Nurse Activism: 15 Ways Nurses Can Affect Real Change

Nurses are strong patient advocates. They protect the health and rights of their patients daily. But beyond patient advocacy, nurses can rally on behalf of other nurses and healthcare providers. As a nurse, you can take simple steps to affect real change in your institution, community, or state.

“Nursing is not only on the front lines of a global pandemic, but they are also on the front lines of systemic wounds affecting the health of patients each and every day,” says Kelsey Noah, BSN, RN, CCRN, an adult intensive care unit nurse in Saint Paul, Minnesota.

Nurses are key advocates for changes as they have a unique insight and perspective on healthcare. Here are 15 ways that nurses and nurse educators can impact healthcare legislation and support local organizations.

Nurses are eyewitnesses to the devastating limitations in healthcare. This includes patients who are unable to afford healthcare and medications.

“It is imperative that nurses band together to advocate for our patient’s healthcare needs, and that includes the reforms needed to improve our healthcare system,” Noah says.

Nurses have been on the front lines of healthcare for decades. They see firsthand the tragedies that result from inequity. One study found that while nurses are more likely to vote, they are not likely to engage in other political activities. Yet, nurses are in a position to bring to light discrimination, bias, and poor healthcare that can drive change.

Legislative decisions affect each person. The small efforts of many nurses can produce a change for patients, the healthcare working environment, and staff shortages.

There are several reasons there is limited political participation from the nursing profession. Many are unaware of the steps they can take to affect change. Others may feel they have inadequate skills or little opportunity to engage in a push for change. Unfortunately, most nursing programs offer limited formal education in political nurse activism.

However, nurses are vital to developing policies that impact their work environment and patient outcomes. Nurses are the largest medical profession. They could be leading the way to redesign healthcare by influencing policy at the local and state levels.

Public demonstrations are a key way any activist group can bring attention to an issue or cause. The United Nurses March, scheduled for May 12, 2022, is an opportunity for nurses to demonstrate and gather in support of other nurses. The Nurses Against Violence website explains more about the cause and how to get involved.

In addition to public demonstrations like marches, consider these 15 ways to become politically involved in creating change in your institution and community.

It’s nearly impossible to be an effective advocate for change if you aren’t informed. Healthcare issues can be confusing, even for those who work in healthcare. There are many sides to each issue, so it’s important to seek resources to understand the issue before getting started.

“Gaining multiple perspectives is important to having more conversations regarding healthcare reform and fosters interdisciplinary collaboration to tackle this issue,” Noah advises.

Healthcare is a multidisciplinary team approach to caring for patient issues. Reforming the system requires an “all-hands-on-deck” approach to use the expertise and advocacy of your colleagues.

Conversations with fellow nurses and other healthcare professionals can spark the desire for activism in others.

National, state, and local nursing professional organizations often have sections dedicated to political nurse activism. They have lobbyists who work with legislatures to educate them on the issues important to healthcare.

Consider taking advantage of a professional nursing organization at your local, state, or federal level and then get involved in the process. Many times it doesn’t take hours of your time and effort. You may be asked your opinion on matters about bedside nursing or to contact your state or federal legislator.

The American Nurses Association (ANA) president encourages nurses to become politically active. He advises nurses to join a professional organization, minority organization, nursing board, or advocate through the ANA.

He stresses that when nurses are not lending their voice to organizations making policies, the non-nurse members will make the decisions.

When nurses understand how the system works and what strategies are effective, they can influence policy. Getting involved in the process can be as simple as writing an email or making a phone call. It can also include:

While the gold standard is evidence-based science, don’t underestimate the power of a personal story. Nurse activism begins by working together to create a unified voice. You can work toward a good working relationship with elected officials through your professional organizations.

Noah encourages nurses to write to state representatives and advocate for policy decisions that can lower healthcare costs or widen the scope for nurse practitioners, for example. These efforts allow for increased freedom of choice and reduce barriers for patients to access care.

One of the best ways to influence policy and politics is through relationships. A simple way to develop a relationship with your elected officials is to do an internship in their office.

If you’re interested in politics as a nurse, interning with elected officials offers you a unique, inside view of how the political office works. It also allows you to contribute to matters involving healthcare personally.

In the U.S. Congress, interns can serve temporarily in the House or Senate, usually without pay. Individual offices make their own rules and guidelines for interns if they have an internship program.

Most states have internship programs with its state congress or the secretary of state, such as this one from Ohio. You may also contact your federal, state, or local government officials to ask about an internship or volunteer position in their local office.

Financial donations to support nurses is one way to contribute to patient-centered healthcare policies. You may think that your small donation won’t make a difference, but your dollars go a long way when many nurses each contribute.

“It can be overwhelming to find ways to contribute to healthcare reform,” Noah says. “But start small and recognize the ability to improve healthcare in this country is a marathon, not a sprint.”

Donating to a nursing organization is one option to place financial support. Most will have a department dedicated to nursing activism at the state or federal level to ensure that nurses are heard when healthcare policies are considered.

Consider the position you hold in your community or your workplace. You likely have more nursing leadership skills, power, or influence than you imagine. Influence comes from networking with nurses and other healthcare professionals.

Healthcare reform develops from the involvement of people at the local, state, and federal levels. Once you take the time to educate and involve them in the process, professionals within healthcare organizations and nursing schools can advocate for change on nurse-led advisory boards or even on social media.

When you are a nurse advocate for change in the healthcare system, it can be easy to get overwhelmed with all the important issues that need attention. It is most effective when you focus on key issues that have a trickle-down effect on the remaining issues.

