As senior political action specialist for the American Nurses Association, Sheila Roit, MPP, RN, had always encouraged nurses to run for office. Then her husband suggested she practice what she preached.

Roit decided he was right. She chose what seemed a safe local race–a soil and water conservation district that never seemed to attract enough candidates to fill its governing board.

Unfortunately for Roit, others had the same idea. Instead of running unopposed, she faced five other candidates for three spots.

Wearing her RN pin wherever she went, Roit introduced herself as a nurse running for office. She talked about the importance of having safe drinking water. She came in fourth with 63,000 votes, about 1,000 behind the third-place candidate.

For a whole day after the election, she cried in her husband’s arms. But after the tears dried, Roit realized several things: She had learned a lot. She had mostly enjoyed the experience. And she was going to do it again.

Roit already has started her campaign for a seat on the board of supervisors of Fairfax County, Va., although the election still is two years away.

Roit and other nurses who have run for office, successfully and unsuccessfully, agree the political arena is intimidating. It’s time-consuming and hard work. Everyone hates fund raising. But those who hold political office say the rewards are worth the effort.

Whether they’ve helped fund a youth fitness center for their community or introduced legislation to alleviate the nursing shortage, all say they believe they are accomplishing something for nurses in a way they never could outside political life.

Nurse politicians and political analysts say there has never been a better or more important time for nurses to run for office.

In the last presidential election, voters listed health care at the top of their concerns, and, as if topics such as Medicare, patients’ rights and prescription drug costs weren’t dear enough to nurses’ hearts, now a nursing shortage looms that promises to directly affect every nurse in the country.

People trust nurses. Nurses, trained to communicate, juggle tasks, advocate for patients and think holistically, have the skills to be effective in political office, nurse analysts and officeholders say.

Despite this, few nurses dare to run. Only three nurses occupy seats in the House of Representatives, and none are U.S. senators. The number in state legislatures has remained at about 100 for the past five years, Roit said. Some state legislatures, such as Illinois, have never had a nurse representative. Nurses say they don’t have time and don’t have money.

"They don’t understand it," said Sue Clark, RN, director of government relations of the Illinois Nurses Association. "They think it might be dirty."

But Clark and others say that recent political events, which vary from state legislation on hospital staffing to national issues like Medicare spending, may draw more nurses into political activity.

"I don’t want someone who has no idea what I do making decisions about how I practice my medicine," said Roit, explaining why she decided to run for office and why she supports other nurse candidates. "I don’t think that’s something we should give away."

Decision to run
Many nurses who have run for office, including the three congressional representatives, say that they never chose politics; it was thrust upon them.

"I never had a dream of running for public office," said Rep. Eddie Bernice Johnson, D-Texas, MPH, RN. "The idea of my running came from people."

Johnson, who in 1972 became the first woman since 1935 to represent Dallas in the Texas House of Representatives, said that she was heavily involved in civic activities well before she ran for office.

After she served terms in the state House of Representatives and Senate, Johnson first was elected to the U.S. House of Representatives in 1992, winning 74 percent of the vote.

Knowing when to run for office is not a secret, she said. "When you get there, you will feel it; you will know it."

Her two fellow nurses in Congress, Rep. Lois Capps, D-Calif., RN, and Rep. Carolyn McCarthy, D-N.Y., LPN, entered the political spotlight after the sudden deaths of their husbands.

In 1993, a gunman randomly shot into a rush-hour commuter train, killing McCarthy’s husband, Dennis, and injuring her son Kevin.

After three years of lobbying against gun violence, McCarthy was furious when her congressional representative voted to repeal an assault weapons law.

She spent two months thinking, "Who am I to run for office?" before supporters persuaded her to oppose him in 1996.

She won, and has held the seat ever since.

Capps’ husband, Walter, died in office in 1997. Like McCarthy, Capps had never been politically active before then. She decided to run for her husband’s seat in a special election because people came to her, asked her to run, and offered moral and financial support. She has been re-electeded twice.

California Assemblywoman Helen Thomson, D-Davis, RN, who followed a path to the state Legislature through a series of local offices, starting with school boards, said she never possessed what she thought of as political ambitions.

"It was never a plan of mine," she said, "but when a door opened, I stepped through it."

Clearing the obstacles
Thomson, who was not working when she ran for school board, said she is not sure she would have run if she had been balancing a job and family responsibilities.

JoAnn Woodward, RN, a certified nurse practitioner who won re-election last year to the board of the Beach Cities Health District in Southern California, said, "It’s a lot of fun, but it takes a lot of time. Not all the time you put in is running the campaign. It’s not over once you win."

Nurses say there’s no getting around the time demands of running for office. But they also say their profession helped prepare them for the grueling demands of the campaign and the job.

"Nurses have the willingness to work long hours, to be focused on getting the job done," Johnson said.

Even more daunting than finding time is the prospect of finding money, nurse candidates said. Roit, who has seen hundreds of letters requesting campaign donations, said her own was the most difficult letter she ever had to write. She stared at it in her printer thinking, "I don’t think I can mail this."

McCarthy said that she needs to be reminded about 90 percent of the time to canvass for money at fund-raisers. Woodward said she raised about $200 the first time she ran for office.

But all candidates say fund raising becomes easier the more they do it.

The nursing profession has plenty of unpleasant jobs as well, Capps said. "You have to grit your teeth and hold your nose and do what you have to do."

But asking for money is easier, she added, if you think of it as asking for a greater good. "You have to get away from the fact that they’re giving you money–they’re giving their causes the money."

The rewards
Those causes, say nurse politicians, make the work, time and fund raising worthwhile.

Capps, who lists the nursing shortage as one of her greatest concerns, is working on legislation to improve access to nursing education, support nurses who want more training and improve the collection of data on the nursing workforce.

McCarthy is a leading advocate for HMO reform and increased funding for cancer research. Johnson has been a staunch supporter of health care for women and children.

Thomson regularly tackles issues such as mental health and access to health care.

Woodward’s board helped build a 7-acre youth fitness center and turned an underused hospital into a multiservice health facility.

"The best thing I did was to improve linkages with community partners," Woodward said. "I listen to what people have to say in the community. I make myself available to people in the community.

"When I say I’m a nurse, people seem to listen."

So do other legislators, McCarthy said. "Your colleagues look at you differently."

She can think of several times when congressmen, who had opposed her on other issues, supported her legislation on health care because she was a nurse and came from the front lines.

Nurses say their skills as well as their knowledge–knowing how to talk to people, seeing all points of view, thinking on their feet and managing many tasks at once—have served them well in political life.

"The only difference between being a staff nurse and being in Congress is that I’ve got 434 other patients," McCarthy said. "My colleagues are all my patients and I’m educating them."