Polly Sheppard has been on a mission since surviving the 2015 Emmanuel AME church massacre in South Carolina. If the killer spared the retired prison nurse in the hope that she would spread his message of gun-toting white supremacy, though, he must be grievously disappointed.In fact, the indefatigable septuagenarian has been delivering her own messages – and like many nurses, she is a very good communicator.
In the years following the notorious shooting, Sheppard crisscrossed the country to speak against gun violence. Then, once she accumulated enough speaker fees she poured her earnings into another passion and established her own Scholarship Foundation to support nursing students in Charleston. Now, as the seventh anniversary of the chilling church murders approaches, Sheppard is focusing on another initiative to reduce future bloodshed: this week she sent an eloquent appeal to South Carolina’s senate urging them to finally pass a hate crimes law.
“Being there, laying under the table with this gun to my head couldn’t be anything but hate.”
Like most hate crime laws, the proposed SC bill would add up to five years to prison sentences for any homicide or assault motivated by hatred of the victim’s race, sexual orientation, gender, religion, or disability. Aside from Wyoming, South Carolina is the only state that has failed to pass some form of law against hate crimes, but the current bill has faced a steep uphill battle. At present eight SC senators are determined to see it expire… which is a painful irony as Emmanuel pastor Clementa Pinckney, a victim of the massacre, had been a senator himself. If the bill ends up on the table as a code blue, though, it won’t be due to inactivity on Sheppard’s part.
In a powerful two-minute video viewed by the senate on April 27, Sheppard addressed the recalcitrant senators. She mused on other ironies, asking some acute questions: “I really can’t understand them standing against a [hate] law, but they can pass a law to kill somebody a firing squad. They can take that to the floor, but they can’t bring the hate crime law to the floor… What’s the problem?” Sheppard also wondered “why South Carolina has to be the last, almost the last to get a hate crime law? Because we didn’t have it. We had to go to the federal government for (the AME killer) to be charged with a hate crime. It makes no sense.”
Sheppard reminded her audience: “Eight members of the South Carolina Senate are giving a safe haven to hate. Every time you look at senator Pinckney’s photograph, you should be reminded that hate killed him.”
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
Board Member for a Health Department, Hospital, or Community-Based Health Care Organization
Chair of a Health Policy Committee for a Voluntary Organization
Executive Director of a State Board of Nursing
Health Policy Analyst
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.
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