40% of Essentials Domains.

The AACN also advocates for weaving policy into nursing curriculum through a competency-based education model. By integrating policy education into various portions of the nursing school curriculum, nursing students can be nurtured to “graduate with strong policy competencies grounded in both academic and practice-based learning”.

In addition, nursing schools should consider supporting “student member” chapters of professional and specialty nursing organizations, if they don’t already. These chapters enrich the nursing school experience by expanding learning opportunities and creating valuable leadership roles for students. Such experiences strengthen CVs, improve job prospects, and encourage future leadership involvement. Early engagement in these organizations also builds a foundation for long-term participation. Since professional and specialty organizations excel at preparing and supporting members to engage in policy work, connecting students with them early can accelerate their ability to influence change as well.

Policy isn’t a prescription. It’s not a medication that we’re responsible for administering. It’s not a diagnosis that we’re unlicensed to render. Policy does, however, have the potential to impact our workplaces, our patients, our communities, and our personal lives as much as any drug, surgery, or illness. As nurses, we’re well qualified to inform policy and we belong at any table where it’s discussed, debated, and determined. We don’t need an invitation to the table—we inherently belong at it—but our potential for effective advocacy hinges on enhanced policy education and engagement with organizations that secure our seat. So go to the dinner party. Your experience as a nurse and the wish to make a difference is the only qualification you need.

Anna Russell BS, MS is in her final semester of the accelerated second degree nursing program at Clemson University, Greenville, SC.

Reference

American Association of Colleges of Nursing. (2021). The Essentials: Core Competencies for Professional Nursing Education. aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf