A nursing career in public policy was considered unique decades ago. However, increasingly nurses have developed the skill and expertise needed to inform the policy-making process through their professional and voluntary endeavors. Nurses now serve in numerous leadership roles where they use their health policy expertise to shape the policy discourse, monitor the impact of legislation, and oversee regulatory processes.

In addition to the increased numbers of nurses working in governmental and nongovernmental agencies, nurses serve as elected officials and work as health ­policy consultants or health care ­lobbyists. Regardless of role or setting, nurses working in the policy arena are ­required to use their public policy acumen to inform legislation, oversee regulations, or advocate for policies that are of benefit to consumers, patients, and the profession.

Nurses serving as elected/­appointed officials or health care lobbyists are immersed in the policy-making process and have a front row seat in influencing the public ­policy ­agenda. Both opportunities ­require a comprehensive knowledge of the complexities associated with ­lawmaking and a willingness to listen and ­assess varying perspectives. The ability to communicate well and build partnerships while working with diverse ­stakeholders cannot be overemphasized.

Noteworthy, three nurses are serving as elected officials during the 115th Congress. Representative Karen Bass, APRN, represents California’s 37th congressional district and is in her fourth term. ­Congresswoman Bass serves as a ranking member of the Subcommittee on ­Africa, Global Health, Global ­Human Rights, and International ­Organizations.

Representative Diane Black, BSN, has represented ­Tennessee’s sixth congressional ­district since 2010. She serves on the House Ways and Means Committee.

Representative Eddie Bernice Johnson, BSN, is the first nurse elected to the U.S. Congress and is now in her thirteenth term representing the 30th congressional district of Texas. Representative Johnson serves on the House Committee on Science, Space and Technology; House ­Transportation and Infrastructure ­Committee; the Aviation Subcommittee; the Highways and Transit ­Subcommittee; and Water ­Resources and Environment Subcommittee.

Many nurses are familiar with former representative, Lois Capps. Capps represented ­California’s 24th congressional district after winning the seat in 1998 after her husband died in office. She championed numerous nursing and health care issues and started the ­Congressional Nursing Caucus.

No doubt, other nurses are well poised to follow suit bringing their expertise to an elected office. For example, Lauren Underwood launched her campaign last fall to represent the fourteenth congressional district in Illinois. Underwood brings a wealth of nursing and government expertise and is passionate about ensuring ­access to high-quality health care for all.

Nurses are also well suited to serve as health care lobbyists because of their vast knowledge of nursing, health, and health care. An extensive knowledge of these and other areas is critical to advocating for legislation aimed at improving access to health care, enhancing health outcomes, and transforming our health care delivery system. Additional competencies needed for such a role include strong interpersonal communication skills, research/analytical skills, detail orientation, knowledge of political, legislative, and ­regulatory processes, and the ability to create and deliver messages to a wide array of diverse stakeholders including legislative officials. Health lobbyists are ­responsible for ­conducting policy analyses and summarizing information that is suitable for a variety of audiences. Nurse lobbyists may work as a consultant employed by a professional/­specialty nursing or non-­nursing ­organization, health care facility, insurance company, or ­pharmaceutical company, to name a few.

The current push to increase the number of nurses serving on boards provides yet another opportunity for nurses to ­become more engaged in aspects of the policy-making process. Depending on the mission of the organization, board members may be responsible for shaping a legislative or advocacy agenda on behalf of the constituents they serve. To ­illustrate, I ­acquired some of my health policy skills while serving as the Chair of ­Public Policy for my local Susan G. Komen Affiliate. In this capacity, I along with board members advocated for breast cancer funding for underserved women and helped to ­shape and monitor the organization’s legislative agenda. This experience provided a unique opportunity for me to serve as a lead spokesperson providing testimony before my state legislature ­regarding the “­Reducing Breast Cancer ­Disparities bill.” This bill includes significant provisions designed to reduce breast cancer disparities among underserved and underinsured women across the entire state.

In addition to some of the previously mentioned career opportunities in the health policy arena, nurses in the following roles utilize their policy knowledge and expertise to advance the nursing profession and transform today’s health care delivery system:

  • Dean/Associate Dean of a School or College of Nursing
  • Director of Government and/or Regulatory Affairs
  • Office of Government Relations
  • Director/CEO of a Government Agency
  • CEO or Executive Director of a Nonprofit Health Care Organization
  • CEO of a Professional Nursing Organization
  • Chief Nursing Officer
  • Surgeon General/Assistant Surgeon General
  • Chair of Health Policy ­Committee for a Professional or Specialty Organization
  • Health Commissioner
  • Board Member for a Health Department, Hospital, or Community-Based Health Care Organization
  • Chair of a Health Policy Committee for a Voluntary Organization
  • Nurse Attorney
  • Hospital Administrator
  • Executive Director of a State Board of Nursing
  • Health Policy Analyst
  • Nurse Regulator

Nurses wishing to pursue a career in health policy can begin by first identifying what is most important to them. ­Nurses who do not have a background in political science or law may need to invest in professional development through formal/informal education. Taking health policy courses is a good step as such course work provides an overview of the policy-making process and may provide some exposure to in-person or virtual lobbying.

Getting involved with the advocacy/legislative arm of one’s professional or specialty organization is yet another great way to gain exposure and experience related to the policy-making process. Many nursing organizations have a policy agenda and work to ensure that their voices are heard on things of importance to the profession and those they serve. Serving as an intern in a legislative ­office for an elected official may also provide some beginning exposure to the policy and legislative process. These types of experiences can enhance one’s credibility when launching a career in public policy.

Participating in health policy fellowships, internships, or other structured immersion activities can go a long way in laying the foundation for future engagement in the policy arena. I cannot overestimate the value of talking with those already in the field. Elected ­officials, nurse/health care lobbyists, and individuals currently running for office as well as other nurse leaders can provide valuable insights regarding the expectations for this type of role. Attending a state board of nursing ­meeting is ­another excellent way to become ­acquainted with the regulatory aspects of the policy-making process. Finally, staying abreast of current and emerging issues in health care and nursing provides a critical foundation for future advocacy and political activism in the health policy arena.

Janice Phillips, PhD, FAAN, RN

Janice M. Phillips, PhD, FAAN, RN, is an independent consultant residing in the Chicagoland area.

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