Nurses work hard to live up to their promise to deliver the very best care to patients. But the reality is that many patient care decisions are made far from the bedside–by lawmakers in Washington, D.C. and state capitols.

Think about the effects of the Affordable Care Act (2010), Medicare (1965), the Health Insurance Portability and Accountability Act (HIPAA) and the continual evolution of minimum nurse-to-patient staffing legislation that began when California passed AB 394 in 1999.

With monumental decisions taking place outside the healthcare environment, nurses must take a role in shaping policy to influence how health care is accessed, paid for, and delivered. Nurses are the largest global healthcare workforce and, are uniquely positioned to understand how health policies impact the health of patients and communities.

Here are just a few examples of pending issues in which nurses should be heavily involved:

  • Health Equity: Multiple legislative initiatives at federal and state levels to assess health equity and reduce implicit biases
  • Nurse Staffing: Only California has passed legislation that mandates minimum nurse-to-patient staffing ratios, but 14 other states have legislation that addresses staffing through transparency, planning and staff nursing decision-making requirements.

Other issues impacting nurses themselves include policies that address scopes of practice, licensure and reciprocity, and those affecting safety in the workplace such as the Needlestick Safety and Prevention Act of 2000.

With the stakes this high, how can we all get involved?

Explore and understand what it is that matters most to you. Your passion will be your fuel.

  • Join your specialty organization. Your specialty organization likely has a committee that gets involved in health policy and advocates for the outcome that they think best serves nurses and the public.
  • Join your state nurses association or the American Nurses Association (ANA). The ANA has an active and robust health policy committee that makes health policy issues easy to understand and get involved in.
  • Know the position statements of your professional organization and provide them with your well-researched opinion in favor or in opposition of policies under consideration.
  • Know who in your own organization represents the interests of your community at your state capital and in Washington DC. They can assist you in connecting the issues and the people who make decisions.
  • Know who represents your district in the U.S. House of Representatives and your U.S. Senator. Having their contact information is a first important step to getting your voice heard. You can and should do the same for your state lawmakers. To think globally and act locally is an effective strategy.

There are a couple of important things to consider to ensure that your journey into health policy and advocacy is successful and personally fulfilling.

  • It is helpful to know the position of your employer on any given policy issue. You can have an honest discussion with your internal health policy person about your views and how to proceed if your views align or differ.
  • Be sure to carefully craft your opinions before writing to lawmakers so that you can have maximum impact. This means seeking the best available evidence with an open mind. Providing a well thought out position can be one of the most powerful things that you do in your professional practice, however, you don’t have to go it along. This is where committees and communities of professional nurses can collaboratively develop the message that gets results.


American Nurses Association. (n.d.). American Nurses Association Professional Policy
Committee. Retrieved June 13, 2023, from,the%20ANA%20Board%20of%20Directors.

National Institute of Nursing Research. (n.d.). Advancing health equity into the future. National
institute of nursing research. Retrieved June 13, 2023, from

Rasheed, S., Younas, A., & Mehdi, F. (2020). Challenges, extent of involvement, and the impact
of nurses’ involvement in politics and policy making in in last two decades: An integrative
review. Journal of Nursing Scholarship, 52(4), 446-455.

Stone, A. (2020). State legislatures are incubators for advocacy advancement. Health Policy &
Advocacy, 24–25.

Yonkaitis, C. F. (2021). The elevator pitch: A 60-second advocacy tool for nurses. American Nurse Journal, 16(1), 54–56.