For example, advocating for improved clinical conditions and staffing ratios also impacts:

Other key issues impacting healthcare are higher pay for nurse educators and smaller teacher-to-student ratios. These changes can improve the quality of education and the skills of a nursing graduate.

Nurses are exposed to various areas within healthcare that need reform to improve healthcare delivery. Nurses are also independent thinkers and innovators.

Consider becoming a nurse entrepreneur and starting your own business to help make changes in healthcare. Your innovation may spread across the country to impact each county and state.

Gail Trauco is an oncology nurse and pharmaceutical trials expert with four decades of experience helping patients navigate the healthcare system. She started her business, The PharmaKon LLC, to increase access to healthcare and meet vulnerable populations’ needs.

The PharmaKon LLC is a nationwide mobile nursing service which brings clinical trials to study subjects. Study subjects can complete study assessments in their home and schedule telehealth visits to see a virtual nurse or other healthcare worker. A courier service picks up lab samples for delivery to local hospital labs or airport drop-off for shipment.

Patients participating with The PharmaKon no longer need to miss valuable work time, worry over childcare, or miss visits due to transportation issues. Patients in rural and marginalized communities have access to innovative clinical trials for healthcare through Trauco’s business.

“It’s an entirely new era of hybrid mobile nurses to support clinical trials,” Trauco says.

Trauco’s nursing experience gave her an invaluable position for innovative thinking and entrepreneurial solutions. Nurses can use their experience to address specific issues and create positive change as well.

Experienced registered nurses (RNs) can be strong teachers and nurse mentors for nursing candidates. Attracting veteran nurses to nurse educator roles arms aspiring nurses with the tools needed to advocate and pursue healthcare change.

Nurse educators are facing several challenges, including a faculty and nursing shortage. Offering higher pay for nurse educators and smaller teacher-to-student ratios may help attract seasoned clinicians. As of January 2022, the average nurse educator base salary is $78,070, which is much lower than the average salary of an advanced practice registered nurse — $99,720. An advanced practice nurse may work with a master’s degree, but most educators hold a doctoral degree in nursing or nursing education.

Anne Dabrow Woods, chief nurse at Wolters Kluwer, Health, Learning, Research, and Practice, says we must be innovative in attracting veteran nurses to consider becoming nurse educators.

“Besides addressing nurse educator salary, we need to encourage nurses with master’s and doctoral degrees to consider becoming adjunct faculty or full-time faculty,” says Dabrow Woods.

Innovation and creativity are driving forces in healthcare and education. Nurse educators must embrace technological advancements, which allows programs to accommodate more students. Arming nurses with these skills helps to produce practice-ready nurses.

Integrating technology can reduce the number of nurses accessing education, which can help staff-to-patient ratios, patient outcomes, and staff stress and burnout.

Adjunct faculty make up the majority of teachers in colleges and universities nationwide. They are contract employees who often receive less compensation than full-time instructors.

Dabrow Woods recommends healthcare systems partner with academic centers to develop adjunct faculty training programs.

This partnership would benefit both the healthcare organization and the college. They might help address the faculty shortage and raise the number of experienced clinicians in faculty roles.

Additionally, healthcare-school partnerships support the program’s ability to admit more students and maintain favorable faculty-student ratios. In turn, the program can produce qualified nurses, which impacts the nurse-to-patient ratio in the hospital. It may also be one strategy to survive the nursing shortage.

Representation in nursing and healthcare is lacking, and this impacts access to mentorship, leadership roles, and negatively affects patient care. Promoting and supporting a diverse nursing staff leads to greater creativity in developing policies that influence change in the organization and beyond.

Nursing administration and executives can actively support local nursing organizations and foundations to support financial aid for marginalized students in the profession.

Healthcare organizations and nurses can help support the development and funding of nursing programs at community colleges. They may offer administrative support and support within the community.

Community colleges are often centrally located within communities. This increases the opportunity for students who may not otherwise have the chance to attend college to improve their life circumstances while adding to the healthcare profession.

Community colleges can also outreach to high schools, so that high school students can prepare for a nursing career.

Having access to entry-level nursing jobs helps open the door for more nurses to enter the field. Additionally, nurses can advocate for state legislators to provide increased funding to community colleges to support higher salaries for nurse educators as well.

Advocating for patients of color as a nurse and diversity and access to educational opportunities are important issues that need addressing in the healthcare system. Nurses and other healthcare professionals care for a diverse patient population, and studies have shown that representation among healthcare providers saves lives.

Data suggest that Black patients requested more preventive care when their physician was Black. In fact, Black newborns cared for by Black physicians experienced a 40% lower mortality penalty than Black infants receiving care from white physicians.

Licensed practical/vocational nurses (LPNs/LVNs) and associate degree in nursing (ADN) programs are more racially and ethnically diverse than bachelor of science in nursing (BSN) programs. By expanding the LPN/LVN and ADN programs, nurses have a more significant opportunity to enter the healthcare field.

LPNs may work while advancing their education through RN-to-BSN bridge programs or LPN-to-RN programs.

Social media, such as the #Asanurse campaign, can help bridge the gap between healthcare professionals and the general public.

While you may not think of yourself as a speaker, it’s important to remember that, as a nurse, you are an expert when you know more than your audience.

You are the expert at the bedside, and after several years of experience, you are the expert in how the nursing staff function in the hospital. You can advocate for nursing through:

While it is impossible for one person to take on all 15 suggestions, it is possible to take on one or two that fit your interests and capacity levels.

If every nurse helped through donations, writing emails, making phone calls, and promoting nurse activism to their colleagues, positive change would be inevitable.