By Barbara Tone, RN
March 9, 2000

Election 2000 is here and the decisions voters make this year may dramatically impact future generations. That is because Election 2000 has the potential to change the way Americans receive health care.

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At national, state, and local levels, citizens are faced with issues such as HMO and Medicare reform, insurance, record privacy, and patients’ rights.

Caught in the crossfire of these healthcare promises are nurses who simply vote on Election Day as a way to exercise their political muscle.

But there is much more nurses can do to make their voices heard, as evidenced by a growing number of nurses who have become vocal about political change.

"Nurses have expanded more into policy-making roles, as well as elected and appointed positions," said Judith K. Leavitt, MEd, RN, FAAN, associate professor of nursing at the University of Mississippi Medical Center in Jackson, and co-author of "Policy and Politics in Nursing and Health Care."

But while the profession has seen a decided increase in activism, there are still large numbers of nurses who don’t see the need to be involved, don’t think they have the time, or simply don’t know where to start.

Making sense of legislative language, finding out whom to call, knowing what to say—and for most, finding time to do anything extra—can be overwhelming. "People always say they don’t have time when they don’t feel committed or passionate about an idea," Leavitt said, "so one of the most important things is to identify an issue you really care about."

Nursing experts advise that the novice find a mentor and start slowly. "I always advise those who are mentoring a neophyte to ‘slice it small,’ " said Stacey Ober, JD, RN, associate director of legislation and government affairs for the Massachusetts Nursing Association, and author of "Making Grassroots Action Effective," a how-to article published in the October 1999 issue of the AORN Journal (Association of periOperative Registered Nurses). "If you ask for one small task, the follow-through is 100 percent. Assignments should be small and specific: ‘Can you get two letters out by the end of the month? Can you make five phone calls this week?’ "

Nurses looking to increase their political knowledge and activity also should consider their professional association as a place to start. "There is not a nursing organization that doesn’t have a legislative agenda," Leavitt said.

Most of these organizations have programs or mentors who can educate the beginner about community groups, legislative activities, and lobbying efforts. Many groups also use phone and e-mail networks to share information about pending legislation.

These efforts, along with participation in state and local healthcare meetings, have paved the way for nurses to work campaigns, lobby for reform, and sit at the policy table.

The opportunities for participation are so diverse that those who don’t see the need to be involved are probably the biggest source of frustration to nursing activists. "I do think that a lot of the problems we’re facing today are the result of people crying, ‘What do I get?’ and not realizing that what you don’t get may be a bigger problem," said Cynthia Shaw Bunch, RN, state and federal legislative coordinator for the Nevada Nurses Association. "If they don’t get involved, nursing will be left out of the process and others that you may not want will be making the decisions for your professional practice."

In recent years, the American Nurses Association has taken steps to assist those who want to increase their participation in the array of decisions being made about health care. The Nurses Strategic Action Team (N-STAT) is one such effort with two components: the first is keeping nurses informed about pending issues and key bills, and sending action alerts to let nurses know when it’s time to contact their legislators; the second is the N-STAT leadership team made up of nurses who have expressed a willingness to serve as liaisons to their legislators, giving a voice and face to nursing issues.

Nurses also can surf the Internet, find out who is the chair of their state health services committee, and get a listing of all pending healthcare legislation to help with political decisions. They also can become active in local political races by hosting house parties, distributing fliers, or by spreading the word on their favorite candidate by phone or e-mail.

There are nearly as many ways to participate as there are nurses but most start with frustration and end with a commitment to follow through.

"You have to start somewhere," said Kandy Pflaster, RN, treasurer of the Nebraska Nurses Association Political Action Committee. "There isn’t anybody who’s nobody. Just get involved. You can make a difference."

One way nurses can begin to make a difference is to know the candidates’ positions on health care. Click here to see where they stand.